Effect and safety of repeated trigone-including intradetrusor BTX-A injection with intermittent catheterization for male adults with NDO and urinary incontinence secondary to spinal cord injury / 中华泌尿外科杂志

Objective:To assess the clinical result of repeated combined detrusor-trigone botulinum toxin A(BTX-A)injection and intermittent catheterization(IC) for male adults with neurogenic detrusor overactivity (NDO) and urinary incontinence(UI) secondary to spinal cord injury(SCI).Methods:From January to August 2021, the data of 43 adult male patients with NDO and UI secondary to SCI who received repeated trigone-including intradetrusor BTX-A injection in Guangdong Provincial Work Injury Rehabilitation Hospital were retrospectively analyzed. The mean age of the patients was (29.1±10.7) years. The mean incontinence specific quality of life (I-QOL) was (39±4.8). The UI episodes was (11.9±2.6), mean voiding volume was (170.7±20.1)ml, mean maximum detrusor pressure at first NDO was (81.4±19.6) cmH 2O and mean volume at first NDO was (169.1±40.0)ml.All patients received trigone-including intradetrusor BTX-A (300 U, 30 sites) injection for four times and IC. Clinical data including I-QOL, bladder diary, video-urodynamic test and adverse events were recorded at baseline and 12 weeks after each injection. Results:Mean interval between four injections were (220.6±27.4), (222.8±24.1) and (224.4±39.0) d ( P=0.13). Compared with baseline data before first injection, mean I-QOL after the first, second, third and fourth injection increased to (54.9±9.1), (56.1±7.9), (61.7±9.1) and (68.8±8.9) (all P<0.001). The number of urinary incontinence cases decreased to 36, 35, 35 and 33 (all P<0.05). The mean urinary incontinence episodes per day decreased to (4.4±0.6), (3.8±0.4), (2.2±0.5) and (2.1±0.3)(all P<0.001). Mean voiding volume increased to (288.3±40.2), (300.0±38.6), (316.9±46.8) and (319.5±36.7) ml (all P<0.001). Mean maximum detrusor pressure at first NDO decreased to (29.4± 11.0), (26.1±8.7), (20.3±5.9) and (18.5±6.0) cmH 2O (all P<0.001) and mean volume at first NDO increased to (270.0±48.7), (284.9±51.3), (287.7±47.9) and (303.0±46.2) ml (all P<0.001), respectively. Compared with four injections, no difference in response was found in the mean I-QOL, the number of urinary incontinence cases, mean urinary incontinence episodes mean voiding volume, mean maximum detrusor pressure at first NDO and mean volume at first NDO (all P>0.05). No de novo VUR occurred and 2 cases of grade Ⅱ VUR at baseline had resolved after the first injection. 9 patients experienced serious gross hematuria within first week after injection, but the urine returned to clear by prolonging the catheter indwelling time or bladder irrigation. 12 patients with active urinary tract infection were treated with indwelling catheter and sensitive antibiotics. Patients continued IC when the symptoms, signs and laboratory examination were normal. Conclusions:Combined detrusor-trigone BTX-A injection and IC could help decrease detrusor pressure, restore some of the lower urinary tract function and improve the quality of life for male patients with NDO and UI secondary to SCI. Repeated injection is as effective and safe as the first injection.

Perioperative nursing characteristics and management of oral cancer patients underwent radical resection and flap reconstrution / 中国实用护理杂志

Objective:To analyze the perioperative clinical characteristics of patients with oral cancer underwent radical resection and flap reconstrution and the nursing managements.Methods:From January 2020 to December 2020, 658 patients with oral cancer underwent radical resection and flap reconstrution in the Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University were retrospectively analyzed. All patients were divided into the elderly group (≥60 years) and the younger group (< 60 years), including 279 cases in the elderly group and 379 cases in the younger group. The perioperative clinical data of the patients were collected, and the perioperative general situation, postoperative complications and influencing factors of complications were analyzed.Results:There were differences between the two groups in the aspects of sex ( χ2 = 12.38, P<0.001), preoperative BMI ( t = 2.43, P = 0.015), smoking history ( χ2 = 18.34, P<0.001), preoperative anesthesia grade ( χ2 = 25.61, P = 0.001), preoperative coexisting disease ( χ2 = 46.97, P<0.001), whether oral floor or tongue cancer ( χ2 = 16.68, P<0.001), whether free flap ( χ2 = 6.81, P = 0.003), operation time ( t = 2.19, P = 0.029), preoperative test index hemoglobin ( t = 4.96, P<0.001), albumin ( t = 5.44, P<0.001), D-dimer( Z = -13.52, P<0.001), calcium levels ( t = 4.07, P<0.001) and postoperative complications ( χ2 = 14.55, P<0.001). Multivariate analysis of postoperative complications showed that the age ( OR = 1.021, 95% CI = 1.005-1.037, P = 0.011), preoperative D-dimer ( OR = 1.219, 95% CI = 1.026-1.447, P = 0.024) and the preoperative coexisting disease ( OR = 1.642, 95% CI = 1.108-2.432, P = 0.013) were the risk factors for the postoperative complications. Multivariate analysis of discharge with tube showed that the age ( OR = 1.017, 95% CI = 1.003-1.031, P = 0.017), preoperative BMI ( OR = 0.917, 95% CI = 0.873-0.963, P = 0.001), whether oral floor or tongue cancer ( OR = 2.135, 95% CI = 1.475-3.091, P<0.001), and operation time ( OR = 1.220, 95% CI = 1.120-1.328, P<0.001) were the related factors for the discharge with tube. Conclusion:In view of the above risk factors, it is beneficial for the physical and mental recovery of patients to pay attention to preoperative evaluation, make adequate preoperative preparation, postoperative nursing and observation, improve swallowing function training, prepare for discharge, pay attention to continuous nursing, and establish a tertiary hospital-community-family rehabilitation system.

Effect and safety of botulinum toxin A injection in external urethral sphincter for male patients with neurogenic detrusor underactivity / 中华泌尿外科杂志

Objective@#To assess clinical effect and safety of botulinum toxin A injection in external urethral sphincter for male patient with neurogenic detrusor underactivity(DU).@*Methods@#A prospective and self-controlled trail was conducted from August 2012 to October 2017. Male patients with nerve injury, dysuria more than 6 months, DU(bladder contractility index less than 100) were enrolled in this study. Exclusion criteria included patients with acute urinary tract infection, bladder stone, benign prostate hyperplasia, urethral stricture and urethral diverticulum.100 IU BTX-A was dissolved in 4ml normal saline, and the solution of BTX- A was injected into 4 different points(3-o’clock, 6-o’clock, 9-o’clock, and 12-o’clock) in external urinary sphincter with each point of 1ml solution. Patients were evaluated at baseline and 12 weeks after injection. The outcomes included post void residual (PVR), maximum flow rate (Qmax), maximum detrusor pressure during voiding phases (Pdet.max), maximum urethral closure pressure (MUCP), the case number of intermittent catheterization (IC)and the score of quality of life (QOL score). Adverse events were also recorded.@*Results@#A total of 58 male patients (all from Guangdong provincial work injury rehabilitation hospital)with mean age 28.6 years suffered from cerebral palsy (n=2), cerebrovascular accident(n=19)and spinal cord injury(n=37) were included into the study. Compared to baseline data, significant difference were observed at week 12 in PVR (56.68 ml vs. 280.11 ml, P<0.001), Pdet.max(23.95 cmH2O vs. 30.01 cmH2O, P=0.019), Qmax(6.74 ml/s vs. 3.28 ml/s, P=0.042), MUCP(48.25 cmH2O vs. 79.34 cmH2O, P<0.001), the case number of IC(40 vs. 58, P<0.001) and QOL score(3.63 vs.5.22, P<0.001) respectively. 5 cases developed perineal pain and 16 cases developed mild transient haematuria. These adverse events were disappeared by medical symptomatic treatment during 3-5 days.@*Conclusions@#BTX-A externalurethral sphincter injections help reduce urethra resistance and also improve the quality of life for patients with neurogenic detrusor underactivity.

Effect and safety of botulinum toxin A injection in external urethral sphincter for male patients with neurogenic detrusor underactivity / 中华泌尿外科杂志

Objective To assess clinical effect and safety of botulinum toxin A injection in external urethral sphincter for male patient with neurogenic detrusor underactivity (DU).Methods A prospective and self-controlled trail was conducted from August 2012 to October 2017.Male patients with nerve injury,dysuria more than 6 months,DU (bladder contractility index less than 100) were enrolled in this study.Exclusion criteria included patients with acute urinary tract infection,bladder stone,benign prostate hyperplasia,urethral stricture and urethral diverticulum.100 IU BTX-A was dissolved in 4ml normal saline,and the solution of BTX-A was injected into 4 different points(3-o'clock,6-o'clock,9-o'clock,and 12-o'clock) in external urinary sphincter with each point of 1ml solution.Patients were evaluated at baseline and 12 weeks after injection.The outcomes included post void residual (PVR),maximum flow rate (Qmax),maximum detrusor pressure during voiding phases (Pdet.max),maximum urethral closure pressure (MUCP),the case number of intermittent catheterization (IC) and the score of quality of life (QOL score).Adverse events were also recorded.Results A total of 58 male patients (all from Guangdong provincial work injury rehabilitation hospital) with mean age 28.6 years suffered from cerebral palsy (n =2),cerebrovascular accident(n =19)and spinal cord injury(n =37) were included into the study.Compared to baseline data,significant difference were observed at week 12 in PVR (56.68 ml vs.280.11 ml,P ＜ 0.001),Pdet.max (23.95 cmH2O vs.30.01 cmH2O,P =0.019),Qmax(6.74 ml/s vs.3.28 ml/s,P =0.042),MUCP(48.25 cmH2O vs.79.34 cmH2O,P ＜0.001),the case number of IC(40 vs.58,P ＜0.001) and QOL score(3.63 vs.5.22,P ＜ 0.001) respectively.5 cases developed perineal pain and 16 cases developed mild transient haematuria.These adverse events were disappeared by medical symptomatic treatment during 3-5 days.Conclusions BTX-A externalurethral sphincter injections help reduce urethra resistance and also improve the quality of life for patients with neurogenic detrusor underactivity.

The efficacy of intratympanic dexamethasone injection for the moderate and severe sudden deafness with BPPV / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the efficacy of intratympanic dexamethasone injection for the moderate and severe sudden deafness with BPPV.@*METHOD@#A total of 63 patients diagnosed with sudden sensorineural hearing loss with BPPV were treated through OPD. Patients were divided into three groups: 20 cases in intratympanic dexamethasone injection as initial treatment (group A); 18 cases in systemic hormone therapy group (group B); 25 cases in intratympanic dexamethasone injection as salvage treatment (group C). In addition, routine drugs were used to all patients.@*RESULT@#The overall effective rate of group A, B and C in hearing recovery was 60.0%, 38.9% and 48.0%, respectively: (1) No significant difference of hearing recovery was observed among three groups (P > 0.05); (2) A significant difference of hearing recovery was evidenced between group A and C (P 0.05).@*CONCLUSION@#Our data showed that intratympanic dexamethasone should be used as initial therapy for treating the moderate and severe sudden deafness with BPPV.

The predictive value of heart rate variability to, and its correlation with ventricular arrhythmias in patients with structural heart disease / 中华老年医学杂志

Objective To investigate the predictive value of heart rate variability to,and its correlation with ventricular arrhythmias in patients with structural heart disease.Methods 24 hours ambulatory electrocardiogram monitoring was administered during March 2012 and October 2013,and standard deviation of the NN interval (SDNN) in the time-domain analysis and sympathetic/vagal ratio in the frequency domain analysis were collected and retrospectively analyzed in 300 patients.Results The incidence rate of ventricular arrhythmias was higher in patients with structural heart disease in SDNN ＜100 ms group than in control group [4.1％ (3/74) vs.39.5％ (45/114),P＜0.01].The sympathetic/vagal ratio was significantly higher in group with structural heart disease and ventricular arrhythmia than in control group(19.9 ±2.3 vs.10.1 ±1.7,P＜0.01)The time-domain index SDNN was negatively correlated with the frequency domain index (sympathetic/vagal ratio) (r=-0.819,P ＜0.01).Conclusions SDNN ＜100ms and the increased sympathetic/vagal ratio can be considered as the predictors of ventricular arrhythmias in patients with structural heart disease.

The preliminary research of progress on sudden deafness with benign paroxysmal positional vertigo patients / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the prognosis of sudden deafness patients with benign paroxysmal positional vertigo (BPPV).@*METHOD@#The clinical data of 24 sudden deafness patients with BPPV was analyzed. The outcome of 125 sudden deafness patients without BPPV at the same time was compared.@*RESULT@#Hearing improvement after three months treatment was 41.67% and 72.80% in sudden deafness patients with BPPV and sudden deafness patients without BPPV, respectively. The difference was statistically significant (P<0.05).@*CONCLUSION@#The prognosis of hearing in sudden deafness patients with BPPV is worse than that in sudden deafness patients without BPPV. BPPV may predict a poor hearing outcome in sudden deafness.

The establishment of a nine X-chromosome short tandem repeat loci multiplex PCR and detection of the polymorphism of these loci / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To establish a nine X-chromosome short tandem repeats (X-STR) loci multiplex PCR method and study the polymorphism of the 9 X-STR loci,and to determine its application in kinship tests for forensic medicine.</p><p><b>METHODS</b>A fluorescent multiplex PCR that simultaneously amplifies 9 X-STR loci, i.e. DXS7133, DXS981, DXS7424, DXS6789, DXS7132, GATA165B12, DXS101, GATA31E08 and DXS10011, were set up. PCR products were analyzed using capillary electrophoresis and ABI prism 3100 Genetic Analyzer with GeneMapper ID 3.1 analysis software.</p><p><b>RESULTS</b>When 251 unrelated male and 112 unrelated female individuals from southern China were tested, 111 alleles were detected. The power of discrimination in females was 0.5837-0.9959. Mean exclusion chance for X-STR in standard trios with daughters was 0.4072-0.9511. Polymorphism information content was 0.4481-0.9531.</p><p><b>CONCLUSION</b>The results demonstrate that the 9 loci in the multiplex system provide high polymorphism information, and the multiplex system provides a fast technology for forensic identification and paternity testing. The X-STR multiplex system can complement the analysis of AS-STR and Y-STR efficiently.</p>

Polymorphism of Five X-STRs Loci with a New Pentaplex PCR / 中山大学学报(医学科学版)

[Objective] To learn about the genetic diversity,we studied the five X-chromosomal STR (X-STR) loci in Guangdong Han Nationality Groups.[Methods] The five Loci (DXS6803,DXS981,DXS6809,DXS6789,and DXS7132) were amplified in a pentaplex PCR reaction.PCR products were analyzed using capillary electrophoresis and ABI prism 3100 Genetic Analyzer,with GeneMapper ID 3.1 Analysis Software.[Results] A total of 363 individuals (181 unrelated male and 182 unrelated female) from Guangdong Han population were tested,54 alleles were observed for these loci.Polymorphism information content is 0.6935 ～ 0.8177.Power of discrimination in females was 0.8976 ～ 0.9562.Mean exclusion chance for X-STR in standard trios with daughters was 0.7805 ～ 0.8467.[Conclusion] The five loci in the multiplex system provide high polymorphism information for forensic identification and paternity testing,particularly for difficult paternity deficiency cases.

Study on the mutation of human short tandem repeats at three loci / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To understand the mutational patterns and mechanism of short tandem repeats(STRs).</p><p><b>METHODS</b>The DNA samples of 19 parent-child pairs with mutations in three loci (FGA, D12S391, and D11S554) were genotyped by silver staining on STR. Alleles to be sequenced were excised from gels, reamplified by PCR, and purified. Sequencing was performed by use of cycle sequencing.</p><p><b>RESULTS</b>There were 18 out of 19 pedigrees in which the 'new' alleles gained or lost a single repeat (8 gains, 7 losses, and 3 being indistinguishable). Only one pedigree lost two repeats. In the 19 pedigrees, there were 13 pedigrees whose 'new' alleles came from fathers, 3 from mothers, 3 from either father or mother. The ratio was 4 1 between fathers and mothers. The mutation of three STR loci occurred in the long, uninterrupted tetranucleotide repeat regions ('CTTT' in FGA, 'AGAT' in D12S391, and 'AAAG' in D11S554).</p><p><b>CONCLUSION</b>Single- step mutations accounted for 95% of STR mutation events in these three loci: FGA, D12S391, and D11S554. The rest were double step mutations. There was no insertion or deletion of an incomplete repeat in any of the pedigrees. The mutation was mainly caused by fathers. The long, uninterrupted tetranucleotide repeats in these three loci might be susceptible to mutation.</p>

A study of genetic polymorphisms of 11 Y chromosome specific STR loci / 中国法医学杂志

Objective To study the genetic polymorphisms of 11 Y chromosome specific STR loci in Guangzhou Han population. Method The DNA extracted from blood samples of unrelated individuals in Han population living in Guangzhou were amplified by PCR. The PCR products were analyzed by using PAGE. Results 3-5 alleles were detected in 11 Y - STR loci respectively in Han population in Guangzhou. The minimum GD value was 0.3037 (DYS434), while the maximum GD value was 0.8455 (DYS390) . Conclusion The 11 Y - specific STR loci are highly polymorphic and are suitable for personal identification and paternity testing.

Exclusion of 15 Short Tandem Repeat Markers in Duo Paternity Testing / 中国法医学杂志

Objective Estimate the paternity exclusion probability for 15 short tandem repeats (CODIS set plus Penta D and Penta E) in duo paternity tests. Methods 644 random individuals were paired to con-struct 207046 fictitious duo families. Cases of non-exclusion or with only one exclusionarylocus were count-ed. Results 27 cases could not be excluded by the 15 STR loci. The combined probability of exclusion was 0.999869. Number of cases showing only one exclusionary locus was 384 (0.185%). Conclusion To con-firm relationship in duo cases with only 15 STRs should be careful. Extensive genetic markers is needed to discriminate one locus exclusion or mutation.

Polymorphism of Locus D13S631 in Guangdong Han Population / 中山大学学报(医学科学版)

【Objective】 To understand the polymorphism of D13S63 1 in Guangdong Han population. 【Method】 Short tandem repeat (STR) locus D13S63 1 was analyzed by means of polymerase chain reaction, following discontinuous el ectrophoresis system. 【Result】 Among 227 unrelated individuals from Guangdong Han population, 6 alleles rang from 197～217 bp could be observed. The most com mon allele with a frequency 0.2907 is allele 201 bp, the rare allele is allele 197 bp with a frequency 0.0903. The heterozygosity, the power of discrimination and the exclusion chance in paternity case were 0.7885，0.9231, 0.5543, respect ively. Segregation studies reveal that D13S631 inherit in Medel's Law. 【Conclus ion】 The result shows that locus D13S631 is highly informative and suitable fo r forensic application.

Polymorphism of DXS6854 Locus in Guangdong Han Population / 中国法医学杂志

Objective To investigate the polymorphism of DXS6854 locus in Guangdong Han population. Methods The DXS6854 locus was analyzed by PCR following polyacrylamide gel electrophoresis and silver staining. Results Among 189 females and 230 males from Guangdong Han population, 8 alleles were observed with frequencies ranging from 0.0026 to 0.4522. Exact tests demonstrated genotype frequencies in females had no departure from Hardy- Weinberg equilibrium. The discrimination powers for female and male original samples were 0.8633 and 0.7012, respectively. When both mother and her daughter were tested, the probability of excluding a random man as a father was 0.6712. Conclusion The DXS6854 locus is appropriate for individual identification and paternity testing involving a female child.

Distribution of four STR loci's haplotypes in Guangdong Han Population / 中国法医学杂志

To investigate haplotype distribution of the Y-chromosome STRs (DYS19, DYS390 and DYS389 locus) in Han population in Guangdong area. The STRs were typed by poplymerase chain reaction followed by discontinuous PAGE system. Among 130 unrelated males, 81 different haplotypes were observed, 52 out of them were found only one time. The haplotype genetic diversity, discrimination power and non-father exclusion chance are 0. 9989, 0. 9824, 0. 9824, respectively. The high informative haplotypes make these STRs useful for the forensic individual identification and paternity testing.

Application of autosomal STR genetic markers in siblings identification / 中国法医学杂志

Objective To discuss the probability of siblings identification by autosomal short tandem repeat (STR). Methods 150 pairs of full siblings and 150 pairs of unrelated individuals were genotyped by the 15 STR loci of Power Plex?6 system. Paternity index of full siblings (Pips) and paternity probability of full siblings (WFS) were calculated with the method of ITO. WFS and allelic matching of the two groups were compared, and three sorts of allelic matching in each pair were tested by chi-square test. Results Wps of 100 pairs of siblings (66.67%) were more than 0.9995; WFS of unrelated individuals were less than 0.8, and that of 100 pairs (66.67%) were less than 0.27. The locus number of the entire-same ranged from 1 to 10, averaged 5.49 in siblings, while in unrelated individuals ranged from 0 to 5 and averaged 1.33; that of the entire-different ranged from 0 to 6, averaged 1.66 in siblings but ranged from 2 to 11 and averaged 6.57 in unrelated individuals; that of the half-same ranged from 3 to 13, averaged 7.85 in siblings, and ranged from 1 to 13, averaged 7.11 in unrelated individuals. By chi-square test, there was significant difference (P0.05) in the half-same between the two groups. Conclusion It is effective to identify siblings by Power-Plex?6 system. Testing of 15 STR loci of PowerPlex?6 system, it suggested that the pair were unrelated individuals when the locus number of the entirely-different is not less than 6 or that of the entirely-same is zero, and that the pair were siblings when the locus number of entirely-different is not more than 1 or that of the entirely-same is not less than 6.