Gonococcal infections of the penile skin and accessory glands in men: high-frequency ultrasound features and their clinical significance / 中华皮肤科杂志

Objective:To investigate ultrasonographic manifestations of gonococcal infections of the penile skin and accessory glands in men, and to assess their clinical significance.Methods:From January 2014 to January 2021, male patients with gonococcal infections of the penile skin and accessory glands were collected from Department of Dermatology, Changshu No.1 People′s Hospital. The diagnosis had been confirmed by laboratory examinations, and these patients had not received relevant treatment. The real-time ultrasound imaging system SIEMENS ACUSON X300 was used to examine the penile skin and accessory gland lesions infected with Neisseria gonorrhoeae, with the probe frequency ranging from 7.5 to 15 MHz. Patients with tubular anechoic fluid-filled areas on the high-frequency ultrasound images received a single dose of intramuscular ceftriaxone (1 g) ; those with oval-shaped anechoic fluid-filled areas on the high-frequency ultrasound images received incision and drainage followed by intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days; those with hypoechoic or mixed echoic areas on the high-frequency ultrasound images received intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days, and if the nodules did not regress after 1-month treatment, local resection would be performed. One month after the treatment, the patients were followed up, and the efficacy was evaluated. Results:A total of 32 male patients with gonococcal infections of the penile skin and accessory glands were collected. They were aged 28.54 ± 3.27 years, all had a history of non-marital sexual contact, and the duration from non-marital sexual contact to the onset of symptoms was 4.45 ± 1.03 days. The disease course was 8.64 ± 1.87 days. Lesions were all solitary, and located at the external urethral meatus in 16 cases (50.00%) , at the glans penis in 7 cases (21.88%) , beside the foreskin frenulum in 5 cases (15.62%) , and at the penile raphe in 4 cases (12.50%) . Sixteen patients (50.00%) presented with sinus-like lesions, 9 (28.13%) with abscesses, 7 (21.87%) with nodules, and all had tenderness on palpation. High-frequency ultrasound examination showed tubular anechoic fluid-filled areas in 16 cases (50.00%) , oval-shaped anechoic fluid-filled areas in 7 cases (21.88%) , hypoechoic areas in 5 cases (15.62%) , and mixed echoic areas in 4 cases (12.50%) . Gonococcal infections involved the cavernous body of the urethra in 16 cases (50.00%) , cavernous body of the penis in 5 cases (15.62%) , and subcutaneous tissue of the penis in 11 cases (34.38%) . After the treatment, all the patients were cured.Conclusion:High-frequency ultrasound can be used in the assessment of skin lesions and selection of treatment regimens for male patients with gonococcal infections of the penile skin and accessory glands.

Status of anxiety and depression in male patients with gonococcal infection in paraurethral ducts before and after paraurethral duct dilatation / 中华医学美学美容杂志

Objective To verify the change of the anxiety and depression of patients anteriorposterior treatment at paraurethral duct dilitation after gonococcal infection of paraurethral duct.Methods Twenty-eight patients of paraurethral duct dilatation after male gonococcal infection of paraurethral duct were enrolled,and the patients were treated in the Department of Dermatology and Venerology,the First People's Hospital of Changshu City.The anxiety and depression of patients anteriorposterior treatment were assessed and compared with Hamilton depression scale and Hamilton anxiety scale.Results The total scores of Hamilton depression scale and Hamilton anxiety scale before treatment were positively correlated with course of disease (r =0.481,P =0.0095;r =0.549,P =0.0025).The total scores of Hamilton depression and anxiety before treatment were from 1 to 31 (18.9±7.5) and from 4 to 30 (14.9±6.8).The symptoms of depression and anxiety appeared in 11 patients and 15 patients respectively.The total scores of Hamilton depression andanxiety after treatment were from 0 to 8 (4.3±1.7) and from 0 to 8 (3.3±1.7).There was no symptom of depression and anxiety.The difference of the total score of Hamilton depression and anxiety before and after treatment had statistical significance (t =12.270,P＜0.001,t =10.626,P＜0.001).The difference of positive rate of depressive and anxious symptom before and after treatment had statistical significance too (x2 =9.05,P=0.003;x2 =13.06,P=0.000).Conclusions The sequelae of gonococcal paraurethral duct infection in male paraurethral duct dilatation can result in the anxiety and depression of patients,which should be treated.Effective therapy can relieve or cure the anxiety and depression of patients without the assistance of psychotropic drugs.

Skin lesion, neuralgia and blood pressure before and after early formal treatment on herpes zoster of the head and face inadults: a quantitative study / 中华医学美学美容杂志

Objective@#To observe the changes of skin lesion, neuralgia and blood pressure in hypertension patients and non-hyperension patients before and after the early formal treatment on herpes zoster in the head and face.@*Methods@#Clinical data were collected from June 2015 to May 2018 in the Department of Dermatology, the First People＇s Hospital, Changshu, Jiangsu province. In 104 cases of hospitalized patients with herpes zoster, 46 cases had high blood pressure (hypertension group); 58 cases did not have high blood pressure (non-hypertension group). The skin lesion, numerical rating scale (NRS) and blood pressure changes were compared between the two groups before and after treatment.@*Results@#A total of 99 patients completed treatment; 45 cases in the hypertensive group included 25 males, 20 females, aged 35 to 71 (52.40±12.51) years; 54 cases in the non-hypertensive group included 30 males and 24 females, aged 36 to 75 (52.62±12.67) years. There was no statistically significant difference in the time of control, improving and healing of skin lesion (t=-0.457, -0.607 and 1.399, P>0.05) . There was no statistically significant difference in NRS between the two groups before treatment (t=-0.009, P=0.993 >0.05). After treatment, the NRS of both groups decreased compared with those before treatment, and the difference was statistically significant (F=151.130, 181.444, P<0.05). There was no significant difference in NRS between the two groups after treatment (Z=-0.032, -0.154, -0.149 and -0.426, P>0.05). In the hypertension group, the rate of blood pressure increase before treatment was 62.22%, and the blood pressure decreased after treatment compared with that before treatment. The difference was statistically significant (P<0.05). In the non-hypertension group, the rate of increase of blood pressure before treatment was 5.56%, and the blood pressure after treatment was lower than before treatment. The difference was not statistically significant before and after treatment (P>0.05).@*Conclusions@#Blood pressure can be increased when herpes zoster occurs. After early formal treatment of herpes zoster, skin lesion healed, neuralgia reduced and blood pressure can return to normal. The history of hypertension and the increase of blood pressurd before treatment has no effect on the recovery of skin lesion and neuralgia.

Effects of high intensity military training on cardiovascular system of military personnel / 解放军医学杂志

Objective To explore the changes of cardiovascular system of military personnel during highly intensive training.Methods One hundred and seventy officers and soldiers were as research subjects,including 100 individuals in high-intensity group and 70 in control group.The levels of serum cortisol (COR),high sensitivity C-reactive protein (hs-CRP),cardiacspecific Troponin T (cTnT) and human heart fatty acid binding protein (H-FABP) were measured when military training ended.All subjects were tested with fatigue assessment instrument (FAI).The data of blood pressure and electrocardiogram were collected from 40 individuals randomly selected from high-intensity group and 36 from control group before and after training for analyzing the blood pressure,arrhythmia and heart rate variability (HRV).Results The levels of COR (indicator related to stress) and hs-CRP (indicator related to inflammation) were significantly higher in high intensity group than in control group (P＜0.05).Highly intensive training can lead to the emergence of myocardial micro-injury,the levels of cTnT and H-FABP were obviously higher than those in control group (P＜0.01),and the mean blood pressure and the severity of fatigue status were significantly higher than those in control group (P＜0.05).The incidence of severe ventricular arrhythmia was lower in both groups (P=1.000).The average heart rate,total heart beats,total number of atrial premature beat,total number of ventricular premature beat,the incidence of sinus arrhythmia and intermittent second degree type Ⅰ atrioventricular block were significantly higher in high intensity group than in control group (P＜0.05).The HRV of high intensity group was obviously decreased (P＜0.01).Conclusion Highly intensive training may induce the military personnel into the state of acute stress and inflammation,which may lead to myocardial injury,increase severity of fatigue status,accompanied with the rise of blood pressure,low HRV and increased incidence of various arrhythmias.

Therapeutic effect of combined glucocorticoids on herpes zoster of the head and face in the elderly / 中华皮肤科杂志

Objective To evaluate the therapeutic effect of combined glucocorticoids on herpes zoster of the head and face in the elderly aged ≥ 60 years.Methods From June 2013 to June 2017,76 patients with herpes zoster of the head and face were enrolled from the Department of Dermatology of Changshu No.1 People's Hospital,and randomly and equally divided into glucocorticoid group and conventional treatment group by drawing lots.The patients in the 2 groups were all treated with intravenous penciclovir (0.25 g,twice a day) for 7 days,intravenous mecobalamine (1 ml,once a day) for 7 days,and topical penciclovir cream four times every day,and the patients in the glucocorticoid group were additionally treated with intravenous methylprednisolone sodium succinate (40 mg,once a day) for 5 days.The time to skin lesion improvement and pain relief,incidence of postherpetic neuralgia and adverse reactions were compared between the two groups.Results The time to skin lesion improvement was shorter in the glucocorticoid group than in the conventional treatment group(P ＜ 0.01).Before the treatment,no significant difference in the numerical rating scale (NRS) score for pain was observed between the 2 groups (P ＞ 0.05).Seven days after the treatment,the NRS score was significantly lower in the glucocorticoid group than in the conventional treatment group (P ＜ 0.05),while there was no significant difference between the 2 groups after 30-and 90-day treatment (both P ＞ 0.05).The incidence rate of postherpetic neuralgia was very low in the 2 groups with no significant difference between them (x2 =0.347,P ＞ 0.05).The 2 groups both showed infrequent and mild adverse reactions.Conclusion Combined glucocorticoids showed marked therapeutic effect and good safety for herpes zoster of the head and face in the elderly.

Factors related to healing time and scarring of herpes zoster in head and face / 中华医学美学美容杂志

Objective To investigate the healing degree of lesions of herpes zoster in the head and face and the risk factor of the discosmetic sequelae.Methods 92 case of herpes zoster in the head and face were enrolled in this study.The patients were treated in dermatological clinic of Changshu No.1 People's Hospital from Jan.2017 to Jun.2018.The clinical data were recorded,such as the time of control,improving and healing of lesion,sex,age,position,the time of therapy starting and the behavior of scratching,extrusion and divest crust.The blood glucose and serum albumin of patients were measured.We observed the remained scars and performed statistic analysis.Results In diabetes group,the control and healing time was (2.40±1.28) d and (10.38+2.47) d respectively,meanwhile the control and healing time was (1.72 ± 0.94) d and (8.32 ± 2.66) d respectively in non-diabetes group (P＜0.05).The single factor analysis indicated that the age,position,diabetes,lesion extrusion,divest crust were the correlation factors of the zoster scar in head and face (P＜0.05).Nevertheless the multifactor logistic regression indicated that the position,diabetes and divest crust were independent risk factors of the zoster scar in head and face (P＜0.05).Conclusions The healing of herpes zoster is affected by diabetes.The independent risk factors of zoster scar in head and face are non-trigeminal nerves positions,diabetes and divest crust.

Effects of non-surgical periodontal therapy on serum inflammatory markers and metabolic level in obese rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of non-surgical periodontal therapy on serum inflammatory factors and metabolism levels in obese rats with experimental periodontitis.</p><p><b>METHODS</b>Sixteen obese rats with experimental periodontitis were randomly divided into treatment group and control group with non-surgical periodontal therapy and no treatment, respectively. Oral glucose tolerance test was performed before treatment and 2 weeks after the treatment. All the rats were sacrificed 2 weeks after treatment and the orbital vein blood was taken to detect fasting blood glucose, fasting insulin, and serum level of C-reactive protein (CRP). Results Two weeks after periodontal treatment, fasting blood glucose (t=2.445, P=0.034) and beta cell function index (t=-2.543, P=0.027) were significantly lower in the treatment group than in the control group. Compared with those in the control group, CRP level (t=2.388, P=0.028) and the area under the curve in the oral glucose tolerance test (t=12.053, P=0.000) decreased significantly in the treatment group.</p><p><b>CONCLUSION</b>Non-surgical periodontal treatment can reduce serum CRP level and improve glucose metabolism in obese rats.</p>

Analysis for the Onset Features and Prognosis in"Migratory Birds"Population With Acute Myocardial Infarction in Hainan Province / 中国循环杂志

Objective: To explore the onset features and prognosis in "migratory birds" population with acute myocardial infarction (AMI) in Hainan province. Methods: A total of 1246 patients diagnosed as coronary aretery disease and admitted in our Hospital during 2012-2015 were consecutively enrolled, including "Migratory birds" group (n=197) and Hainan group (n=58). Clinical information, risk factors, interventional strategies and in-hospital outcomes were recorded and compared. Results: The patients' age, histories of hypertension, diabetes, smoking and blood lipids were similar between 2 groups. In "Migratory birds" group, the average time from arriving Hainan to AMI onset was (3.15±2.67) days. Compared with Hainan group, "Migratory birds" group had the higher ratio of acute STEMI occurrence [70.56% (139/197) vs 51.72% (30/58), P=0.003], more patients with single+double coronary artery diseases (P=0.009), and thrombus aspiration (P=0.008); while less stent implantation, P=0.007. "Migratory birds" group also presented the higher ratios of cardiac shock after AMI (12.69%vs 3.45%, P=0.044), and cardiac shock+death (16.24% vs 3.45%, P=0.022). Conclusion: "Migratory birds" AMI patients had the higher ratios of acute STEMI, with more simple lesions and thrombus aspiration, they usually had poor prognosis.

High-frequency ultrasound imaging-guided wedge resection for the treatment of paraurethral duct dilatation following gonococcal paraurethral duct infection in 11 male patients / 中华皮肤科杂志

Objective To evaluate therapeutic effects of wedge resection on male paraurethral duct dilatation following gonococcal paraurethral duct infection. Methods With the aid of high-frequency ultrasound images, 11 male patients with paraurethral duct dilatation following gonococcal paraurethral duct infection were treated with wedge resection. The data were collected, including the surgical duration, amount of bleeding during the surgery, period of wound healing and complications. If the ostium beside the external urethral orifice disappeared within 4 weeks after the surgery, there was no discharge from the ostium with pressure, and no tubular echoic area was observed by high-frequency ultrasound imaging, the patient was considered to be recovered. If none of the above three conditions could be met, the surgical treatment was considered to be ineffective. Results The average surgical duration was 19.19 ± 2.71 minutes(range, 14-23 minutes), the average amount of bleeding during the surgery was 11.09 ± 2.07 ml (range, 8-14 ml), and the average period of wound healing was 14.91 ± 1.45 days(range, 13-17 days). Of the 11 patients, 10 were cured, and 1 showed no response. No complications were observed in any of the 11 patients, and no defects formed in the glans penis. Conclusion Wedge resection is a kind of effective therapy for paraurethral duct dilatation following gonococcal paraurethral duct infection in males.

Beneficial effect of periodontal therapy on insulin resistance and lipid metabolism in obese rats with periodontitis / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of periodontal therapy in controlling periodontitis and on insulin resistance and lipid metabolism in obese rats with periodontitis.</p><p><b>METHODS</b>Sprague-Dawley rats were randomized into normal group (group C), obese group (group O), periodontitis combined with obesity group (group P) and periodontal treatment group (group T). The obese rats in groups P and T were subjected to ligation of the maxillary second molar with silk thread to induce experimental periodontitis, and the rats in group T received periodontal therapy after the ligation. All the rats were sacrificed at the age of 24 weeks for measurement of blood lipids, insulin and blood glucose levels, and insulin resistance index (HOMA-IR) was calculated. The expressions of insulin receptor substrate-1 (IRS-1) and IRS-2 in the liver tissues were detected using real-time quantitative polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>Compared with the obese rats in group O, the rats in group P showed significantly higher HOMA-IR and LDL-C and lower expressions of IRS-1 and IRS-2 mRNA expression and HDL-C level (P<0.05). Compared with those in group P, the mRNA expressions of IRS-1 and IRS-2 and HDL-C level were significantly increased and LDL-C level, TC level and HOMA-IR were all decreased in group T (P<0.05), but the level of TG was comparable between the two groups. Pathological examination revealed lessened inflammatory cell infiltration and tissue destruction in the upper jaw of the rats in group T; the rats in group P presented with the most obvious upper jaw destruction and steatosis and inflammatory cell infiltration in the liver.</p><p><b>CONCLUSION</b>Periodontal inflammation can downregulate the expression of IRS-1 and IRS-2 and increase insulin resistance and dyslipidemia in obese rats. Periodontal therapy produces a beneficial effect in improving insulin resistance and reducing dyslipidemia in obese rats.</p>

Association between cardiac changes and stress, and the effect of peroxisome proliferator-activated receptor-γ on stress-induced myocardial injury in mice / 华中科技大学学报（医学）（英德文版）

This study was aimed to investigate the effect of stress induced by high-intensity exercises on the cardiovascular system. In the epidemiological investigation, 200 subjects (test group) engaged in special high-intensity exercises, and 97 who lived and worked in the same environment and conditions as those in the test group, but did not participate in the exercises served as controls. In the second part of the study, 50 mice were randomly divided into control group, exhaustive swimming group, white noise group, exhaustive swimming plus white noise group, and pioglitazone intervention group. The results showed that the plasma concentrations of the myocardial injury markers heart fatty acid-binding protein (H-FABP), C-reactive protein (CRP), β-endorphin (β-EP) and levels of psychological stress were significantly increased in test group as compared with control group; special high-intensity exercises resulted in a significant elevation of the incidence of cardiac arrhythmias. Animal experiments showed that the plasma levels of corticosterone (CORT) and troponin I (TnI) were raised while the level of SOD was reduced in exhaustive swimming group, white noise group, and exhaustive swimming plus white noise group. The expression levels of PPARγ mRNA and protein were decreased in myocardial tissues in these groups as well. HE staining showed no remarkable change in myocardial tissues in all the groups. Treatment with pioglitazone significantly decreased the plasma levels of TnI and CORT, while increased the level of SOD and the expression levels of PPARγ mRNA and protein. It was concluded that the high-intensity exercises may induce a heavy physical and psychological stress and predispose the subjects to accumulated fatigue and sleep deprivation; high-intensity exercises also increases the incidence of arrhythmias and myocardial injury. PPARγ may be involved in the physical and psychological changes induced by high-intensity exercises.

Association between cardiac changes and stress, and the effect of peroxisome proliferator-activated receptor-γ on stress-induced myocardial injury in mice / 华中科技大学学报（医学）（英德文版）

This study was aimed to investigate the effect of stress induced by high-intensity exercises on the cardiovascular system. In the epidemiological investigation, 200 subjects (test group) engaged in special high-intensity exercises, and 97 who lived and worked in the same environment and conditions as those in the test group, but did not participate in the exercises served as controls. In the second part of the study, 50 mice were randomly divided into control group, exhaustive swimming group, white noise group, exhaustive swimming plus white noise group, and pioglitazone intervention group. The results showed that the plasma concentrations of the myocardial injury markers heart fatty acid-binding protein (H-FABP), C-reactive protein (CRP), β-endorphin (β-EP) and levels of psychological stress were significantly increased in test group as compared with control group; special high-intensity exercises resulted in a significant elevation of the incidence of cardiac arrhythmias. Animal experiments showed that the plasma levels of corticosterone (CORT) and troponin I (TnI) were raised while the level of SOD was reduced in exhaustive swimming group, white noise group, and exhaustive swimming plus white noise group. The expression levels of PPARγ mRNA and protein were decreased in myocardial tissues in these groups as well. HE staining showed no remarkable change in myocardial tissues in all the groups. Treatment with pioglitazone significantly decreased the plasma levels of TnI and CORT, while increased the level of SOD and the expression levels of PPARγ mRNA and protein. It was concluded that the high-intensity exercises may induce a heavy physical and psychological stress and predispose the subjects to accumulated fatigue and sleep deprivation; high-intensity exercises also increases the incidence of arrhythmias and myocardial injury. PPARγ may be involved in the physical and psychological changes induced by high-intensity exercises.

Comparison of high-frequency ultrasound imaging and 3.0 T magnetic resonance imaging for the examination of males with gonococcal inflammation of paraurethral glands / 中华皮肤科杂志

Objective To investigate the morphologic characteristics of gonococcal inflammation of paraurethral glands in males. Methods Eleven male patients with gonococcal inflammation of paraurethral glands were examined by both real-time ultrasound imaging (Siemens Acuson X300) and 3.0 T magnetic resonance imaging (MRI, Philips Achieva). Results High-frequency ultrasound imaging revealed tubular echoic areas with well-defined borders and smooth margins in all the patients. The inside of these tubular areas was weak-echoic. These tubular echoic areas were blind in one end, but open in the other end, and ran in parallel with the urethra. The mean lumen diameter was 1.1 ± 0.2 mm (range, 0.7 - 1.3 mm) , and the mean lumen length was 8.4 ± 0.6 mm (range, 7.0 - 12.0 mm). Anechoic liquid-filled areas were seen in the tubular echoic areas in two patients. Paraurethral ducts were not detected by 3.0 T MRI in these patients. Conclusions High-frequency ultrasound imaging can clearly show the morphologic characteristics of gonococcal inflammation of paraurethral glands in males, and provide valuable ultrasound images for surgery.

Study on effect of Hypericum perforatum on pharmacokinetics of zedoary turmeric oil in compound antiviral preparation / 中国中药杂志

<p><b>OBJECTIVE</b>To study zedoary turmeric oil (ZTO) and the pharmacokinetics of its homemade compound antiviral preparation in New Zealand rabbits.</p><p><b>METHOD</b>RP-HPLC was used to determinate the content of germacrone in rabbit plasma after oral administration.</p><p><b>RESULT</b>After oral administration of ZTO and its homemade compound antiviral preparation, the plasma concentration-time curve of germacrone is in conformity to two-compartment open model. The pharmacokinetic parameters of ZTO: t1/2alpha, t1/2beta, Vd, CL, AUC and Ka were (1.52 +/- 0.59), (1.97 +/- 0.27) h, (47.59 +/- 2.29) L x kg(-1), (176.77 +/- 7.65) L x h(-1) x kg(-1), (5.70 +/- 0.70) mg x h x L(-1) and (0.97 +/- 0.11) h(-1), respectively, while those of compound preparation were (0.41 +/- 0.03), (1.47 +/- 0.35) h, (75.21 +/- 5.21) L x kg(-1), (287.79 +/- 6.39) L x h(-1) x kg(-1), (3.91 +/- 0.53) mg x h x L(-1) and (5.14 +/- 1.26) h(-1), respectively. There was no significant difference between the above two groups of pharmacokinetic parameters, expect that Ka of compound preparation was significantly higher than that of ZTO (P < 0.05).</p><p><b>CONCLUSION</b>Hypericum perforatum in compound preparation doesn't impact the distribution and elimination of active ingredients of ZTO in New Zealand rabbits, but it improves the absorption speed, and shortens the time of drug absorption, which contributes to rapid efficacy of ZTO in rabbits.</p>

Effect of endoscopic third ventriculostomy in treating severe obstructive hydrocephalus in premature infant / 中华实用儿科临床杂志

Objective To discuss the treatment and the clinical effect of endoscopic third ventriculostomy on severe obstructive hydrocephalus in premature infant.Methods Eleven patients were operated,ultrasound,CT and MRI showed severe obstructive hydrocephalus and cerebral spinal fluid absorption was normal.The technique was that endoscope was inserted through the foramen of Monro into the third ventricle,then perforating the floor of the third ventriculostomy.Comparison before and after surgery of ventricular system ultrasonic measurement about the change of lateral ventricle and the MRI and CT imaging changes were performed.The complications,operation effect and security were observed.The bailey baby scale and Peabody movement function scale was used to assess the patient's neurologic system status.Results The follow-up time was 6 months and 6 years after operation,an excellent operative result was got in 9 cases.The ventricular width of 1 patient was mild ventriculomegaly,but stayed stabilily.No change of ventricular width was found in 1 case.Additional shunt were needed in 1 case.No severe complications were found.The left and right lateral ventricle measured by ultrasonic before operation were (9.60 ± 3.52) mm and (8.63 ± 3.10) mm before operation,and (5.50 ± 2.20) mm and (4.90 ± 2.70) mm after operation.The 11 cases of lateral ventricle side edema were disappeared,the follow-up time in 9 cases were more than 12 months,obstructive hydrocephalus clinical symptoms were relieved.Conclusions Ventricular mirror operation significantly improve severe hydrocephalic short and longterm poor prognosis,it is a safe,effective and less complications of minimally invasive surgery.

Radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia guided by magnetic navigation system: a prospective randomized comparison with conventional procedure / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Atrioventricular nodal reentrant tachycardia (AVNRT) is one of the most common paroxysmal supraventricular tachyarrhythmias. The aim of the study was to prospectively compare the characteristics of radiofrequency catheter ablation of AVNRT guided by a magnetic navigation system with the conventional procedure.</p><p><b>METHODS</b>Patients with AVNRT diagnosed by electrophysiological tests were randomized into two groups. In the conventional technique group (CMT), a common 4-mm-tip quadrapolar temperature-controlled ablation catheter was used. In the magnetic navigation system guidance group (MNS), a magnetic 4-mm-tip quadrapolar temperature-controlled ablation catheter was used. The following parameters were collected and compared between the two groups: ablation procedure time, patient fluoroscopy time, operator fluoroscopy time, energy delivery numbers, maximal energy per deployment, success rate, complication rate and operative cost.</p><p><b>RESULTS</b>Forty patients were enrolled and randomized into CMT and MNS groups. The age, gender, tachycardia history and basic cardiovascular diseases of the two groups were comparable (P > 0.05). All procedures were conducted successfully without complications. No tachycardia recurred during the follow-up period of (9.3 ± 2.6) months. In the MNS group, the patient and operator fluoroscopy times ((11.5 ± 4.3) min, (4.2 ± 1.5) min), energy delivery numbers (3.2 ± 0.9), and maximal energy per deployment ((16.9 ± 3.4) W) were shorter or lower than those of the CMT group ((14.3 ± 6.2) min, (13.6 ± 3.5) min, 6.3 ± 2.1, (23.7 ± 1.3) W, respectively) (P < 0.05). But the operative cost for the MNS group was higher than that of the CMT group (P < 0.01).</p><p><b>CONCLUSION</b>Magnetic navigation system guided radiofrequency catheter ablation of AVNRT has the advantages of shorter fluoroscopy time and lower energy delivery numbers and maximal energy per deployment compared to the present conventional ablation technique.</p>

Role of the lung in the progression of multiple organ dysfunction syndrome in ageing rat model / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Multiple organ dysfunction syndrome in the elderly (MODSE) is a problem with high mortality in the critical care of elderly patients. The pathogenesis of MODSE remains elusive. This study aimed to establish rat models of MODSE and to investigate the pathogenetic mechanism responsible for the development of MODSE in the rat models.</p><p><b>METHODS</b>Twenty-four-month old rats (elderly) received intravenous injection of lipopolysaccharide (LPS) to induce rat model of MODSE. In the model, we observed the physical responses, biochemical indices changes, histopathological features of vital organs, including lung, liver, heart, and kidney. We also investigated the sequence of individual organ dysfunction and changes of proinflammatory factors. Three-month-old rats, serving as young rat controls, received parallel procedures. Besides, normal saline injection was also performed on elderly and young control rats.</p><p><b>RESULTS</b>All rats displayed different degree of physical response after LPS injection, preceded by deterioration of respiratory status. At 6 hours, lung injury was observed, which started earlier than other organ injury that was observed in about 24 hours. Furthermore, all vital organ injury was more severe in elderly rats than in young rats at the same time points. After LPS injection, pulmonary alveolar macrophages apoptosis rate increased obviously, and was more significant in elderly rats ((43.4 ± 8.4)%) than in young rats ((24.2 ± 3.0)%). LPS injection also enhanced tumor necrosis factor a (TNF-a) concentration significantly in these organs. Its peak concentration appeared at 6 hours in lung tissue and at 24 hours in other organs after LPS injection. TNF-a level was higher in elderly rats than in young rats at the same time points. The increase was most significant in lung tissue. After intravenous administration of LPS, toll-like receptor 4 (TLR4) expression in lung tissue was upregulated markedly, and peaked at 6 hours. In contrast, upregulation of TLR4 expression in liver peaked at 24 hours, lagging behind that in the lung.</p><p><b>CONCLUSION</b>Lung is the first and most seriously injured organ in rat model of MODSE and it may play an "initiating" role in the development of MODSE.</p>

Fifteen-year evolving trends of etiology and prognosis in hospitalized patients with heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the etiological and prognostic changes of hospitalized patients with chronic heart failure.</p><p><b>METHODS</b>This retrospective study analyzed 7319 hospitalized patients (male 62.07%) with validated primary discharge diagnosis of chronic heart failure in Chinese PLA General Hospital in Beijing from January 1, 1993 to December 31, 2007. Etiological characteristics, comorbidities and 30-day hospitalized mortality in the following three periods: 1993 - 1997 (n = 1623), 1998 - 2002 (n = 2444), and 2003 - 2007 (n = 3252) were compared.</p><p><b>RESULTS</b>(1) The patient age increased [(56.0 ± 17.5) years, (57.8 ± 17.6) years and (62.7 ± 15.5) years, P < 0.01] and hospital stay time decreased [(31.3 ± 17.4) days, (22.7 ± 14.1) days and (20.1 ± 15.2) days, P < 0.01] from 1993 to 2007. (2) The common causes of heart failure were coronary heart disease, hypertension, rheumatic valvular heart disease and diabetes mellitus. From 1993 - 1998 to 2003 - 2007, the proportion of patients with coronary heart disease, hypertension and diabetes mellitus rose from 37.2%, 23.3% and 12.3% to 46.8%, 46.7% and 21.1%, respectively (all P < 0.05). Meanwhile the proportion of patients with rheumatic valvular heart disease fell from 35.2% to 16.6% (P < 0.05). (3) The main etiologies and comorbidities were atrial fibrillation, myocardial infarction, pneumonia, chronic obstructive pulmonary disease and renal failure. From 1993 - 1998 to 2003 - 2007, atrial fibrillation was the most common cause of heart failure, and the rate of myocardial infarction, pneumonia and renal failure rose from 11.0%, 8.9% and 5.2% to 14.7%, 14.5% and 9.1%, respectively (all P < 0.05) and the rate of COPD fell from 12.9% to 8.4% (P < 0.05). (4) The 30-day hospitalized mortalities in the three periods were 7.0%, 4.5% and 5.1%, respectively, and the mortalities in the 1998 - 2002 and 2003 - 2007 periods were lower than those of in the 1993 - 1998 period (all P < 0.05). The mortality related to coronary heart disease decreased significantly from 1993 to 2007 (9.3%, 5.0% and 3.8% in the three periods, respectively, P < 0.05).</p><p><b>CONCLUSIONS</b>It is demonstrated that the primary diseases causing heart failure were coronary heart disease, hypertension, diabetes mellitus and rheumatic valvular heart disease, and the former three diseases exhibited a upward trend and the later one exhibited a downward trend. Moreover, the proportion of comorbidities in patients with heart failure increased over the study period. The 30-day hospital mortality exhibited a downward trend and decreased significantly in patients with coronary heart disease or myocardial infarction.</p>

Peptide bond scission of staphylococcal enterotoxin C2 and related factors / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the limited digestion of recombinant staphylococcal enterotoxin C2 (SEC2-His)in different conditions.</p><p><b>METHODS</b>The purified recombinant SEC2-His was treated with different reagents and the cleavage of rSEC2 molecule was observed by SDS-PAGE.</p><p><b>RESULT</b>The cleavage occurred in positions Cys93-Cys110 of the disulfide loop. Complete auto-cleavage of recombinant SEC2 was observed in solution at 37degrees within 24 hrs, and that was accelerated under alkaline conditions. The auto-cleavage of the recombinant protein was inhibited in the presence of beta-ME (2%), PMSF (5-10 mmol/L), imidazole (1 mol/L) or crude E.coli lysate. Non-specific degradation of recombinant SEC2 was promoted with the increasing of the concentration of H(2)O(2).</p><p><b>CONCLUSION</b>The recombinant SEC2-His is broken down in special site of protein, which may be associated with the protein structure.</p>

Predictors for development of multiple organ dysfunction syndrome in elderly patients with acute myocardial infarction / 老年心脏病学杂志（英文版）

Multiple organ dysfunction syndrome (MODS) is one of the leading causes of death in ICU patients.However,there have been few studies on the role of MODS as a cause of death in patients with acute myocardial infarction (AMI),particularly in those at advanced age.Our study aimed to investigate the incidence and to identify the predicting factors of MODS in elderly patients with AMI.Methods We identified consecutive patients with AMI who were discharged from the Chinese PLA General Hospital between January 1993 to June 2006.Medical records of 800 consecutive patients aged 60 years or over were analyzed retrospectively.Multivariate logistic regression was used to determine factors predicting in-hospital development of MODS.Results Twenty-seven (3.4%) patients developed MODS within 30 days after AMI.Compared with patients without MODS,patients with MODS had higher in-hospital mortality rates (55.6% vs 11.6%,P＜0.001 ) and more frequent complications of cardiogenic shock (25.9% vs 6.2%,P＜0.001),heart failure (HF) (59.3% vs 18.2%,P＜0.001 ),cardiac arrhythmia (44.4% vs 26.4%,P＜0.05) and pneumonia (55.6% vs 16.3%,P＜0.001).Multivariate logistic regression analysis showed the major predictors for the occurrence of MODS secondary to AMI were advanced age (≥ 75 years,odds ratio 2.64,95% confidence interval [CI] 1.13 to 6.61),heart rate/＞ 100 bpm on admission (odds ratio 1.74,[CI] 1.14 to 2.64),in-hospital complication of HF (odds ratio 3.03,[CI] 1.26 to 7.26) and pneumonia (odds ratio 2.82,[CI] 1.18 to 6.77).Conclusions MODS is not the uncommon complication in elderly patients with AMI and is associated with poor prognosis.Advanced age,heart failure and pneumonia are predictors of the development of MODS in patients with AMI.(J Geriatr Cardiol 2008;5:199-202)