Effect of acupuncture combined with low frequency rTMS on comorbid mild-to-moderate depressive disorder and insomnia: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the impacts of acupuncture on depressive mood and sleep quality in patients with comorbid mild-to-moderate depressive disorder and insomnia, and explore its effect mechanism.@*METHODS@#A total of 60 patients with comorbid mild-to-moderate depressive disorder and insomnia were randomly divided into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 2 cases dropped off). In the observation group, acupuncture and low frequency repeated transcranial magnetic stimulation (rTMS) were combined for the intervention. Acupuncture was applied to Baihui (GV 20), Yintang (GV 24+), Neiguan (PC 6) and Yanglingquan (GB 34), etc., the needles were retained for 30 min; and the intradermal needles were embedded at Xinshu (BL 15) and Danshu (BL 19) for 2 days. After acupuncture, the rTMS was delivered at the right dorsolateral prefrontal cortex (R-DLPFC), with 1 Hz and 80% of movement threshold, lasting 30 min in each treatment. In the control group, the sham-acupuncture was adopted, combined with low frequency rTMS. The acupoint selection and manipulation were the same as the observation group. In the two groups, acupuncture was given once every two days, 3 times weekly; while, rTMS was operated once daily, for consecutive 5 days a week. The duration of treatment consisted of 4 weeks. Hamilton depression scale-17 (HAMD-17) and Pittsburgh sleep quality index (PSQI) scores were observed before and after treatment, as well as 1 month after the treatment completion (follow-up period) separately. Besides, the levels of nerve growth factor (BDNF) and γ-aminobutyric acid (GABA) in the serum were detected before and after treatment in the two groups.@*RESULTS@#After treatment and in follow-up, the HAMD-17 scores were lower than those before treatment in the two groups (P<0.05), and the scores in the observation group were lower than the control group (P<0.05). After treatment, the total scores and the scores of each factor of PSQI were reduced in the two groups in comparison with those before treatment except for the score of sleep efficiency in the control group (P<0.05); the total PSQI score and the scores for sleep quality, sleep latency, sleep efficiency and daytime dysfunction in the observation group were all lower than those in the control group (P<0.05). In the follow-up, except for the scores of sleep duration and sleep efficiency in the control group, the total PSQI score and the scores of all the other factors were reduced compared with those before treatment in the two groups (P<0.05); the total PSQI score and the scores of sleep quality, sleep latency, sleep duration, sleep efficiency and daytime dysfunction in the observation group were lower than the control group (P<0.05). After treatment, the levels of serum BDNF and GABA were increased in comparison with those before treatment in the observation group (P<0.05), and the level of serum BDNF was higher than that in the control group (P<0.05).@*CONCLUSION@#Acupuncture relieves depressive mood and improves sleep quality in patients with comorbid mild-to-moderate depressive disorder and insomnia. The effect mechanism may be related to the regulation of BDNF and GABA levels and the promotion of brain neurological function recovery.

Clinical effects of free peroneal artery perforator flaps in repairing forefoot skin and soft tissue defect wounds assisted with three-dimensional computed tomography angiography / 中华烧伤杂志

Objective: To investigate the clinical effects of free peroneal artery perforator flaps in repairing forefoot skin and soft tissue defect wounds assisted with three-dimensional computed tomography angiography (3D-CTA). Methods: A retrospective observational study was conducted. From March 2017 to September 2019, 15 patients with skin and soft tissue defect wounds in the forefoot were treated in the Department of Burn and Plastic Surgery of Yidu Central Hospital of Weifang, including 12 males and 3 females, with age of 18-60 years. The wound area on admission was 3.0 cm×3.0 cm-9.0 cm×8.0 cm. The 3D-CTA examination before operation was performed to select the peroneal artery perforating vessels with appropriate length of vascular pedicle and good blood perfusion. According to the wound area and the perforating vessels of the peroneal artery located by 3D-CTA, the peroneal artery perforator flaps of 3.5 cm×3.5 cm-9.5 cm×8.5 cm carried with lateral sural cutaneous nerve was designed and cut, and the nerve was anastomosed with the nerve of the wound. The wound in the donor site of the flap was directly sutured or covered with medium-thickness skin graft from the thigh. The consistencies of type, diameter, and perforating position of perforating vessel of the peroneal artery detected by 3D-CTA before the operation with those of the actual measurement during operation were observed. The length of time for flap cutting and the survival of the flap after operation were recorded. During follow-up of 12 months after the operation, the patients were instructed to evaluate the foot function according to the Maryland foot function score standard, and the wound healing in the donor area and the occurrence of complications affecting the motor function of limb were observed. Data were statistically analyzed with paired sample t test. Results: The types of peroneal artery perforating vessels in patients measured during the operation were septocutaneous perforator of 12 cases, musculocutaneous perforator of 2 cases, and musculomuscular septal perforator of 1 case, which were consistent with those measured by preoperative 3D-CTA. The diameter of the peroneal artery perforating vessel measured by preoperative 3D-CTA was (1.38±0.17) mm, which was close to (1.40±0.19) mm measured during the operation (t=0.30, P>0.05). The horizontal distance from the starting point of the perforating vessel to the outer edge of the shank was (42±6) mm, and the vertical distance from the starting point of the perforating vessel to the level of the lateral ankle tip was (219±14) mm measured by preoperative 3D-CTA, which were respectively close to (43±6) and (221±15) mm of intraoperative measurement (with t values of 0.46 and 0.38, respectively, P>0.05). The length of time for cutting flap was (31±6) min. All flaps survived post operation without vascular crisis. During follow-up of 12 months after the operation, the foot function was evaluated as excellent in 11 cases, good in 3 cases, and fair in 1 case, the donor site wound healed well, the scar was not noticeable with no contracture, and the motor function of joints was not affected. Conclusions: Free peroneal artery perforator flap is one of the effective methods to reconstruct skin and soft tissue defect wounds in the forefoot, and the risk of surgery can be reduced when the anatomical location of the perforating vessels is confirmed by 3D-CTA.

Regulatory Roles of Exercise⁃regulated Circadian Rhythm in Muscular Atrophy / 中国生物化学与分子生物学报

As people age, the population of the elderly increases rapidly. With the change of work and lifestyle, the problems such as reduced physical activity and irregular routine become more serious, which results in the significantly increased incidence of skeletal muscle atrophy, and reduced health status and life quality of elderly. At the same time, the imbalance of diets, the decrease of physical activity, and the fluctuation of hormone levels further aggravate the occurrence of skeletal muscle atrophy, and its pathological mechanisms mainly correlated with chronic inflammation, mitochondrial dysfunction, deficient autophagy, increased apoptosis, impaired muscle satellite cell function, and disrupted circadian rhythm. Skeletal muscles, as the largest peripheral biological clock of the body, can affect the fiber structure, mitochondrial function, and muscle mass of skeletal muscles by regulating the circadian core genes BMAL1 and CLOCK. As an important intervention strategy to improve skeletal muscle masses, exercise can also activate the circadian signal pathway and regulate its phase, thus improving muscle regeneration and muscle strengths and delaying muscle atrophy. Therefore, from the perspective of circadian rhythm, this article summarizes the occurrence of muscular atrophy and the molecular mechanism of potential exercise intervention to provide new ideas for the targeted regulation of the prevention, treatment, and rehabilitation of muscular atrophy.

Inhibition of activated K-opioid receptor to myocardical hypertrophy induced by ET-1 in neonatal rats by extracellular signal-regulated kinase pathway / 中国药理学通报

Aim To investigate the inhibitory effect of kappa-opioid receptor(κ-OR)stimulation on extracellular signal-regulated kinase pathway on ET-1-induced cardiomyocyte hypertrophy in vitro cultured myocardial cells from neonatal rats.Methods Myocardial cells of neonatal rats were cultured in vitro.The hypertrophic myocytes were induced by ET-1(10 nmol·L-1)before κ-OR agonist U50488H(1 μmol·L-1)was administered.The antihypertrophic effect of κ-OR stimulation was observed in the presence of U0126(1μmol·L-1), Ro-31-8220(50 nmol·L-1)and PTX(5 mg·L-1).The cardiomyocytes volume was measured by computer photographalysis system.The relative expression of ERK1/2 was determined by Western blot.The morphological changes in cardiomyocytes were observed under an inverted phase contrast microscope.The expression of mRNA of atrial natriuretic peptide(ANP)was determined by RT-PCR.Results Compared with normal control group, ET-1 could induced cardiomyocyte hypertrophy.Compared with ET-1 model group, U50488H(1 μmol·L-1)could obviously inhibit ET-1-induced increase of the cardiomyocytes volume, expression of ANPmRNA and expression of ERK1/2, which was similar to U0126(1 μmol·L-1)and Ro-31-8220(50 nmol·L-1); however, the inhibitory effects of U50488H were partly lost when preincubated with U0126(1 μmol·L-1)and Ro-31-8220(50 nmol·L-1); the inhibitory effects of U50488H, U0126(1 μmol·L-1)and Ro-31-8220(50 nmol·L-1)were lost when preincubated with NOR-BNI.Conclusion The stimulation of kappa-opiod can inhibit myocardial hypertrophy induced by ET-1, which is possibly via attenuating ERK1/2.

The role of Toll-like receptors in chemoradiotherapy-induced gastrointestinal mucositis / 口腔疾病防治

@#Mucositis is a common gastrointestinal complication in cancer patients undergoing chemoradiotherapy, including oral mucositis and gastrointestinal mucositis, with clinical manifestations of oral ulcers, vomiting, diarrhea and pain that seriously reduce the quality of life of patients and even affect anticancer therapy. Toll-like receptor (TLR) are important receptors involved in innate immunity and in the development of chemoradiation-induced mucositis by mediating the effect between microorganisms and the host. A comprehensive understanding of the role of TLR in mucositis is helpful to guide the prevention and treatment of mucositis. This paper reviews the available studies on TLR and mucositis. The results of the literature review indicate that different TLR have different roles in chemoradiation-induced mucositis: TLR2 is an important receptor in the inflammatory cascade of chemoradiation-induced mucositis; TLR4 activation can increase gastrointestinal mucosal inflammation and lead to oral epithelial ulceration; TLR5 agonists can reduce the degree of radiation-induced mucositis damage; and antagonizing or knocking out TLR9 can reduce chemoradiation-induced gastrointestinal mucositis. However, no TLR agonists or inhibitors have yet been applied in clinical practice, and additional studies are needed to explore the role of different TLR in mucositis in the future to provide a reference for the precise prevention and treatment of chemoradiation-induced mucositis.

Behavior of Seeking Medical Care for People with Disabilities within Context of Health Poverty Alleviation Initiatives / 中国康复理论与实践

Objective:To study the behavior of seeking medical care for people with disabilities under the background of Health Poverty Alleviation. Methods:Descriptive statistics method was used to analyze the behavior of seeking medical care for people with disabilities based on the data of the National Health Poverty Alleviation Dynamic Management System. Results:The Three Batch action plan mainly focuses on contracted services for chronic diseases; the number of visits for people with disabilities gradually increases, the proportion of visits within the county increases, and the proportion of hospitalizations decreases. The hospitals visited are mainly secondary hospitals, township health hospitals and community health service centers, and the medical expenditure is relatively high. These phenomena are different among disability conditions. Conclusion:The behavior of people with disabilities was remarkably improved after Health Poverty Alleviation. In the future, we should consolidate the achievements of Health Poverty Alleviation, increase the prevention of chronic diseases for people with disabilities, and further improve the accessibility of medical services and the level of medical security for people with disabilities.

Regulatory roles of microRNAs in sarcopenia and exercise intervention / 生理学报

Sarcopenia is an age-related degenerative disease, in which skeletal muscle mass and function are reduced during aging process. Physical intervention is one of the most effective strategies available for the treatment of sarcopenia. Studies have shown that microRNAs (miRNAs), as important regulators of gene expression, play an important role in maintaining the homeostasis of senescent skeletal muscle cells by regulating skeletal muscle cell development (proliferation and differentiation), mitochondrial biogenesis, protein synthesis and degradation, inflammatory response and metabolic pathways. Furthermore, exercise can combat age-related changes in muscle mass, composition and function, which is associated with the changes in the expression and biological functions of miRNAs in skeletal muscle cells. In this article, we systematically review the regulatory mechanisms of miRNAs in skeletal muscle aging, and discuss the regulatory roles and molecular targets of exercise-mediated miRNAs in muscular atrophy during aging process, which may provide novel insights into the prevention and treatment of sarcopenia.

Advance in Role of Mitochondrial Quality Control in Exercise for Sarcopenia (review) / 中国康复理论与实践

Sarcopenia is a process in which skeletal muscle mass and strength are gradually declining, resulting a main health challenge for the old adults. Mitochondria can maintain the integrity of structure and function of skeletal muscle by improving biosynthesis, antioxidant defense, fusion/fission dynamics and mitophagy. Mitochondrial dysfunction is a important factor leading to the complex etiology of sarcopenia. Exercise can regulate mitochondrial quality control pathways by activating mitochondrial biogenesis and mitophagy to maintain optimal mitochondrial function, thereby delaying and preventing the onset and progression of sarcopenia.

Regulatory Role of Exercise-induced Autophagy in Rehabilitation of Sarcopenia (review) / 中国康复理论与实践

Sarcopenia is an aging-related disease with a significant reduction in mass and strength of skeletal muscle due to the imbalance between protein synthesis and degradation. Autophagy acts as a conserved mechanism regulating the balance of protein metabolism in body and can be regulated by multiple signaling pathways such as AMP-activated protein kinase (AMPK), insulin like growth factor (IGF)/ protein kinase B (Akt)/ mammalian target of rapamycin (mTOR) and phosphatidylinositol 3 kinase (PI3K)/Akt/mTOR induced by exercise. Exercise-activated autophagy regulates skeletal muscle remodeling and homeostasis under different physiological and pathological conditions, which is the key to skeletal muscle health maintenance. This article reviewed the regulator roles and potential molecular mechanisms of varying exercise-induced autophagy in the prevention, treatment and rehabilitation of sarcopenia.

Related Factors of Rehabilitation Needs of People with Disabilities in Jiangsu,China / 中国康复理论与实践

Objective To explore the rehabilitation needs of people with disabilities and the related factors,so as to provide a scien-tific basis for the rehabilitation policy-making for people with disabilities. Methods From June,2014 to July,2015,based on the national special survey of basic services and needs of people with disabilities in Jiangsu,China,this paper clarified the factors related with the rehabilitation needs of the disabled into the individual characteristics, economic characteristics, environmental characteristics and so on by the de-scriptive statistics method. The Logit model was established to explore the factors related with rehabilitation needs. Results In Jiangsu,43% people with disabilities aged 16 and above had rehabilitation needs.Contingency table analysis and Chi square test showed that individual characteristics,economic characteristics and environmental character-istics had significant impact on the rehabilitation needs of the disabled.Multiple regression analysis showed that all the 18 variables were the significant related factors. Conclusion In order to meet the rehabilitation needs of the disabled, the refined and precise rehabilitation program should be designed in line with the different characteristics of the disabled.Through the effective docking of sup-plies and needs,we can provide accurate rehabilitation services for the disabled.

Cefoxitin plus levofloxacin for prevention of severe infection after transrectal prostate biopsy / 中华男科学杂志

<p><b>Objective</b>To evaluate the effect of cefoxitin prophylactic in reducing the incidence of severe infection after transrectal prostate biopsy (TRPB).</p><p><b>METHODS</b>This retrospective study included 155 cases of TRPB with a 5-day administration of oral levofloxacin at 200 mg bid (the control group) and another 167 cases with a 3-day administration of oral levofloxacin at the same dose plus intravenous cefoxitin at 2.0 g 2 hours before TRPB (the experimental group) according to the distribution characteristics of drug-resistance bacteria in our department. The patients of the control and experimental groups were aged (68.68 ± 8.12) and (68.72 ± 7.51) years, with PSA levels of (19.78 ± 21.57) and (21.15 ± 42.63) μg/L, involving (11.68 ± 1.44) and (11.77±1.02) biopsy cores, respectively. Comparisons were made between the two groups of patients in the incidence rate of severe infection, which was defined as lower urinary track symptoms plus the systemic inflammatory response syndrome (SIRS) within 7 days after TRPB.</p><p><b>RESULTS</b>The incidence rate of postoperative severe infection was significantly lower in the experimental group than in the control (0.6% ［1/167］ vs 5.8% ［9/155］, P < 0.05). Blood cultures revealed positive E-coli strains in 6 cases in the control group, including 5 ESBL-positive and 4 quinolone-resistant and amikacin-sensitive cases, all sensitive to cefoxitin, cefoperazone/sulbactam and imipenem. The only one case of severe infection was shown to be negative in blood culture.</p><p><b>CONCLUSIONS</b>Preoperative intravenous administration of cefoxitin according to the specific distribution characteristics of drug-resistance bacteria can significantly reduce the incidence of severe infection after TRPB.</p>

Development of specific and quantitative methods for the quality control of the polysaccharides from sea-tangle and sargassum / 中国天然药物

Polysaccharides from numerous traditional Chinese medicines have been proven as the bioactive ingredients and are hence used as the quality control markers. However, the assessment criteria always show a poor specificity, due to the lack of systematic comparison among the analogous herbs. In the present study, two similar materials, namely sea-tangle and sargassum, were selected as the model herbs to develop more specific methods for quality control. Two well-established methods, determination of the total polysaccharides content and monosaccharides composition analysis, were both employed. Based upon the quantitative results, the evaluation criteria of the polysaccharides contents of not less than 2.0% and 1.7% were proposed for sea-tangle and sargassum, respectively. Nine identical monosaccharide derivatives appeared on the HPLC chromatograms of the hydrolysis and derivatized solutions of the two drugs. Principal component analysis and orthogonal partial least squares discriminant analysis using the peak areas of monosaccharides derivatives as the variables were performed, and the results indicated that mannuronic acid and xylose with the opposite concentrations in the two drugs were the differential components. A discriminative criterion using the peak area ratio of these two monosaccharides derivatives was proposed for the qualitative identification. In conclusion, a more specific and quantitative quality control method was developed for sea-tangle and sargassum.

An epidemiological investigation on a dengue fever outbreak / 预防医学

Objective To analyze the epidemiological characteristics of dengue fever outbreak in Shaoxing City,and to provide a scientific basis for the prevention and control.Methods A retrospective epidemiological investigation was conducted to search the patients by given definition.Enzyme linked immunosorbent assay (ELISA)was used for detecting the anti -dengue virus antibodies.The serum samples from patients were collected for dengue virus isolation and the positive samples were identified by RT -PCR.Breteau Index was carried out to monitor the density of mosquito larva. Results A total of 42 cases were found with no death reported.The symptoms mainly included fever (1 00%),fatigue (59. 52%),arthralgia(50. 00%),headache (47. 62%)and rash (38. 1 0%).The outbreak lasted for 71 days with the first case occurred in July 1 5 and the last in September 23.The peak was from August 30 to September 5. Thirty seven cases were located in Keqiao District and 5 cases were in Yuecheng District.The male/female ratio was 1 . 33∶1 .The age of cases ranged from 1 0 to 79 years old with the 40 -(1 9. 05%)and 50 -(1 9. 05%)age group making the largest proportion.The outbreak also showed family aggregation.IgM antibody and nucleic acid of dengue virus were detected from serum samples of 1 2 patients.The sequence of the isolation indicated that this outbreak was caused by dengue virus typeⅡ.Conclusion The imported cases,high density of mosquito vector and missed diagnosis might contribute to this outbreak.Developing a practical scheme for mosquito elimination,improving diagnostic capacity of medical staff and their consciousness of reporting could be important ways to control dengue fever.

An analysis on the prognostic factors of community -acquired pneumonia among children / 预防医学

Objective To explore the prognostic factors of community -acquired pneumonia (CAP)among children. Methods A total of 783 children with CAP admitted to hospital from 2009 to 2012 were selected.Related information including baseline data was extracted from the hospital health records and analyzed by univariate and multiple logistic regression analysis.Results The logistic regression analysis showed that obnubilation (OR =5.866,95%CI =2.020 -17.033),dysphoria (OR =1.420,95%CI =1.038 -1.942),multi -infection(OR =1.376,95%CI =0.993 -1.907) and polypnea(OR =1.026,95%CI =1.004 -1.049)were the independent risk factors that influenced the prognosis of patients with community -acquired pneumonia.Conclusion More attentions should be paid to CAP children with the symptoms of obnubilation,dysphoria,multi -infection and polypnea.

Application of Warthin-Starry stain, immunohistochemistry and transmission electron microscopy in diagnosis of cat scratch disease / 中华病理学杂志

<p><b>OBJECTIVE</b>To evaluate the diagnostic utility of Warthin-Starry silver stain, immunohistochemistry and transmission electron microscopy in the detection of human Bartonella henselae infection and pathologic diagnosis of cat scratch disease (CSD).</p><p><b>METHODS</b>The paraffin-embedded lymph node tissues of 77 histologically-defined cases of cat scratch disease collected during the period from January, 1998 to December, 2008 were retrieved and studied using Warthin-Starry silver stain (WS stain) and mouse monoclonal antibody against Bartonella henselae (BhmAB stain). Five cases rich in bacteria were selected for transmission electron microscopy.</p><p><b>RESULTS</b>Under electron microscope, the organisms Bartonella henselae appeared polymorphic, round, elliptical, short rod or bacilliform shapes, ranged from 0.489 to 1.110 microm by 0.333 to 0.534 microm and often clustered together. Black short rod-shaped bacilli arranged in chains or clumps were demonstrated in 61.0% (47/77) of CSD by WS stain. The organisms were located outside the cells and lie mainly in the necrotic debris, especially near the nodal capsule. In 72.7% (56/77) of the cases, dot-like, granular as well as few linear positive signals were observed using BhmAB immunostain and showed similar localization. Positive results for both stains were identified in 59.7% (46/77) of the cases. When applying both stains together, Bartonella henselae was observed in 74.0% (57/77) of the case. The difference between the results obtained by WS stain and BhmAB immunostain was of statistical significance (P < 0.05).</p><p><b>CONCLUSIONS</b>Bartonella henselae is the causative pathogen of cat scratch disease. WS stain, BhmAB immunostain and transmission electron microscopy are helpful in confirming the histologic diagnosis. Immunostaining using BhmAB can be a better alternative than WS stain in demonstrating the organisms.</p>

Characterization of the changes in comparative genomic hybridization in esophageal cancer patients with family history / 南方医科大学学报

<p><b>OBJECTIVE</b>To characterize the profile of chromosomal imbalances in esophageal cancer (EC) with or without family history in Linzhou, Henan Province of China.</p><p><b>METHODS</b>Comparative genomic hybridization (CGH) was used to examine 13 cases with positive family history of EC and 32 cases with negative family history of EC. RESULTS DNA copy number gains on chromosome 10q was observed only in the cases with postivie family history of EC (30%), and none in cases with a negative family history (P<0.05). DNA copy number losses on chromosome 15q were significantly higher in cases with postivie family history (38% vs 6%, P<0.05). The frequency of DNA copy number gains in 3q, 5p, 7p, 8q and DNA copy number losses in 3p, 19q, 9q were similar in the two groups (both beyond 20%) (P>0.05).</p><p><b>CONCLUSIONS</b>Frequent DNA copy number gains on chromosome 10q and losses on chromosome 15q in EC casers with postivie family history indicate that these chromosome sites may harbor the genes related to high susceptibility to EC. Such chromosomal sites as 3q, 5p, 7p, 8q, 3p, 19q, and 9q may contain important genes related with the environmental risk factors of esophageal carcinogenesis.</p>

Change in ambulatory arterial stiffness index with advancing age and the correlation with 24 hours pulse pressure in healthy individuals / 中华心血管病杂志

<p><b>OBJECTIVE</b>Ambulatory arterial stiffness index (AASI) has been recently proposed to reflect the dynamic relation between diastolic and systolic blood pressure throughout the whole day. The aim of our study was to investigate the change in AASI with advancing age and the correlation with 24 hours pulse pressure (24 h PP) in healthy individuals.</p><p><b>METHODS</b>246 healthy subjects [mean age (59.7 +/- 14.6) years, women 38.6%] underwent 24 hours ambulatory blood pressure monitoring (ABPM) in normal life style. The blood pressure recordings, heart rate (HR), mean arterial pressure (MAP) and pulse pressure (PP) were analyzed simultaneously by computer for every 30 minutes during 6:00 am-22:00 pm and every 60 minutes during 22:00 pm-6:00 am. Using all the blood pressure recordings, we plotted diastolic against systolic blood pressure from each individuals and calculated the regression slope. AASI was derived from 1 minus this regression slope.</p><p><b>RESULTS</b>In 246 healthy individuals, AASI increased with age. Among the healthy individuals, the 95th percentile of AASI was 0.56, the upper boundary of the 95% prediction interval of AASI in relation to age were 0.49 at 20 - 39 years, 0.59 at 40 - 59 years, 0.69 at 60 - 79 years, 0.79 at > or = 80 years. The correlation coefficient between AASI and 24 h PP was 0.497 (P < 0.01). AASI linearly increased with age in healthy individuals, whereas the relation between pulse pressure and age was curvilinear.</p><p><b>CONCLUSIONS</b>AASI as a index reflecting blood pressure relationship, manifested the corresponding change with advancing age. The correlation between AASI and traditional index 24 h PP indicated AASI as a new measure of arterial stiffness.</p>

SEM observation on leaf epidermis of different Ephedra species / 中国中药杂志

<p><b>OBJECTIVE</b>Characters of stem epidermis, leaf epidermis and stoma could be used as important microcosmic morphological characteristic when inheritance trend is studied in Ephedra breeding and identification.</p><p><b>METHOD</b>The stomatic density, stoma major axis and mimor axis, stomatic morphylogy, characters of leaf and stem epidermis of 6 Ephedra plants' stems were examined by SEM.</p><p><b>RESULT</b>The stomatic density and characteristic of leaf epidermis and stem epidermis in six Ephedra species was differenc, there were no obvious morphological differences in stoma shape and size. The guard cells were covered with heavy cuticle and sunken stomata, which were the typical characteristics of xerophytes. The stomas of leaf lower epidermis were oblong or hexagon, but the stomas of steam epidermis were narrowed-oblong or dumbbell-shape, they all belonged to anomalous type.</p><p><b>CONCLUSION</b>The stoma type and characters of Ephedra plants is stable and conservative, there was no obvious morphological differences in stoma shape and size between species, so it is difficult to distinguish different species by the variance of stomas, but that can be applyed to distinguish Ephedra from others at plant taxonomy.</p>

Early detection and treatment of pyonephresis(report of 41 cases) / 中华泌尿外科杂志

Objective To improve the level of early detection and treatment of pyonephrosis. Methods This study included 41 cases(17 men and 24 women;mean age,49 years)of pyonephrosis.A variety of examinations,including urinary analysis,blood analysis,kidney nuclear medicine scan,ultrasonog- raphy,intravenous urography(IVU),and CT were used for the early diagnosis of pyonephrosis.Pereutaneous nephrostomy(PCN)drainage was done for the interim management of pyonephrosis,then phase 2 operation was performed in 28 cases.The double-J tube was placed in ureter by ureteroscope for drainage,and then phase 2 operation was done in 2 cases.Emergency operation was done in 10 cases.The remaining 1 case un- derwent ESWL after anti-infective therapy.Results Definite diagnosis of pyonephrosis before operation was made by invasive examinations in 31 cases(75.6%),and by percutaneous drainage in 4 cases;the other 6 cases were detected during operation.Only 6 cases(14.6%)underwent nephrectomy;the other 35 cases (85.4%)underwent kidney-sparing operation.Follow-up of 3 months to 9 years was available in 37 cases. No nephrectomy was needed in 33 cases with spared kidney.Serum creatinine was normal in the 4 cases un- dergoing nephrectomy.Conclusions The key to the treatment of pyonephrosis by kidney-sparing surgery is early diagnosis,timely drainage and relief of obstruction.Ultrasonography plays an important role in the early diagnosis of pyonephrosis,and CT has a high sensibility in the diagnosis.Pereutaneons nephrolithotomy (PCNL)secondary to drainage through pereutaneous nephrostomy was beneficial to the patients with kidney stones or upper ureter stones.

Underestimate the histologic grade by biopsy preoperative in bladder urotheliai carcinoma / 中华泌尿外科杂志

Objective To compare the histologic grade between biopsy and postoperative specimen in bladder urothelial carcinoma,and approach the state and the reasons of underestimate the histologic grade preoperative.Methods We retrospectively 82 cases of urothelial carcinoma at the Third Affiliated Hospi- tal of the Sun Yat-Sen University.For all the cases in this study,the histologic grade,using the 1998 World Health Organization and International Society of Urological Pathologists(WHO/ISUP)classification,was i- dentical when the biopsy specimen and postoperative specimen were compared.Results In this study,35 cases,28 cases and 19 cases were G_1、G_2、G_3 by biopsy preoperative,respectively;while 22 cases,32 cases、28 cases were G_1、G_2、G_3 postoperative,respectively.There were 24 cases(29.3%)underestimate the histo- logic grade by biopsy preoperative in the 82 cases,while 4 cases(4.9%)overestimate preoperative.The state of underestimate the histologic grade is correlated with the location of biopsy,tissue dose and the conser- vation of pathology judgment.Conclusions There were 24 cases(29.3%)underestimate the histologic grade by biopsy preoperative.We should pay more attention to this state of underestimate the histologic grade preoperative in the treatment of bladder urothelial carcinoma.