加压冲洗系统在膀胱结石碎石术中的应用研究

目的评价气压弹道碎石加压冲洗系统在电切镜外鞘辅助输尿管镜气压弹道碎石取石术处理膀胱结石的应用价值。方法分析陕西省宝鸡市中心医院3年内接受气压弹道碎石术的膀胱结石患者的临床资料,123例患者随机分为两组:A组62例,采用加压冲洗系统电切镜外鞘辅助输尿管镜气压弹道碎石取石术;B组61例,采用艾力克吸引球辅助电切环结合输尿管镜气压弹道碎石取石术。术后均常规留置三腔导尿管。比较两组的手术时间、结石清除率及术后并发症等情况。结果全部患者成功碎石取石,两组的碎石时间比较有差异(P<0.05);术后随访3~12个月,两组泌尿系超声及腹平片复查均未见结石残留及复发。结论术中应用气压弹道碎石加压冲洗系统可以缩短电切镜外鞘辅助输尿管镜气压弹道碎石术清石时间,该方法处理膀胱结石安全有效,值得推广应用。

Investigating adolescent mental health of Chinese students during the COVID-19 pandemic:Multicenter cross-sectional comparative investigation

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has caused significant challenges for adolescent mental health.AIM To survey adolescent students in China to determine the effects of the COVID-19 pandemic on their mental health.METHODS A multicenter cross-sectional comparative investigation was conducted in March 2022.We collected demographic information and survey data related to the COVID-19 pandemic.The Patient Health Questionnaire-9 and Generalized Anxiety Disorder Screener scales were used for objective assessment of depression and anxiety.RESULTS We collected mental health questionnaires from 3184 students.The investigation demonstrated that adolescents most strongly agreed with the following items:Increased time spent with parents,interference with academic performance,and less travel.Conversely,adolescents most strongly disagreed with the following items:Not having to go to school,feeling an increase in homework,and not socializing with people;34.6%of adolescents were depressed before COVID-19,of which 1.9%were severely depressed.After COVID-19,26.3%of adolescents were prone to depression,of which 1.4%were severely depressed.24.4%of adolescents had anxiety before COVID-19,with severe anxiety accounting for 1.6%.After COVID-19,23.5%of adolescents were prone to anxiety,of which 1.7%had severe anxiety.CONCLUSION Chinese adolescents in different grades exhibited different psychological characteristics,and their levels of anxiety and depression were improved after the COVID-19 pandemic.Changes in educational management practices since the COVID-19 pandemic may be worth learning from and optimizing in long-term educational planning.

Expression,clinicopathologic,and prognostic significance of MMP15 in operable pancreatic ductal adenocarcinoma

Objective:Matrix metalloproteinase 15(MMP15)has been previously reported to be involved in many cancers.However,its expression pattern in pancreatic ductal adenocarcinoma(PDAC)remains contradictory.In addition,its clinicopathologic and prog-nostic significance in this malignancy has not been elucidated.Methods:Expression of MMP15 was immunohistochemically detected in a tissue microarray of formalin-fixed paraffin-em-bedded samples from 95 patients of PDAC after surgery.Its expression pattern and relations with clinicopathologic factors and disease-specific survival(DSS)were then evaluated.Finally,its expression and prognostic value were measured in the on-line publically available database,GEPIA,using TCGA data.Results:In comparison of all samples and 75 paired ones,MMP15 expression in tumor tissues was all significantly higher than that in para-tumor ones(P=.037 and.016).Furthermore,tumoral MMP15 expression was associated with peri-neural invasion.Survival anal-ysis showed that patients with high tumoral MMP15 expression had significantly poorer DSS than those with low MMP15 expression(P=.0059).In univariate and multivariate Cox regression tests,tumoral MMP15 expression was all significantly predictive for DSS.In the on-line publically available GEPIA database,MMP15 was also overexpressed in PDAC,but was not found to be prognostic.Conclusion:Our results indicated that MMP15 expression was elevated in operable PDAC and might have a prognostic impact.

Effect of Right Heart Systolic Function on Outcomes in Patients with Constrictive Pericarditis Undergoing Pericardiectomy

Background： To determine the influence of right ventricular function in patients with constrictive pericarditis （CP） undergoing surgery and to compare the outcomes of patients who received surgery with those managed medically. Methods： Patients with the diagnosis of CP and healthy volunteers were recruited from January 2006 to November 2011. Patients with CP chose to either receive pericardiectomy or medical management. Echocardiographic measurements were performed to evaluate heart function, and survival was recorded. Results： A total of 58 patients with CP （36 received pericardiectomy, 22 managed medically）, and 43 healthy volunteers were included. CP patients who received surgery had a higher survival rate than those managed medically （P = 0.003）, and higher st, rvival was also seen in the subgroup of CP patients with severely impaired right systolic function. Albumin level, left ventricular end-diastolic dimension, and tricuspid regurgitation velocity were associated with survival in CP patients who received surgery. Conclusions： Preoperative right heart function does not affect surgical outcomes. Patients with severely impaired preoperative right systolic function obtain a greater survival advantage with surgery than with medical treatment.