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Objective To explore the computed tomography angiography(CTA)and clinical features of Takayasu's arteritis(TA)with peripheral artery involvement.Methods In this retrospective study,CTA scan was performed in a total of 184 TA patients.TA patients were divided into two groups:60 patients within peripheral artery involvement(peripheral artery involvement group)and 124 patients without peripheral artery involvement(peripheral artery non-involvement group).The difference in comparison of clini-cal data and CTA findings were analyzed.Results A total of 194 peripheral arteries were involved in 60 patients.The most suscep-tible peripheral artery were axillary artery(52,26.8％),middle cerebral artery(26,13.4％)and femoral artery(22,11.3％).In the peripheral artery involvement group,the most common CTA manifestation was luminal stenosis(141,72.7％).The lumen dilata-tion,lumen stenosis with dilatation and wall calcification were not easy to be observed.The age and duration of disease in peripheral artery involvement group were significantly greater than those in peripheral artery non-involvement group(P＜0.05).The proportion of the peripheral artery involvement group in the active phase was significantly lower than that of the peripheral artery non-involvement group(P＜0.05).The incidence of pain in the limbs in peripheral artery involvement group was significantly higher than that in peripheral artery non-involvement group(P＜0.05).The utilization rate of tocilizumab in the peripheral artery involvement group was significantly higher than that in the peripheral artery non-involvement group(P＜0.05).Conclusion TA involving peripheral arteries is more common in patients with a long course of disease and in the inactive phase.Patients are prone to pain in their limbs.The CT A manifestations of these patients are also special,that is,the involved peripheral arteries are not prone to lumen dilatation and wall calcification.
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Beijing Children's Hospital affiliated to the Capital Medical University set up a three-tiered system for hemophilia and explore solutions for local and remote referral modes.Through the establishment of electronic database,improving drug management,assisting medical insurance reimbursement and other auxiliary measures,it smooths the two-way referral path of children with hemophilia.It can rationally allocate medical resources,promote the development of local professional medical ability,make rational use of rare disease drugs,improve the efficiency of medical insurance funds,strengthen the service capability of children with rare diseases through the joint reform of three medical systems,and ensure the treatment of difficult and severe child patients,improve the accessibility of high-quality diagnosis and treatment,effectively reduce the financial burden of patients.
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Objective To evaluate the radiation protection of “four-in-one” dental X-ray equipment and to investigate the safety interlock of the equipment by measuring the scattered radiation at the position of the patient during operation. Methods A cone-beam CT dental phantom was used to simulate the patient’s head. The intra-oral and extra-oral components of the “four-in-one” X-ray equipment were installed in a 5 m2 room. The scattered radiation at patient position was measured using a γ/X-ray survey meter, and the effects of intra-oral and extra-oral components were compared. Results For a 5 m2 room, when CBCT was exposed under typical conditions, the dose at the patient's position was 10.70 uSv/h when there was an intra-oral component and 10.60 uSv/h when there was no intraoral component. The intra-oral part did not affect the radiation dose at the patient's position. When the intra-oral component was exposed, the dose rate at the patient's position was 4.05-6.85 uSv/h, and the extra-oral part did not affect the scattered dose of the patient examined with intra-oral components. Conclusion The evaluation of radiation protection of new equipment must comprehensively consider radiation safety and equipment operation safety. The results of this study provide suggestions for clinical radiation protection supervision and evaluation of “four-in-one” dental X-ray equipment.
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Objective An X-shaped cushioning insole with variable stiffness was designed to explore its effects on plantar pressure and internal stress of diabetic patients with toe amputation. Methods Based on CT images, the feet-calf finite element model of diabetic patients with toe amputation was established, and the insole was divided into different areas according to distribution characteristics of the planter pressure. The three-dimensional (3D) printed cushioning insole with an X-shaped sandwich structure was designed. The modulus of the sandwichstructure was changed by changing thickness of the sandwich structure panel. For simulation analysis, the divided area was filled with the X-shaped sandwich structure with different modulus. Results The peak plantar pressure of diabetic patients with toe amputation was in calcaneal region, and the combined insoles with 1. 2 mpanel thickness in toe area, 1. 4 mm panel thickness in metatarsal area, 2. 0 mm panel thickness in middle area and 1. 6 mm panel thickness in heel area had the best decompression effect. Compared with bare feet, the peak pressure in heel area of the insole, the peak pressure in phalangeal head area and the stress in plantar softissues were reduced by 40. 18% , 31. 7% , and 50. 44% , respectively. Conclusions The 3D printed insoles with variable stiffness can effectively reduce surface pressure and internal stress of the sole and reduce probability of the 2nd toe amputation
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With the rapid development of pet hospitals and the increasing application of radiological diagnosis in China, the protection of staff and assistants in these hospitals is worthy of attention. Based on the progress in international management and research with respect to radiological diagnosis and protection in animal hospitals, this paper presents a brief review of the current situation, existing problems and management regulations of animal hospitals in China. It summarizes typical issues that may be encountered in radiation protection by government departments, animal hospitals, radiation professionals and assistants in animal hospitals. It also puts forward the key points of radiation protection in animal hospitals in China, which can provide scientific suggestion to assist government in decision-making and standardizing and improving the radiation protection in animal hospitals.
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ObjectiveTo analyze the characteristics of plantar pressure of diabetic patients during gait cycle, and to design a offloading insole with variable stiffness. MethodsThe plantar pressure experiment was carried out and a database including 157 subjects was established. The differences of plantar pressure distribution were analyzed among diabetic patients with and without peripheral neuropathy, and healthy people. The insole pressure area was divided, and porous units were filled in different insole areas according to the pressure gradient. The fed-calf-insole finite element model of diabetic patients was constructed. The simulation analysis of different insole schemes was carried out under the conditions of push-off, footheel-strike and dynamic neutrality posture, and to explore the most reasonable insole stiffness design. ResultsCompared with the healthy group, the percentage of peak pressure and high pressure in the left and right heel areas of diabetic neuropathy patients showed a decreasing trend, in which the left peak pressure was significantly reduced by 11% (P = 0.026) and the percentage of high pressure was significantly reduced by 9.8% (P = 0.02). When the porous elements of 2.5 MPa and 1.9 MPa were used in the high pressure area of the insole metatarsal and high pressure area of the heel, the peak plantar pressure of footheel-strike, dynamic neutral and push-off was reduced by 42.4%, 27.4% and 26.4%, and the peak stress of the soft tissue was reduced by 49.8%, 43.6% and 25.1%, respectively. ConclusionThere is a higher risk of ulcer in the metatarsal region than in the heel region for diabetic patients. The variable stiffness insoles based on the optimization of plantar pressure and internal stress under multi-posture can effectively reduce the peak pressure of plantar and peak stress of soft tissue during walking, which provides a reference for the design of variable stiffness insoles.
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Objective:To analyze the radiological protection situation in the workplace of medical X-ray diagnostic equipment in primary medical institutions in south Xinjiang Uygur Autonomous Region, and then put forward necessary measures and suggestions.Methods:In accordance with the national medical radiation protection monitoring program and the requirements of relevant standards for radiological health, medical X-ray diagnostic equipment in radialogical diagnosis and treatment institutions was tested selectively for workplace radiological protection, with the result statistically analyzed.Results:From 2018 to 2021, radiological protection test was conducted for 84 workplaces in 15 radiological diagnosis and treatment institutions in 4 districts of south Xinjiang, with a pass rate of 98.8%, which was consistent with the mainland including the eastern and central regions in the country.Conclusions:Based on the current situation in radiological diagnosis and treatment institutions on medical radiation protection in south Xinjiang, it is recommended to strengthen the supervision and management of radiological diagnosis and treatment equipment, improve the testing and technical capabilities of the local medical radiation monitoring technical teams and raise the level of radiological health work in the south Xinjiang.
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Objective:To investigate the correlation between intraplaque hemorrhage (IPH) and new-onset embolic cerebral infarction after basilar artery angioplasty or stenting.Methods:Consecutive patients with severe basilar atherosclerotic stenosis underwent basilar artery angioplasty or stenting in the Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine from January 2015 to February 2022 were retrospectively enrolled. High resolution magnetic resonance vessel wall imaging (HRMR-VWI) and diffusion-weighted imaging (DWI) were performed within one week before procedure, and brain DWI or CT examination was performed within 72 h after procedure to determine the patients with new-onset embolic cerebral infarction.Results:A total of 32 patients were enrolled in the analyze. IPH existed in 10 patients with basilar artery culprit plaque, and 5 had new-onset embolic cerebral infarction after procedure. The incidence of embolic cerebral infarction in the IPH group was significantly higher than that in the non-IPH group (50% vs. 0%; P=0.001). The proportion of patients with IPH in the embolic cerebral infarction group was significantly higher than that in the non-embolic cerebral infarction group (100% vs. 18.5%; P=0.001). Conclusion:IPH may be associated with new-onset embolic cerebral infarction after basilar artery angioplasty or stenting.
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Female pelvic floor dysfunction is caused by pelvic floor dysfunction due to pelvic,pelvic organs and lumbosacral tissue lessions,deformities,tumors,trauma,surgery,pregnancy and dystocia.It is called bladder-urethral dysfunction associated with pelvic floor injury.Early diagnosis and targeted treatment of bladder-urethral dysfunction are the key to prevent upper urinary tract damage and obtain good curative effect.Nervous system and urodynamic monitoring are prerequisites for accurate diagnosis and reasonable treatment.
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Objective To study the correlation between female urination abnormalities and pelvic floor injury.Methods A total of 193 adult women with urination abnormalities from January 2015 to January 2017 were selected from Foshan Maternal and Child Hospital of Guangdong Province,including 84 cases of lower urinary tract symptoms (LUTS),71 cases of overactive bladder (OAB) and 38 cases of stress urinary incontinence (SUI).All patients aged 38-82 years (mean 51 ± 3.74) were enrolled according to their clinical symptoms.100 adult female patients without obvious symptoms such as abnormal urination were selected as the control group.Pelvic floor pain points were examined and scored in both groups.Results In the 193 cases,the number of pain points in LUTS,OAB and SUI were 1 093,983 and 415,respectively,a total of 2 491.The total pain scores of pain points were 7 163,6 480 and 2 583,with a total of 16 226 points.There were 100 cases in the control group with 527 pain points,and the total pain points were 1 377 points.According to the pelvic floor injury formula,the injury scores of the inspection group and the control group were calculated to be 3.59 vs 0.24 respectively,with statistically significant difference (P ＜ 0.01).The pelvic floor injury scores of LUTS group,OAB group and SUI group were 3.67,4.18 and 2.46 respectively,with statistically significant difference (P ＜ 0.01).Conclusions Overall,female urination abnormalities are significantly associated with pelvic floor injury,which are consistent with clinical observation.
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Objective To investigate the relationship between pelvic floor pain and pelvic floor injury in female patients with lower urinary tract disease.Methods Transvaginal and rectal pelvic floor acupressure was used to perform pelvic floor pain point examination in women with lower urinary tract disease.The number of tender points and the pain point of tenderness were recorded.R~ults The positive rate of pelvic pain points was 61.5％ (3 507 checkpoints,2 156 checkpoints had tenderness);there was a difference in the degree of pain caused by pain points in different regions (H =159.144,P ＜0.01).There was no difference in pain level between the P3 area,P4 and P5 areas and P2 (adjust P =1),and the pain points of the other areas were statistically different from the pain level (adjust P ＜ 0.01).Conclusions The density of tender points and degree of pain in pain points in female pelvic floor are related to the pelvic floor injury.It is of clinical significance to evaluate the degree of pelvic floor injury by taking the pelvic floor pain point.
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Objective To investigate the role of high mobility group box 1 (HMGB1) in hepatic endoplasmic reticulum stress (ERS) in rats with trauma. Methods Sixty SPF Sprague-Dawley (SD) rats were randomly divided into groups (n = 6). The rat model of liver injury following traumatic stress was established by continuous compressing the bilateral hind-limbs of rats for 3 hours and then intermittent compressing and decompressing for 30 minutes respectively three times with standard weight of 15 kg. The experiment 1 was divided into two groups: control group and 6, 18, 30 hours after crush. The experiment 2 was divided into control group, crush model group (18 hours after crush), HMGB1 inhibitor sodium butyrate (SB) or ethyl pyruvate (EP) groups, and SB or EP treatment groups (500 mg/kg SB solution or 40 mg/kg EP solution was injected intraperitoneally after 3 hours crush). The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum were measured with automatic biochemistry analyzer. Histopathological severity of liver injury was assessed by hematoxylin and eosin (HE) staining. The expressions of HMGB1 and ERS-related proteins were detected with Western Blot. The expression and translocation of HMGB1 in liver tissue were evaluated by immuno-histochemical technique. Results ① Compared with the control group, the pathological changes of liver injury, the levels of AST and ALT in serum and protein expression of HMGB1 as well as ERS-related proteins such as glucose regulated protein 78 (GRP78), caspase-12, and inositol-requiring enzyme 1α (IRE1α) in liver tissue were significantly increased after traumatic stress, and reached the peak at 18 hours. The expression of C/EBP-homologous protein (CHOP) was increased in a time-dependent manner and peaked at 30 hours after crush. Immunohistochemistry showed that HMGB1 expression increased at 6 hours after crush, some HMGB1 shifted from nucleus to cytoplasm, and the expression was more obvious at 18 hours. ② Compared with crush model group, the expressions of HMGB1 and ERS-related proteins were significantly decreased following the administration of HMGB1 inhibitors SB or EP (HMGB1/β-actin: 0.703±0.213, 0.512±0.075 vs. 1.041±0.186; GRP78/β-actin:0.614±0.052, 0.450±0.115 vs. 0.847±0.120; caspase-12/β-actin: 0.636±0.066, 0.812±0.142 vs. 1.086±0.130;CHOP/β-actin: 0.314±0.046, 0.621±0.123 vs. 0.996±0.764; IRE1α/β-actin: 0.473±0.033, 0.519±0.094 vs. 0.742±0.054, all P < 0.05), the levels of serum AST and ALT were significantly decreased [AST (U/L): 1 030.50±427.73, 1 414.50±347.86 vs. 2 122.20±322.76; ALT (U/L): 285.75±11.30, 368.50±80.58 vs. 473.80±33.54, all P < 0.01], the degree of acute liver injury was reduced. Only SB or EP could not affect the parameters mentioned above. Conclusion HMGB1-ERS pathway was involved in mediating traumatic stress-induced acute liver injury in rats.
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Objective To investigate the difference between histopathological changes of brain white matter in low-density lipoprotein receptor (LDLR) homozygous mutation rats with hypercholesterolemia and wild-type rats.Methods Thirty LDLR-/-rats and 28 wild-type rats were selected.Plasma cholesterol levels were measured by enzyme-linked immunosorbent assay at 15,18 and 26 weeks old respectively.The axonal structure of the corpus callosum area was observed by transmission electron microscopy.The myelin basic protein (MBP) of the corpus callosum area was quantitatively analyzed by Western blotting.In addition,at 26 weeks old,the myelin sheaths were stained by fast blue staining.The expression level of MBP in white matter was further detected by immunofluorescence staining,and the morphological changes of glial cells were observed.Results Compared with the wild-type rats,the plasma cholesterol concentration in LDLR-/-rats increased significantly,and it could be as high as 3.3 times at 26 weeks.The results of electron microscopy showed that the LDLR-/-rats had axonal injury at 15 weeks and aggravated gradually over time.At 26 weeks,Western blot analysis of the LDLR-/-rats showed that the MBP expression level of the corpus callosum area decreased significantly.Fast blue staining showed loosening of nerve fibers,diffuse vacuole formation,and myelinated nerve fiber loss in the corpus callosum area.In addition,it was also found that the number of oligodendrocytes in LDLR-/-rats was significantly reduced,and large numbers of astrocytes and microglia were activated.Conclusions LDLR-/-rats will have spontaneous hypercholesterolemia.Axonal injury,demyelination,decreased oligodendrocytes,as well as the abnormal activation of astrocytes and microglia are present in the early adult brain white matter area.
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Congenital cryptorchidism is one of the most common congenital anomalies of the male genitalia.Early treatment for cryptorchidism can help to reduce the occurence of infertility,testicular cancer and torsion.Because the mechanism of testicular is very complex,the efficiency of drug treatment is only 20％,and the long-term impact has been uncertain.Thus hormonal therapy in cryptorchidism is still controversial.Some progresses in hormonal treatment of congenital cryptorchidism in recent years are reviewed is this article.
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Congenital cryptorchidism is one of the most common congenital anomalies of the male genitalia.Early treatment for cryptorchidism can help to reduce the occurence of infertility,testicular cancer and torsion.Because the mechanism of testicular is very complex,the efficiency of drug treatment is only 20％,and the long-term impact has been uncertain.Thus hormonal therapy in cryptorchidism is still controversial.Some progresses in hormonal treatment of congenital cryptorchidism in recent years are reviewed is this article.
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Objective To discuss the correlation between female chronic pelvic pain and pelvic floor anatomy.Methods The female patiems of chronic pelvic pain 179 cases,age 28-67 years,average 49.4 years;pelvic pain history 8 months-9 years,average 2.8 years;167 cases has childbirth history,43 cases has surgery history,which gynecological surgery 31 cases,and urinary surgery 7 cases,and anus surgery 5 cases.Results High incidence of female pelvic pain were 30-60 age (incidence of 54.8％),93.3％ has birth history,24％ has operation history,the myofascial tissue pain higher than the organ,were 87.4％ than 12.6％ (P ＜ 0.01),the front of pelvic pain higher than back,were 65.6％ than 21.8％ (P ＜ 0.01).Conclusions Female chronic pelvic pain associated with the particularity of the pelvic anatomy and physiological,with the tissue of pelvic floor and urogenital diaphragm of primary injure and chronic inflammation is an important cause of chronic pelvic pain.
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The pelvic floor dysfunction associated lower urinary tract disease.It is women who often multiple diseases,is closely related to the perineum and urogenital diaphragm tissue of old injury and chronic inflammation caused by pregnancy,childbirth,surgical delivery,injection of pelvic trigger point and interventional treatment for the pelvic floor dysfunction associated lower urinary tract diseases is significance.
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According to the demand of the State Department and Health and Family Planning Commission,to promote the development of healthy service industry,improve the health care services and accelerate the development of health industry,as well as the explore of the status of population,society and economic development in China in recent years,it preliminarily discussed care industry.It aimed to discuss the nursing industry;improve the problems of insufficient nursing industry population and unreasonable allocation for the current nursing resources;propose the innovation of health care to satisfy the increasing health care demand of the special population in China;discuss the industrialization of health care,establish the feasibility of health care industrial clusters and preliminarily discuss the development of the care industry.
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Radical cystectomy surgery is the main surgery for muscle invasive bladder caner and some high-risk non-invasive bladder cancer.It is the most complex surgery in Urology and is accompanied by the most of complications.Enhanced recovery after surgery aims to mitigate the surgical stress response,which can reduce the morbidity of complications,hospital stay time and the cost.This article is to summarize the enhanced recovery after surgery protocols in radical cystectomy surgery.
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AIM:To investigate the effects of high plasma triglyceride (TG) caused by apolipoprotein C Ⅲ( ApoC Ⅲ) transgene on the occurrence and development of abdominal aortic aneurysm ( AAA) .METHODS:The animal models of hypercholesterolemia and hypercholesterolemia combined with hypertriglyceridemia were established by feeding high-fat diet to LDLR-/-and ApoC Ⅲ+LDLR-/-mice, respectively.AAA was induced in these mice by pancreatic elastase. By evaluating the incidence of AAA, relative maximal abdominal aortic diameter, disruption of the elastic lamellar structure and expression of matrix metalloproteinases ( MMPs) in the aorta walls of the AAA, the occurrence and development of AAA were compared in LDLR-/-and ApoC Ⅲ+LDLR-/-mice fed with either chow diet or high-fat diet.In addition, an in vitro TNF-α-induced aneurysmal microenvironment model on vascular smooth muscle cells ( VSMC) was used to study the impact of triglyceride-rich lipoproteins ( TRLs) from mice with normal or high contents of ApoCⅢon elastin protein expres-sion.RESULTS:Feeding the high-fat diet aggravated the severity of AAA in the LDLR-/-mice.ApoC Ⅲ+LDLR-/-mice fed with high-fat diet had less severe AAA than LDLR-/-mice fed with high-fat diet.TRLs inhibited degradation of VSMC elas-tin protein induced by TNF-α, and in vitro TRLs from the mice with high content of ApoC Ⅲ, compared to those with nor-mal content of ApoC Ⅲ, had better inhibitory effect on the degradation of elastin.CONCLUSION:High plasma TG caused by ApoC Ⅲtransgene alleviates AAA of the LDLR-/-mice induced by elastase and high-fat diet.The effect is probably attrib-uted to the hypertriglyceridemia caused by ApoC Ⅲtransgene.