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Objective@#Comparison of the efficacy of mini flank incision and laparoscopy in the treatment of infants with ureteropelvic junction obstruction.@*Methods@#We retrospectively analyzed 85 cases of infants with ureteropelvic junction obstruction in our hospital from Jan. 2016 to Jan. 2018, all the patients underwent dismembered pyeloplasty. According to the surgical approach, they were divided into two groups: There were 45 cases in the mini flank incision group, including 39 males and 6 females, aged from 1 month to 3 years, with a median age of 4 months, and 40 patients in the laparoscopy group, including 33 males and 7 females, aged from 2 months to 3 years, with a median age of 9 months. The clinical effects of the two groups were compared.@*Results@#The patients were followed up for 12-24 months. The operation time[(68.0±15.3)min vs.(79.6±18.8)min], fasting time[(5±1)h vs.(14±8)h] and indwelling time of peri-renal drainage tube[(3.1±1.4)d vs.(4.3±2.2)d] in the mini flank incision group were shorter than those in the laparoscopy group (P<0.01), but there was no significant difference in the amount of blood loss[(2.1±0.9)ml vs.(2.2±0.6)ml] during the operation (P>0.05). The recurrence rate[0 vs.5%(2/40)] and the incidence of complications[11.1%(5/45)vs. 17.5%(7/40)] in the mini flank incision group were lower than those in the laparoscopy group, but there was no statistical difference (P>0.05).@*Conclusions@#Pyeloplasty via mini flank incision or laparoscopy are both safe, effective and cosmetic.Mini flank incision surgery has the advantage of short operation time, easy to master and less disturbance of physiological function. Pyeloplasty via mini flank incision it is one of the reasonable options for the treatment of infants with ureteropelvic junction obstruction.
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Objective Comparison of the efficacy of mini flank incision and laparoscopy in the treatment of infants with ureteropelvic junction obstruction.Methods We retrospectively analyzed 85 cases of infants with ureteropelvic junction obstruction in our hospital from Jan.2016 to Jan.2018,all the patients underwent dismembered pyeloplasty.According to the surgical approach,they were divided into two groups:There were 45 cases in the mini flank incision group,including 39 males and 6 females,aged from 1 month to 3 years,with a median age of 4 months,and 40 patients in the laparoscopy group,including 33 males and 7 females,aged from 2 months to 3 years,with a median age of 9 months.The clinical effects of the two groups were compared.Results The patients were followed up for 12-24 months.The operation time[(68.0 ± 15.3) min vs.(79.6 ± 18.8) min],fasting time [(5 ± 1) h vs.(14 ± 8) h] and indwelling time of peri-renal drainage tube [(3.1 ± 1.4) d vs.(4.3 ± 2.2) d] in the mini flank incision group were shorter than those in the laparoscopy group (P ＜ 0.01),but there was no significant difference in the amount of blood loss[(2.1 ± 0.9) ml vs.(2.2 ± 0.6) ml] during the operation (P ＞ 0.05).The recurrence rate [0 vs.5 ％ (2/40)]and the incidence of complications[11.1％ (5/45) vs.17.5％ (7/40)] in the mini flank incision group were lower than those in the laparoscopy group,but there was no statistical difference (P ＞ 0.05).Conclusions Pyeloplasty via mini flank incision or laparoscopy are both safe,effective and cosmetic.Mini flank incision surgery has the advantage of short operation time,easy to master and less disturbance of physiological function.Pyeloplasty via mini flank incision it is one of the reasonable options for the treatment of infants with ureteropelvic junction obstruction.
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Objective To study the clinical features, diagnosis and treatment of torsion of testes in newborn. Method Neonates who were diagnosed with neonatal testicular torsion and admitted to Shenzhen Children's Hospital from March 2008 to July 2018 were studied. The clinical data such as days in age, time of onset, clinical manifestations, time of ultrasound examination, characteristics of ultrasound examination, surgery time, surgical types, postoperative conditions, pathological findings, and follow-up results were retrospectively analyzed. Result A total of 12 infants with torsion of testes were enrolled. The average onset time was 2.9 d, ranged from 1～10 d. The time of onset was within 24 h after birth in six infants. The median duration from onset to seeing a doctor was 3.5 d, ranged from 2 h to 28 d. First manifestations being reported grammer were scrotal swelling or mass, including 7 cases on the left side and 5 cases on the right side. Among them, 9 cases were associated with redness or cyanosis of the scrotum. Ultrasound was characterized by the disappearance or significant reduction of testicular parenchymal blood flow signal, and the sensitivity of ultrasound was 100％. The average time from admission to operation was (2.1±1.1) h. All the 12 infants had orchiectomy,after necrosis of unilateral testicle was confirmed. Eight of them underwent contralateral test icular fixation. The average operation time was 46 min. There was no wound bleeding or infection postoperatively, and the average hospital stay was 6.4 d. The pathological features were blurred residual contour of the seminiferous tubule (9 cases) or the disappearance of the seminiferous tubule structure (3 cases). After 3 to 24 months of follow-up, no contralateral testicular torsion or atrophy was found. Conclusion The rate of testicular necrosis in children with torsion of testes is high. The newborn with scrotal swelling should be diagnosed promptly with color Doppler ultrasound. If necessary, surgical exploration should be performed in time.
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Objective To explore the effect of selective beta-1 adrenoreceptor blocker on exercise tolerance in patients with hyperten-sion. Methods From May, 2015 to May, 2016, 72 patients with hypertension were divided into two groups, according to whether taking the selective beta-1 receptor blocker. Group A (n=35) took the selective beta-1 receptor blocker two weeks before cardiopulmonary exercise, while group B (n=37) did not take anything at the same time. The exercise tolerance was compared between two groups. Results The maxi-mal systolic blood pressure, peak heart rate, one-minute heart rate after exercise (HR1) and rate-pressure product were lower in group A than in group B (t>2.012, P0.05). Conclusion The selective beta-1 adrenore-ceptor blocker could reduce myocardial oxygen consumption, and improve vagus nerve activity, but did not reduce exercise tolerance in pa-tients with hypertension.
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Neurogenic bladder is a class of diseases in the damage of normal urine and storage function that are resulted from any cause of central or peripheral nerve damage,which is also called neurogenic bladder dysfunction (neuropathic bladder dysfunction,NBSD).Children~ neurogenic bladder is a common cause of congenital spinal cord dysplasia with high morbidity,and progressive development can cause the urine impaired even life-threatening.The treatment of neurogenic bladder cannot obtain satisfactory results yet.This review summarizes the recent advances in the treatment of neurogenic bladder.
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Objective To investigate the serum lipids levels of Chinese men with chronic paraplegia.Methods A total of 650 male paraplegics admitted to the China Rehabilitation Research Center (CRRC) for rehabilitation therapy from Jan 2004-Dec 2008 were investigated. The inclusion criteria were a definite paraplegic history (T2-L5 spinal cord injury); complete data; age 18-60 years; and no history of stroke. TG, TC, LDL and HDL serum lipid profiles were studied. Results These male paraplegics showed significantly higher mean TG and TC levels and lower mean HDL levels than the nation-wide averages for similar males ( TG 1.72 mmol/L vs. 1.36 mmol/L; TC4.42 mmol/L vs. 4.30 mmoL/L; HDL 0.99 mmol/L vs. 1.18 mmol/L). No difference in average LDL levels was found. TG, TC and LDL levels were correlated positively with age, but HDL was not. Duration of paraplegia correlated positively with HDL levels, but negatively with LDL. The prevalence of dyslipidemia was 67% , and the prevalence of low HDL was 64%. Conclusions The serum lipid profiles of the young male paraplegics showed a high prevalence of dislipidemia, significantly low HDL levels with a high prevalence of low HDL, and no correlation with age. TG, TC and LDL levels increased with age. The duration of paraplegia was correlated positively with HDL but negatively with LDL, probably due to increased exercise of the upper limbs.
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@#ObjectiveTo explore the arrhythmia happened in patients with cervical spinal cord injury (CSCI). Methods61 patients with CSCI were retrospectively analyzed. ResultsThe overall incidence of sinus bradycardia was 26.2%, which was higher in the cases within 3 months (52.4%) than over (12.5%); and was higher in cases injured the cord above C5（46.2%）than lower (C6-8,11.4%). ConclusionThe risk of arrhythmia is still high in chronic phase, which still need to monitor.
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@#ObjectiveTo investigate the relationship between high-sensitivity C reactive protein （hs-CRP） and oxygen uptake efficiency slope (OUES) in patents with cardiovascular disease. MethodsExercise tests, following a symptom-limited standard Bruce protocol with simultaneous respiratory gas-exchange measurements, were performed on a treadmill in 17 post-PCI patients, 21 stable angina pectoris and 24 patients with essential hypertension (EH). The oxygen uptake (VO2), minute ventilation (VE) were determined. The OUES was derived from the relation between VO2 (ml/min) and VE (L/min) during incremental exercise and was determined by VO2=a×lgVE+b, where a = OUES. The OUES was calculated from data of the first 75% (OUES75) and 100% (OUES100) of exercise duration. The serum hs-CRP was measured by immunoassays, and the left ventricular ejection fraction (LVEF) was measured with echocardiography. ResultsOUES75 （r=-0.506,P＜0.001）, OUES100 （r=-0.567,P＜0.001） and LVEF （r=-0.286,P＜0.01） were correlated with lg(hs-CRP). In stepwise multivariable linear regression models, lg(hs-CRP) （β=-0.374，P=0.006）, body height （β=-1.854，P=0.036）, body weight （β=-5.033，P=0.034）were independent risk factors of lower OUES75. lg(hs-CRP) （β=-0.396，P=0.003）, body height （β=-2.157，P=0.013）, body weight （β=-5.912，P=0.011） were independent risk factors of lower OUES100. ConclusionThe serum leveles of hs-CRP may be the useful marker that reflecting cardiopulmonary functional reserve and left ventricular function.
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Objective To explore the expression of nitric oxide synthases including neuronal nitric oxide synthases(nNOS), inducible nitric oxide synthases(iNOS), endothelial nitric oxide synthases (eNOS) in neurogenic bladder tissues, and analyze it's producing feature and significance. Methods There were 30 cases with neurogenic bladder(18 males, 12 females). The average age was 6.3±3.1 years. All patients appeared with myelodysplasia, urinary and fecal incontinence in different degree. Twenty-six cases were manifested with hyperreflexia bladders, and all patients were treated with surgical procedures. During operation, collected bladder tissue samples including tissues of apex vesicae and tissues of bladder neck, and all tissues were enveloped with mineral wax. All tissues were detected for nNOS, iNOS, and eNOS respectively in tissues of apex vesicae and tissues of bladder neck,and with normal bladder tissues as control group (bladder tissues of hypospadia, 10 cases), and according to clinical features, to explore the expression of NOS, and to analyze the relationship among them. Results In normal apex vesicae tissues, all cases stained with nNOS, and distributed among bundles of smooth muscles, and surface of smooth muscles and interstitial tissue, histochemica;score (HS) 2.8-4.0 and 1.2-2.7. There were no stained cells in bladder tissues of iNOS, and HS was very low, HS:0-0. 4 and 0-0.1 ;eNOS mainly distributed in interstitial tissues in rarefaction manners, and mainly in vascular endothelial cell (VEC), and smooth muscles had no stainings the most expression among them was nNOS, and mainly distributed in bladder neck tissues. In neurogenic bladder tissues, the main expression of NOS type was iNOS, and nNOS decreased significantly. eNOS mainly expressed in VEC among interstitial tissues, and had no staining in smooth muscle cells and collagenoblast and rarefaction of microvessel in bladder tissues, and microvessel density decreased significantly than normal bladder tissues. Microvessal density(MVD) in bladder tisssus (6. 8± 3.2/100per square) was less than that in normal tissues (16.7±6.3/100 per square). Conclusions In normal bladder tissues, nNOS mainly distributes in bladder neck and urethra, and nitric oxide mainly derives from nNOS. Much more matrix fibers, fewer nitrogenergic nerves, and less nNOS expression are seen in neurogenic bladder interstitial tissue. There are more iNOS expressions in bladder tissues,and NO is mainly derived from iNOS, and it may play an important role in pathological bladder tissues, especially in fibrosis of bladder wall. eNOS may be considered as angiopoietic labeling, and may evaluate the blood supply of bladder.
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@#Objective To investigate the efficacy of the oxygen uptake efficiency slope (OUES), obtained from submaximal exercise, as an index of cardiopulmonary functional reserve in adults. Methods Exercise tests, following a symptom-limited standard Bruce protocol with simultaneous respiratory gas measurement, were performed on a treadmill in 33 healthy adults free of clinically recognized cardiovascular disease and 31 patients with heart disease. The OUES was derived from the relation between oxygen uptake (VO2) and minute ventilation (VE) during incremental exercise and was determined by VO2=alog10VE+b, where a=OUES. The OUES was calculated from data of the first 75%, 90% and 100% of exercise duration (as 75%OUES，90%OUES and 100%OUES). Results The 100%OUES，90%OUES and 75%OUES were not significantly different from each other（F=0.212，P=0.809）. The 75%OUES was slightly lower (1.9%) than the 100%OUES. The 100%OUES, the 90%OUES and the 75%OUES correlated with the peak VO2 （r=0.836,r=0.824 and r=0.777, P<0.001, respectively）. The VAT correlated with the peak VO2 （r=0.878，P<0.001），and the VE/VCO2 at VAT correlated with the peak VO2 （r=-0.584，P<0.001）. The 100%OUES correlated with the 90%OUES and the 75%OUES （r=0.991 and r =0.945, P<0.001, respectively）. Conclusion The OUES is an index of exercise performance and cardiopulmonary functional reserve on healthy adults and patients with cardiac disease. The 75%OUES from submaximal exercise can be an index of cardiopulmonary functional reserve for patients with cardiac disease.
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@#Objective To investigate the effect of long-term cardiac rehabilitation on risk factors with doctor supervision after percutaneous coronary intervention(PCI). Methods One hundred and twelve patients after PCI were divided into the cardiac rehabilitation group(56 cases) and the control group (56 cases). All of the patients were given medication and health education, meanwhile the cardiac rehabilitation group received 4～6 weeks hospitalized cardiac rehabilitation program and one year ambulatory cardiac rehabilitation with doctor supervision. Risk factors were assessed six mouths and twelve mouths after the treatment. Results The risk factors except diastolic blood pressure and body weight index improved more significantly in the cardiac rehabilitation group than in the control group. Clinical event in the cardiac rehabilitation group is lower than in the control group. Conclusion Long-term cardiac rehabilitation with doctor supervision is safe, efficiency and good compliance to improve risk factors of coronary heart disease after PCI except diastolic blood pressure and weight management.
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@#Objective To investigate the relationship between objectively determined daily physical activities and blood pressure levels in Chinese adults. Methods 125 individuals who participated in routine physical examinations of health were investigated, include systolic pressure, diastolic pressure, pulse pressure, and daily walking steps determined by pedometer. Results The daily walking steps correlated negatively with systolic pressure（Male r=－0.613, P＜0.01; Female r=－0.430, P＜0.01） and diastolic pressure (male r=－0.686, P＜0.01; female r=－0.388,P＜0.01). Daily walking steps of normotensive, pre-hypertensive, and hypertensive groups were (18249±6066) step/d, (10395±3788) step/d, (6232±3967) step/d for males, and (12564±6927) step/d, (11458±5084) step/d, (6153±3569) step/d for females respectively （P＜0.05）. Conclusion The daily physical activity determined by walking steps correlated negatively with blood pressure in Chinese adults. Hypertensives often live in low active or sedentary lifestyle. Active lifestyle （≥10000 step/d） may help keep normal blood pressure for Chinese adults.
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@#Objective To investigate the relationship between daily walking-steps and serum lipids.Methods 120 individuals who participated in routine physical examinations of health were investigated, objective measurements included triacylglycerol (TG), total cholesterol (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL), and daily walking-steps were determined by pedometer.Results The daily walking-steps were correlated negatively to TG ( r=-0.351, P＜0.01), and positively to HDL ( r=0.284, P＜0.05) for male after adjustment for age.Conclusion Daily walking-steps determined by pedometer are correlated negatively to TG levels, and positively to HDL levels for male. No correlations are found between daily walking-steps and levels of TC, LDL for male. No correlations are found between daily walking-steps and serum lipids for female.
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@# Objective To investigate the relationship between daily physical activities determined by walking-steps and the obesity indices including body weight，Body Mass Index (BMI)，waist and hip circumference and their ratio in adults. Methods 125 individuals who participated in routine physical examinations of health were measured with body weight, BMI, waist and hip circumference/ratio, daily physical activities determined by walking steps. Results For males, daily physical activities correlated negatively with body weight （r=-0.397，P＜0.01）, BMI （r=-0.499，P＜0.01）, waist circumference （r=-0.490, P＜0.01） and the ratio of waist vs. hip circumference （r=-0.478，P＜0.01）, whereas body weight（r=-0.342，P＜0.01）, BMI （r=-0.249，P＜0.05）, and hip circumference （r=-0.303，P＜0.05） for females. Daily walking-steps were significantly different among the groups of normal weight (11491±6100) steps/d, overweight (9314±5722) steps/d, and obesity (6141±2985) steps/d (P＜0.01). Conclusion Daily physical activities determined by walking steps correlated significantly with obesity indices.
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@# The author discussed the necessitude of synchronization of cardiac interventional therapy and cardiac rehabilitation, and the methodology of cardiac rehabilitation medicine education in the article.
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@# Objective To infect human pulmonary artery smooth muscle cells with different HIV-based vectors, and introduce foreign genes into the cells with HIV-based lentivirus vectors.MethodsThe human pulmonary artery smooth muscle cells, U87.CD4.CCR5 and U87.CD4.CXCR4, were infected with ADA/Luc, HXB2/Luc, VSV-G/Luc and VSV-G/GFP.ResultsU87.CD4 with corresponding coreceptors could be infected by ADA/Luc and HXB2/Luc, however, the human pulmonary artery smooth muscle cells could not be infected by ADA/Luc and HXB2/Luc, even pseudotypes. VSV-G/Luc and VSV-G/GFP could be transfered into the human pulmonary artery smooth muscle cells. After 3 days post-infection, the relative proportion of positive cells of human pulmonary artery smooth muscle cells expressing VSV-G/GFP was 18%.ConclusionHIV-based lentivirus vectors can introduce foreign genes into the human pulmonary artery smooth muscle cells.