Regulation of ischemic stroke by circadian rhythm and intervention by traditional Chinese medicine / 中国中药杂志

Circadian rhythm is an internal regulatory mechanism formed in organisms in response to the circadian periodicity in the environment, which modulates the pathophysiological events, occurrence and development of diseases, and the response to treatment in mammals. It significantly influences the susceptibility, injury, and recovery of ischemic stroke, and the response to therapy. Accumulating evidence indicates that circadian rhythms not only regulate the important physiological factors of ischemic stroke events, such as blood pressure and coagulation-fibrinolysis system, but also participate in the immuno-inflammatory reaction mediated by glial cells and peripheral immune cells after ischemic injury and the regulation of neurovascular unit(NVU). This article aims to link molecular, cellular, and physiological pathways in circadian biology to the clinical consequences of ischemic stroke and to illustrate the impact of circadian rhythms on ischemic stroke pathogenesis, the regulation of NVU, and the immuno-inflammatory responses. The regulation of circadian rhythm by traditional Chinese medicine is reviewed, and the research progress of traditional Chinese medicine intervention in circadian rhythm is summarized to provide a reasonable and valuable reference for the follow-up traditional Chinese medicine research and molecular mechanism research of circadian rhythm.

Effects of Dexmedetomidine Intratracheal Instillation on Quality of Emergence from General Anesthesia in Patients Undergoing Gynecologic Laparoscopic Operation / 中山大学学报(医学科学版)

[Objective]To evaluate the effects of dexmedetomidine intratracheal instillation on quality of emergence from general anesthesia in patients undergoing gynecologic laparoscopic operation. [Methods]Ninety patients of ASA I orⅡ,aged 18~64 years old,weighed 40~80 kg,scheduled for elective gynecological 1aparoscopic surgery under general anes-thesia,expected surgery time 1-2 h,requiring endotracheal extubation after surgery,were randomly divided into 3 group (n=30 each):control group(group C),exmedetomidine administered intratracheally group(group D1)and dexmedetomi-dine administered intravenously group(group D2).At the beginning of operation,2 μg/kg of dexmedetomidine were infused intratracheal through the drug injection hole of disposable enhanced Ⅲendotracheal tube in group D1 and 0.5 μg/kg of dex-medetomidine were intravenous pumped in 10 minutes in group D2,while saline was used in group C.The patients were sent to postanesthesia care unit after extubaion. MAP and HR were recorded at the time of dexmedetomidine or saline infused (T0),and 5,10,15,30 min(T2-T4)after dexmedetomidine or saline infused,immediately after extubation(T5),and 5,10,15,30 min(T6-T9)after extubation.The time of the patients to recover spontaneous breath,eye opening,extubation and direc-tional power were recorded.The cough reflex scores and sedation-agitation scale during extubation,the visual analogue scale and Ramsay sedation scale at 30 minutes after extubation were also recorded.[Results]①Compared with T0,MAP and HR increased statistically at T5~T7in group C,MAP increased statistically at T5~T6and HR increased statistically at T5~T7in group D1 and D2(P<0.05).Compared with group C,MAP and HR at T5~T7decreased statistically in group D1 and D2(P<0.05).②The scores of cough reflex,sedation-agitation scale and visual analogue scale were significantly lower in group Dl and D2 than in group C(P<0.5).③The incidence of agitation,high blood pressure and tachycardia were significantly lower in group D1 and D2 than in group C(P<0.05).[Conclusions]Either intravenous pumping or intratracheal instillation of dex-medetomidine for patients undergoing gynecological laparoscopic surgery can effectively keep stable perioperative hemody-namics,relieve cough reflex,agitation incidence and enhance the quality of emergence from general anesthesia recovery.

Calyceal diverticulum mimicking simple parapelvic cyst: a case report / 中国医学科学杂志(英文版)

Calyceal diverticulum is a cystic intrarenal cavity lined by nonsecretory transitional epithelium that communicates with the collecting system via a narrow isthmus or infundibulum. It is a rare anatomic anomaly with an incidence of 0.2% to 0.6% in the patients undergoing renal imaging.1 Single imaging modality usually cannot differentiate calyceal diverticulum from other cystic renal diseases.2 Here, we report a 60-year-old male who was reliably diagnosed with calyceal diverticulum by retrograde urography combined with non-enhanced computed tomography (CT) and magnetic resonance urography (MRU).

Flexible ureteroscopy in management of asymptomatic calyceal calculi in flight attendants / 第二军医大学学报

Objective To evaluate the value of flexible ureteroscopy (F-URS) in managing asymptomatic calyceal calculi for flight attendants. Methods We retrospectively analyzed the clinical data of 8 flight attendants who were surgically treated for asymptomatic calyceal calculi at our hospital from January 2008 to May 2012. The demographic information, disease characteristics, and perioperative information were collected. Results Eight patients had a total of 37 intrarenal calculi, with bilateral renal stones found in 2 patients. The mean number of stones per kidney in our patients was 3.7+0.7 (range 3-5). The mean size of individual stone was (4.5+1.5) mm (range 2-8 mm). The mean stone size per kidney was (16.8 ± 4.7) mm (range 6-20 mm). The mean operation time was (45.0+7.6) min (range 30-56 min) and the average postoperative hospital stay was (1.8+0.5) d (range 1-2 d). Mean time lost from work due to F-URS was (13.0+1.1) d (range 12-15 d). No severe complications occurred during the operation. Stone free rate was 100% at 2 weeks after treatment as showed by a follow-up CT scan. Conclusion F-URS with holmium laser is a safe, effective and minimally invasive procedure, and may serve as a first-line therapy for asymptomatic calyceal calculi for flight attendants.

Simultaneous bilateral flexible ureteroscopy with holmium laser lithotripsy: Analysis of safety and efficacy / 第二军医大学学报

Objective To discuss the safety and efficacy of simultaneousbilateral flexible ureteroscopy (SBFU) with holmium laser lithotripsy for bilateral renal or ureteral calculi. Methods The clinical data of 78 patients (51 males, 27 females; average age [43 ± 12] years, range 22 to 74 years) who underwent SBFU with holmium laser lithotripsy for bilateral renal or ureteral calculi in our hospital between January 2004 and February 2013 were retrospectively reviewed. The mean number of stones per case was 3. 0±0. 5 (range 2 to 5), and the mean diameter of the largest stone was (2. 5±1. 2) cm (range 1. 0 to 5. 0 cm). The operation was conducted under intravenous anesthesia. The upper ureteral calculi was removed firstly by ureteroscopy with holmium laser when it existed. After the ureteral access sheath was placed, flexible ureteroscopy was inserted into the renal pelvis, and then a 200

Volumes of total prostate and transitional zone are positively correlated with age in benign prostatic hyperplasia patients / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the total prostate volume (TPV) and prostate transitional zone volume (TZV) in different age groups of benign prostatic hyperplasia patients, calculate the transitional zone index (TZI), and analyze correlation of age with the above parameters.</p><p><b>METHODS</b>We divided 1,563 BPH patients into 4 age groups (50-59, 60-69, 70-79 and 80-89 y), measured their TPV and TZV by rectal ultrasonography, calculated their TZI and evaluated all the data obtained by statistical analysis.</p><p><b>RESULTS</b>The TPV, TZV and TZI of the BPH patients were shown to be (32.27 +/- 15.76) ml, (9.55 +/- 98) ml and 0.28 +/- 0.13 in the 50-59 y group; (40.93 +/- 17.45) ml, (14.94 +/- 11.83) ml and 0.34 +/- 0. 16 in the 60-69 y group; (46.56 +/- 20.31) ml, (19.54 +/- 19.25) ml and 0.39 +/- 0.16 in the 70-79 y group; and (47.85 +/- 26.63) ml, (20.40 +/- 16.78) ml and 0.41 +/- 0.19 in the 80-89 y group. Both TPV and TZV were positively correlated with the patients' age, (r1 = 0.232, r2 = 0.256).</p><p><b>CONCLUSION</b>TPV and TZV increase with age in BPH patients, the latter even more obviously than the former.</p>

Study on the results of treating tuberculosis inpatient in the general hospitals: a correspondence analysis / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the current status of treatment among inpatients of tuberculosis (TB) in general hospitals, and to related to different attrributes.</p><p><b>METHODS</b>A retrospective study was designed for inpatients with TB who were discharged from general hospitals in Nachong region, 2003. Factors associated with the results of treatment were selected, using Chi-square test. Further correspondence analysis (CA) was used to visualize the relationship between attributes of inpatients and results of treatment in general hospitals.</p><p><b>RESULTS</b>Statistically significant factors associated with treatment results would include gender, age, state of illness at access to hospital, comorbidity and length of stay, while ways of payment, occupation and marital status were not statistically significant. The joint plot of CA showed results as follows: (1) Attributes of inpatients died in general hospitals were clearly different from that of cured or improved inpatients. (2) Result of hospitalization on treatment was more likely to be 'improved' for TB inpatients who were male, aged > or = 15 yrs, and with urgent condition when administered into the hospitals. (3) Result of cure was likely to be seen among inpatients who were female, length of stay >8 days, with no comorbidity, and with average illness state when accessing to hospitals. (4) Bad treatment results were appeared for inpatients younger than 15 yrs, with critical state when administered to hospitals.</p><p><b>CONCLUSION</b>(1)CA provided us with a new way on how to extract useful information from miscellaneous data of the patients. (2) The relationships between the results of treatment from the general hospitals and TB inpatients' attributes might provide tips to develop a series of corresponding strategies for treating TB inpatients with special attributes in order to obtain higher cure rate.</p>

Association between single-nucleotide polymorphisms in estrogen receptor beta gene and risk of prostate cancer / 中华外科杂志

<p><b>OBJECTIVE</b>This study was undertaken to investigate the relationship of some single nucleotide polymorphisms (SNPs) of estrogen receptor beta (ERbeta) with the risk of prostate cancer (CaP).</p><p><b>METHODS</b>The allele, genotype distribution in an association study with case-control samples involving 40 CaP cases and 86 unrelated healthy male subjects was analyzed. In these individuals, three upstream regions of the proximal ER promoter SNPs (rs3829768, rs1271572, rs3841304) and exon 7 SNP (rs1256049) were analyzed by directly sequencing amplified PCR products of genomic DNA.</p><p><b>RESULTS</b>Four polymorphisms were identified. The rs3841304 was excluded from further analysis because of significant deviation from the Hardy-Weinberg equilibrium. The genotype and allele frequency of rs3829768 (A/G) and rs1271572 (C/A) in the upstream region of proximal promoter were significantly decreased in the CaP cases versus control (P < 0.01).</p><p><b>CONCLUSIONS</b>Our study suggests that this disease of interest is highly associated with rs3829768 (A/G) and rs1271572 (C/A) in CaP cases. CaP, prostate cancer; ERalpha, estrogen receptor alpha; ERbeta, estrogen receptor beta; SNP, Single nucleotide polymorphisms; betaERKO, ERbeta knockout; PIN, prostatic intraepithelial neoplasia; HWE, Hardy-Weinberg equilibrium; NRE, Negative Regulatory Element.</p>

High-power holmium laser with percutaneous nephrolithotripsy for kidney calculi / 中华外科杂志

<p><b>OBJECTIVE</b>To assess the efficacy and safety of the high-power holmium laser with percutaneous nephrolithotripsy for kidney calculi.</p><p><b>METHODS</b>The high-power (60 W: 3.0 J x 20 Hz) holmium laser with percutaneous nephrolithotripsy was performed on 52 patients with single kidney pelvic or calyceal stones (average stone diameter 3.1 cm), 36 patients with multi-kidney pelvic and calyceal stones (average diameter 2.8 cm), 24 patients with staghorn stones (average diameter 6.8 cm). The duration of stone surgery, stone-free rate and complication were assessed.</p><p><b>RESULTS</b>The mean duration of stone surgery was 44 min, the stone-free rate was 66% (74/112) after the first session, 89% (100/112) at the end of session. 3 patients had high fever after percutaneous nephrolithotripsy, no other adverse events were noted.</p><p><b>CONCLUSIONS</b>The high-power holmium laser with percutaneous nephrolithotripsy can fragments calculi quickly and reduces the length of time of operation. It is an effective and safe technique for kidney calculi.</p>