[Comparison of the efficacy of thulium fiber laser and holmium laser lithotripsy in the treatment of upper urinary tract stones].

Objective: To compare the efficacy of thulium fiber laser (TFL) and holmium laser (HL) in the treatment of upper urinary tract stones. Methods: A total of 76 patients diagnosed with upper urinary tract stones by radiographic examination and who required ureteroscopy lithotripsy or retrograde intrarenal stone surgery were prospectively enrolled from the Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine between January 2022 and June 2022. Patients were divided into TFL group (n=38) and HL group (n=38) in a 1∶1 ratio according to the randomization schedule. The perioperative outcomes and stone-free rate of two groups were recorded and compared. Results: Finally, the clinical data of 71 patients were completely collected, including 55 males and 16 females, with a mean age of (45.7±14.1) years old. There were 36 patients in TFL group and 35 patients in HL group, and there was no significant difference in age, body mass index, gender, Charlson comorbidity index, stone site, stone location, stone size and stone density between two groups (all P>0.05). All the surgeries were successfully performed with no intraoperative complications. There were no significant differences between the two groups in terms of operation time, stone displacement during lithotripsy, visual field clarity, changes in hemoglobin, leukocyte, and C-reactive protein, and length of postoperative hospital stay (all P>0.05), but the laser action time[M (Q1,Q3)] in the TFL group was 30.0 (20.0, 48.8)s, which was significantly shorter than that in the HL group [90.0 (50.0, 120.0)s, P<0.001]. The stone-free rates of TFL group and HL group were 97.2% (35/36) and 88.6% (31/35), and there was no significant difference (P=0.337). The postoperative complication incidences of TFL group and HL group were 36.1% (13/36)and 22.9% (8/35), respectively, and the difference was not significant either (P=0.221). For ureter stones, the laser action time in TFL group was 22.5 (20.0, 43.8)s, which was significantly shorter than that in HL group [80.0 (50.0, 120.0)s, P<0.001]. For stones with maximum diameter≤10 mm, the laser action time in TFL group was 20.0 (10.0, 25.0)s, which was significantly shorter than that in HL group [50.0 (40.0, 80.0)s, P<0.001]. For stones with maximum diameter>10 mm, the laser action time in TFL group was 60.0(42.5, 180.0)s, which was significantly shorter than that in HL group [180.0(120.0, 210.0)s, P=0.035]. For stones with density≤1 000 CT, the laser action time in TFL group was 30.0 (20.0, 45.0)s, which was significantly shorter than that in HL group [95.0 (47.5, 120.0), P=0.001]. For stones with density>1 000 CT, the laser action time in TFL group was 30.0 (20.0, 90.0)s, which was significantly shorter than that in HL group [80.0 (55.0, 180.0)s, P=0.033]. Conclusion: TFL lithotripsy is an effective and safe surgical procedure for the treatment of upper urinary tract stones, with similar clinical efficacy but shorter laser action time compared to HL lithotripsy.

[MDT management of nonalcoholic fatty liver disease].

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the clinic and is closely associated with obesity and related metabolic diseases such as type 2 diabetes, cardiovascular and cerebrovascular diseases, and chronic renal disease. The clinical harm is becoming increasingly severe. Multidisciplinary diagnosis and treatment (MDT) management is an effective way to improve the efficiency of NAFLD prevention and treatment, but the specific implementation path remains to be explored. This article reviews the theoretical basis, implementation path, dilemmas, and challenges of MDT management for NAFLD patients in order to provide a reference for better NAFLD prevention and treatment.

[Progress in the pharmacological treatment of tobacco dependence in special populations].

Schizophrenic and pregnant smokers with tobacco dependence had always been excluded from most large treatment trials for nicotine dependence. As weight gain was found to be common after smoking cessation, obese people were more likely to have a reduced willingness to quit smoking and an increased risk of relapse. This article reviewed the latest research progress in pharmacological treatment of tobacco dependence in schizophrenia, pregnant women, and obese people.

Dual-energy CT perfusion imaging for differentiating invasive thymomas, thymic carcinomas, and lymphomas in adults.

AIM: To evaluate the role of dual-energy computed tomography perfusion (DECTP) imaging in differentiating invasive thymomas (ITs), thymic cancers (TCs), and lymphomas in adults. MATERIALS AND METHODS: Ninety-five patients with solid masses in the prevascular mediastinum who underwent DECTP examinations were enrolled in this study. The perfusion parameters (blood flow, BF; blood volume, BV; mean transit time, MTT; permeability surface, PS) and spectral parameters (water concentration, WC; iodine concentration, IC; normalised iodine concentration, NIC; the slope of spectral radiodensity [Hounsfield units] curve, λHU) of the lesions were analysed. RESULTS: There were no differences in the MTT or WC values among ITs, TCs, and lymphomas (all p>0.05). The IC, NIC, and λHU values in the optimal arterial and venous phases and PS values of TCs were higher than those of ITs and lymphomas (all p<0.05), and there were no differences between ITs and lymphomas (all p>0.05). The BF and BV values of lymphomas were lower than those of ITs and TCs (all p<0.05), and there were no differences between ITs and TCs (all p>0.05). The cut-off values for BF and BV used to differentiate lymphomas from ITs and TCs were 42.83 ml/min/100 g and 4.66 ml/100 g, respectively (area under the receiver operating characteristic curve: 0.847 and 0.839; sensitivity, 80.6% and 82.1%; specificity, 75% and 71.4%; accuracy, 78.9% and 81.1%). CONCLUSIONS: The perfusion and spectral parameters of DECTP imaging help to identify ITs, TCs, and lymphomas, and BF and BV values help to differentiate lymphomas from ITs and TCs.

Multiple vertebral compression fractures in a human immunodeficiency virus-positive patient with glucocorticoid-induced Cushing syndrome treated with percutaneous vertebroplasty: a case report.

The authors present a rare case of multiple vertebral compression fractures in a young female with iatrogenic glucocorticoid-induced Cushing syndrome and concomitant human immunodeficiency virus (HIV) infection. Both long-term steroid use and HIV infection may lead to osteopenia or even osteoporosis. Multiple vertebral fractures in young patients are very uncommon and should alert the examiner to investigate any underlying cause. Treatment choices include pharmacological agents such as bisphosphonates or parathyroid hormone and even surgical interventions such as percutaneous vertebroplasty.

Near-GeV Electron Beams at a Few Per-Mille Level from a Laser Wakefield Accelerator via Density-Tailored Plasma.

A simple, efficient scheme was developed to obtain near-gigaelectronvolt electron beams with energy spreads of few per-mille level in a single-stage laser wakefield accelerator. Longitudinal plasma density was tailored to control relativistic laser-beam evolution, resulting in injection, dechirping, and a quasi-phase-stable acceleration. With this scheme, electron beams with peak energies of 780-840 MeV, rms energy spreads of 2.4‰-4.1‰, charges of 8.5-23.6 pC, and rms divergences of 0.1-0.4 mrad were experimentally obtained. Quasi-three-dimensional particle-in-cell simulations agreed well with the experimental results. The dechirping strength was estimated to reach up to 11 TeV/mm/m, which is higher than previously obtained results. Such high-quality electron beams will boost the development of compact intense coherent radiation sources and x-ray free-electron lasers.

Early Signal of Emerging Nuclear Collectivity in Neutron-Rich

Radioactive ^{129}Sb, which can be treated as a proton plus semimagic ^{128}Sn core within the particle-core coupling scheme, was studied by Coulomb excitation. Reduced electric quadrupole transition probabilities, B(E2), for the 2^{+}⊗πg_{7/2} multiplet members and candidate πd_{5/2} state were measured. The results indicate that the total electric quadrupole strength of ^{129}Sb is a factor of 1.39(11) larger than the ^{128}Sn core, which is in stark contrast to the expectations of the empirically successful particle-core coupling scheme. Shell-model calculations performed with two different sets of nucleon-nucleon interactions suggest that this enhanced collectivity is due to constructive quadrupole coherence in the wave functions stemming from the proton-neutron residual interactions, where adding one nucleon to a core near a double-shell closure can have a pronounced effect. The enhanced electric quadrupole strength is an early signal of the emerging nuclear collectivity that becomes dominant away from the shell closure.

The effect of a brief mindfulness-based intervention on personal recovery in people with bipolar disorder: a randomized controlled trial (study protocol).

BACKGROUND: With the advent of the recovery movement in mental health, a humanistic paradigm shift has occurred, placing the focus on personal recovery (i.e., hope, identity, and life meaning) instead of functional or clinical recovery only (i.e., symptom reduction or increases in physical function). Along the journey of recovery, people with bipolar disorder (BD) struggle to cope with recurring mood fluctuations between depression and mania. Mindfulness-based interventions (MBIs) have the potential to result in improvements in personal recovery outcomes. Thus, this protocol will evaluate the efficacy and mechanisms of a brief MBI for helping individuals with BD with their personal recovery. It is hypothesized that adults with BD randomly assigned to a brief MBI intervention will report greater improvements in personal recovery than those in a waiting list control condition. In addition, it is hypothesized that such benefits will be mediated by improvements in emotion awareness, emotion regulation, and illness acceptance. Moreover, the specific stage of BD is hypothesized to moderate the beneficial effects of the brief MBI, such that those in the early stage of BD will report more benefits regarding emotion awareness and emotion regulation, whereas those in the late stage of BD will report more advantages concerning illness acceptance. METHOD: One hundred and fifty-four adults with BD will be recruited from hospitals and community settings for this research project. This study will use a mixed methods design. A randomized-controlled trial will be conducted to compare a brief MBI (four sessions in total) group and a waiting list control group. Assessments will be made at baseline, after intervention, and at six-month follow-up. In addition, a qualitative and participatory research method called Photovoice will be employed to further understand the experiences of the participants who receive the brief MBI along their personal recovery journey. DISCUSSION: If the study hypotheses are supported, the findings from this research project will provide empirical support for an alternative treatment. Moreover, by identifying the mechanisms of the beneficial effects of the brief MBI, the findings will highlight process variables that could be specifically targeted to make MBI treatment even more effective in this population. TRIAL REGISTRATION: This study is registered with the Chinese Clinical Trial Registry ( ChiCTR- 1900024658 ). Registered 20th July 2019.

Level Attraction Due to Dissipative Magnon-Photon Coupling.

We report dissipative magnon-photon coupling caused by the cavity Lenz effect, where the magnons in a magnet induce a rf current in the cavity, leading to a cavity backaction that impedes the magnetization dynamics. This effect is revealed in our experiment as level attraction with a coalescence of hybridized magnon-photon modes, which is distinctly different from level repulsion with mode anticrossing caused by coherent magnon-photon coupling. We develop a method to control the interpolation of coherent and dissipative magnon-photon coupling, and observe a matching condition where the two effects cancel. Our work sheds light on the so-far hidden side of magnon-photon coupling, opening a new avenue for controlling and utilizing light-matter interactions.

Chronic obstructive pulmonary disease deaths, disability-adjusted life years, and risk factors in Hubei province of mid-China, 1990-2015: the Global Burden of Disease Study 2015.

OBJECTIVES: The trends of chronic obstructive pulmonary disease (COPD) mortality and prevalence from 1990 to 2015 in Hubei province of mid-China remain unknown. We used findings from the Global Burden of Disease (GBD) 2015 study to estimate the COPD burden and attributable to risk factors in Hubei province of China from 1990 to 2015. STUDY DESIGN: The GBD study uses various analytical tools and a diverse set of data sources to generate comparable estimates of deaths and mortality rates broken down by age, sex, cause, year, and geography. METHODS: Data were extracted from the GBD 2015 study. Statistical models were used to produce comprehensive results of COPD deaths, prevalence, disability-adjusted life years (DALYs), years of life lost, years lived with a disability, and attributable to risk factors in Hubei. The median of the percent change and 95% uncertainty intervals were determined for the period between 1990 and 2015. RESULTS: In 2015, there were 37,144 deaths from COPD in Hubei, accounting for 10.05% of the total deaths in Hubei. The age-standardized COPD death rate was reduced by 60.28% from 188.67 per 100,000 (in 1990) to 74.94 per 100,000 (in 2015). The age-standardized prevalence decreased from 4.30% (1990) to 2.85% (2015). By 2015, the leading risk factors for all ages COPD DALYs were smoking and ambient particulate matter pollution, accounting for 44.69% and 32.91%, respectively. The proportion of ambient ozone pollution was increasing steadily each year since 1990. CONCLUSION: Hubei has made substantial progress in reducing the mortality due to COPD since 1990, but the absolute number of COPD cases is increasing steadily, given the population growth and aging. The increasing contribution from smoking, ambient particulate matter pollution, and ambient ozone pollution should require growing attention.

Electromagnetic Moments of Radioactive

Radioactive ^{136}Te has two valence protons and two valence neutrons outside of the ^{132}Sn double shell closure, providing a simple laboratory for exploring the emergence of collectivity and nucleon-nucleon interactions. Coulomb excitation of ^{136}Te on a titanium target was utilized to determine an extensive set of electromagnetic moments for the three lowest-lying states, including B(E2;0_{1}^{+}→2_{1}^{+}), Q(2_{1}^{+}), and g(2_{1}^{+}). The results indicate that the first-excited state, 2_{1}^{+}, composed of the simple 2p⊕2n system, is prolate deformed, and its wave function is dominated by excited valence neutron configurations, but not to the extent previously suggested. It is demonstrated that extreme sensitivity of g(2_{1}^{+}) to the proton and neutron contributions to the wave function provides unique insight into the nature of emerging collectivity, and g(2_{1}^{+}) was used to differentiate among several state-of-the-art theoretical calculations. Our results are best described by the most recent shell model calculations.

Protease sensitivity and redistribution of CD71 and glycophorin A on K562 cells.

Transmembrane proteins are delivered to plasma membrane from the endoplasmic reticulum and Golgi complex by vesicular transport along with the cytoskeletal network. Disruption of this process likely affects transmembrane protein expression. K562 cells were digested with Streptomyces griseus protease for different periods of time, and then re-cultured with different cytoskeletal and glycosylation inhibitors. Cell viability and surface expression of transferrin receptor (CD71) and glycophorin A (GPA) were analyzed before and after re-culture by flow cytometry. We found that digestion with protease almost completely removed extracellular CD71 and GPA but their expression recovered to the initial levels after re-culture for 8 h and 24 h, respectively. The microtubule depolymerizer colchicine promoted cell surface recovery of CD71 but inhibited that of GPA; the microtubule stabilizer paclitaxel inhibited cell surface recovery of CD71 but promoted that of GPA; the microfilament depolymerizer cytochalasin D had no effect on cell surface recovery of CD71 and GPA; the microfilament stabilizer phalloidin inhibited cell surface recovery of GPA. The glycosylation inhibitor tunicamycin inhibited the recovery of both CD71 and GPA, and BADGP inhibited the recovery of GPA. These studies show differential sensitivities of surface proteins on K562 cells to proteases, and suggest molecular mechanisms of transmembrane protein transport and cycling.

[Trend analysis of the burden of ischemic heart disease in China, 1990 to 2015].

Objective: The objective of this study is to analyze the trend of burden of ischemic heart disease (IHD) in China between 1990 and 2015. Methods: Data were collected from the results of 2015 Global Burden of Disease Study. We arranged and analyzed the mortality and disability-adjusted life year (DALY) for IHD by sexes, ages and provinces (excluding Taiwan, China) in China between 1990 and 2015. The age-standardized rates were determined using the average world population age structure in the period of 2010-2035 as a reference, and the changes of the related indicators were calculated. Results: In 2015, IHD caused 1 461 thousand deaths, and its age-standardized death rate was 114.8 per 100 000. Number of DALYs from IHD were 25 765 thousand in 2015, with the age-standardized DALY rate at 1 760.2 per 100 000. From 1990 to 2015, the age-standardized death rate for IHD in China increased by 13.3% but age-standardized DALY rate decreased by 3.9%. Number of IHD DALYs among male (16 664 thousand) was higher than it among female (9 101 thousand) in China in 2015, and 83.5% of total DALYs from IHD occurred among people aged over 50 years old. Province with highest age-standardized death rate was Heilongjiang, with rate at 187.4 per 100 000 in 2015. Qinghai (54.0%) increased most and Macao (-52.3%) decreased most from 1990 to 2015. Province with highest age-standardized DALY rate was Xinjiang, with rate at 3 040.8 per 100 000 in 2015. Qinghai (33.2%) increased most while Macao (-59.0%) decreased most between 1990 and 2015. Conclusion: Burden of IHD in China increased remarkably from 1990 to 2015, especially among males and people aged over 50 years old. The differences among provinces were obvious.

[Research advances in diagnosis of non-alcoholic fatty liver disease].

Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases in clinical practice, and the spectrum of NAFLD includes nonalcoholic simple fatty liver, nonalcoholic steatohepatitis, and liver cirrhosis. Some patients may even progress to hepatocellular carcinoma. At present, the gold standard for the diagnosis of NAFLD is liver biopsy, but since this is an invasive examination and has high costs, its application is limited in clinical practice. More and more studies have focused on noninvasive diagnostic methods for NAFLD, including serological markers, fatty liver predictive model, and imaging examinations. Emerging diagnostic techniques, including genomics, proteomics, glycomics, and metabolomics, also play an important role in the diagnosis of NAFLD.

High-Brightness High-Energy Electron Beams from a Laser Wakefield Accelerator via Energy Chirp Control.

By designing a structured gas density profile between the dual-stage gas jets to manipulate electron seeding and energy chirp reversal for compressing the energy spread, we have experimentally produced high-brightness high-energy electron beams from a cascaded laser wakefield accelerator with peak energies in the range of 200-600 MeV, 0.4%-1.2% rms energy spread, 10-80 pC charge, and ∼0.2 mrad rms divergence. The maximum six-dimensional brightness B_{6D,n} is estimated as ∼6.5×10^{15} A/m^{2}/0.1%, which is very close to the typical brightness of e beams from state-of-the-art linac drivers. These high-brightness high-energy e beams may lead to the realization of compact monoenergetic gamma-ray and intense coherent x-ray radiation sources.

Inflammatory facial acne during uncomplicated pregnancy and post-partum in adult women: a preliminary hospital-based prospective observational study of 35 cases from Taiwan.

BACKGROUND: Pregnancy is associated with significant changes in hormones and metabolism which can also exert impact on the skin. OBJECTIVES: The study was aimed to evaluate the facial acne severity during pregnancy and post-partum period and to identify risk factors for acne in pregnancy. METHODS: A hospital-based prospective study on pregnant women at age ≥18 years was conducted during their routine maternal examination. The severity of inflammatory facial acne was evaluated by the number of acne lesions and Global Acne Severity Scale, based on pictures taken at the three trimesters of pregnancy and post-partum period. Risk factors were identified by review of medical chart and questionnaires. Correlation with acne severity was statistically analysed. RESULTS: Thirty-five pregnant women were included in this study with ages ranging from 25 to 40 years. The average number of facial acne was highest in the second trimester. Primigravida, female gender and low birth weight for gestational age of the newborn were associated with higher numbers of facial acne in the second and third trimester in our series. CONCLUSIONS: Further investigation on a larger population and the relevant hormone changes is required to confirm and explain our findings.

LECT2 association with macrophage-mediated killing of Helicobacter pylori by activating NF-κB and nitric oxide production.

Helicobacter pylori employs unique methods to colonize the stomach, which induces chronic inflammation. It is also able to avoid eradication by macrophages and other immune cells. Leukocyte cell-derived chemotaxin 2 (LECT2), a multi-functional cytokine involved in many pathological conditions, has recently been shown to activate macrophages via the CD209a receptor. Therefore, we aimed to investigate the effects of LECT2 on H. pylori-infected macrophages. Macrophages were treated with recombinant LECT2, and both their ability to kill H. pylori and produce nitric oxide were analyzed. Western blot was performed to determine nuclear translocation and protein phosphorylation of p65, a subunit of nuclear factor (NF)-κB. Transfection experiments were performed to analyze the signaling pathway of LECT2 in macrophages. We found that treatment with LECT2 enhanced H. pylori killing and nitric oxide production in macrophages. In addition, DNA-binding activity and nuclear translocation of p65 were up-regulated by LECT2 treatment. Furthermore, we found that NF-κB activation by LECT2 was mediated by Raf-1 in macrophages, and Raf-1 phosphorylation was specifically altered in response to LECT2. Moreover, LECT2 induced Ser28 phosphorylation in the intracellular domain of CD209a. CD209a Ser28 phosphorylation was required for LECT2-induced Raf-1 and NF-κB activation in RAW264.7 macrophages. Our study showed that the effects of LECT2 on H. pylori killing and nitric oxide production were dependent on CD209a phosphorylation, Raf-1, and NF-κB activation. Together, these results demonstrate for the first time that exposure to LECT2 can modulate specific intracellular mechanisms downstream of CD209a to enhance H. pylori killing and nitric oxide production in macrophages.

[Investigation and analysis for impact factors of distress in patients with first diagnosed lung cancer].

OBJECTIVE: To study the impact factors of psychological distress in patients with first diagnosed lung cancer. METHODS: The cross-sectional study was applied to newly diagnosed lung cancer patients who received treatments in Cancer Center of West China Hospital of Sichuan University in Chengdu from June 2013 to March 2015 by distributed questionnaires. The general information of the patients, the hospital anxiety and depression scale (HADS) and distress management screening measure (DMSM) were included in the questionnaire to evaluate the states of distress, pain and the factors related to the distress of the patients. RESULTS: The survey investigated a total of 390 patients with first diagnosed lung cancer, including 291 male patients and 99 female patients. The proportion of the patients with positive anxiety symptom was 26.7% (104/390), with positive depression symptom was 27.7% (108/390), and with positive distress symptom was 30.0% (117/390). On the top five problem list of DMSM were worry, disease treatment, breathing, pain and sleep. The Spearman correlation analysis showed that anxiety score, depression score, and the pain intensity were positively correlated with the distress. Multiple linear regression analysis showed that gender (ß=-0.209, P=0.003), age (ß=-0.098, P=0.042), chronic disease (ß=0.378, P<0.001), and pain score (ß=0.100, P=0.029) could affect the distress of the patients. Smoking (ß=0.111, P=0.041) could affect the anxiety of newly diagnosed lung cancer patients. CONCLUSION: The gender, age, chronic disease and pain score of the patients are the independent factors of the psychological distress of first diagnosed lung cancer patients. Smoking is the predictive factors of the patients with anxiety. Controlling the pain intensity and the clinical process of chronic disease of the patients actively, solving the sleep and breathing problem and helping the patients to quit smoking progressively could alleviate the psychological distress of the patients.