Semirigid Ureteroscopy Therapy against Childhood Kidney Stones

Objective

The purpose of the current study was to assess the effectiveness of semirigid ureterorenoscopy (URS) as first-line therapy for early childhood patients with <20 mm stones in the pelvic, middle, or upper calices.

Methods

In all, 61 pediatric kidney stone patients who had flexible ureteroscopy (fURS) between January 1, 2010, and December 31, 2019, were included in this study. Before fURS, semirigid URS employed the UreTron or holmium: YAG (Ho : YAG) laser was conducted. When semirigid URS was unsuccessful, fURS was used for retrograde intrarenal surgery (RIRS). All participants were monitored clinically for a minimum of three months after each procedure.

Results

The patient's mean age was 4.52 ± 1.53 years, and 52 (83.61%) participants underwent semirigid URS successfully. Mean procedural duration of semirigid URS was 36.49 ± 7.72 min. The stone-free rate after semirigid URS was 92.16% (47/51). During the postprocedural medical observation, there were no serious adverse effects.

Conclusions

Based on the present study's findings, semirigid URS is a low-risk, effective therapy for kidney stones in selected pediatric patients.

[Clinical evaluation value of visual analogue scale combined with C-reactive protein for the prognosis of peritonsillar abscess]

Objective:The aim of this study is to investigate the clinical value of visual analogue scale combined with serum C-reactive protein in evaluating the prognosis of peritonsillar abscess. Method:Thirty-one patients be hospitalized with peritonsillar abscess were enrolled in this study, who were treated by puncture and antibiotic from January 2016 to February 2017. VAS and CRP level were detected on the 1, 3, 5 day of hospitalization for all the patients. Result:Twenty-five patients were cured after 5 days. The 1, 3, 5 day's VAS of forty-seven patients were 8.20±1.25, 4.42±1.05, 1.41±0.55, respectively, and the CRP level were (62.41±8.61), (20.46±5.32), (5.41±1.95)mg/L, respectively (P<0.05) in the three days. The 1, 3 day's VAS of six patients were 8.41±1.44, 7.37±1.15, respectively, and the CRP level were (59.85±8.35), (45.33±7.46)mg/L, with no significant difference (P>0.05) in the two days. But the fifth day' VAS was 1.55±0.65, and the CRP level was 10.24±2.57 mg/L, with statistically significant difference (P<0.05)) compared with the first day. Conclusion:Subjective evaluation used by VAS and objective evaluation used by CRP level to assess the prognosis of peritonsillar. Therefore, VAS score combined with C-reactive protein detection is more accurate for the prognosis of tonsil abscess evaluation..

Chronic alcohol administration affects purine nucleotide catabolism in vivo

AIMS

To investigate the relationship between chronic alcohol administration and purine nucleotide metabolism in vivo.

MAIN METHODS

Rat models of alcohol dependence and withdrawal were used. The concentrations of uric acid (UAC), urea nitrogen (UREA), creatinine (CREA), and beta-2-microglobulin (β2-M) and creatinine clearance rate (CCR) in plasma were measured. The PLC method was used to detect the absolute content of purine nucleotides in different tissues. Enzymatic activities of adenosine deaminase (ADA), xanthine oxidase (XO), ribose 5-phosphate pyrophosphokinase (RPPPK), glutamine phosphoribosylpyrophosphate amidotransferase (GPRPPAT), hypoxanthine-guanine phosphate ribose transferase (HGPRT), and adenine phosphoribosyltransferase (APRT) in the tissues were analyzed. Real-time PCR was used to determine the relative level of ADA and XO.

KEY FINDINGS

The renal function of rats with alcohol dependence was normal. Further, the content of purine nucleotides (GMP, AMP, GTP, and ATP) in tissues of the rats was decreased, which indicated that the increased uric acid should be derived from the decomposition of nucleotides in vivo. The activity of XO and ADA increased, and their mRNA expression was enhanced in the alcohol dependence group, but there was no significant difference in the activity of RPPPK and GPRPPAT in the liver, small intestine, and muscle; furthermore, no significant difference in the activity of HGPRT and APRT was observed in the brain.

SIGNIFICANCE

These results indicate that chronic alcohol administration might enhance the catabolism of purine nucleotides in tissues by inducing gene expression of ADA and XO, leading to elevation of plasma uric acid levels.

Association of body composition with bone mineral density in northern Chinese men by different criteria for obesity

With impressive economic development, obesity has emerged as a critical public health issue in China. Recently it was reported that obesity has taken an adverse effect on osteoporosis. Because there is different body mass index (BMI) for obesity globally, studies based on BMI levels on association of obesity with osteoporosis were quite few. Therefore, we discussed the relationship of body composition with skeletal BMD according to WHO BMI and BMI on Working Group on Obesity in China (WGOC).

METHODS

A total of 502 adult men aged 20-89 were enrolled as healthy subjects for osteoporosis study at Qianfoshan Hospital, Shandong University between September 2008 and August 2010. According to WHO BMI, all subjects were divided into three groups: normal weight (18.5 ≤ BMI < 25 kg/m(2), n = 202), overweight (25 ≤ BMI < 30 kg/m(2), n = 242), and obesity (BMI ≥ 30 kg/m(2), n = 58). According to WGOC BMI, normal weight (18.5 ≤ BMI < 24 kg/m(2), n = 137), overweight (24 ≤ BMI < 28 kg/m(2), n = 225), and obesity (BMI ≥ 28 kg/m(2), n = 140). Total body and regional BMD, lean mass (LM), lean body mass index (LBMI), fat mass (FM), percent body fat (%BF) and fat mass index (FMI) were measured by dual-energy X-ray absorptiometry. Age-partial Pearson correlation analyses between body composition-related parameters and BMD. Multiple regression analyses were performed to explore the associations of BMD with LM, LBMI, FM, %BF and FMI.

RESULTS

Fat mass (FM), %BF, FMI, LM and LBMI were positively correlated with BMD at almost sites (P < 0.001) in all subjects. However, the relationship was not different among groups. LM, LBMI, FM and FMI were positively correlated with BMD (P < 0.01) in normal weight. LM and LBMI appeared significantly positive with BMD in overweight and obesity according to WHO and WGOC criteria. %BF and FMI were negative significance with BMD at total body and some regional BMD according to WHO criteria in overweight (P < 0.05). In two obese groups, %BF appeared negatively significant with BMD (P < 0.05) according to WGOC criteria, and %BF and FMI appeared negatively significant with BMD (P < 0.05) according to WHO criteria. In regression of independent variables as FM and LM, LM showed statistically positively significant relations with BMD at almost sites (P < 0.05) in all groups. FM appeared positively significant with BMD in normal groups and overweight group according to WGOC criteria. In regression of independent variables as %BF and FMI, %BF and FMI appeared statistically negatively significant relations with BMD in overweight and obesity, but %BF and FMI were inconsistent in same site.

CONCLUSIONS

Lean mass (LM) and LBMI could help to determinant of BMD, and %BF and FMI were adverse to BMD in overweight and obesity. Comparing with two criteria, we found the differences in fat-related parameters and BMD according to WHO criteria were more obvious than that according to WGOC criteria. We also found that %BF and FMI were useful to research the relationship between osteoporosis and obesity at the same time.

Quantification of Phase Values of Cerebral Microbleeds in Hypertensive Patients Using ESWAN MRI

PURPOSE

The presence of cerebral microbleeds (CMBs) may have predictive and diagnostic value for cerebrovascular diseases. The purpose of our study was to measure the phase values (PVs) of CMBs by phase maps.

METHODS

We retrospectively analyzed 75 patients with hypertension who had CMBs using enhanced T2*-weighted angiography (ESWAN). The PVs of CMBs were measured and documented. The mean PVs of CMBs were correlated with demographic features and the grade of white matter lesions for seven brain regions.

RESULTS

A total of 275 CMBs were found. Their mean PV was - 1.39 ± 0.29 radians. The mean PV of CMBs in seven brain regions was significantly lower than that of red nucleus and substantia nigra of healthy controls (P <  .05). The mean PV of CMBs in the basal ganglia gray matter was significantly lower than that of the brainstem, subcortical white matter, and cerebellum (P < 0.05). In subcortical white matter, the PVs were significantly lower in patients with hypertension < 10 years than for those patients with hypertension ≥ 10 years (P < 0.05). In basal ganglia gray matter, the PVs were significantly lower in men than in women (P < 0.05). There was no significant correlation between the PVs of CMBs and the demographic features addressed or the grade of white matter lesions.

CONCLUSIONS

Measurement of the PV of phase maps using ESWAN sequence provides quantitative information for detection of CMBs. The measurement data reported herein will provide a reference for a longitudinal study of CMBs in the future.

[Electrophysiological effects of calcitonin gene-related peptide on isolated sinoatrial node of the rabbit]

The purpose of this study was to investigate the electrophysiological effects of calcitonin gene-related peptide (CGRP) on the pacemaker cell of rabbit sinoatrial node (SAN) and to determine whether I(Ca) is involved in the effects. Action potentials (AP) were recorded from the isolated SAN with microelectrode technique. It was found: (1) CGRP (1 nmol/L) had no effect on AP configuration; CGRP (10 nmol/L) increased the maximal diastolic potential, AP amplitude and depolarization velocity of 0 and 4 phases, and decreased sinus cycle length and AP duration. After applying CGRP for 20 min the above effects reached to a maximum. (2) CGRP (100 nmol/L) caused arrhythmia in the SAN. (3) Calcium channel antagonists, CdCl2 and verapamil attenuated the electrophysiological changes in AP of SAN induced by CGRP (20 nmol/L). The results indicate that a calcium-dependent mechanism may underlie the CGRP effects.

[Monitoring of FiO2 mask under nebulized oxygen therapy for post-heart surgery patients]

Using Oxygen-Meter measure FiO2 directly inside the patient's mask in different oxygen flow. The purpose was to realize the actual FiO2 that patient inspirated. So oxygen therapy can be carried on correctly and scientifically and provide basis for respiratory monitoring and management post heart surgery. When patient breathe in oxygen in mask nebulize way, a porbe of oxygen meter was put in through a side hole 10 minutes later, the result was recorded. It demonstrated that when oxygen flow was 5L/min FiO2 inside mask was 56% approximately 58%. That means it's not correct to determine FiO2 according to the oxygen flow meter. The oxygen-meter should be used to monitor in order to avoid complications caused by incorrect adjustment and ensure the post heart surgery patient to recovery quickly.