Two-shift operation mode can improve the efficiency and comfort of flexible ureteroscopic holmium laser lithotripsy for the treatment of renal calculi larger than 1.5cm

Purpose:

To compare two-shift operation mode and single player mode different impact on surgical results and operator comfort in flexible ureteroscopic holmium laser lithotripsy for renal calculi larger than 1.5cm.

Materials and Methods:

From december 2017 to december 2018, 92 patients with renal calculi admitted to Qilu Hospital and were treated through flexible ureteroscopy. They were randomized in two-shift group (n=50) and single player group (n=42). The operative time, blood loss, hospitalization stay after operation, residual fragments (≥4mm) rate, fragmentation speed, postoperative complications and operator's fatigue score were compared.

Results:

There was no significant difference between two groups regarding age, gender, illness side, stone size, blood loss, operative time, postoperative hospitalization stay, complications, etc (p >0.05). The fragmentation speed was 44.5±20.0mm3/min in two-shift group compared with 34.2±17.3mm3/min in single player group (p=0.037). Residual fragments (≥4mm) rate after first surgery was 18% in two-shift group, while the residual fragments (≥4mm) rate was 40.5% after first surgery in single player group (p=0.017). The total fatigue score of two-shift group was 8.4 compared to 29.9 in single player group (p <0.001).

Conclusion:

In flexible ureteroscopic holmium laser lithotripsy for the treatment of renal calculi larger than 1.5cm, two-shift operation mode can raise the fragmentation speed and stone clearance rate, as well as significantly lower operator's fatigue level and improve operator's comfort.

Combination of metformin and luteolin synergistically protects carbon tetrachloride-induced hepatotoxicity: Mechanism involves antioxidant, anti-inflammatory, antiapoptotic, and Nrf2/HO-1 signaling pathway

Liver diseases are one of the fatal disorders due to the vital role of the liver. Carbon tetrachloride (CCl₄ ) is the most perceived chemical substance utilized in developing models of hepatic damage. Metformin (Met) is a potent antidiabetic and redox modulatory agent that has shown anticancer and protective effects on various organs. Therefore, addition of therapy with natural antioxidative agents or herbal extracts shows defensive impacts against different injuries inside the body. Luteolin (Lut) can be found in several customary Chinese remedies. It has been reported for various pharmacological actions such as antitumor, antioxidative, and anti-inflammatory impacts. Here, the liver injury rat model was established using CCl₄ (1.00 mL/kg body weight) in vivo. The protective roles of Met and Lut separately or in combination were observed in hepatotoxicity induced by CCl₄ . The result was shown that both Met and Lut, while individually used, were normally active in diminishing CCl₄ -caused hepatotoxicity. The combination of two drugs performed synergistically to improve liver damage caused by CCl₄ , as shown by the considerably improved liver dysfunction. Met and Lut showed highly antioxidative effects on CCl₄ -treated rats moderately by increasing the activities and expression of the antioxidant enzymes. Along with this, a combination of Met and Lut significantly suppressed inflammatory responses, which is evidenced by the reduced level of inflammatory cytokines together with interleukin 1 beta (IL-1β), tumor necrosis factor alpha (TNF-α), and interleukin 6 (IL-6). Additionally, CCl₄ -agitated apoptosis was intensely reduced by Met and Lut through reducing cleaved caspase-3 and Bax (pro-apoptotic factor) while increasing Bcl-2 (antiapoptotic factor) signaling pathways. Cotreatments of Met and Lut upregulated nuclear factor erythroid 2-related factor 2 (NRF2) and heme oxygenase-1 (HO-1) expression in the CCl₄ -intoxicated rat's liver. The above result recommended that combination of Met and Lut may have a substantial potential and synergizing impact against CCl₄ -induced hepatotoxicity.

An efficient or methodical review of immunotherapy against breast cancer

Breast cancer (BC) is one of the most widespread malignancies in women worldwide. Breast cancer is mainly classified into a few key molecular subtypes in accordance with hormone and growth factor receptor expression, etc. In spite of numerous advances in the remedy of breast cancer, the development of metastatic disease remains an untreatable and repeated basis of cancer death for women. Preclinical and clinical studies of immunotherapy in cancer remedy have been in progress for the past quite a few decades by an effort to accelerate, augment, and modulate the immune system to spot and devastate cancer cells. Advancement of cancer immunotherapy is rapidly increasing with eminent and most interesting therapy compared to other therapy like targeted therapy, cytotoxic chemotherapy, radiation as well as surgery. Cancer immunotherapy, also known as biological therapy, which denotes the controlling and by means of the patient's own immune system to goal the cancer cells rather than using an extrinsic therapy. In that way, focusing of cancer immunotherapy developing mediators that stimulates or enhances the immune system's recognition and destroying the cancer cells. This review describes a holistic outlook and deeper understanding of the biology of immunotherapy within the system of tumor microenvironment of breast cancer that improve clinical research and constructive impact on the study conclusion.

The crystal structure of 1,4-dinitroso-2,3,5,6-tetraacetoxy-piperazine, C12H16N4O10

C12H16N4O10, monoclinic, C2/c (no. 15), a = 21.953(3) Å, b = 7.0292(9) Å, c = 13.5984(19) Å, β = 127.569(4)°, V = 1663.23(40) Å3, Z = 4, R gt(F) = 0.0555, wR ref(F 2) = 0.1224, T = 122(2) K.

Risk factors analysis of nosocomial pneumonia in elderly patients with acute cerebral infraction

To investigate the risk factors of nosocomial pneumonia (NP) in elderly patients with acute cerebral infarction (ACI).In this study, 324 aged 70 years and over patients with ACI who were admitted to the inpatient department of TianJin First Hospital (China) from January 2012 to February 2018 were retrospectively analyzed. The patients were divided into NP group (80 patients) and non-NP group (244 patients) according to whether NP was occurred 48 hours after hospitalization. Baseline profiles and biochemical analyses were compared between 2 groups. Information regarding risk factors for NP in elderly patients with ACI was collected from all patients. Associations with NP and outcome were evaluated.Among the total patients, NP occurred in 80 (24.69%) patients. There were no statistically significant differences between risk of NP and sex, current drinking, diabetes mellitus, stroke history, and levels of serum UA, TG, HDL-C, LDL-C, Glucose, chloride, potassium. Multivariate logistic regression analysis showed that the independent risk factors for NP were living alone (OR 4.723; CI 1.743∼12.802; P = .002), initial NIHSS score (OR 1.441; CI 1.191∼1.743; P = .000), NRS2002 score (OR 0.139; CI 0.087∼0.223; P = .000), BMI (OR 1.586; CI 1.353∼1.858; P = .000), a past pneumonia history (OR 0.073; CI 0.017∼0.321; P = .001), atrial fibrillation (AF) (OR 0.129; CI 0.033∼0.499; P = .003), CRP (OR 1.050; CI 1.017∼1.085; P = .003), BUN (OR 0.603; CI 0.448∼0.812; P = .001) and Cr (OR 1.036; CI 1.015∼1.057; P = .001). Level of albumin was an independent protective factor of NP in elderly patients with ACI (OR 0.865; CI 0.750∼0.999; P = .048). Furthermore, elderly patients with ACI who had NP had worse clinical outcomes both during hospitalization and after discharge (P < .05).We identified significant risk factors for NP in elderly patients with ACI, including living alone, initial NIHSS score, malnutrition, a past pneumonia history, AF, CRP, and Renal function were associated with NP in elderly patients with ACI. The clinical course was worse and the duration of hospital stay was longer in NP patients than in non-NP patients.

The relationships between odors and environmental factors at bloom and non-bloom area in Lake Taihu, China

Lake Taihu has been experiencing taste and odor (T&O) events recently. And for the purpose of seeking the environmental factors having great influences on T&O compounds and supplying theory information for preventing the occurrence of T&O problems, Redundance analysis (RDA) was conducted for the dissolved and particle-bound forms of T&O compounds. And the whole lake was divided into the blooming and non-blooming areas. Results indicated that environmental factors, including biotic and abiotic factors, made great contributions to the variation of T&O compounds in Lake Taihu. The key biotic factors included Microcystis, Oscillatoria and chlorophyll-a. Microcystis made great contribution of these compounds in the blooming area and had close relationship with those particulate forms of odorants in Taihu. Oscillatoria made great and absolute contribution to odorants in the non-blooming area. Chlorophyll-a influenced greatly the odorants in the blooming area and had significant relationship with the particle-bound fractions in the whole lake. Dissolved oxygen and water temperature were the dominant abiotic factors with large contributions.

Corilagin Attenuates the Parkinsonismin Japanese Encephalitis Virus Induced Parkinsonism

This study evaluates the protective effect of corilagin against Parkinsonismin Japanese encephalitis virus (JEV) induced Parkinson’s disease. The JaGAr-01 strain of virus was used to induce JE. The virus was injected into the rats (13 days age) at the midpoint between the two ears. Adult rats, 12 week after the inoculation of virus, were used for the further study. Corilagin (20 mg/kg) and levodopa with dopa decarboxylase inhibitor (LEV, 10 mg/kg) were administered intraperitoneally for the duration of one week. Bradykinesia and the levels of dopamine in the brain were estimated at the end of protocol. There was a significant decrease inthe motor function in the corilagin, LEV and LEV + corilagin treated groupscompared to the negative control group. However treatment with corilagin, LEV and LEV + corilagin significantly increases the level of dopamine in the brain compared to the negative control group. This study concludes that corilagin ameliorates the Parkinsonismin JEV induced Parkinsonism. Moreover it shows a synergistic effect when treated with LEV. Data presented in the investigation supports that corilagin can be used clinically.

[Enzyme kinetic analysis of Oncomelania hupensis exposed to active ingredient of Buddleja lindleyana (AIBL)]

OBJECTIVE

To analyze the enzyme kinetics of active ingredient of Buddleja lindleyana (AIBL) against Oncomelania hupensis, the intermediate host of Schistosoma japonicum.

METHODS

O. hupensis snails were placed in 1 000 ml of 3.55 mg/L AIBL solution for 24, 48 h and 72 h, respectively, and the enzyme kinetics of alanine aminotransferase (GPT) was determined by Reitman-Frankel assay, lactate dehydrogenase (LDH) by the chemical inhibition lactic acid substrate method, alkaline phosphatase (AKP) by the disodium phenyl phosphate colorimetric method, acetylcholine esterase (AChE) and malate dehydrogenas (MDH) by ELISA, and succinate dehydrogenase (SDH) by the phenazine methyl sulfate reaction method (PMS) in the soft tissues of O. hupensis before and after AIBL treatment.

RESULTS

Following exposure to 3.55 mg/L AIBL solution for 24 h, the GPT, LDH, and AKP activities significantly improved in the soft tissues of O. hupensis, while the SDH and MDH activities were significantly lowered in the head-foot and liver. However, AIBL treatment did not cause significant effect on AChE activity in O. hupensis.

CONCLUSIONS

AIBL causes significant damages to O. hupensis liver and can efficiently act on anaerobic and aerobic respiration loci, which will hinder energy metabolism, and cause inadequate energy supply in cells used for normal secretion, eventually leading to O. hupensis death.

Investigations on surface morphology and bandgap engineering of single crystal boron-doped silicon irradiated by a nanosecond laser

We irradiate the single crystal boron-doped silicon (Si) at various laser fluences with 100 laser shots in ambient air at room temperature using an Nd:YAG laser and investigate its surface morphology and optical properties. The optical microscopy gives evidence of the formation of a crater and reveals that the heat-affected zone and melted area are increased with increase in laser fluence from 1.1 to 15.4  J/cm². The micrographs obtained by scanning electron microscopy (SEM) show that the micro- and nano-structures such as microcracks, bubbles, nucleation sites, clusters, redeposited layered material, nanoparticles, and alike water droplet structures are formed on a laser-exposed Si surface. The optical profilometry of the irradiated Si further confirms the ablation and redeposition of the material and shows that the depth of the crater is increased from 12.1 to 15.2 μm with increase in fluence from 1.1 to 15.4  J/cm². Raman spectroscopy of the samples shows that the irradiation generates anneal effects due to higher temperature, which increases the crystallinity of the Si. The ellipsometric analysis shows that the irradiation of Si with increasing laser fluence changes its optical constants (refractive index and extinction coefficient), which further influence its optical properties, e.g., reflectivity, absorptivity, and energy bandgap. The absorptivity of laser irradiated Si tends to increase with increasing laser fluence, and the energy bandgap is decreased accordingly due to increase in structural disorders. Our study shows that the controlled laser irradiation can tune the energy bandgap of exposed Si, and it makes the Si materials useful for the fabrication of optoelectronic devices such as solar cells, photovoltaic cells, and LEDs.

[Epidemiological analysis of malaria prevalence in Jiangsu Province in 2015]

Objective To understand the malaria epidemic situation and characteristics in Jiangsu Province in 2015, so as to provide the evidence for malaria elimination. Methods The data of malaria cases in Jiangsu Province in 2015 were collected from China's routine diseases surveillance information system. Results Totally 405 imported cases were reported in Jiangsu Province in 2015, and the cases increased by 14.08% compared with those in 2014. All the malaria cases were imported, and 5 cases (1.23%) were from Southeast Asia and 400 (98.77%) were from 25 African countries or regions. The imported malaria cases were reported in 13 cities across Jiangsu Province, where Taizhou, Lianyungang, Nantong, Huaian and Yangzhou cities accounted for 68.64% of all the cases in the province. Jiangsu Institute of Parasitic Diseases (JIPD) reference lab checked all the cases and classified 299 falciparum malaria cases, 13 vivax malaria cases, 18 quartan malaria cases, 71 ovale malaria cases, and 4 mixed Plasmodium infection cases. Conclusions In Jiangsu Province, there are no local malaria cases for 4 consecutive years, but the imported cases are on the rise. Compared to 2014, the imported vivax cases increased significantly in 2015. It should be the key points to strengthen the surveillance of imported malaria cases, improve malaria diagnosis and treatment abilities for all levels of medical institutions, and promote the abilities of Plasmodium check, and focus survey and disposal of all Center for Disease Control (CDC) staffs across Jiangsu Province.

[Diagnostic knowledge and skills of parasitic diseases based on competition of professional personnel in Jiangsu Province, China]

Objective To understand the integrated ability of parasitic disease prevention and control of professional personnel of Jiangsu Province through the contest. Methods Totally 56 players from the whole province were selected, and all the players participated in the contest. The theory knowledge and skill scores were collected and the statistical analyses were conducted. Results The average theoretical score of the participants was 88.86±15.56 and the passing rate was 91.1%. The average skill operating score was 69.16±16.01 and the passing rate was 67.9%. The average Plasmodium microscopy score was 16.54±8.09 and the passing rate was 50%. The average helminth egg microscopy score was 34.27±10.66 and the passing rate was 67.9%. There were statistical differences among the age groups and different levels of schistosomiasis endemic situation (F = 5.10, 6.39, both P < 0.01). The theoretical knowledge including schistosomiasis, malaria, hydatid disease and others and the score rates were 91.07%, 90.94%, 85.83% and 90.93%, respectively. The hydatid disease score rate was lower (χ² = 19.17, P < 0.01). The radar chart displayed that the score rates of tabletting and microscopy test in Kato-Katz film production, malaria blood film production and microscopy test were all low. Conclusion In Jiangsu Province, the participants have higher score in the theory test. However, they have lower skill test score, especially in the parasite species identification. The operational skills still need to be strengthened for center for disease control (CDC) participants.

Corrosion wear characteristics of TC4, 316 stainless steel, and Monel K500 in artificial seawater

Wear-induced corrosion can accelerate material degradation, and the passive film in the wear track is only partially destroyed.

Safety, Tolerability and Pharmacokinetic and Pharmacodynamic Learnings from a Double-Blind, Randomized, Placebo-Controlled, Sequential Group First-in-Human Study of the TRPV1 Antagonist, JNJ-38893777, in Healthy Men

BACKGROUND AND OBJECTIVE

Nociceptive and neuropathic pain, one of common reasons of disability and loss of quality life, are often undertreated due to safety concerns with current therapies. This study assessed the safety, tolerability, pharmacokinetics and pharmacodynamics of JNJ-38893777, a potent and selective transient receptor potential vanilloid 1 (TRPV1) channel antagonist in healthy men.

METHODS

In a single-center, double-blind, placebo-controlled, sequential group, single-ascending-dose phase 1 study, 80 healthy men (18-45 years old; body mass index 18.5 to <30 kg/m(2)), randomized to two groups, received either JNJ-38893777 (n = 6) or placebo (n = 2) in a dose-escalation manner. The study was designed in two parts: Part 1, an early tablet formulation was administered under fasting conditions at 5, 15, 45, 125, 250, or 500 mg; Part 2, a new tablet formulation was administered in a fasting state (250 mg) and a high-fat fed state (250 mg, 375 mg, or 500 mg). Serial plasma and urine samples (collected over 120 h post-dose) were analyzed using LC-MS/MS for pharmacokinetic evaluations.

RESULTS

JNJ-38893777 concentrations peaked from 3.0 to 5.5 h (median) post-administration, and then declined multi-exponentially with a prolonged terminal phase. Renal clearance was negligible. Maximum concentration (C max) and area under the concentration-time curve from time zero to infinity (AUC∞) of the early formulation increased with increasing doses but less than dose-proportionally over 5-500 mg (fasted) doses. The new tablet formulation showed no improvements in the fasting state but showed an 11- to 22-fold increase in JNJ-38893777 exposure; interindividual variability reduced from 73-85% to 23-24%, and a significant increase (P < 0.05) in heat pain detection threshold (~3 °C) was observed in the fed state. Mild to moderate adverse events were observed, with no evidence of exposure dependence up to 500 mg (fed). Concentration-related increases in body temperature or changes in Fridericia-corrected QT interval (QTcF) were not observed.

CONCLUSION

JNJ-38893777 was tolerated at single doses up to 500 mg (fed) and is suitable for further clinical development.

Changes in mast cell infiltration: a possible mechanism in detrusor overactivity induced by visceral hypersensitivity

OBJECTIVE

To establish the detrusor overactivity (DO) model induced by visceral hypersensitivity (VH) and investigate the relationship between mast cell (MC) infiltration and DO.

MATERIALS AND METHODS

Sixty rats are divided into 4 groups randomly: Group 1:Baseline group; Group 2: DO group; Group 3: CON group; Group 4: VH group. The colorectal distension (CRD) and abdominal withdral reflex (AWR) scores are performed to evaluate VH. The cystometric investigation and histological test of MC infiltration are assessed.

RESULTS

The threshold pressure of CRD in the VH group is significantly lower than that in the CON group (P<0.001). At the distension pressure ≥20 mmHg, the AWR scores of the VH group are significantly higher than those of the CON group (10 mmHg: P=0.33; 20 mmHg: P=0.028; 40 mmHg: P<0.001; 60 mmHg: P<0.001; 80 mmHg: P<0.001). DO model is successfully established in the VH group (DO rate=100%). Compared with the CON group, the numbers of MC infiltration are significantly increased in the VH group, including submucosa of bladder (P<0.001), mucosa lamina propria/mesentery of small intestine (P<0.001), and mucosa lamina propria/mesentery of large intestine (P<0.001). Furthermore, more MC activation as well as degranulation are observed in the VH group.

CONCLUSIONS

It is indicated that DO model can be established in the VH rats. The MC infiltration may play an important role in DO induced by VH, and may be helpful to understand the mechanisms of DO in VH patients.

Laparoscopic Resection of Retroperitoneal Paragangliomas: A Comparison with Conventional Open Surgical Procedures

OBJECTIVE

Paraganglioma (PGL) is a rare type of tumor that arises from the extra-adrenal paraganglia. Laparoscopic adrenalectomy is well established for the treatment of adrenal pheochromocytomas, but laparoscopic resection of PGLs is controversial. In this study, we compared the clinical outcomes of laparoscopic and conventional open surgical procedures for PGLs. We also analyze the safety and feasibility of laparoscopic technique for renal hilar PGLs.

METHODS

A retrospective review of all patients who underwent resection of retroperitoneal PGLs from 2002 to 2014 in our hospital was performed. Twelve patients underwent open procedures, and 15 underwent laparoscopic procedures. The preoperative, intraoperative, and postoperative data were collected and analyzed.

RESULTS

PGLs located at the renal hilum were predominantly both in the Lap group (n = 9) and open group (n = 7). Laparoscopic procedures in 14 of 15 patients were effectively completed without conversion to open surgery; one case with renal hilar tumor was converted to open surgery because of bleeding. The baseline characteristic of the patients in each group was well equivalent with respect to patient age, gender, body mass index, and tumor size. In the Lap group, the perioperative indexes were significantly different from those of the open group (each p < 0.05), including operative time (217.36 ± 51.90 vs 175.67 ± 36.79; p = 0.029), estimated blood loss (80.71 ± 83.52 vs 172.50 ± 160.86 mL; p = 0.047), and postoperative hospital stay (5.64 ± 1.95 vs 8.58 ± 1.97 days; p = 0.001). However, the intraoperative hemodynamic parameters and intensive care unit stay days were similar in both the groups. The perioperative data of the two procedures for renal hilar PGLs were compared. The Lap group showed estimated blood loss, and postoperative hospital stay outcomes were more favorable than the open group. Other data were similar in both the groups.

CONCLUSION

Laparoscopic procedure is safe and feasible in the treatment of patients with retroperitoneal PGLs. Laparoscopic resection of PGLs from the renal hilum is technically challenging. However, it is possible to safely undertake laparoscopic resection of these tumors by an experienced surgeon.

[Reconstruction and measurement of a digital dental model using grating projection and reverse engineering]

OBJECTIVE

This work lays the foundation for establishing a digital model database with normal occlusion. A digital dental cast is acquired through grating projection, and model features are measured through reverse engineering.

METHODS

The grating projection system controlled by a computer was projected onto the surface of a normal dental model. Three-dimensional contour data were obtained through multi-angle shooting. A three-dimensional model was constructed, and the model features were analyzed by using reverse engineering. The digital model was compared with the plaster model to determine the accuracy of the measurement system.

RESULTS

The structure of three-dimensional reconstruction model was clear. The digital models of two measurements exhibited no significant difference (P > 0.05). When digital and plaster models were measured, we found that the crown length and arch width were not statistically different (P > 0.05), whereas the difference between the crown width and arch length was statistically significant (P < 0.05).

CONCLUSION

The reconstruction of a digital model by using the grating projection technique and reverse engineering can be used for dental model measurement in clinic al and scientific research and can provide a scientific method for establishing a digital model database with normal occlusion.