Research progress of new multifunctional bone cement in bone tumor therapy / 中国修复重建外科杂志

OBJECTIVE@#The research progress of new multifunctional bone cement in bone tumor therapy in recent years was reviewed, in order to provide help for the future research of anti-tumor bone cement.@*METHODS@#The related literature on the treatment of bone tumors with new multifunctional bone cement at home and abroad in recent years was extensively reviewed and summarized.@*RESULTS@#The new multifunctional bone cements include those with the functions of photothermotherapy, magnetic thermotherapy, chemoradiotherapy, and antibacterial after operation, which are discussed from the aspects of anti-tumor, drug controlled release, and cytotoxicity. Controlled drug release has been achieved in multifunctional bone cements by adjusting heat and pH or incorporating particles such as chitosan oligosaccharides and γ-cyclodextrin. At present, multifunctional bone cement with hyperthermia, radiotherapy, and chemotherapy has effectively inhibited the local recurrence and distant metastasis of bone tumors. Broadening the application of bone cement for photothermal and magnetic thermal therapy to deeper bone tumors, investigating more precise controlled release of drug-loaded bone cement, and introducing nanoparticles with both thermal conversion and intrinsic enzymatic activities into bone cement for synergistic anti-tumor therapy are promising research directions.@*CONCLUSION@#The new multifunctional bone cement inhibits bone tumor cells, promotes new bone formation in bone defects, and prevents incision infection after tumor resection. Certain progress has been made in anti-tumor, antibacterial, drug-controlled release, and reduction of cytotoxicity. Expanding the deeper application range of the new multifunctional bone cement, verifying the safety in clinical application, and focusing on the individualized treatment of the new multifunctional bone cement are the problems that need to be solved in the future.

Progress in antibacterial/osteogenesis dual-functional surface modification strategy of titanium-based implants / 中国修复重建外科杂志

OBJECTIVE@#To review antibacterial/osteogenesis dual-functional surface modification strategy of titanium-based implants, so as to provide reference for subsequent research.@*METHODS@#The related research literature on antibacterial/osteogenesis dual-functional surface modification strategy of titanium-based implants in recent years was reviewed, and the research progress was summarized based on different kinds of antibacterial substances and osteogenic active substances.@*RESULTS@#At present, the antibacterial/osteogenesis dual-functional surface modification strategy of titanium-based implants includes: ① Combined coating strategy of antibiotics and osteogenic active substances. It is characterized in that antibiotics can be directly released around titanium-based implants, which can improve the bioavailability of drugs and reduce systemic toxicity. ② Combined coating strategy of antimicrobial peptides and osteogenic active substances. The antibacterial peptides have a wide antibacterial spectrum, and bacteria are not easy to produce drug resistance to them. ③ Combined coating strategy of inorganic antibacterial agent and osteogenic active substances. Metal ions or metal nanoparticles antibacterial agents have broad-spectrum antibacterial properties and various antibacterial mechanisms, but their high-dose application usually has cytotoxicity, so they are often combined with substances that osteogenic activity to reduce or eliminate cytotoxicity. In addition, inorganic coatings such as silicon nitride, calcium silicate, and graphene also have good antibacterial and osteogenic properties. ④ Combined coating strategy of metal organic frameworks/osteogenic active substances. The high specific surface area and porosity of metal organic frameworks can effectively package and transport antibacterial substances and bioactive molecules. ⑤ Combined coating strategy of organic substances/osteogenic active substancecs. Quaternary ammonium compounds, polyethylene glycol, N-haloamine, and other organic compounds have good antibacterial properties, and are often combined with hydroxyapatite and other substances that osteogenic activity.@*CONCLUSION@#The factors that affect the antibacterial and osteogenesis properties of titanium-based implants mainly include the structure and types of antibacterial substances, the structure and types of osteogenesis substances, and the coating process. At present, there is a lack of clinical verification of various strategies for antibacterial/osteogenesis dual-functional surface modification of titanium-based implants. The optimal combination, ratio, dose-effect mechanism, and corresponding coating preparation process of antibacterial substances and bone-active substances are needed to be constantly studied and improved.

Impacts of androgen deprivation therapy on the risks and outcomes of SARS-CoV-2 infection in patients with prostate cancer / 亚洲男科学杂志(英文版)

Studies have investigated the effects of androgen deprivation therapy (ADT) use on the incidence and clinical outcomes of coronavirus disease 2019 (COVID-19); however, the results have been inconsistent. We searched the PubMed, Medline, Cochrane, Scopus, and Web of Science databases from inception to March 2022; 13 studies covering 84 003 prostate cancer (PCa) patients with or without ADT met the eligibility criteria and were included in the meta-analysis. We calculated the pooled risk ratios (RRs) with 95% confidence intervals (CIs) to explore the association between ADT use and the infection risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and severity of COVID-19. After synthesizing the evidence, the pooled RR in the SARS-CoV-2 positive group was equal to 1.17, and the SARS-CoV-2 positive risk in PCa patients using ADT was not significantly different from that in those not using ADT (P = 0.544). Moreover, no significant results concerning the beneficial effect of ADT on the rate of intensive care unit admission (RR = 1.04, P = 0.872) or death risk (RR = 1.23, P = 0.53) were found. However, PCa patients with a history of ADT use had a markedly higher COVID-19 hospitalization rate (RR = 1.31, P = 0.015) than those with no history of ADT use. These findings indicate that ADT use by PCa patients is associated with a high risk of hospitalization during infection with SARS-CoV-2. A large number of high quality studies are needed to confirm these results.

Bendamustine combined with pomalidomide and dexamethasone in relapsed multiple myeloma with extramedullary disease: a multicenter study / 中华血液学杂志

Objective: To evaluate the efficacy and safety of bendamustine combined with pomalidomide and dexamethasone (BPD regimen) in the treatment of relapsed multiple myeloma (MM) with extramedullary disease. Methods: This open, single-arm, multicenter prospective cohort study included 30 relapsed MM patients with extramedullary disease diagnosed in seven hospitals including Qingdao Municipal Hospital. The patients were treated with BPD regimen from February 2021 to November 2022. This study analyzed the efficacy and adverse reactions of the BPD regimen. Results: The median age of the 30 patients was 62 (47-72) years, of which 18 (60% ) had first-time recurrence. The overall response rate (ORR) of the 18 patients with first-time recurrence was 100%, of which three (16.7% ) achieved complete remission, 10 (55.5% ) achieved very good partial remission (VGPR), and five (27.8% ) achieved partial remission (PR). The ORR of 12 patients with recurrence after second-line or above treatment was 50%, including zero patients with ≥VGPR and six patients (50% ) with PR. Three cases (25% ) had stable disease, and three cases (25% ) had disease progression. The one-year progression free survival rate of all patients was 65.2% (95% CI 37.2% -83.1% ), and the 1-year overall survival rate was 90.0% (95% CI 76.2% -95.4% ). The common grade 3-4 hematology adverse reactions included two cases (6.7% ) of neutropenia and one case (3.3% ) of thrombocytopenia. The overall adverse reactions are controllable. Conclusions: The BPD regimen has good efficacy and tolerance in relapsed MM patients with extramedullary disease.

Clinical efficacy of super-mini-percutaneous nephroscope combined with flexible ureteroscopic lithotripsy in oblique supine lithotomy position in the treatment of 2.0-3.0 cm renal calculi / 现代泌尿外科杂志

【Objective】 To compare the clinical safety and effectiveness of super-mini-percutaneous nephroscope (SMP) combined with flexible ureteroscopic lithotripsy (FURL) in oblique supine lithotomy position and FURL alone in the treatment of 2.0-3.0 cm renal calculi. 【Methods】 Clinical data of 55 patients treated during Jan.2018 and May 2021 were retrospectively analyzed, including 47 cases complicated renal calculi, and 14 cases of lower calyceal calculi with infundibulopelvic angle ≤30°. SMP combined with FURL was performed in 23 cases (combined group), and FURL alone was performed in 32 cases (FURL group). The operation time, hemoglobin reduction, postoperative hospital stay, hospitalization expenses, stone-clearance rate and complications were compared. 【Results】 All operations were successful. Compared with the FRUL group, the combined group had significantly more hemoglobin reduction [(16.30±10.17) g/L vs. (6.94±6.61) g/L], longer postoperative hospital stay [(5.35±1.61) d vs. (3.19±1.26) d], and higher hospitalization expenses [(22 481±2 234) yuan vs. (18 209±2 584) yuan] (P0.05]. One month after surgery, CT results showed that the combined group had higher stone-clearance rate (91.30% vs. 65.63%, P=0.027). There was no difference in the complication rate (21.74% vs. 21.88%, P>0.05). One case (4.35%) in the combined group and 5 cases (15.63%) in the FURL group received retreatment (P>0.05). 【Conclusion】 SMP combined with FURL in oblique supine lithotomy position is safe and effective in the treatment of 2.0-3.0 cm renal calculi, with high stone-clearance rate and low complication rate.

Malignant melanoma of penis: a case report / 中华泌尿外科杂志

Melanoma of penis is rare. A case was reported in this paper. Penile mass was found for 14 months. Penile tumor resection+ left inguinal lymph node biopsy and bilateral ilioinguinal lymph node dissection were performed. Postoperative pathology showed malignant melanoma of the penis with bilateral ilioinguinal lymph node metastasis. This patient was treated with pabolizumab for 17 cycles. After 22 months follow-up, the patient had no disease progression.

Advances in biodegradation of macrolide antibiotics / 生物工程学报

Macrolide antibiotics are a class of broad-spectrum antibiotics with the macrolide as core nucleus. Recently, antibiotic pollution has become an important environmental problem due to the irregular production and abuse of macrolide antibiotics. Microbial degradation is one of the most effective methods to deal with antibiotic pollution. This review summarizes the current status of environmental pollution caused by macrolide antibiotics, the degradation strains, the degradation enzymes, the degradation pathways and the microbial processes for degrading macrolide antibiotics. Moreover, the critical challenges on the biodegradation of macrolide antibiotics were also discussed.

Meta-analysis of corneal topography-guided and wavefront aberration-optimized comparison of higher-order aberrations after FS-LASIK / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the effect of higher-order aberrations(HOAs)after topography-guided and wavefront-optimized femtosecond laser-assisted <i>in situ</i> keratomileusis(FS-LASIK). <p>METHODS: We searched on PubMed, the Cochrane Library, Medline, CNKI, CBM, VIP and WanFang Data database for randomized controlled trials(RCTs)and comparative studies(CTs). The published languages were limited to Chinese and English. The risk bias tool provided by the Cochrane cooperation scale and Newcastle-Ottawa Scale were used to assess the risk bias of included studies of RCTs and CTs. The published biases of included studies were assessed by the Egger test. Meta-analysis was performed with Review Manager 5.4.<p>RESULTS: Two randomized controlled trials and six comparative studies with a total of 987 subjects were included(482 in the topography-guided FS-LASIK group, 505 in the wavefront optimized FS-LASIK group). The Meta-analysis showed that the topography-guided group has a better effect than the wavefront-optimized group in spherical equivalent, the difference between the two groups was statistically significant \〖<i>WMD</i>=0.11, 95%<i>CI </i>(0.07, 0.14), <i>P</i><0.00001\〗. And the results also indicated that there was a significant difference between the two groups with HOAs \〖<i>WMD= </i>-0.09, 95%<i>CI </i>(-0.13,-0.05), <i>P</i><0.0001\〗, spherical aberrations \〖<i>WMD=</i>-0.05, 95%<i>CI </i>(-0.09, -0.01), <i>P</i>=0.008\〗 and coma \〖<i>WMD=</i>-0.08, 95%<i>CI </i>(-0.12, -0.05), <i>P</i><0.00001\〗.<p>CONCLUSION: Based on the available evidence, topography-guided FS-LASIK has higher diopter and lower HOAs, spherical aberrations and coma than wavefront-optimized FS-LASIK.

Meta-analysis of 0.01% Atropine for Asian adolescents and children of low and medium myopia in diopter and axial length / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the effects of 0.01% atropine for Asian adolescents and children of low and medium myopia in diopter and axial length. <p>METHODS:We searched on PubMed, the Cochrane Library, Embase, CNKI, CBM, VIP and WanFang Data database for randomized controlled trials(RCTs). The published languages were limited to Chinese and English. The risk bias tool provided by the Cochrane cooperation scale was used to assess the risk bias of included studies of RCTs. The published biases of included studies were assessed by the Egger's test. Meta-analysis was performed with Review Manager 5.4. <p>RESULTS: Seven randomized controlled trials with a total of 979 subjects were included(440 in the 0.01% atropine group and 539 in the control group). The Meta-analysis showed that 0.01% atropine has a better effect than the control group in controlling the diopter growth in moderate and low myopia of Asian adolescents and children. The difference between the two groups was statistically significant \〖<i>WMD</i>=0.50, 95%<i>CI </i>(0.37, 0.64), <i>P</i><0.00001\〗. And the results also indicated that the change in axial length of 0.01% atropine was significantly less than the control group, the difference between the two groups was statistically significant \〖<i>WMD</i>= -0.20, 95%<i>CI </i>(-0.30, -0.10), <i>P</i>=0.0001\〗.<p>CONCLUSION: Based on the available evidence, 0.01% atropine offer in controlling axial length and diopter growth of low and medium myopia in Asian adolescents and children.

Expression of SOX4 gene and its biological effects in endometrial carcinoma / 解剖学报

Objective To investigate the expression of sex determining region Y box protein 4(SOX4) gene and its biological effects in endometrial carcinoma. Methods 156 cases of endometrial carcinoma tissues, adjacent tissues of endometrial carcinoma and 156 cases of endometrial atypical hyperplasia were collected; Immunohistochemistry was used to detect the expression of SOX4 in endometrial cancer, endometrial dysplasia and normal endometrial tissue, and to analyze the relationship between SOX4 and the clinical characteristics of patients with endometrial cancer. After establishing the SOX4 overexpression/silencing Ishikawa cell strain using the lentivirus transfection technique, MTT, flow cytometry and Transwell chamber method were used to detect the cell proliferation, apoptosis, migration and invasion ability, and Western blotting method was used to detect SOX4, β-catenin and E-cadherin protein expression changes. Results The expression of SOX4 in endometrial cancer tissue was higher than that in normal endometrial tissue and endometrial atypical hyperplasia (P<0.05). SOX4 expression was correlated with invasion depth, International Federation of Obstetrics and Gynecoogy (FIGO) stage and lymph node metastasis (P<0.05). Compared with control group, SOX4 overexpressed Ishikawa cells have significantly increased proliferative ability, migration and invasion ability, significantly reduced apoptosis rate, significantly increased SOX4 and β-catenin protein expression, and significantly reduced E-cadherin protein expression (all P< 0.05). while the proliferation ability, migration and invasion ability of Ishikawa cells interfered by SOX4 were significantly reduced, the apoptosis rate was significantly increased, the expression of SOX4 and β-catenin protein was significantly reduced, and the expression of E-cadherin protein was significantly increased (all P<0.05). Conclusion S0X4 gene is highly expressed in endometrial cancer tissues, which may promote the development of endometrial cancer by activating Wnt/β-catenin signaling pathway.

Design of Multimodality Wheelchair Based on Double Parallelogram Mechanism / 中国康复理论与实践

Objective:To design a multimodality wheelchair in order to meet many use requirements of the lower limbs dyskinesia patients. Methods:For some shortcomings of the existing multimodality wheelchair such as heavy structure and drive redundancy, the design of multimodality wheelchair based on double parallelogram mechanism is studied, and a simple and reliable multimodality wheelchair mechanism is presented. Rotary actuation drives the double parallelogram mechanism and makes parts of the wheelchair move, and three posture transformations are realized. The coupling movement of the back and leg rest realizes the transformation of sitting and supine posture, and the coupling movement of seat and back realizes the change of sitting and standing posture. The mechanical analysis of wheelchairs based on uniform load was carried out, and the rotation moment is calculated. Results:When the driving torque changed from sitting position to supine position, it increased with the increase of rotation angle and reached a peak value. When the driving torque changed from sitting position to standing position, it gradually decreased with the increase of rotation angle. Then the dynamics simulation is carried out in Adams software, the calculated results were basically consistent with the simulation results. Conclusion:The proposed mechanism is helpful to realize the lightweight design of multimodality wheelchair, and meets the design needs of intelligent multimodality wheelchair.

Correlation between serum vitamin D and coronary artery lesion severity and short-term prognosis in patients with coronary artery disease / 上海交通大学学报（医学版）

Objective: To explore the relationship between serum vitamin D level and coronary artery lesion severity and short-term prognosis in coronary artery disease (CAD) patients. Methods: A total of 323 CAD patients diagnosed according to coronary angiogram were selected and the coronary artery lesion severity was evaluated by using Gensini score. Clinical data was collected and serum level of vitamin D and other indicators were determined for statistical analysis. Results: All patients were divided into tertile according to Gensini score. The level of serum vitamin D concentration was significantly different from the lowest tertile to the highest tertile (P=0.000). Serum vitamin D level was negatively correlated with Gensini score in CAD patients (r=-0.182, P=0.001). Multivariate linear analysis showed that vitamin D level was an independent predictor of Gensini score (β=-0.795, P=0.000). There was no difference in the incidence of major advanced cardiovascular events between vitamin D deficiency patients and normal vitamin D level patients (2.05% vs 3.17%, P=0.202) after (18.14±3.04) months' follow-up. Conclusion: There is an independently negative correlation between serum vitamin D and coronary artery lesion severity in CAD patients.

Robot-assisted laparoscopic upper urinary tract reconstruction surgery: A review of 108 cases by a single surgeon / 北京大学学报(医学版)

OBJECTIVE@#To summarize the experiences and outcomes of 108 robot-assisted laparoscopic upper urinary tract reconstruction surgeries conducted by a single surgeon.@*METHODS@#We consecutively and retrospectively reviewed 108 patients who underwent robot-assisted laparoscopic upper urinary tract reconstruction surgeries by a single surgeon from November 2018 to January 2020. The patient demographics, perioperative variables, postoperative complications and follow-up data were recorded. Fifty-three modified dismembered pyeloplasties (MDP), 11 spiral flap pyeloplasties (SFP), 11 ure-teroureterostomies (UUT), 4 lingual mucosal onlay graft ureteroplasties (LMU), 5 appendiceal onlay flap ureteroplasties (AU), 11 ureteral reimplantations (UR), 6 Boari flap-Psoas hitch surgeries (BPS) and 7 ileal ureter replacements (IUR) were enrolled finally. The success was defined as the improvement in subjective pain levels, and the improvement in the degree of hydronephrosis at ultrasound.@*RESULTS@#All the surgeries were successfully completed without open or laparoscopic conversion. The median operative time was 141 min (range: 74-368 min), median blood loss was 20 mL (range: 10-350 mL) and median hospital stay was 4 d (range: 3-19 d) in MDP group, with the success rate of 94.3%. The median operative time was 159 min (range: 110-222 min), median blood loss was 50 mL (range: 20-150 mL) and median hospital stay was 5 d (range: 3-8 d) in SFP group, with the success rate of 100%. The median operative time was 126 min (range: 76-160 d), median blood loss was 20 mL (range: 10-50 mL) and median hospital stay was 5 d (range: 4-9 d) in UUT group, with the success rate of 100%. The median operative time was 204 min (range: 154-250 min), median blood loss was 30 mL (range: 10-100 mL) and median hospital stay was 6 d (range: 4-7 d) in LMU group, with the success rate of 100%. The median operative time was 164 min (range: 135-211 min), median blood loss was 75 mL (range: 50-200 mL) and median hospital stay was 8.5 d (range: 6-12 d) in AU group, with the success rate of 100%. The median operative time was 149 min (range: 100-218 min), median blood loss was 20 mL (range: 10-50 mL) and median hospital stay was 7 d (range: 5-10 d) in UR group, with the success rate of 90.9%. The median operative time was 166 min (range: 137-205 min), median blood loss was 45 mL (range: 20-100 mL) and median hospital stay was 5 d (range: 4-41 d) in BPS group, with the success rate of 83.3%. The median operative time was 270 min (range: 227-335 min), median blood loss was 100 mL (range: 10-100 mL) and median hospital stay was 7 d (range: 5-26 d) in IUR group, with the success rate of 85.7%.@*CONCLUSIONS@#The surgeon performed and modified numerous complicated upper urinary tract reconstruction surgeries by the robotic platform, which facilitated the development of the standardized upper urinary tract reconstruction surgical technique.

Application of preoperative three-dimensional image reconstruction in the treatment of ureteropelvic junction obstruction / 北京大学学报(医学版)

OBJECTIVE@#To investigate the value of preoperative three-dimensional image reconstruction in the treatment of ureteropelvic junction obstruction (UPJO).@*METHODS@#We reviewed data on 40 patients (22 male cases, and 18 female cases) diagnosed with UPJO in Peking University First Hospital from May 2017 to April 2019. The median age was 26.5 years (IQR 23.25-38.75) years. There were 11 patients complicated with ectopic vessels, 14 patients with kidney stones, 3 patients with horseshoe kidney, and 6 patients with obstruction after pyeloplasty. All the patients underwent preoperative enhanced CT scan, and the CT data were reconstructed into three-dimensional image models. The obstruction position of ureteropelvic junction and the relationship between ureteropelvic junction and blood vessels and organs were observed by three-dimensional models to assist planning surgery. Thirty-seven patients underwent laparoscopic pyeloplasty (including 3 cases combined with pyelolithotomy with flexible cystoscope, 1 case combined with pyelolithotomy by sun-style cystoscope, 1 case with laparoscopic ureter resection and anastomosis, 3 cases of laparoscopic pyeloplasty of horseshoe kidney), 2 patients underwent laparoscopic ventral onlay lingual mucosal graft ureteroplasty, and 1 patient underwent robot-assisted laparoscopic pyeloplasty.@*RESULTS@#Three-dimensional CT image clearly showed the relationship between the obstruction of ureteropelvic junction and blood vessels and organs after three-dimensional reconstruction. The type, diameter, position and direction of the ectopic vessels could be observed clearly before operation according to the three-dimensional reconstruction model, and the number, size, location and shape of renal calculi or other masses, the number of involved renal calyces and the anatomical distribution in the renal pelvis and calyces could be also evaluated preoperatively. After comprehensive analysis of the above information, individualized operation plans were performed on the patients, all the 40 cases were successfully completed with the surgery without any transfer to open surgery. The average operative time was (129.91±37.90) min (range: 75 to 273), the average blood loss was (48.1±78.0) mL (range: 10 to 400), the average hospitality was (5.04±1.99) d (range: 2 to 10), and the average postoperative drainage time was (3.8±1.4) d (range: 2 to 8).@*CONCLUSION@#The preoperative three-dimensional image reconstruction has a high clinical value in the treatment of ureteropelvic junction obstruction, and it is of great help to assist surgery planning and is worthy of further clinical promotion and application.

ERLIN2 expression in glioblastoma and its correlation with prognosis / 国际生物医学工程杂志

Objective:To analyze the expression of endoplasmic reticulum lipid raft-associated protein 2 (ERLIN2) in glioblastoma tissues, and to analyze its correlation with the clinicopathological features and prognosis of patients with glioblastoma.Methods:The TCGA database was used to analyze the expression level of ERLIN2 mRNA in glioblastoma. KM-plotter was used to analyze the correlation between ERLIN2 expression and prognosis in patients with glioblastoma. The expression level of ERLIN2 protein in 78 cases of glioblastoma tissue was determined by immunohistochemical staining, and then the tissue samples were divided into high expression and low expression groups according to the ERLIN2 expression level. The clinical and pathological data of patients were collected, including age, gender, tumor laterality, recurrence, isocitrate dehydrogenase(IDH) mutation, and the correlation between ERLIN2 protein and clinicopathological characteristics was further analyzed.Results:The mRNA of ERLIN2 was significantly overexpressed in glioblastoma, and the overall survival rate of patients with high ERLIN2 expression was low, suggesting a poor prognosis. The results of immunohistochemistry and clinicopathological analysis showed that ERLIN2 protein was significantly overexpressed in glioblastoma, and its expression level was significantly related to tumor recurrence.Conclusions:ERLIN2 protein is significantly overexpressed in glioblastoma tissues, and its expression level is related to the clinicopathological characteristics and poor prognosis, suggesting that ERLIN2 can be used as a potential prognostic factor for glioblastoma.

The relationship between uric acid urolithiasis and dyslipidemia / 中华泌尿外科杂志

Objective:To evaluate the relationship between dyslipidemia and uric acid urolithiasis, and explore the risk factors of uric acid urolithiasis.Methods:93 patients with uric acid urolithiasis identified by stone composition analysis were retrospective analyzed from January 2014 to October 2019 were classified as uric acid urolithiasis group.Among them there were 77 men accounting for 82.8%, 16 women accounting for 17.2%, the median age is 64 years old.According to sex, age and other conditions, 321 patients with calcium oxalate urolithiasis in the same period were selected as calcium oxalate stone group. Among them there were 264 men accounting for 82.2%, 57 women accounting for 17.8%, the average age is 64 years old.While 306 non-stone people examined in hospital as control group in the same period who matched with age and gender. Among them there were 252 men accounting for 82.4%, 54 women accounting for 17.6%, the average age is 61 years old. There was no significant difference in age and sex ratio among the three groups. The body mass index (BMI) of uric acid urolithiasis group, calcium oxalate urolithiasis group and control group were significantly different( P<0.01). Serum uric acid, urine pH and blood lipids: triglyceride (TG), cholesterol (TC), high density lipoprotein (HDL-C) and low density lipoprotein (LDL-C) were recorded in the three groups, and the correlation between the above indexes and stone composition was analyzed.The uric acid urolithiasis group was divided into hyperuricemia(HUA) group (n=41) and Non HUA group (n=52) according to serum uric acid, and 66 cases with HUA were selected in the control group. The dyslipidemia and urine pH levels of the above three groups were compared. The multivariate Logistic regression analysis was used to identify the independent risk factors associated with uric acid urolithiasis formation. Results:There were significant differences in TG level, incidence of hypertrigly-ceridemia, low HDL-cholesterolemia, high LDL-cholesterolemia, serum uric acid and urine pH between uric acid urolithiasis group and calcium oxalate urolithiasis group( P<0.05). Significant differences were seen in TG level, HDL-C level, incidence of hypertriglyceridemia and low HDL-cholesterolemia, serum uric acid and urine pH between uric acid urolithiasis group and control group.There was significant difference in urine pH between uric acid urolithiasis with and Non HUA group. Significant difference in the incidence of hypertriglyceridemia and low HDL-cholesterolemia were seen between uric acid urolithiasis with HUA group and HUA group.Multivariate Logistic regression analysis showed that obesity(odds ratio=1.68, P<0.001), hypertriglyceridemia(odds ratio=7.37, P=0.002), low HDL-cholesterolemia(odds ratio=10.46, P=0.001) and low urinary pH(odds ratio=0.10, P<0.001) were independent risk factors for uric acid urolithiasis. Conclusions:Dyslipidemia was more likely associated with uric acid urolithiasis. Obesity, hypertriglyceridemia, low HDL-cholesterolemia and low urinary pH are closely related to the occurrence of uric acid urolithiasis.

Pharmacological effects of the active ingredient genkwanin in Leonurus on coagulation and anti-inflammation in mice / 西安交通大学学报(医学版)

Objective: To investigate the pharmacological effects of genkwanin, the active ingredient in Leonurus on coagulation and anti-inflammation in mice. Methods: The body torsion pain caused by acetic acid model, auricle swelling induced by xylene, and the blood capillary permeability model were used to investigate the analgesic and anti-inflammatory effects of genkwanin in mice. Results: The clotting time was significantly reduced in medium- and high-dose genkwanin groups compared with the control group (P0.05) in the low-dose genkwanin group, a significant reduce of A value (P<0.05) in the medium-dose group, and an extremely significant decrease of A value (P<0.01) in the high-dose group. Conclusion: Genkwanin can promote blood coagulation function of mice, and reduce the times of their body torsion pain caused by acetic acid, showing obvious analgesic effects. Furthermore, genkwanin can inhibit auricle swelling of mice induced by xylene and reduce the blood capillary permeability of their abdominal cavity, suggesting its mild anti-inflammatory effects. The findings can provide clinical evidence for treating dysmenorrheal and endometritis.

Prevention of sudden cardiac death in patients with ejection fraction reduced heart failure receiving ICD implantation / 中国实用内科杂志

OBJECTIVE: By recording the treatment events of implantable cardioverter defibrillator(ICD) in patients with ejection fraction reduced heart failure(HFrEF), to analyze the difference in primary and secondary prevention patients. METHODS: A single center retrospective study was conducted. HFrEF patients with ICD or cardiac resynchronization therapy with cardioverter defibrillator(CRT-D) implanted in Peking Union Medical College Hospital from January 2006 to December 2017 were enrolled in our study. Basic clinical data was collected and ICD treatment events were recorded during follow-up. The appropriate treatment events were identified according to electrocardiogram recorded by ICD. The ICD treatment events of primary and secondary prevention patients were analyzed. RESULTS: 1) A total of 145 patients with HFrEF implanted with ICD or CRT-D were enrolled, 103 primary prevention patients and 42 secondary prevention patients. Primary prevention patients had longer left ventricular end-systolic diameter(LVESD) and lower left ventricular ejection fraction(LVEF) than secondary prevention patients. 2) Multivariate competitive risk regression analysis showed that secondary prevention patients and male patients had higher risk of receiving appropriate treatment and appropriate shock therapy. 3) K-M curve and Log-Rank test showed that there was no significant difference in the risk of inappropriate treatment between primary and secondary prevention patients. The main cause of inappropriate treatment was atrial flutter or atrial fibrillation. CONCLUSION: 1) Primary prevention patients have lower risk of receiving appropriate treatment and appropriate shock therapy than secondary prevention patients; 2) There is no significant difference between primary and secondary prevention patients in the risk of inappropriate treatment. The main cause of inappropriate treatment events is atrial flutter or atrial fibrillation.

Expression of Cx43 and Cx45 in Cardiomyocytes of an Overworked Rat Model / 法医学杂志

Objective To study the effect of overwork stress response on the expression of connexin 43（Cx43） and connexin 45（Cx45） in cardiomyocytes and on cardiac function. Methods The experimental animals were divided into control group, overworked 1-month group and overworked 2-month group. A overworked rat model was established by forcing swimming of overworked group. The expressions of Cx43 and Cx45 in myocardial tissues of experimental animals were detected by Western blotting, while the corresponding myocardial tissues were stained with hematoxylin-eosin （HE） staining and Masson's staining, then histologically observed. Results Western blotting results showed that, compared with the control group, Cx43 expression in myocardial tissues of overworked rats decreased while Cx45 expression increased. HE staining and Masson's staining results showed that hypertrophy, rupture and interstitial fiber tissue hyperplasia were observed in myocardial fibers of overworked rats. Conclusion Overwork stress response may affect cardiac function as an independent factor and may even cause heart failure or arrhythmias and lead to death.

The Concept, Status Quo and Forensic Pathology of Karoshi / 法医学杂志

"Karoshi" originates from Japan's economic take-off period in the 1960s and 1970s. It is generally believed that overwork lead to the accumulation of fatigue, which triggers the outbreak of potential diseases, and results in sudden death. Karoshi causes great harm to both the community and families because it occurs primarily in 30 to 60 year old young adults. Japan put Karoshi into the category of industrial injury for the first time in 2001 and started to undertake a series of studies in the sociological and pathological fields. However, there is a tremendous gap in the forensic pathological diagnosis domain. In China, research on Karoshi started from the 1990s and is closely related to the reform and opening up policy as well as economic development. According to the incomplete statistics, 600 thousand people die from overwork each year in China, the highest in the world. Karoshi has become one of the most serious social problems in China at the present stage, thus a systematic study in the sociology and forensic pathology fields is urgently required. This paper summarizes the past and present status of Karoshi, and puts forward the problems that need attention during the judicial expertise of Karoshi from forensic pathology perspective.