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Introduction Ureteroscopic lithotripsy has become the first choice for the treatment of middle and lower ureteral stones, but it still has a certain rate of surgical failure. Here we aimed to determine the factors that may affect the success rate of holmium laser ureterolithotripsy (HLU) and provide the basis and guidance for its future use. Aim To evaluate the risk factors for HLU failure. Material and methods The clinical data of 385 patients undergoing holmium laser ureterolithotripsy from 2009 to 2012 were retrospectively reviewed to analyze the impact of gender, age, stone side, stone size, stone location, stone number, degree of hydronephrosis, stone impaction, previous extracorporeal shock lithotripsy (ESWL), and associated urinary tract infection (UTI) on the success or failure of surgery. Results Surgical success was achieved in 338 (87.8%) patients versus surgical failure in 47 (12.2%) patients. Univariate analysis revealed that the degree of hydronephrosis (p = 0.024), stone impaction (p = 0.003), stone location (p = 0.012), and previous ESWL (p = 0.037) were risk factors for surgical failure. Multivariate logistic regression revealed that stone impaction (odds ratio (OR) = 2.66; p = 0.018) and stone location (OR = 2.11; p = 0.013) were significantly associated with surgical failure. Since some cases of ureterostenosis developed postoperatively, we continued follow-up. The patients had the stent for a year and underwent regular follow-up checks until 5 years. No cases of ureterostenosis recurred. Conclusions Ureteroscopic lithotripsy is a safe procedure with few complications. Stone impaction and proximal location are the risk factors for its failure.

Objectives: To evaluate the feasibility, efficiency, and safety of the transradial approach (TRA) for cerebral angiography versus the transfemoral approach (TFA) in patients. Methods: In this trial, 2314 patients underwent cerebral angiography, with 1085 patients undergoing the procedure via radial access and 1229 via transfemoral access. The arterial puncture time, operation success rate, oppression time on puncture points, local vascular complication incidence (including bleeding, hematoma, and pseudoaneurysm), deep venous thrombosis of lower limbs (DVT), and bradycardia/hypotension were observed and compared between the two groups. Results: Of the patients who underwent cerebral angiography via radial access, the procedure was successful in 1070 patients; compared with 1219 patients with transfemoral access, there was no significant difference (P > 0.05) in the success rate or the arterial puncture time. Radial access patients were less likely to present with oppression time on puncture points, local vascular complications, DVT, and bradycardia/hypotension compared with femoral access patients. Conclusions: For patients undergoing cerebral angiography, radial and femoral approaches are both safe and effective. However, the lower rate of local vascular complications may be a reason to use the radial approach. Keywords: Cerebral angiography, Transradial approach, Transfemoral approach, Intervention

Patients with urothelial carcinoma (UC) of the bladder have a high risk of death in China. However, a lack of comprehensive molecular profiling in Chinese Han population hinders the development of targeted therapies for bladder cancer. In our present study, we collected fresh bladder tumors from low-grade (T1, N0, M0, G1) non-muscle invasive bladder cancer (NMIBC) patients (n = 16) and high-grade (T2-4, N0, M0, Gx) muscle-invasive bladder cancer (MIBC) patients (n = 16) with their paired normal bladder tissues, and subjected the total genomic DNAs to targeted next-generation sequencing (NGS) for 94 cancer-associated genes. NGS results showed that 30.9% of detected genes (29/94) was mutated in 32 urothelial carcinoma bladder tissues. Furthermore, our results and ICGC database showed that FGFR3, KMT2D, TP53, KDM6A, and ARID1A were the most frequently mutated genes in UC patients. Of note, NMIBC and MIBC displayed distinguishable genomic alterations. FGFR3, KMT2D, AKT1, ARID1A, and STAG2 were the most frequently mutated genes in NMIBC patients, whereas mutations of TP53, CREBBP, FGFR3, KDM6A, KMT2D, and ARID1A were frequently detected in MIBC. Intriguingly, gene ontology and clustering analysis revealed that these frequently mutated genes were highly enriched in signaling pathways responsible for cancer development. Taken together, the mutation frequency of genes associated with UC development in NMIBC and MIBC was screened out in Chinese Han population and elucidation of the related mechanisms provides theoretical basis and technical support for the development of early diagnosis and therapeutic strategies in UC.

Metal balls are often used as standard bodies in the target RCS measure based on precise theoretical calculations, and the accuracy of RCS measure data is directly related to the experiment measure. This paper mainly studies the calibration of metal balls at high temperatures in target RCS measure. Firstly, the high temperature field of targets is analyzed, and it is found that the changes of amplitude and phase distributions of the electromagnetic field surrounding the heated target. Then the echo of the standard metal ball at the ambient temperature is obtained through experiments, and the data is used as the calibration. Several temperature points of the target ranging from 30° to 800°C are selected for RCS measure to obtain the standard body RCS data, and get the experiment error less than 0.5 dB based on the temperature dependence of RCS data of 200 mm diameter metal ball. Therefore, RCS data are not sensitive to the temperature below 800°C, so the high temperature performance measure of the stealth targets can be calibrated at ambient temperature, which can obviously improve the efficiency at the high temperature.

BACKGROUND This study was conducted to evaluate the performance of multislice computed tomography (MSCT) to diagnose high-density thymic cysts and thymomas in lesions measuring < 3 cm. METHODS The records of 42 patients admitted to Ningbo No. 2 Hospital with an anterior mediastinal mass (diameter < 3 cm) suspected of carcinoma originating from the thymus were retrospectively analyzed. All patients underwent surgery and pathological examination. Twenty-eight were diagnosed with thymic cysts and 14 with thymoma. The features of thymic cysts and thymomas revealed on MSCT were compared. RESULTS Mediastinal masses with a triangular or teardrop shape and a straight mediastina-lung border were more likely to be diagnosed as thymic cysts (P < 0.05), while those with a bulging nodule-lung border were more likely thymomas (P < 0.05). Using the CT value as a reference for differential diagnosis, the diagnostic sensitivity, specificity, and area under the receiver operating characteristic curve for CT values of non-contrast CT images, enhanced CT values, and ΔCT values were 0.65 (0.47-0.84), 0.95(0.86-1.00), and 0.96 (0.89-1.00), respectively. CONCLUSION MSCT of high-density thymus gland nodules (maximum diameter ≤ 3 cm) can reveal specific features that could be helpful for differential diagnosis.

People who suffers renal angiomyolipoma (AML) has a low quality of life. It is widely known that genetic factors including TSC2 mutation contribute to certain populations of renal AML-bearing patients. In this study, we are the first to identify novel TSC2 mutations in one Chinese renal epithelioid AML patient: c.2652C>A; c.2688G>A based on sequencing result from biopsy tissue. These two somatic mutations cause a translational stop of TSC2, which leads to mTORC1 activation. Given the fact that activation of mTORC1 ensures cell growth and survival, we applied its inhibitor, FDA-approved everolimus, to this woman. After months of treatment with everolimus, Computer-Tomography (CT) scan results showed that everolimus successfully reduced tumor growth and distal metastasis and achieved partial response (PR) to everolimu according to Response Evaluation Criteria in Solid Tumors (RECIST version 1.1). Further Blood Routine Examination results showed the concentration of red cell mass, hemoglobin, white blood cell (WBC), platelets and hematocrit (HCT) significantly returned to normal levels indicating patients with these two TSC2 mutations could be effectively treated by everolimus.

A good performance of motion capture, which belongs to body sensor network, depends on a reasonable design of MAC protocol. The purpose of this study is to design a reliable and highly extensible protocol for applying in motion capture. The proposed MAC protocol can easily be actualized by the timer in the chip. With this MAC protocol, the network would be built quickly. One or more nodes could be added easily in the net or deleted randomly from the net. In order to verify the superiority of this protocol, a series of experiments were designed. The results showed that the mean of simulation receive frames for node1-node7 from each stage were very close to the original frames. In addition, the final Pocket Loss Rates for node1-node7 were 0.081%, 0.175%, 0.143%, 0.249%, 0.248%, 0.044% and 1.897%, which could be in the error-allowed range. Thus, this protocol is stable and reliable, which can be widely used to capture human movement signal.

Due to the urgent need for high precision surgical equipment for minimally invasive spinal surgery, a novel robot-assistant system was developed for the accurate placement of pedicle screws in lumbar spinal surgeries. The structure of the robot was based on a macro-micro mechanism, which includes a serial mechanism (macro part) and a bi-planar 5R parallel mechanism (micro part). The macro part was used to achieve a large workspace, while the micro part was used to obtain high stiffness and accuracy. Based on the transfer function of dimension errors, the factors affecting the accuracy of the end effectors were analyzed. Then the manufacturing errors and joint angle error on the position-stance of the end effectors were investigated. Eventually, the mechanism of the strain energy produced by the deformation of linkage via forced assembly and displacements of the output point were calculated. The amount of the transfer errors was quantitatively analyzed by the simulation. Experimental tests show that the error of the bi-planar 5R mechanism can be controlled no more than 1 mm for translation and 1° for rotation, which satisfies the required absolute position accuracy of the robot.