Application value of ventricular intracranial pressure monitoring in the treatment of unilateral temporal lobe cerebral contusion / 中华创伤杂志

Objective:To explore the application value of ventricular intracranial pressure monitoring (V-ICPM) in the treatment of unilateral temporal lobe cerebral contusion.Methods:A retrospective cohort study was conducted to analyze the clinical data of 295 patients with unilateral temporal lobe cerebral contusion admitted to 904th Hospital of PLA Joint Support Force from January 2014 to August 2021, including 172 males and 123 females; aged 14-78 years [(46.3±14.7)years]. V-ICPM was used in 136 patients (V-ICPM group), who received surgical or non-surgical treatment according to the monitoring, while not in 159 patients (non-V-ICPM group), who received routine surgery or non-surgical treatment. The two groups were compared in terms of the rates of intracranial hematoma clearance by craniotomy, decompressive craniectomy (DC) and dehydration and osmotic therapy during hospitalization, use time of 20% mass fraction of mannitol and 30 g/L hypertonic salt, displacement rate of brain midline structure of head CT≥10 mm after discharge, rate of intracranial infection, hydrocephalus and epilepsy, and Glasgow Outcome Scale (GOS) at 6 months after discharge.Results:All patients were followed up for 6-12 months [(8.9±2.1)months]. During hospitalization, the rate of intracranial hematoma clearance by craniotomy and the rate of DC in V-ICPM group were 35.3% (48/136) and 8.1% (11/136), lower than 47.2% (75/159) and 22.0% (35/159) in non-V-ICPM group ( P<0.05 or 0.01). There was no significant difference between the two groups in the rate of dehydration and osmotic therapy or the use time of mannitol (all P>0.05). The use time of hypertonic salt in V-ICPM group was (7.2±2.5)days, more than (4.1±1.8)days in non-V-ICPM group ( P<0.05). After discharge, the displacement rate of brain midline structure of head CT in V-ICPM group was 29.4% (40/136), lower than 42.8% (68/159) in non-V-ICPM group ( P<0.05). There was no significant difference between the two groups in the rate of intracranial infection, hydrocephalus and epilepsy (all P>0.05). Six months after discharge, the good rate of GOS in V-ICPM group was 91.2% (124/136), significantly better than 81.8% (130/159) in non-V-ICPM group ( P<0.05). Conclusion:For unilateral temporal lobe cerebral contusion, V-ICPM is associated with reduced rate of craniotomy exploration and DC, decreased incidence of complications and improved prognosis of the patients in spite of longer use time of hypertonic salt.

Laparoscopic simple prostatectomy for large volume benign prostate hyperplasia: a report of 30 cases / 现代泌尿外科杂志

【Objective】 To investigate the feasibility of laparoscopic simple prostatectomy (LSP) in the treatment of large volume benign prostate hyperplasia (BPH). 【Methods】 Clinical and follow-up data of 30 patients with large volume BPH treated with LSP in our hospital during Feb.2019 and Dec.2021 were retrospectively analyzed. All patients underwent extraperitoneal LSP operation. The perioperative and 1-12 month postoperative follow-up data were analyzed. 【Results】 The average prostate volume was (92.4±38.9) mL, operation time (125±45) min, and weight of resected prostate (60.25±16.90) g. The hemoglobin decreased by (12.21±7.25) g/d after operation. No blood transfusion was needed. There was no need for bladder irrigation after operation in 21 cases (70%), and 9 cases (30%) had bladder irrigation time of (0.95±0.49) d. The postoperative catheter indwelling time was (6.92±2.51) d, and hospital stay (5.36±1.63) d. During the follow-up of (9.25±5.4) months, there was 1 case of postoperative intestinal obstruction (Clavien-Dindo grade II), 1 case of transient urinary incontinence (Clavien-Dindo grade I), and 1 case of delayed hematuria (Clavien-Dindo grade I). No urethral stricture occurred. The maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), International Prostate Symptom Score (IPSS) and quality of life (QoL) 3 months after operation were significantly improved compared with those before operation (P0.05). 【Conclusion】 LSP is safe and effective in the treatment of large volume BPH. It has advantages of complete resection of glands, minor bleeding and short postoperative bladder irrigation time. However, it still needs to be confirmed by a prospective control study of large samples.

Impact of COVID-19 epidemic on inventory of red blood cells in local and municipal blood stations in China / 中国输血杂志

【Objective】 To evaluate and analyze the impact of COVID-19 epidemic on inventory of red blood cells (RBCs)in local and municipal blood stations in China, and to provide reference for the management of public health emergencies. 【Methods】 Relevant data from 2018 to 2021 were collected, and the differences in the volume of qualified RBCs, the usage efficiency of inventory RBCs, the average daily distribution of RBCs,the blood distribution rate of RBCs prepared by 400 mL whole blood, the difference in the average storage days of RBCs at the time of distribution, the average daily inventory of RBCs and the time of the average daily inventory of RBCs to maintain the distribution in 24 local and municipal blood stations in China during the COVID-19 epidemic and non-epidemic periods were retrospectively analyzed. 【Results】 Compared with non-epidemic periods, the volume of qualified RBCs [(117 525.979 ±52 203.175)U] and the average daily distribution of RBCs [( 156. 468 ± 70. 186) U ] increased significantly, but the usage efficiency of inventory RBCs decreased(97.24%±0.51%) significantly (P0.5). 【Conclusion】 During the COVID-19 epidemic, the inventory management of RBCs operated well, the overall inventory remained relatively stable, the stock composition and storage period showed no significant change.

Clinical Efficacy of Qihuang Jianpi Zishen Granules in Treating Cardiac Involvement in Systemic Lupus Erythematosus / 中国实验方剂学杂志

ObjectiveTo investigate the clinical efficacy and safety of Qihuang Jianpi Zishen granules in the treatment of cardiac involvement in systemic lupus erythematosus （SLE）. MethodA total of 62 SLE patients with cardiac involvement treated in the Department of Rheumatology and Immunology， the First Affiliated Hospital of Anhui University of Chinese Medicine from June 2021 to December 2022 were randomized into control and observation groups （n=31）. The control group was treated with methylprednisolone tablets and hydroxychloroquine sulfate tablets， and the observation group with Qihuang Jianpi Zishen granules on the basis of the therapy in the control group. After 12 weeks of treatment， the two groups were compared in terms of the therapeutic effect， cardiac function indicators ［left atrial end-diastolic diameter （LADd）， left ventricular end-diastolic diameter （LVDd）， left ventricular posterior wall thickness （LVPWTd）， peak blood flow velocity in early diastolic period （peak E）， peak blood flow velocity in late diastolic period （peak A）， E/A ratio， stroke volume （SV）， left ventricular ejection fraction （LVEF）， left ventricular short axis shortening rate （LVFS）， and B-type natriuretic peptide （BNP）］， vascular damage indicators ［nitric oxide （NO）， endothelin-1 （ET-1）， vascular endothelial growth factor （VEGF）， and homocysteine （Hcy）］， inflammation indicators ［erythrocyte sedimentation rate （ESR） and hypersensitive C-reactive protein （Hs-CRP）］， anti-double-stranded DNA （dsDNA） antibodies， disease activity index （SLEDAI） score， mitigation of symptoms and signs， and occurrence of adverse reactions. ResultThe total response rate in the observation group was 87.09%， which was higher than that （67.74%） in the control group （P<0.01）， and the incidence of adverse reactions had no significant difference between the two groups. After treatment， the control group showed lowered LVDd， LVPWTd， BNP， ET-1， VEGF， and Hcy （P<0.05） and increased E peak， E/A ratio， SV， LVEF， and LVFS （P<0.05）. In the observation group， LADd， LVDd， LVPWTd， peak A， BNP， NO， ET-1， VEGF， and Hcy decreased （P<0.05）， while peak E， E/A ratio， SV， LVEF and LVFS increased （P<0.05） after treatment. The treatment in both groups decreased the scores of palpitation， chest tightness， dyspnea， and edema （P<0.05）， reduced ESR， Hs-CRP， ds-DNA， and SLEDAI （P<0.05）. After treatment， the observation group had lower LADd， LVDd， LVPWTd， peak A， BNP， and scores of palpation， chest tightness， dyspnea， and edema （P<0.05） and higher peak E， E/A ratio， SV， LVEF， and LVFS （P<0.05） than the control group. In addition， the observation group had lower NO， ET-1， VEGF， Hcy， ESR， Hs-CRP， ds-DNA， and SLEDAI than the control group （P<0.05）. ConclusionQihuang Jianpi Zishen granules combined with hydroxychloroquine sulfate and methylprednisolone can improve multiple indicators and mitigate the symptoms and signs of SLE patients with cardiac involvement， demonstrating a clinical application value.

Influence of ApoE gene polymorphisms on therapeutic effects of lipid-lowering statins among patients with ischemic cerebral infarction / 中华医学遗传学杂志

OBJECTIVE@#To assess the influence of apolipoprotein E (ApoE) gene polymorphisms on the therapeutic effect of lipid-lowering statins in patients with ischemic cerebral infarction.@*METHODS@#One hundred and six patients with ischemic cerebral infarction who orally took lipid-lowering statins for 3 months were enrolled. Changes in serum triacylglycerol (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) before and after the drug administration were analyzed. ApoE gene polymorphisms were detected by real-time fluorescent quantitative PCR, and genotypes of ApoE gene in patients with different effects were compared.@*RESULTS@#The detection rates for E2/E2, E2/E3, E3/E3, E2/E4 and E3/E4 genotypes were 0.94%, 11.32%, 63.21%, 1.89% and 22.64%, respectively. And the detection rates for E2, E3 and E4 alleles were 7.55%, 80.19% and 12.26%, respectively. Biochemical phenotypes included E2 type (13 cases, 12.26%), E3 type (69 cases, 65.09%) and E4 type (24 cases, 22.65%). Before administration, TG and TC of E2 type were the highest (P<0.05), but no significant difference was detected in HDL-C and LDL-C among the three phenotypes (P>0.05).Following the drug administration, TG, TC and LDL-C were decreased, while HDL-C was increased. HDL-C of E2 type was the highest, TC and LDL-C of E4 type were the highest (P<0.05). The E3/E3 ratio in low-efficiency group at admission was lower than that in the high-efficiency group, while the E3/E4 ratio was higher than that in the high-efficiency group (P<0.05). The proportion of E3 allele in low-efficiency group was lower than that in high-efficiency group, while the proportion of E4 allele was higher than that in high-efficiency group (P<0.05).@*CONCLUSION@#ApoE gene polymorphisms are closely correlated with the therapeutic effect of lipid-lowering statins in patients with ischemic cerebral infarction. The lipid-lowering effects are more significant in patients with E2 and E3 genotypes, but were poor in those with the E4 genotype. Personalized regimens should be applied.

Effects of sevoflurane on right ventricular myocardial fibrosis induced by pulmonary arterial hypertension in rats / 中华麻醉学杂志

Objective:To evaluate the effects of sevoflurane on right ventricular myocardial fibrosis caused by pulmonary arterial hypertension (PAH) in rats.Methods:Eighteen SPF healthy adult male Wistar rats, weighing 260-300 g, were divided into 3 groups ( n=6 each) by a random number table method: control group (group C), group PAH and PAH plus sevoflurane group (group PS). The PAH model was established by single intraperitoneal injection of monocrotaline 60 mg/kg in group PAH and group PS, while the equal volume of normal saline was intraperitoneally injected in group C. Sevoflurane 1.5 MAC was inhaled for 1 h starting from the end of injection, twice a week for 6 weeks in total, in group PS.Echocardiography was performed at the end of 6th week to measure right ventricular end-diastolic diameter (RVEDD), right ventricular anterior wall end-diastolic thickness (RVWTd), interventricular septal end-diastolic thickness (IVSTd), pulmonary artery inner diameter (PAID) and pulmonary valve orifice maximum peak velocity (PV). At the end of 6th week, the hearts were taken to measure the weight of right ventricle, interventricular septum and left ventricle, and Fulton′s index was calculated, and the tissue of the lower lobe of the right lung was taken, the outer diameter and inner diameter of the vascular wall were measured to calculate the vascular wall thickness index (WT), and total vascular area and lumen area were measured to calculate the vascular wall area index (WA) after HE staining.The myocardial tissue of the right ventricle was obtained to observe the degree of myocardial fibrosis (with a light microscope after Masson staining) and to detect the expression of TGF-β1 (after immunofluorescence staining) and expression of TGF-β1, phosphorylated Smad3 (p-SMad3) and Smad7 (by Western blot). Results:Compared with group C, Fulton′s index, RVEDD, RVWTd, IVSTd, PAID, WT and WA were significantly increased, PV was decreased, the expression of TGF-β1 and pSmad3 in right ventricular myocardial tissues was up-regulated, the expression of Smad7 was down-regulated( P<0.01), and myocardial fibrosis occurred in group PAH.Compared with group PAH, Fulton′s index, RVEDD, RVWTd, IVSTd, PAID, WT and WA were significantly decreased, PV was increased, the expression of TGF-β1 and pSmad3 in right ventricular myocardial tissues was down-regulated, the expression of Smad7 was up-regulated ( P<0.05 or 0.01), and myocardial fibrosis was significantly improved in group PS. Conclusion:Sevoflurane can improve the myocardial fibrosis in right ventricle induced by PAH in rats, and the mechanism may be related to inhibiting activation of TGF-β1/Smad3 signaling pathway.

Effect of propofol on right ventricular hypertrophy induced by pulmonary arterial hypertension in rats / 中华麻醉学杂志

Objective:To evaluate the effect of propofol on right ventricular hypertrophy induced by pulmonary arterial hypertension (PAH) in rats.Methods:Twenty-two clean-grade healthy adult male Wistar rats, weighing 250-280 g, were divided into 3 groups using a random number table method: control group (group C, n=8), PAH group (group PH, n=6) and propofol group (group P, n=8). In PH and P groups, monocrotaline 60 mg/kg was injected intraperitoneally to establish the model of PAH, while the equal volume of normal saline was administered in group C. Propofol 100 mg/kg was injected intraperitoneally twice a week for 6 consecutive weeks starting from 2 weeks after establishment of the model in group P. The weight of rats was measured before establishment of model and after administration, and the weight difference (△BW=weight after administration-weight before administration) was calculated.At the end of administration, the right ventricular end-diastolic dimension (RVEDD), right ventricular wall thickness in diastole (RVWTd), intraventricular septum in diastole (IVSd), left ventricular posterior wall in diastole (LVPWd) and maximal velocity of pulmonic valve (PV) were measured using cardiac ultrasound.The animals were then sacrificed, and the lungs and hearts were removed for examination of the pathological changes (after haematoxylin and eosin staining) and for determination of the degree of myocardial fibrosis in right ventricular (by Masson staining), expression of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in lung tissues and myocardial tissues of the right ventricle (by immunohistochemistry). Results:Compared with group C, △BW and PV were significantly decreased, RVWTd, IVTd and RVEDD were increased, the thickness of the wall of pulmonary arterioles and myocardial cell penetration area in right ventricular were increased, the expression of IL-6 and TNF-α in lung tissues and myocardial tissues of right ventricle was up-regulated ( P<0.05 or 0.01), inflammatory cell infiltration and structural disorders were found in lung tissues, and intercellular spaces were widened, and the myocardial tissue was extensively fibrotic in group PH.Compared with group PH, △BW and PV were significantly increased, RVWTd, IVTd and RVEDD were decreased, the thickness of the wall of pulmonary arterioles and myocardial cell penetration area (the area of cardiomyocytes in which the nucleus located in the middle) were decreased, the expression of IL-6 and TNF-α in lung tissues and myocardial tissues of right ventricle was down-regulated ( P<0.05 or 0.01), inflammatory cell infiltration, structural disorders, intercellular spaces and degree of fibrosis were improved in group P. Conclusion:Propofol can alleviate right ventricular hypertrophy induced by PAH, and the mechanism is probably related to reduction of inflammatory responses in rats.

Recombinant bovine basic fibroblast growth factor for the treatment of corticosteroid-dependent dermatitis: a randomized double-blind placebo-controlled trial / 中华皮肤科杂志

Objective To evaluate the safety and efficacy of recombinant bovine basic fibroblast growth factor in the treatment of corticosteroid-dependent dermatitis.Methods A randomized,double-blind,placebo-controlled clinical trial was carried out.By simple randomization,64 patients with corticosteroid-dependent dermatitis were randomly and equally divided into 2 groups:treatment group topically applying recombinant bovine basic fibroblast growth factor gel twice a day for 4 consecutive weeks,and control group topically applying the gel vehicle twice a day for 4 consecutive weeks.Clinical symptoms and signs were scored before the treatment and after 1-,2-and 4-week treatment.Meanwhile,the water content of the stratum corneum,skin sebum content and transepidermal water loss (TEWL) of the skin lesions were detected.Results Thirty-one patients in the treatment group and 30 in the control group completed the trial.The clinical symptom and sign scores in the treatment group were significantly lower at week 2 and 4 after starting treatment (1.35 ± 0.55 and 1.00 ± 0.45,respectively) than that before treatment (2.77 ± 0.43,both P ＜ 0.05),as well as lower at week 1 (2.06 ± 0.51),2 and 4 after starting treatment than that in the control group (2.43 ± 0.57,2.17 ± 0.53,1.93 ± 0.45,respectively,all P ＜ 0.05).The treatment group showed significantly increased water content of the stratum corneum at week 4 after starting treatment,significantly increased skin sebum content,but decreased TEWL at week 2 and 4 after starting treatment compared with those before treatment (all P ＜ 0.05).Compared with the control group,the treatment group showed significantly higher skin sebum content at week 2 and 4 after starting treatment,higher water content of the stratum corneum,but lower TEWL at week 4 after starting treatment (all P ＜ 0.05).No adverse reactions were observed in either of the 2 groups.Conclusion Recombinant bovine basic fibroblast growth factor is effective and safe for the treatment of corticosteroid-dependent dermatitis,and contributes to repairing and reconstructing the skin barrier function.

Interference of hemolysis on glycated albumin determined by ketoamine oxidase method and its correction / 临床检验杂志

Objective To investigate the effects of hemolysis on glycated albumin (GA) determined by ketoamine oxidase method and its correction.Methods GA concentration and hemolytic parameter(optical density,A) in non-hemolytic serum and different degree hemolytic serum samples were measured.The impact of hemolysis on GA and the relationship between hemolysis and GA were analysed.A formula was developed to correct the interference of hemolysis on GA measurement using regressive Multiple analysis.Results Compared with non-hemolytic serum,hemolysis resulted in the significantly decreased concentrations of GA detected by ketoamine oxidase method(P ＜ 0.01),which were significantly associated with the degree of hemolysis (R2 =0.943 4).Y and Z represented GA concentration of non-hemolytic serum and different degree hemolytic serum,while X represented optical density of hemolytic parameter.Formulas for GA measurement were presented:Y =2.468X + Z-0.015 73,GA concentrations of hemolytic samples can be reverted to the values without statistical difference from the GA concentration in corresponding non-hemolytic samples.The bias of corrected GA was less than 10％.Conclusion Our results indicate that the level of GA measured through ketoamine oxidase method is negatively affected by hemolysis.The formula of mathematical correction of GA results in hemolytic samples should be suitable for the requirements of clinical laboratory.

The effect of stress environment on the density of bladder pacemaker cells in PDU / 实用医学杂志

Objective To investigate the density of bladder pacemaker cells (ICC) in prostatic hyperplasia with detrusor underactivity (PDU) and the impact of stress environment on its growth. Methods 23 PDU guinea pig models and 26 pigs for control (BPH, n = 6; normal group, n = 20) were developed. After water-filled urodynamic pressure measurement of bladder for three groups , detrusor tissue was made into frozen sections. TheICC numberwere measured with immunofluorescence stainingand observed by confocal microscopy. Further ICC cells in vitro were cultured under stress environment and its counts were analyzed by colony formation assay. Results Decreased density of ICC was observed in PDU group (0.28 ± 0.52)% compared to control [(5 ± 0.36)%,P < 0.05] and the BPH group (5.4% ± 0.42)%, P < 0.05). The ratio of dimer and monomer [(6.13 ± 1.45)%] in PDU group was significantly lower than those of the control [31.55 ± 9.67)%, P < 0.05] and the BPH group [(71.52 ± 8.95)%, P < 0.05]. There is a negative correlation between the density of ICC in vitro and duration of stress. By contrast , there is a positive correlation between the density of ICC and incubation time after the stress is removed. Conclusion Distribution of decreased density of ICC is involved in the pathogenesis of PDU , which may be due to long-term stress environment. Thus eliminating stress environment may help restore ICC density in PDU.

Investigation of Lipoprotein(a)Levels in 8 442 Adults in Nanjing / 现代检验医学杂志

Objective To explore the relationship between Lp (a)level and age,gender in Nanjing area.Methods 8 442 ser-um specimens from examination individuals were collected in the First Affiliated Hospital of Nanjing Medical University in 2014.Lp (a)was measured by immune turbidimetry method.All the subjects were divided into six groups:15~29,30~44, 45~59,60~69,70~79 and ≥80 years old.SPSS21.0 software was used to carry out statistics.Results The Lp(a)level in female [134±197 mg/L (M±QR,the same below)]was higher than that in male significantly (U =8 355 137,P 0.05.Lp(a)of six groups in female were 128.0 ± 194.0,128.0 ± 187.0,139.0 ± 207.0,157.0 ± 228.0, 173.5±227.0 and 150.0±201.0 mg/L.The difference was statistically significant between 2 and 3 groups,theU value was 641 147,P =0.006,respectively.The difference was not statistically significant between 1 and 2 groups,3 and 4 groups,4 and 5 groups,5 and 6 groups,theU value were 783 676,92 442.5,16 069.5 and 3 038,respectively;P all>0.05.Conclusion Lp (a)level in healthy population in Nanjing area is related to gender and age groups,it is necessary to establish different reference ranges.

Study on the status of catastrophic disease medical assistance under NRCMS in A City at Hubei Province and B County at Guizhou Province / 中国卫生政策研究

Objective:This paper designs to analyze the status of catastrophic disease medical assistance in A and B regions, and put forward feasible suggestions to improve the medical assistance level and financial effects. Methods:We selected A city at Hubei province and B county at Guizhou province as sample areas, and obtained 872 copies of questionnaires in the field survey. Then, out-of-pocket health expenditure per year, the incidence, and rel-ative gap of catastrophic health expenditure before and after the financial aid were calculated. Results: Catastrophic disease medical assistance plays a limited role in relieving patients' economic burden. Low financial aid rate, narrow range, high deductibles and low ceiling level are responsible for much lower effective financial aid rate. Conclusion:Raise financial aid rate and widen the scope of medical assistance gradually;Establish effective link-up between cata-strophic disease medical assistance and catastrophic disease insurance / basic medical insurance;Put outpatient OOP into the scope of catastrophic disease medical assistance.

Study of negotiation mechanism at designated hospitals at provincial level for catastrophic diseases / 中华医院管理杂志

Stakeholder theory and game theory were applied to analyze the stakeholders,role definition,participation,interest,power,position and the shift of positions under different conditions in the negotiation.Use SPSS 17.0 to analyze the database of NCMS in 2009～2010 in three counties of Hubei province,and then employ Linear programming method to do a case study of price negotiation.It is difficult to meet all stakeholders' expectations under the current condition of catastrophic disease insurance pooled at municipal-level.Medical cost differences in tertiary hospitals at provincial level are small for different regions,which constitute a basis for price negotiation at provincial level.Besides,the negotiation at province level can effectively address the conflicts of interest,and promote the negotiations.Negotiation at provincial level for such diseases,and formulating unified pricing standards for multi-wins.

Rare type of congenital adrenal hyperplasia / 中华实用儿科临床杂志

Congenital adrenal hyperplasia (CAH) is an autosomal recessive genetic disease due to glucocorticoid biosynthesis enzyme deficiency,in addition to the common types such as 21-hydroxylase,11 β-hydroxylase deficiency,also include rare types such as 3 β-hydroxysteroid dehydrogenase deficiency,17α-hydroxylase deficiency and congenital lipoid adrenal hyperplasia (CLAH).These rare types of CAH have multiple clinical manifestations,which are easily missed or misdiagnosed.This article focus on molecular genetics,pathophysiology,clinical manifestations and treatment principles of above 3 rare types of CAH.

Expression of Engrailed-2 and β-catenin in bladder urothelial carcinoma and their significance / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the expressions of Engrailed-2 (EN2) and β-catenin in bladder urothelial carcinoma and explore their significance.</p><p><b>METHODS</b>Sixty bladder urothelial carcinoma samples of different grades and stages and 10 normal bladder mucosal tissues were examined for expressions of EN2 and β-catenin proteins and mRNA using immunochemistry, Western blotting and RT-PCR. RESULTS Compared to normal bladder mucosa, bladder urothelial carcinoma tissues showed significantly increased expressions of EN2 and β-catenin proteins (P<0.05), and the high-grade carcinoma tissues exhibited significantly stronger expressions than the low-grade ones (P<0.05); the expressions of the proteins increased also significantly with advanced pathological stages of bladder urothelial carcinoma (P<0.05). The expressions of EN2 and β-catenin mRNAs showed a consistent pattern of changes with their protein expressions.</p><p><b>CONCLUSION</b>The expressions of EN2 and β-catenin are significantly increased in bladder urothelial carcinoma. EN2 may contribute to the development and progression of bladder urothelial carcinoma by activating Wnt/β-catenin signal pathway.</p>

Effects of blood-lipid report's reformat on outpatients' behavior and knowledge of dyslipidemia therapy / 中华全科医师杂志

Objective To evaluate the effects of blood-lipid report's reformat on outpatients' behavior and knowledge of dyslipidemia therapy.Methods The blood-lipid report was reformatted by adding three tables from the Chinese Guideline on the Prevention and Treatment of Adult Dyslipidemia on its back.The same questionnaire was used twice to evaluate the patients' behavior and knowledge of dyslipidemia therapy before and after reformat.Results Before and after reformat,the rates of correct deterination of their own risk stratification were 26.0％ ( 112/430 ) and 26.3％ ( 115/438 ) respectively.The awareness rates of Different LDL-C goals among different persons wcre 37.0％ (159/430) and 35.8％ (157/438).Only 0.7％ (2/306) and 1.0％ (3/299) of patients knew their blood lipid goals (P =0.557).When the report showed normal blood lipid levels,the percentages of taking lipid-lowering drug were 47.6％ ( 230/483 ) and 46.6％ ( 216/464 ),20.5％ ( 99/483 ) and 19.0％ ( 88/464 ) of patients questioned the prescription.Non-medication rates were 31.9％ ( 154/483 ) and 34.5％ ( 160/464 ) respectively before and after reformat ( P ＞ 0.05 ).For patients requiting lipid-lowering drug therapy by the guideline,treatment rate improved significantly in the low-risk group (13.3％ vs.75.0％,P =0.002).Treatment rate slightly increased in the high-risk and very high-risk groups after reformat (54.0％ vs.56.8％,62.4％ vs.69.0％,P ＞ 0.05 ).Rates of achieving lipid goal showed no change [ 41.5％ ( 102/ 245 ) vs.44.5％ ( 114/256 ),P ＞ 0.05 ] after reformat,especially among the very high-risk patients [17.9％(12/68) vs.21.6％(11/52),P＞0.05].Conclusions The blood-lipid report reformat did not improve the patient behaviors and knowledge of the prevention and treatment of dyslipidemia because of poor treatment rate and medication compliance.The combination of patient education and thorough blood-lipid report reformat may help to increase the attainment rate of dyslipidemia therapy.

Current status of non-viral vectors for siRNA delivery / 药学学报

RNA interference (RNAi) is a newly developed technology. It is the different levels of gene silencing induced by specific degradation of targeted genes in vivo, and both exogenous and endogenous double-stranded RNAs could induce the specific degradation. RNAi has been applied in tumor therapy, viral infection, hepatitis B and many other diseases. siRNA is the effector molecule which induces the RNAi in vivo. But naked siRNA is easily degradated by RNases in vivo, and the half-life is short. Meanwhile, the transfection efficiency of the naked siRNA is comparatively low. So the naked siRNA needs the help of vectors to penetrate the cell membrane and take action. Viral vectors have the potential immunogenicity and mutagenicity in gene therapy. Therefore, non-viral vectors are drawing more and more attention. The latest development of the non-viral vectors is summarized in this review.

Types and spontaneous Ca2+ waves of ICC in the bladder of guinea pig / 中华泌尿外科杂志

Objective To discuss the types of ICC and characteristics of spontaneous Ca2+ waves of different types of ICC in the bladder of guinea pig. Methods Frozen-sections were made from the bladder of guinea pig and ICC were cultured in vitro. Cells were stained by indirect immunofluorescent method and detected by Laser scanning confocal microscope. The ICC cultured in vitro were divided randomly into 4 group: dimmer ICC,monomer ICC,dimmer ICC treated with 2-APB group and monomer ICC treated with 2-APB group according to the cell morphology and disrupted with 2-APB.The calcium concentration of ICC cultured in vitro were marked with Fluo-4 AM and disrupted by 2-aminoethoxydipheylbrate (2-APB, 100 μmol/L) in dimmer ICC treated with 2-APB group and monomer ICC treated with 2-APB group. The calcium oscillation function of ICC was observed under Laser scanning confocal microscope. Results For the monomer ICC and dimmer ICC in frozen sections and cultured in vitro,there were increased frequency (P＜0.01) and amplitude (P＜0.05) of spontaneous Ca2+ waves in dimmer ICC compared with the monomer monomer ICC. But after the cells disrupted by 2-APB after 15 min,There were decreased frequency (P＜0.01) and amplitude (P＜0.01) of spontaneous Ca2+ waves in the dimmer ICC treated with 2-ABP group compared with the dimmer ICC. The changes(P＞0.05) of spontaneous Ca2+ waves was not statistical significance in monomer ICC treated with 2-ABP group compared with monomer ICC group. Conclusions The bladder of guinea pig may exist 2 different types of ICC, dimmer ICC and monomer ICC. The excitability of spontaneous Ca2+ waves of dimmer ICC could be higher than in monomer ICC. The special structure of dimmer ICC may contribute to the formation of high spontaneous Ca2+ waves.

A humeroulnar distraction manual technique for elbow stiffness after upper limb fracture / 中华物理医学与康复杂志

Objective To investigate simple manual humeroulnar distraction for alleviating elbow stiffness due to upper limb fracture. Methods Twenty-seven patients with elbow stiffness due to upper limb fracture were divided into control and experimental groups. Before treatment there was no significant difference in stiffness between the groups. The controls were treated with the combined mobilizations and passive stretching. The experimental group was treated with manual humeroulnar distraction alone. Both groups were treated for four weeks. Range of motion ( ROM) and the Mayo elbow function scale (MEFS) were used to evaluate elbow function before and after 4 weeks of treatment. Results After 4 weeks, there was a significant difference between the groups. In the experimental group average ROM reached (110±20) °,an average of 29.6°better than the controls (80.4±23.6) °. MEFS scores also showed significant differences between the experimental group (93. 85±7. 95) and the control group (83.93±9. 24). Conclusions Humeroulnar joint distraction might increase ROM and improve the functioning of stiff elbow joints. This finding may help rehabilitation professionals choose more effective manual mobilization techniques for treating elbow stiffness after upper limb fracture.

Expression and significance of c-kit messenger ribonucleic acid and c-kit protein in diabetic cystopathy in guinea pig / 中国病理生理杂志

AIM: To determine the expression of c-kit mRNA and protein in the bladders in guinea pigs with diabetic cystopathy (DCP) and to explore the correlation and mechanisms between c-kit expression and DCP. METHODS: Sixty guinea pigs were divided randomly into control group (n=20) and experimental group (n=40). The guinea pigs in experimental group were injected with streptozotocin (STZ) to induce diabetes mellitus. After fed for 10 weeks, the animals in both groups were tested with urodynamics, and the guinea pigs in experimental group were divided into the subgroups of DCP and the diabetic no-cystopathy (NDCP) group according to the results of urodynamics. mRNA expression of c-kit was detected by reverse transcription polymerase chain reaction (RT-PCR) and protein expression of c-kit was tested and analyzed by laser scanning confocal microscope. RESULTS: Decreased expression of c-kit mRNA was observed in DCP group compared to control and the NDCP group. The ratio of c-kit mRNA and GAPDH was 5.66±0.54 in controls (P<0.05), 5.54±1.28 in NDCP group (P<0.05) and 4.65 ±0.47 in DCP group. c-kit protein expression significantly declined in DCP group. The mean value of fluorescence intensity was 856.52± 53.03 in control group, 844.67± 59.24 in NDCP group and 548.69± 48.51 in DCP (P<0.01).CONCLUSION: The declined expression of c-kit) gene at transcription and translation levels destroys the SCF/c-kit signal pathway, leading to the dysfunction of Cajal-like) cells in DCP guinea pig, so the abnormal expression of c-kit gene is involved in the pathogenesis of DCP.