Complicated Bosworth fracture-dislocation: A case report and review of the literature / 中华创伤杂志(英文版)

Bosworth fracture and dislocation is relatively rare, accounting for about 1% of ankle fractures. It is characterized by the proximal fibula fracture embedded in the posterolateral distal tibia. Due to an insufficient understanding of this fracture, it is easy to cause missed diagnosis and misdiagnosis in clinical practice. Due to the insertion of the fracture, it is challenging to perform closed reduction, and improper treatment is easy to cause complications. Surgical treatment is recommended for this type of fracture. In order to improve the understanding of orthopedic surgeons about Bosworth fracture and dislocation, this paper reports the diagnosis and treatment of 2 cases of Bosworth fracture and dislocation, and reviews the literature on Bosworth fracture's mechanism, diagnosis, classification, complications, and treatment options in recent years.

Evidence mapping analysis of traditional Chinese medicine intervention in pulmonary fibrosis / 中国中药杂志

This study utilized evidence mapping methodology to systematically identify, describe, and evaluate the evidence from relevant research on traditional Chinese medicine(TCM) interventions in patients with pulmonary fibrosis. CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, EMbase, and Cochrane Library were searched from database inception to March 2023 for systematic reviews/Meta-analysis/network Meta-analysis on TCM interventions in pulmonary fibrosis. The quality of included studies was assessed using the AMSTAR 2 scale, and the evidence mapping approach was employed to present comprehensive information on populations, intervention methods, the sample size in systematic reviews/Meta-analysis, and conclusion classifications. Ultimately, 44 systematic reviews/Meta-analysis/network Meta-analysis were included. Apart from syndrome differentiation and treatment, TCM injections accounted for a significant proportion of the observed interventions. The treatment methods were mainly focused on nourishing Qi and Yin, promoting blood circulation, resolving stasis, and dredging collaterals. The results from the included studies demonstrated that TCM treatment for pulmonary fibrosis could improve efficacy, increase lung function, improve PaO_(2 )levels, increase the 6-minute walk distance(6MWD), alleviate clinical symptoms, and enhance patients' quality of life. Based on the assessment using the AMSTAR 2 scale, methodological issues were identified, including the lack of protocol registration, failure to provide a list of excluded literature, and incomplete explanations regarding the impact of heterogeneity and bias on the results. The evidence mapping revealed that 42 conclusions were beneficial, while two conclusions were potentially beneficial. Overall, the quality of evidence was relatively low, primarily due to methodological imprecision and publication bias. Although TCM showed certain efficacy in the treatment of pulmonary fibrosis, the quality of reported literature, methodological quality, and overall evidence quality need improvement. It is recommended to conduct high-quality and standardized studies in the future to provide better evidence-based guidance.

Construction of HMGA2 knockout model of human papillary thyroid cancer cell line TPC-1 / 中华内分泌外科杂志

Objective:To construct a TPC-1 cell model that stably knocks out the HMGA2 by using CRISPR/Cas9 gene editing technology. Methods:Recombinant pLV[2gRNA]-EGFP:T2A:Puro- U6> {hHMGA2 [gRNA# A1]*}- U6>{hHMGA2 [gRNA#A2]*} of lentiviral plasmid vector was constructed: targeting HMGA2 Dual-gRNA sequence was designed, the synthesized Dual-gRNA fragment into pLV [2gRNA]-EGFP was cloned: T2A:Puro-U6 vector, extract a single clone for sequencing verification. the constructed recombinant plasmid vector with lentivirus was packed, and TPC-1 cells were infected, puromycin was used to obtain HMGA2 knock-out single clone, PCR and sequencing verification were performed, and real-time fluorescent quantitative qPCR was used to detect HMGA2 mRNA in cells Knockout efficiency. Results:After sequencing verification, pLV [2gRNA]-EGFP targeting HMGA2: T2A: Puro-U6>{hHMGA2 [gRNA#A1]*}-U6>{hHMGA2 [gRNA #A2]*} plasmid was successfully constructed; A single clone was picked for PCR identification and gene sequencing, TPC-1 cells were successfully obtained with HMGA2 gene completely knocked out; TPC-1 cells with HMGA2 knocked out were detected by real-time fluorescent quantitative qPCR, and they did not express HMGA2 mRNA.Conclusion:CRISPR/Cas9 gene editing technology enables us to construct a human papillary thyroid cancer cell line TPC-1 cell model with stable knockout of HMGA2.

Predictive effect of central lymph node intensity on lateral lymph node metastasis for papillary thyroid carcinoma / 中华内分泌外科杂志

Objective:To investigate the risk factors and predictive effect of lateral cervical lymph node metastasis of papillary thyroid carcinoma (PTC) by applying the concept of central lymph node metastasis intensity.Methods:This study retrospectively analyzed integrated clinic data of 106 cases with PTC undergoing treatment of cervical lymph node dissection in Department of Thyroid and Breast Surgery of the Affiliated Hospital of Inner Mongolia Medical University from Dec. 2009 to Jan. 2014. Based on whether lateral cervical lymph nodes had metastasis, patents were classified into lymph node metastasis positive group ( n=75 cases) , lymph node metastasis negative group ( n=31 cases) . This study explored metastasis-associated risk factors of age, gender, triiodothyronine (T3) , thyroxine (T4) , free triiodothyronine (FT3) , free thyroxine (FT4) , thyroid stimulating hormone (TSH) , thyroglobulin antibody (TGAb) , thyroid peroxidase antibody (TPOAb) , whether combined with Hashimoto’s disease, tumor location, infringing the membrane, mulifocality, tumor glands distribution, tumor diameter, number of central lymph node metastases, central lymph node metastasis ratio, and analyzed the effects of central lymph node metastasis intensity on lateral cervical lymph node metastasis. SPSS 21.0 software was used for data analysis, the metering data of normal distribution was expressed as ± s, and t test was used for comparison between groups. Count data was expressed as a rate (composition ratio) , and comparisons between groups were performed by χ2 test or Fisher exact probability method. Results:Univariate analysis found that whether combined with Hashimoto’s disease ( P=0.087) , tumor location ( P=0.249) , tumor glands distribution ( P=0.219) and tumor diameter ( P=0.224) had no correlation with lateral cervical lymph node metastasis, which showed no statistical significant differences ( P>0.05) . Infringing the membrane ( P=0.030) , mulifocality ( P=0.031) , number of central lymph node metastases ( P=0.022) and central lymph node metastasis ratio ( P=0.001) had correlation with lateral cervical lymph node metastasis, which showed statistical significant differences ( P<0.05) . The number of central lymph node metastases and the increase of central lymph node metastasis ratio had positive correlation with the occurrence of lateral cervical lymph node metastasis; when the number of central lymph node metastases was ≥4 or (and) the central lymph node metastasis ratio was ≥20%, the incidence of lateral cervical lymph node metastases increased significantly, and the difference was statistically significant ( P<0.05) . Conclusion:Infringing the membrane and mulifocality are risk factors for lateral cervical lymph node metastasis. When central lymph node metastasis intensity: number of metastases ≥4 or (and) metastasis ratio ≥20%, lateral cervical lymph node dissection is recommended.

Simple nucleus pulposus removal for the treatment of prolapsed and displaced lumbar disc herniation / 中国骨伤

OBJECTIVE@#To explore the clinical effect of the simple nucleus pulposus removal and small incision interlaminar window in the treatment of prolapsed and displaced lumbar disc herniation.@*METHODS@#From February 2016 to February 2018, 35 patients with single-segment prolapse and displaced lumbar disc herniation were treated by the simple nucleus pulposus removal and small incision interlaminar window under general anesthesia. Among them, there were 21 males and 14 females;aged (42±17) years;27 cases of L@*RESULTS@#All the operations were successful and the operation time was 30 to 60 min with an average of 40 min, the intraoperative blood loss was 10 to 30 ml with an average of 20 ml. All the patients were followed up for 1 to 3 years with an average of 1.2 years. Thirty-five patients with low back pain and lower limb symptoms were significantly relieved or disappeared. According to modified Macnab standard, 29 cases obtained excellent results, 5 good, and 1 fair.@*CONCLUSION@#Applying the concept of minimally invasive operation, small incision interlaminar window and simple nucleus pulposus removal for the treatment of prolapsed and displaced lumbar disc herniation has the advantages of short operation time, definite curative effect, and less trauma. And it is a safe and effective surgical method under the premise of strict control of the indications.

Regularity of prescription medication of Xin'an Wang's internal medicine in treating stomach cramps based on data mining / 中国中药杂志

The study analyzes the medication rules of Xin'an Wang's internal medicine for treating stomach cramps by data mining technology,in order to provide reference for clinical medication. Through the summarization of the medical cases of stomach cramps treated by Xin'an Wang's doctors( Wang Ren-zhi,Wang Zhong-qi,Wang Le-tao),statistics was made for the frequency of symptoms,signs,syndromes and drugs in Office 2010. Apriori algorithm in IBM SPSS Modeler 14. 1,and SPSS Statistics 22. 0 were used for association rule analysis and cluster analysis. The results showed that the 310 prescriptions collected involved totally 322 syndromes( including symptoms and signs) and 336 drugs,with the cumulative dose of 4 072 times; the symptoms were correlated to the spleen and stomach,liver and gallbladder,and the heart system; syndrome differentiation was mainly based on liver-Qi invasion of the stomach,diet impairment to the stomach,deficiency of spleen and stomach and cold syndrome; commonly used drugs were Qi regulating drugs,phlegm eliminating drugs and blood circulation promoting and stasis removing drugs; high-frequency drug complex network diagram showed that Pinelliae Rhizoma,Aurantii Fructus,Trichosanthis Fructus,Allii Macrostemonis Bulbus were closely related; the analysis showed 12,20,and 17 two,three,and four association rules; cluster analysis showed 10 pairs of Trichosanthis Fructus-Allii Macrostemonis Bulbus,Pinelliae Rhizoma-Aurantii Fructus,and Aspongopus-Toosendan Fructus drug combinations. According to Xin' an Wang's doctors,stomach cramps are closely related to liver and spleen,Qi stagnation,phlegm and blood stasis are the standard.Xin'an Wang's doctors give the first priority on " deoppilation",focus on soothing the liver and spleen,activating Qi and eliminating phlegm,and promoting blood circulation,and refer to use modified Xiaoxianxiong Decoction and modified Gualou Xiebai Banxia Decoction based on symptoms.

Effects of calcium ionophore A23187 on proliferation ,cycle and expression of caspase-3 in hepatic stellate cells stimulated by transforming growth factor-β1 / 西安交通大学学报(医学版)

Objective To study the effect of calcium ionophore A23187 on the proliferation , cycle and expression of caspase-3 in rat hepatic stellate cells by stimulated transforming growth factor Bata 1 (TGF-β1 ) . Methods Hepatic stellate cells were cultured in 37 ℃ and 50 mL/L CO2 incubator .The cells were divided into 5 groups:blank group ,TGF-β1 (5 ng/mL) group ,TGF-β1 +low-,medium-and high-dose calcium ionophore A23187 groups:5 ng/mL TGF-β1 stimulation for 24 h ,and then 1μmol/L ,2μmol/L and 4 μmol/L of calcium ion carrier A23187 was added and treated for 24 h .The cells proliferation was detected by MTT .The cell cycle was detected by flow cytometry and the expression of caspase-3 was detected by immunoblotting .Results Different concentrations of calcium ionophore A23187 could significantly inhibit the proliferation of cells ( P< 0 .05 ) . And the dose of calcium ionophore A23187 increased ;RGR in the low-,medium-and high-dose groups was 85 .93% ,61 .71% ,and 48 .43% (P<0 .05) .There was significant difference between the two groups (P<0 .05) .The higher the dose of calcium ionophore A23187 ,the higher the proportion of G1 phase cells ,the lower the ratio of S+ G2 cells ( P<0 .05) ,with significant difference (P<0 .05) .With the increase of calcium ionophore A23187 concentration ,the expression of caspase-3 protein increased significantly ( P< 0 .05 ) . Conclusion Calcium ionophore A23187 prevents hepatic stellate cells from G1 phase to S phase and G2 phase ,inhibits its proliferation and up-regulates the expression of caspase-3 .

Hypertension Management System Based on Mobile Intelligent Computation / 医学信息学杂志

In this paper,a hypertension management system based on mobile intelligent computation is built,intorduces its overall architecture and function realization.The user side can implement collection and monitoring of body signs,behavior monitoring,hypertension riskassessment and emergence help,etc.In addition,the doctor side can assist the doctor in diagnosis service.With the help of this system,the user can know his/her physical status and make self-adjustment in time,and the doctor can quickly track the progressof the patient and provide health guidance.As a result,the personalized hypertension management for both the doctor and the patient can be achieved.

Pulmonary arterial hypertension as leading manifestation of methylmalonic aciduria: clinical characteristics and gene testing in 15 cases / 北京大学学报(医学版)

Objective:To deepen our understanding of Methylmalonic aciduria (MMA) associated pulmonary hypertension (PH) by analyzing the characteristics of clinical presentation,pulmonary high resolusion CT(HRCT),treatment response and gene mutation.Methods:This study includes 15 cases of pediatric patients with MMA associated PH diagnosed and treated in Peking University First Hospital pediatric department between May 2012 and May 2016 with symptoms of PH as their leading presentation.Clinical symptoms and signs were recorded,Routine blood laboratory examinations was done including arterial blood gas analysis.Plasma total homocysteine (Hcy) and brain natriuretic peptide (BNP) level were measured.MMA gene mutation was analyzed.Chest HRCT was done in most of the patients.Standard treatment strategy to MMA and PH was given and follow up study was done,and the related literature was reviewed.Statistical analysis was done.The diagnosis of MMA was made by methylmalonic acid level ＞ 100 times the normal value in the urine.The diagnosis of PH was made by pulmonary arterial systolic pressure (PASP) ＞ 40 mmHg,which was estimated by the measurement of tricuspid regurgitation velocity through Doppler Echocardiography.Results:(1) Patient characteristics:There were 10 male and 5 female patients diagnosed as MMA associated PH,aged 0.5 to 13.8 years,with an average of (5.0 ± 4.3) years.The age of onset of PH was (3.7 ± 3.5) years,with an early onset type MMA in 5 cases and late-onset type in 10 cases.(2) Clinical presentation:Among the 15 cases of MMA,the first symptoms were associated with PH in 10 cases,so PH and MMA were diagnosed at the same time,and PH was diagnosed 3 to 72 months post MMA presentation in the other 5 cases.The main presentations of PH were techypnea/dyspnea and cyanosis in 11 cases each,weakness and fatigue on exertion in 6 cases,and edema in 4 cases.PH WHO functional classification (WHO FC) was Class Ⅱ in 4,Class Ⅲ in 5 and Class Ⅵ in 6 cases,with an average of Class 3.1 ± 0.8.Multi-system involvements were common with the highest frequency in the kidney (14 cases).Macrocytic anemia was present in 8 cases and subclinical hypothyroidism in 5 cases,and mild to moderate mental retardation in 4 cases.(3) Laboratory examination:PASP of the 15 patients was from 49 to 135 mmHg,with an average of (90.3 ±23.9) mm Hg.Total blood Hcy level was severely elevated to (121.2 ± 48.2) μmol/L (range:35.0-221.0 μmol/L),and Hcy ＞ 100 μmoL/L within 11 cases.Plasma BNP level was also elevated,median 794 ng/ L (range:21.0-4 995.0 ng/L) with 12 cases ＞ 300 ng/L.Blood gas analysis showed low arterial blood oxygen saturation between 70％ and 94％,with an average of 81.4％ ±8.4％.(4) Chest HRCT:chest HRCT showed a diffuse ground-glass centrilobular nodular opacities with septal line thickening in the lungs in 9 cases,and with associated mediastinal lymph node enlargement in 1 case,which indicated pulmonary veno-occlusive disease (PVOD),a rare type of pulmonary arterial hypertension (PAH).There was lung infection or edema in 3 cases,and interstitial infiltration and mesh-like feature in other 3 cases,which was inferred to interstitial lung disease.(5) Gene mutation:Genetic testing was done in 10 cases,totally 5 reported disease-causing mutations were found.There were 100％ presence of MMACHC c.80A ＞ G mutation in all the 10 patients tested,with the allelic genes of c.609G ＞ A mutation in 6 patients,including a sister and a brother from the same parents.(6).Treatment and follow up:Intramus cular hydroxocobalamin or vitamin B12 was given to all of the patients,together with betaine,levocarnidtine,folinic acid and vitamin B6.According to the severity of PH,single or combined PAH targeted drugs was given to 11 cases.By an average of (20.0 ± 13.5) days of in-hospital treatment in 13 patients (excepting 1 case treated as outpatient),symptoms remarkably resolved,WHO FC reduced to an average of Class 2.4 ±0.9,PASP dropped to (69.4 ±21.3) mmHg,and plasma Hcy and BNP level were decreased to (74.9 ± 25.9) μmol/L and (341.6 ± 180.2) ng/L,respectively.The above values all reached statistical significance (P ＜ 0.05) compared with each related value before treatment.Therewere 2 patients who expired during hospitalization despite of treatment.At the end of 3 months' follow up,all of the 13 patients disposed oxygen,and PASP significantly dropped to 38.7 ± 7.9 mmHg,and plasma BNP returned to normal,but plasma Hcy level showed no further decline.At the last follow up of 27.5 ± 19.0 (range:11-64) months,all the patients' PASP remained normal except for the 13.8-year-old boy with 6 years-long history of MMA and almost 3.6 years' history of PH still having PASP 58 mmHg.Conclusion:PH is a severe complication of MMA combined type,especially cblC type,it is more often happens in late-onset type of male patients and can be the first and leading manifestations of MMA.Its clinical symptoms are urgent and severe,characterized by tachypnea/dyspnea and cyanosis,and sometimes right heart failure,hypoxemia is usually present,chest HRCT is often indicative of PVOD,lung edema and interstitial lung disease may occur.Rapid diagnosis and targeted treatment of MMA with appropriate anti-PAH mcdication can reverse PH and save life.MMACHC gene c.80A ＞ G mutation may be the hot point of MMA cblC type associated PH.

Effect of grape seed proanthocyanidins on phenotype marker protein of renal cells in db/db mice / 临床与实验病理学杂志

Purpose To investigate the effect of grape seed proanthocyanidins on the phenotype-transforming marker protein expression of db/db renal cells in mice model of type 2 diabetes,and to explore the protective mechanism of grape seed extract on diabetic renal injury in db/db mice.Methods Male db/db diabetic mice were randomly divided into two groups:diabetic group (db/db group) and diabetic + grape seed proanthocyanidin extract group (db/db + GSPE).The same week-old male db/m mice was used as normal controls (db/m) and grape seed proanthocyanidin extract gavage treatment group (db/m +grape seed proanthocyanidin extract group,db/m + GSPE).The mice of db/db + GSPE group and db/m + GSPE group were administered daily with grape seed proanthocyanidin extract (5mg/kg) by gavage.Results Renal tissues of db/db diabetic mice showed increased expression of α-SMA,p-p38MAPK,pERK1/2 and 8-OHdG level,and down-regulation in E-cadherin expression compared with db/m group (P ＜ 0.05).However,the alternations of α-SMA,p-p38,p-ERK1/2,E-cadherin protein levels,and 8-OHdG level,in db/db group were reversed by addition of grape seed proanthocyanidin extract (P ＜ 0.05).Conclusion Grape seed proanthocyanidin extract inhibits the epithelial to mesenchymal transition (EMT) associated protein,by decreasing ROS production,and activating p38 MAPK and ERK1/2.These findings suggest that grape seed proanthocyanidin extract provides a treatment option for diabetic nephropathy.

Stabilities and related mechanism of sulfobutyl ether-β-cyclodextrin liposomes loaded with asparaginase / 中国药理学通报

Aim To investigate the stabilities and related mechanism of sulfobutyl ether-β-cyclodextrin liposomes loaded with asparaginase(ASDL).Methods Reverse evaporating method was used for the preparation of ASDL,and the acid-base stability,thermal stability,antitrypsin stability,plasma stability and storage stability of ASDL were tested.Moreover,fluorescence spectrum method was utilized to explore the stability enhancement mechanisms of ASDL.Results The results of stability showed that the acid-base stability,thermal stability,antitrypsin stability,plasma stability and storage stability of ASDL were all superior to asparaginase.Fluorescence experiment results indicated that the improved characteristics of ASDL might be related to the changes of the surrounding microenvironment of fluorescent chromophore or the structure of hydrophobic.Conclusion ASDL can effectively protect asparaginase from the external environment,such as hydrolase,pH,temperature and so on,to improve the stabilities of asparaginase.

Clinical Characteristics and Therapeutic Efficacy of Multiple Myeloma Combined with Renal Amyloidosis / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical characteristics of multiple myeloma (MM) combined with renal amyloidosis and its curative efficacy and prognosis.</p><p><b>METHODS</b>The clinical data of 22 cases of newly diagnosed multiple myeloma combined with renal amyloidosis treated in our hospital from November 2011 to July 2015 were analyzed retrospectively.</p><p><b>RESULTS</b>According to Intenational Staging System (ISS), among above-menthioned 22 patients the ISS II accounted for 77.2% (17/22), ISS III accounted for 22.8% (5/22). The patients with renal impairment accounted for 36.4% (8/22), with anemia 40.9% (9/22), with serum album < 35 g/L 86.4% (19/22), with urinary protein positive 100% (22/22). The evaluation of the curative efficacy of the 22 cases was as follows: CR 13.6% (3/22); VGPR 4.5% (1/22); PR 22.8% (5/22); SD 45.5% (10/22); PD 13.6% (3/22). Out of 9 patients with effective treatment, 3 cases (3/9, 33.3%) achieved "improved" in renal amyloidosis, 4 cases (4/9, 44.5%) achieved stable in renal amyloidosis, 2 cases (2/9, 2%) achieved "worsened" in renal amyloidosis. Among 17 cases who were followed up, 7 cases died, 10 cases survived, the average duration of follow-up for these cases was 11 (1-37) months, the median overall survival (OS) time was 19 (95% CI 9.2-28.8) months.</p><p><b>CONCLUSION</b>MM with renal amyloidosis is rare, refractory and has a poor prognosis. Whether there is impairment of kidney function or not, renal amyloidosis shall be taken into consideration if the MM patients got massive proteinuria especially nephritic syndrome. Bortezomib may improve the curative efficacy.</p>

Men With Severe Lower Urinary Tract Symptoms Are at Increased Risk of Depression / 대한배뇨장애요실금학회지

PURPOSE: Lower urinary tract symptoms (LUTS) comprise a set of common, bothersome symptoms in middle-aged and elderly men. Recent research suggests that depressive symptoms may influence the symptoms of benign prostatic hyperplasia (BPH). We performed a community-based cross-sectional study to evaluate the correlation between LUTS and depression. METHODS: The survey was conducted in a rural community during four periods in August 2009, 2010, 2011, and 2012. Two validated questionnaires were used to examine LUTS and depressive symptoms. These included the International Prostate Symptom Score/quality of life (IPSS/QoL) and the Korean version of the Center for Epidemiological Studies-Depression scale (CES-D-K). Patients were categorized in the depressive symptom group if their CES-D-K score was >16 points. RESULTS: A total of 711 men were included in this study. Thirty-five participants (4.92%) were found to have depressive symptoms. There was a positive correlation between depressive symptoms and LUTS severity (P<0.001). As compared to the mild LUTS group, the odds ratio (OR) of depression was 2.868 (95% confidence interval [CI], 1.293-6.362; P for trend<0.001) in the moderate LUTS group, and 4.133 (95% CI, 1.510-11.313; P for trend<0.001) in the severe LUTS group. In a model considering multiple variables such as age, education level, smoking, and exercise, the OR in the moderate LUTS group was 2.534 (1.125-5.708, 95% CI, P for trend=0.005), while that in the severe LUTS group was 3.910 (95% CI, 5.708-11.154; P for trend=0.005). In addition, depression was related to voiding symptoms. CONCLUSIONS: Men with severe LUTS are at higher risk of depression than those with less severe urinary symptoms. The severity of voiding symptoms worsens depression. More aggressive urological diagnosis and treatment is needed in patients with severe LUTS, due to the impact on depressive symptoms and QoL.

Successful Treatment of Intractable Bleeding Caused by Radiation-Induced Hemorrhagic Gastritis Using Oral Prednisolone: A Case Report / Journal of the Korean Cancer Association, 대한암학회지

Radiation-induced hemorrhagic gastritis is an intractable and dangerous condition. We describe a 59-year-old female patient with radiation-induced hemorrhagic gastritis. The patient underwent postoperative radiation therapy with a dose of 54 Gy in 30 fractions after a radical operation for a Klatskin tumor. Radiation volume included the gastric antrum. Approximately three months after radiation therapy, she was admitted for melena and anemia. Esophagogastroduodenoscopy showed an area of bleeding in the gastric antrum that was so diffuse that effective laser coagulation was not feasible. After failure of various treatments and transfusion of 7,040 mL of packed red blood cells, we successfully stopped the hemorrhage using oral prednisolone treatment. Based on this case, we think that oral prednisolone treatment can be tried as a first treatment for potentially life-threatening radiation-induced hemorrhagic gastritis.

Thrombolytic Therapy Using Urokinase for Management of Central Venous Catheter Thrombosis

PURPOSE: The management of central venous catheters (CVCs) and catheter thrombosis vary among centers, and the efficacy of the methods of management of catheter thrombosis in CVCs is rarely reported. We investigated the efficacy of bedside thrombolysis with urokinase for the management of catheter thrombosis. MATERIALS AND METHODS: We retrospectively reviewed data from patients who had undergone CVC insertion by a single surgeon in a single center between April 2012 and June 2014. We used a protocol for the management of CVCs and when catheter thrombosis was confirmed, 5,000 U urokinase was infused into the catheter. RESULTS: A total of 137 CVCs were inserted in 126 patients. The most common catheter-related complication was thrombosis (12, 8.8%) followed by infection (8, 5.8%). Nine of the 12 patients (75%) with catheter thrombosis were recanalized successfully with urokinase. The rate of CVC recanalization was higher in the peripherally inserted central catheter (PICC) group (87.5%) than the chemoport group (50%). Reintervention for catheter-related thrombosis was needed in only 2.2% of patients when thrombolytic therapy using urokinase was applied. Age <60 years (P=0.035), PICC group (P=0.037) and location of the catheter tip above the superior vena cava (P=0.044) were confirmed as independent risk factors for catheter thrombosis. CONCLUSION: Thrombolysis therapy using urokinase could successfully manage CVC thrombosis. Reintervention was rarely needed when a protocol using urokinase was applied for the management of CVC thromboses.

Brain and Skin Metastasis From Urothelial Carcinoma of the Bladder

Brain and skin metastasis from urothelial carcinoma of the bladder is rare. There have been few case reports of the clinical course of patients with metastatic urothelial carcinoma of the brain and skin. In the present case, a 60-year-old man had undergone radical cystectomy with an ileal conduit owing to urothelial carcinoma (T1N0M0). The patient developed dizziness 9 years later and a solitary brain tumor was discovered in his left cerebellar hemisphere. The tumor was totally resected and the mass was verified to be metastatic urothelial carcinoma. One year after the metastasectomy of the brain lesion, multiple erythematous nodular lesions developed on his abdominal skin. The skin lesions were excised and verified to be metastatic urothelial carcinoma. This report describes this case of urothelial carcinoma of the bladder that metastasized to the brain and abdominal skin.

Analysis of the pregnancy outcomes of 13 723 tubes of sperm specimens from the sperm bank / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the safety of assisted reproductive technology (ART) with donated sperm from the sperm bank and the differences in the pregnancy outcomes of different means of promoting pregnancy.</p><p><b>METHODS</b>We analyzed and compared the feedback data on promoting pregnancy with donated sperm from the sperm bank by artificial insemination by donor (AID), in vitro fertilization (IVF), and intracytoplasm sperm injection (ICSI).</p><p><b>RESULTS</b>Totally, 13 723 tubes of sperm specimens were used for ART. The number of specimens used differed in different clinical reproductive centers, some using 1 tube and others using 2 tubes per cycle. The 13 723 tubes were used for a total of 7 743 cycles. Among the 7 123 cycles of AID, there were 1 415 clinical pregnancies (19.87%), 1 221 normal births (86.29%), 169 abortions (11.94%), 6 cases of birth defects (0.43%), 19 ectopic pregnancies (1.34%), and 0 sexually transmitted infection. Among the 571 cycles of IVF, there were 367 clinical pregnancies (64.27%), 330 normal births (89.92%), 35 abortions (9.54%), 0 birth defect, 2 ectopic pregnancies (0.54%), and 0 sexually transmitted infection. Among the 49 cycles of ICSI, there were 28 clinical pregnancies (57.14%), 25 normal births (89.29%), 3 abortions (10.71%), 0 birth defect, 0 ectopic pregnancy, and 0 sexually transmitted infection. There were statistically significant differences in the rate of clinical pregnancy among AID, IVF and ICSI (P < 0.05), but not between IVF and ICSI (P > 0.05), nor were there any significant differences in the rates of abortion, birth defects and ectopic pregnancy among AID, IVF and ICSI (P > 0.05).</p><p><b>CONCLUSION</b>None of the recipients of the donated sperm from the sperm bank was infected with sexually transmitted diseases. AID, IVF and ICSI showed no significant differences from natural conception in the rates of abortion, birth defects and ectopic pregnancy. ART with donated sperm from the sperm bank is safe. IVF and ICSI are associated with a higher rate of pregnancy than AID, though the latter costs less than the former two.</p>

Evaluation of global and regional left ventricular systolic function in patients with frequent isolated premature ventricular complexes from the right ventricular outflow tract / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Frequent premature ventricular complexes from the right ventricular outflow tract (RVOT-PVCs) are associated with left ventricular dysfunction. This study adopted two-dimensional speckle tracking imaging to evaluate global and regional left ventricular myocardial function in patients with frequent RVOT-PVCs.</p><p><b>METHODS</b>This study included 30 patients with frequent RVOT-PVCs and 30 healthy subjects. Aortic systolic velocity-time integral (AoVTI) and myocardium strain in circumferential (CS), radial (RS) and longitudinal (LS) directions were evaluated by conventional echocardiography and speckle tracking imaging. All values of patients with RVOT-PVCs were recorded during sinus (PVC-S) and PVC beats (PVC-V).</p><p><b>RESULTS</b>Significant differences were demonstrated in global CS, RS and LS between the control subjects and the PVC-V (CS: (17.46 ± 2.48)% vs. (11.52 ± 3.28)%, RS: (48.26 ± 10.20)% vs. (20.92 ± 9.78)%, LS: (19.89 ± 2.62)% vs. (11.79 ± 3.66)%, P < 0.01), and in segmental RS and LS of nearly all the left ventricular segments. Statistical differences in segmental CS between the PVC-V and the control subjects were only observed in anterior, anteroseptal and septal segments (only seen in anteroseptal and septal segments at apex). Furthermore, V/S AoVTI (AoVTI during the PVC beat divided by AoVTI during the sinus beat, then multiplied by 100%) correlated with coupling interval (r = 0.67, P < 0.001) and global strain (CS: r = 0.48, P = 0.007; RS: r = 0.65, P < 0.001; LS: r = 0.65, P < 0.001).</p><p><b>CONCLUSIONS</b>Frequent RVOT-PVCs can induce global and regional left ventricular systolic dysfunction. The reduction of hemodynamic parameters relates to the coupling interval and the global systolic function.</p>

What Are the Risk Factors for Complication in Transumbilical Single-Port Appendectomy?

PURPOSE: Along with the development of minimally invasive surgery, laparoscopic surgery has recently been adopted worldwide. In cases of laparoscopic appendectomy, single port appendectomy is increasingly being adopted due to its cosmetic advantages and reduced pain. This study was conducted to evaluate the risk factors associated with post-operative complications in single port appendectomy. METHODS: Forty-nine consecutive patients who underwent transumbilical single port appendectomy (TUSPLA) were enrolled in this study. We reviewed the initial WBC count, hsCRP, position of the appendix, and intra operative findings and then analyzed the data by univariate and multivariate analysis. RESULTS: Complications were observed in five of the 49 patients (10.2%). Specifically, wound complications were observed in three patients (6.1%), and periappendiceal fluid collection occurred in two patients (4.1%). Univariate analysis revealed a retrocecal type appendix (p=0.046) and overweight (BMI> or =23, p=0.034) as risk factors significantly correlated with the occurrence of complications. Conversely, retrocecal type appendix (p=0.121) and overweight (BMI> or =23, p=0.329) were not significantly correlated with complications upon multivariate analysis. CONCLUSION: For patients with a high risk of postoperative complications, including those with retrocecal appendix undergoing TUSPLA and obese patients, sufficient informed consent is necessary, and intensive monitoring for the incidence of complications must be considered postoperatively. However, further studies enrolling larger groups of patients should be conducted to confirm these findings.

Analysis of the Risk Factors for Overactive Bladder on the Basis of a Survey in the Community

PURPOSE: To evaluate the risk factors for overactive bladder (OAB) in a population aged 40 years and over in the community. MATERIALS AND METHODS: We conducted a community-based survey of OAB in a population aged 40 years and over in Guri City and Yangpyeong County, South Korea, by use of the overactive bladder symptom score (OABSS) questionnaire. A total of 926 subjects were included in the final analysis. The definition of OAB was more than 2 points for the urgency score and 3 points for the sum of scores. In addition, the subjects were asked about age, dwelling place, marital status, educational status, behavioral factors (smoking, drinking, etc), and medical history. Categorical variables were analyzed by using the logistic regression model and were adjusted for age by using the logistic regression model. RESULTS: Overall OAB prevalence was 14.1% (130/926), made up of 49/403 males (12.2%) and 81/523 females (15.5%). OAB prevalence increased with age (p<0.0001). Risk factors for OAB were educational status (age-adjusted p=0.0487), stroke (p=0.0414), osteoporosis (p=0.0208), asthma (p=0.0091), rhinitis (p=0.0008), and cataract. Other factors (dwelling place, marital status, smoking, drinking, hypertension, diabetes, hyperlipidemia, myocardial infarction, angina, tuberculosis, atopic dermatitis, hepatitis B, and depression) were not associated with OAB. CONCLUSIONS: The prevalence of OAB in our study was about 14.1% and the risk factors for OAB were educational status, stroke, osteoporosis, asthma, rhinitis, and cataract. Knowledge of these risk factors may help in the diagnosis and treatment of OAB.