Urodynamic study of bladder dysfunction after radical hysterectomy of cervical cancer / 中华老年医学杂志

Objective:To explore the urodynamic characteristics of bladder function in patients with abnormal urination after radical hysterectomy of cervical cancer.Methods:In a prospective self-controlled study, a total of 84 patients with cervical cancer and clinical stage of ⅠB to ⅡA, meeting the preoperative inclusion criteria in our hospital from January 2016 to June 2018 were enrolled.All patients were tested for urodynamic testing 1 week before and 6 months after surgery.Patient bladder function status was observed and evaluated before and after surgery and urodynamic examination results were analyzed.Results:Of 84 study cases, the 58 patients developed abnormal urination after radical surgery, there were no urination abnormalities in 26 cases.There was no significant difference in age, clinical stage and pathological diagnosis between patients with and without urination abnormalities.Abnormal urination after radical surgery included difficulty in urinating(55%), frequent urination with a feeling of urination not complete(34%), stress urinary incontinence(7%), and urinary incontinence(4%). Among the 26 patients without urination abnormalities after radical surgery, only one case showed an abnormal urodynamic examination(abnormal bladder sensation). In patients without abnormal urination after surgery, differences in the urodynamic examination findings between pre-and post-surgery were not statistically significant(all P> 0.05). At the same time, in all cases of abnormal urination after radical hysterectomy of cervical cancer, 43 patients(74%)with bladder dysfunction had normal urination pattern before operation, but after operation, the urination abnormality required abdominal pressure.Of the patients with bladder dysfunction after surgery, the maximum flow rate(Qmax)was(12.9±10.3)ml/s, the average flow rate(Qave)was(6.0±4.2)ml/s, the voided volume was(148.0±36.8)ml, voiding time was(32.9±22.1)s, maximum flow time was(11.4±5.0)s, postvoid residual urine was(260.2±219.2)ml, maximal detrusor pressure was(12.1±8.9)cmH 2O, bladder compliance was(16.1±4.3)ml/cmH 2O, normal desire to void was(354.5±204.3)ml, maximal capacity was(587.4±152.5)ml, maximum urethral pressure was(97.6±33.1)cmH 2O, maximum urethral closure pressure was(89.9±36.4)cmH 2O, and function urethral length was(29.6±6.5)mm; In comparison, the above indexes-corresponding values at 1 week before surgery were respectively as follows: the Qmax was(25.1±11.4)ml/s, the Qave was(11.4±6.6)ml/s, the voided volume was(318.6±96.4)ml, voiding time was(29.2±18.5)s, maximum flow time was(6.7±3.9)s, postvoid residual urine was(29.9±21.5)ml, maximal detrusor pressure was(31.9±21.4)cmH 2O, bladder compliance was(78.1±33.9)ml/cmH 2O, normal desire to void was(258.2±185.5)ml, maximal capacity was(335.1±124.9)ml, maximum urethral pressure was(96.4±33.9)cm H 2O, maximum urethral closure pressure was(88.5±35.2)cmH 2O, and function urethral length was(37.2±7.2)mm.It can be seen that Qmax, Qave, voided volume, maximum detrusor pressure, bladder compliance, and functional urethral length in patients with abnormal urination are significantly lower after radical hysterectomy of cervical cancer than before the surgery.While, normal desire to void, maximum capacity, maximum flow time, and postvoid residual urine volume were higher after radical hysterectomy than before surgery( P<0.05). In addition, there was no significant difference in voiding time, maximum urethral pressure and maximum urethral closure pressure between pre-and post-operation.Besides, it is worth noting that there was no significant difference in preoperative urodynamic test results between patients without abnormal urination versus patients with abnormal urination( P>0.05), and the difference in urodynamic test results between the two groups is statistically significant( P<0.05). There was no statistically significant difference in abnormal urination and in urodynamic test results between different clinical stages and between different pathological types( P>0.05). Conclusions:The characteristics of urinary dynamics in patients with abnormal urination after radical hysterectomy of cervical cancer are mainly manifested as decreased bladder sensory function and abnormal detrusor function.And the urodynamic test can provide objective clinical indicators for early diagnosis.

Thermosensitive Hydrogel Loaded with Primary ChondrocyteDerived Exosomes Promotes Cartilage Repair by Regulating Macrophage Polarization in Osteoarthritis

BACKGROUND@#Intra-articular injection is a classic strategy for the treatment of early osteoarthritis (OA). However, the local delivery of traditional therapeutic agents has limited benefits for alleviating OA. Exosomes, an important type of extracellular nanovesicle, show great potential for suppressing cartilage destruction in OA to replace drugs and stem cellbased administration. @*METHODS@#In this study, we developed a thermosensitive, injectable hydrogel by in situ crosslinking of Pluronic F-127 and hyaluronic acid, which can be used as a slow-release carrier to durably retain primary chondrocyte-derived exosomes at damaged cartilage sites to effectively magnify their reparative effect. @*RESULTS@#It was found that the hydrogel can sustainedly release exosomes, positively regulate chondrocytes on the proliferation, migration and differentiation, as well as efficiently induce polarization of M1 to M2 macrophages. Intraarticular injection of this exosomes-incorporated hydrogel significantly prevented cartilage destruction by promoting cartilage matrix formation. This strategy also displayed a regenerative immune phenotype characterized by a higher infiltration of CD163+ regenerative M2 macrophages over CD86+ M1 macrophages in synovial and chondral tissue, with a concomitant reduction in pro-inflammatory cytokines (TNF-a, IL-1b, and IL-6) and increase in anti-inflammatory cytokine (IL-10) in synovial fluid. @*CONCLUSION@#Our results demonstrated that local sustained-release primary chondrocyte-derived exosomes may relieve OA by promoting the phenotypic transformation of macrophages from M1 to M2, which suggesting a great potential for the application in OA.

Construction of training program for improving psychological nursing ability of clinical nurses / 中国实用护理杂志

Objective:To construct a training program to improve the psychological nursing ability of clinical nurses, so as to provide a strong guarantee for the clinical development of psychological nursing.Methods:By consulting the literature, related books and investigating the curriculum of nursing colleges, the first draft of the training program was drawn up. Four departments of Cardiovascular Medicine of the Second Xiangya Hospital of Central South University from May to August 2019 were recruited and 64 nurses were trained. After the training, the training program was revised again. After two rounds of training and modification, the second draft of the training program was formed, and then Delphi method was used to conduct two rounds of expert consultation on the second draft of the training program.Results:The positive coefficients of experts in the two rounds of consultation were 94.1% and 96.7% respectively, and the average authority coefficient of experts was 0.81. The final training contents included 5 first-class indexes, 18 second-class indexes and 45 third-class indexes. The coefficient of variation of each item of training contents was 0.06-0.23, and the coefficient of variation of training methods and training duration of each part was 0.06-0.17.Conclusions:The training program is scientific, reasonable, detailed and practical, which can provide guarantee for improving the psychological nursing ability of clinical nurses.

Breastfeeding of Infants Born to Mothers with COVID-19: A Rapid Review

BackgroundExisting recommendations on whether mothers with COVID-19 should continue breastfeeding are still conflicting. We aimed to conduct a rapid review of mother-to-child transmission of COVID-19 during breastfeeding. MethodsWe systematically searched Medline, Embase, Web of Science, Cochrane library, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang, and preprint articles up to March 2020. We included studies relevant to transmission through milk and respiratory droplets during breastfeeding of mothers with COVID-19, SARS, MERS and influenza. Two reviewers independently screened studies for eligibility, extracted data, assessed risk of bias and used GRADE to assess certainty of evidence. ResultsA total of 4481 records were identified in our literature search. Six studies (five case reports and one case series) involving 58 mothers (16 mothers with COVID-19, 42 mothers with influenza) and their infants proved eligible. Five case reports showed that the viral nucleic acid tests for all thirteen collected samples of breast milk from mothers with COVID-19 were negative. A case series of 42 influenza infected postpartum mothers taking precautions (hand hygiene and wearing masks) before breastfeeding showed that no neonates were infected with influenza during one-month of follow-up. ConclusionsThe current evidence indicates that SARS-CoV-2 viral nucleic acid has not been detected in breast milk. The benefits of breastfeeding may outweigh the risk of SARS-CoV-2 infection in infants. Mothers with COVID-19 should take appropriate precautions to reduce the risk of transmission via droplets and close contact during breastfeeding.

Efficacy and Safety of Antibiotic Agents in Children with COVID-19: A Rapid Review

BackgroundThe aim of this review was to evaluate the efficacy and safety of antibiotic agents in children with COVID-19, as well as to introduce the present situation of antibiotics use and bacterial coinfections in COVID-19 patients. MethodsWe searched Cochrane library, Medline, Embase, Web of Science, CBM, Wanfang Data and CNKI from their inception to March 31, 2020. In addition, we searched related studies on COVID-19 published before March 31, 2020 through Google Scholar. We evaluated the risk of bias of included studies, and synthesized the results using a qualitative synthesis. ResultsSix studies met our inclusion criteria. Five studies on SARS showed an overall risk of death of 7.2% to 20.0%. One study of SARS patients who used macrolides, quinolones or beta lactamases showed that the mean duration of hospital stay was 14.2, 13.8 and 16.2 days, respectively, and their average duration of fever was 14.3, 14.0 and 16.2 days, respectively. One cohort study on MERS indicated that macrolide therapy was not associated with a significant reduction in 90-day mortality (adjusted odds ratio [OR] 0.84, 95% confidence interval [CI] 0.47-1.51, P = 0.56) and improvement in MERS-CoV RNA clearance (adjusted hazard ratio [HR] 0.88, 95% CI 0.47, -1.64], P = 0.68). According to the findings of 33 studies, the proportion of antibiotics use ranged from 19.4% to 100.0% in children and 13.2% to 100.0% in adults, despite the lack of etiological evidence. The most commonly used antibiotics in adults were quinolones, cephalosporins and macrolides and in children meropenem and linezolid. ConclusionsThe benefits of antibiotic agents for adults with SARS or MERS were questionable in the absence of bacterial coinfections. There is no evidence to support the use of antibiotic agents for children with COVID-19 in the absence of bacterial coinfection.

Differences in urodynamics between Parkinson's disease and multiple system atrophy patients with lower urinary tract symptoms / 中华老年医学杂志

Objective:To investigate the urodynamic characteristics in Parkinson's disease(PD)versus multiple system atrophy(MSA)patients with lower urinary tract symptoms(LUTS).Methods:We performed a retrospective study in PD and MSA patients admitted to the First Affiliated Hospital of Zhengzhou University and undergone urodynamic examinations from January 2016 to June 2019.A total of 178 patients, mean age(59.2±9.7)years were enrolled, with 64 PD patients, 74 MSA patients and 40 normal controls.Urodynamic parameters included maximum flow rate(Qmax), post-voided residual urine volume(PVR), bladder compliance(BC), overactive bladder(OAB), maximum cystometric capacity(MCC)and detrusor pressure at maximum flow rate(PdetQmax). Bladder function was assessed.Results:Frequent urination(68.8%)was the most common LUTS in PD patients, as opposed to urinary retention(91.9%)in MSA patients.The Qmax, PdetQmax and incidence of OAB were higher and the PVR were lower in PD patients than in MSA patients [free-flow(FF)-Qmax: (13.5±7.1)ml/s vs.(10.1±5.2)ml/s, U=26.98, P<0.01]; pressure-flow study(PFS)-Qmax: [(13.6±5.7)ml/s vs.(10.5±3.3)ml/s, U=34.90, P<0.01]; PFS-PdetQmax: [(23.9±11.3)cm H 2O vs.(16.3±8.6)cmH 2O, U=35.04, P<0.01]; OAB: (46.9% vs.27.0%, χ2=5.85, P<0.01); FF-PVR: [(30.4±20.0)ml vs.(161.7±79.8)ml, U=-71.81, P<0.01]; PFS-PVR: [(65.9±30.7)ml vs.(212.6±83.0)ml, U=-65.29, P<0.01]. Compared with the control group, the incidences of OAB and PFS-PVR were increased and the MCC and PdetQmax were decreased in the PD group(OAB: 46.9% vs.7.5%, χ2=6.15, P<0.018); PFS-PVR: [(65.9±30.7)ml vs.(22.2±10.4)ml, U=47.25, P<0.01]; MCC: [(305.1±79.7)ml vs.(389.6±65.2)ml, U=-52.13, P<0.01]; PdetQmax: [(23.9±11.3)cmH 2O vs.(37.3±10.3)cmH 2O, U=-49.88, P<0.01]. Compared also with the control group, the MSA group had a lower Qmax, PdetQmax and MCC, FF-Qmax: [(10.1±5.2)ml/s vs.(16.3±4.7)ml/s, U=-50.11, P<0.01]; PFS-Qmax: [(10.5±3.3)ml/s vs.(13.1±5.0)ml/s, U=-27.54, P<0.05]; PdetQmax: [(16.3±8.6)cmH 2O vs.(37.3±10.3)cmH 2O, U=-84.92, P<0.01]; MCC: [(284.3±71.8)ml vs.(389.6±65.2)ml, U=-39.31, P<0.01], a higher PVR, lower bladder compliance(BC)and a higher incidence of OAB(FF-PVR: [(161.7±79.8)ml vs.(22.0±13.0)ml, U=84.82, P<0.01]; PFS-PVR: [(212.6±83.0)ml vs.(22.2±10.4)ml, U=112.54, P<0.01]; BC: (28.4% vs.7.5%, χ2=6.81, P<0.01); OAB: (27.0% vs.7.5%, χ2=17.62, P<0.01). Conclusions:PD and MSA patients with LUTS have bladder dysfunction.MSA patients have more serious bladder dysfunction than PD patients.

Characteristic bioanalysis of skeletal muscle cells gene markers in septic patients / 中华危重病急救医学

OBJECTIVE@#To analyze the characteristics of skeletal muscle cells gene markers in septic patients by using bioinformatics.@*METHODS@#The differential gene expression of marker microarrays (GSE13205) in skeletal muscle tissue of patients with sepsis was obtained from gene expression omnibus (GEO) database of National Center for Biotechnology Information (NCBI). Gene differential expression analysis was carried out using online GEO2R provided by NCBI. Data processing, analysis and mapping were carried out using online bioinformatics array research tool (BART) and Cytoscpe software, the software of the national resource for network biology. Functional annotation and pathway analysis of differential expression genes were performed using Kyoto encyclopedia of genes and genomes (KEGG) and gene ontology (GO) provided by the database for annotation, visualization and integrated discovery (DAVID), and protein interaction analysis was further performed in search tool for the retrieve of interacting genes/proteins (STRING-DB).@*RESULTS@#The TOP250 genes were extracted from the GSE13205 dataset. A total of 242 differentially expressed genes were included in the analysis. Among them, 78 up-regulated genes and 164 down-regulated genes were identified. After extensive data analysis, these differentially expressed genes were enriched into different biological processes or subsets of molecular functions, mainly enriched in the positive and negative regulation of growth, mineral absorption and other pathways. The 14 most closely related genes among differentially expressed genes were identified from the protein interaction network.@*CONCLUSIONS@#The differential expression genes in patients with sepsis were mainly concentrated on cell growth and apoptosis and mediating tumor-related immune function regulation.

Urodynamic evaluation of bladder function in patients with parkinsonism dominant multiple system atrophy with abnormal urination / 中华神经科杂志

Objective@#To investigate the urodynamic characteristics and clinical significance of bladder function in patients with parkinsonism dominant multiple system atrophy (MSA-P) with abnormal urination. @*Methods@#The clinical data of 58 patients with multiple system atrophy (MSA) and urinary dysfunction who were hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2015 to June 2018 were analyzed. The bladder function status of MSA-P patients was evaluated, and the characteristics of urinary motility examination results were analyzed. @*Results@#According to the diagnostic criteria, 51 patients were MSA, and seven patients were suspicious, all diagnosed as MSA-P. All MSA-P patients had abnormal urination with different symptoms, including dysuria (77.6%), frequent urination (62.1%), urgency (62.1%), urinary incontinence (65.5%), urinary retention (12.1%). Of the MSA-P patients with abnormal urination, the maximum flow rate (Qmax) was (12.46±2.85) ml/s, the average flow rate (Qave) was (5.19±2.06) ml/s, the voided volume was (171.73±11.47) ml, postvoid residual urine was (136.15±10.47) ml, maximal detrusor pressure was (20.78±3.55) cmH2O, bladder compliance was (16.59±2.91) ml/cmH2O, normal desire to void was (223.64±11.02) ml, and maximal capacity was (287.57±12.51) ml. The Qmax, Qave, voided volume, maximal detrusor pressure, bladder compliance, normal desire to void, and maximal capacity of patients with MSA-P with abnormal urination were significantly decreased, while the bladder residual urine volume was significantly increased, with statistically significant differences compared to normal reference values (P<0.05). @*Conclusion@#The urinary motility of bladder function in patients with MSA-P and urinary abnormalities is mainly characterized by decreased bladder compliance and detrusor dysfunction, while urodynamic testing is helpful for early diagnosis.

Relationship between bullying and emotional behavior problems in middle school students / 中华行为医学与脑科学杂志

Objective@#To investigate the current situation of emotional and behavioral problems and analyze the influencing factors of middle school students.@*Methods@#The general information questionnaire, the strengths and difficulties questionnaire (student version), and the illinois bullying scale were used to evaluate 680 students in two middle schools in Hunan province.Statistical analysis was performed using t test, analysis of variance, Pearson correlation analysis and stepwise multiple regression analysis.@*Results@#(1) The detection rate of total difficulty (12.09±5.67), conduct problem (2.42±1.66), hyperactivity/attention defect (3.65±2.08), emotional (2.82±2.32), peer relationship problem (3.21±1.79) and pre-socialization behavior (7.02±2.39) were 11.2%, 11.2%, 7.7%, 6.9%, 11.0% and 14.5%.(2)The scores of total difficulties, conduct problem, hyperactivity/attention deficit and peer relationship problems of boys were higher than that of girls(t=2.79, 4.03, 2.44, 3.40, all P<0.05), while the score of pre-socialization behavior of boys was lower than that of girls (t=-5.29, P<0.05). (3) The scores of total difficulties, conduct and peer relations, pre-socialization of rural students were significantly different with those of urban students(t=-3.93, -2.55, -7.00, 5.26, all P<0.05). (4) The score of total difficulties, conduct problem, hyperactivity/attention deficit and emotional symptoms of left-behind students were higher than that of un-left-behind students (t=-3.18, -2.50, -2.67, -2.40, 2.19, all P<0.05). (5) Middle school students with different fathers' education levels showed different scores of total difficulties, peer relationship problem and pre-socialized behavior(F=3.84, 7.10, 6.20, all P<0.05), while middle school students with different mothers' education levels showed different scores of total difficulties and peer relationship problem(F=3.97, 7.38, both P<0.05). (6) The scores of total difficulties, emotional symptoms, conduct problems, and hyperactivity/attention deficit of the middle school students were significantly positively correlated with the total score of the bullying total scale, the bullish subscale, the bullying subscale, and the fighting subscale(r=0.165-0.430, P<0.05). (7) Gender, urban and rural areas, left-behind or not, maternal education level, bullying, being bullied, fighting were the influencing factors of middle school students' emotion and behavior problems(β=0.010-0.533, P<0.05).@*Conclusion@#Some middle school students in Hunan province have emotional and behavioral problems and more attention should bo paid to mental health education.

The mediating role of internalized stigma between insight and self-esteem among patients with schizophrenia / 中华行为医学与脑科学杂志

Objective@#To explore the relationship between internalized stigma and insight, self-esteem in patients with schizophrenia.@*Methods@#A total of 144 schizophrenic patients were investigated by the general information questionnaire, insight and treatment attitude questionnaire (ITAQ), internalized stigma of mental illness scale-Chinese version (ISMI-C) and the self-esteem scale (SES). Pearson correlative analysis and Bootstrap program mediation effect test were used to data analysis.@*Results@#There was a significantly positively correlation between insight score(11.24±4.08) and internalized stigma score(2.18±0.65) of 144 schizophrenic patients(r=0.236, P<0.05). The Self-esteem score(27.57±3.76) was negatively correlated with insight score(r=-0.177, P<0.05) and internalized stigma score(r=-0.661, P<0.05). The mediation effect test analysis showed that the internalized stigma played a full mediating role in the relationship between insight and self-esteem, and the effect size was -0.143.@*Conclusion@#Insight can indirectly affect self-esteem via internalized stigma in patients with schizophrenia.Taking measures to decrease inpatients' internalized stigma level and improve their illness awareness should be paid attention in clinical practice.

The mediating role of internalized stigma between insight and self-esteem among patients with schizo-phrenia / 中华行为医学与脑科学杂志

Objective To explore the relationship between internalized stigma and insight,self-es-teem in patients with schizophrenia. Methods A total of 144 schizophrenic patients were investigated by the general information questionnaire,insight and treatment attitude questionnaire (ITAQ),internalized stigma of mental illness scale-Chinese version (ISMI-C) and the self-esteem scale (SES). Pearson correlative analysis and Bootstrap program mediation effect test were used to data analysis. Results There was a significantly positively correlation between insight score(11. 24±4. 08) and internalized stigma score(2. 18±0. 65) of 144 schizophrenic patients(r=0. 236,P<0. 05). The Self-esteem score(27. 57±3. 76) was negatively correlated with insight score(r=-0. 177,P<0. 05) and internalized stigma score(r=-0. 661,P<0. 05). The mediation effect test analysis showed that the internalized stigma played a full mediating role in the relationship between insight and self-esteem,and the effect size was -0. 143. Conclusion Insight can indirectly affect self-es-teem via internalized stigma in patients with schizophrenia. Taking measures to decrease inpatients' internal-ized stigma level and improve their illness awareness should be paid attention in clinical practice.

Characteristic bioanalysis of skeletal muscle cells gene markers in septic patients / 中华危重病急救医学

Objective To analyze the characteristics of skeletal muscle cells gene markers in septic patients by using bioinformatics. Methods The differential gene expression of marker microarrays (GSE13205) in skeletal muscle tissue of patients with sepsis was obtained from gene expression omnibus (GEO) database of National Center for Biotechnology Information (NCBI). Gene differential expression analysis was carried out using online GEO2R provided by NCBI. Data processing, analysis and mapping were carried out using online bioinformatics array research tool (BART) and Cytoscpe software, the software of the national resource for network biology. Functional annotation and pathway analysis of differential expression genes were performed using Kyoto encyclopedia of genes and genomes (KEGG) and gene ontology (GO) provided by the database for annotation, visualization and integrated discovery (DAVID), and protein interaction analysis was further performed in search tool for the retrieve of interacting genes/proteins (STRING-DB). Results The TOP250 genes were extracted from the GSE13205 dataset. A total of 242 differentially expressed genes were included in the analysis. Among them, 78 up-regulated genes and 164 down-regulated genes were identified. After extensive data analysis, these differentially expressed genes were enriched into different biological processes or subsets of molecular functions, mainly enriched in the positive and negative regulation of growth, mineral absorption and other pathways. The 14 most closely related genes among differentially expressed genes were identified from the protein interaction network. Conclusion The differential expression genes in patients with sepsis were mainly concentrated on cell growth and apoptosis and mediating tumor-related immune function regulation.

Node metastatic and prognostic analysis of superficial thoracic esophageal squamous cell carcinoma with T1 status / 中华胸心血管外科杂志

Objective To investigate the pattern of lymph node metastasis and the long-term survival in patients with superficial thoracic esophageal squamous cell carcinoma(ESCC) with T1 status.Methods 176 patients with pathologically confirmed superficial ESCC with T1 status who underwent Mckeown esophagectomy between January 1999 and January 2010 were retrospectively enrolled.Tumor invasion is classified according to the Japanese Association of esophageal cancer classification standard.Epithelial layer and mucosa(m) divided into epithelial layer(M1),lamina propria mucosa(M2),muscularis mucosa(M3),submucosa(M3).Submucosa(Tsm) were average divided into submucous upper 1/3 (SM1),middle 1/3 (SM2) and lower 1/3 (SM3).Node metastatic pattern of different tumor invasion and the prognostic indication is investigated.Results The rate of node metastasis in patients with SM invasion is significantly higher than those with m invasion (28.2％ vs.4.4％,P =0.001);the 5-year survival rate of patients with SM invasion is significantly higher than those with m invasion (91.4％ vs.75.8％,P =0.048).The rate of node metastasis in patients with M1,M2,and M3 invasion is 0,0,and 6.2％,respectively;the rate of node metastasis in patients with SM1,SM2,and SM3 invasion is 20.0％,29.4％,and 33.3％,respectively,with the 5-year survival rate of 86.5％,77.4％,and 67.3％,respectively.The highest rate of lymph node metastasis in the neck region,mainly in the right cervical paraesophageal lymph nodes(101R).The rate of cervical lymph node metastasis in patients with SM1,SM2,and SM3 invasion is 15.0％,20.6％ and 24.6％,respectively.The rate of 101R metastasis in patients with SM1,SM2,and SM3 invasion is 10％,8.8％ and 24.6％,respectively.Univariate analysis showed that there is no significant difference between lymph node metastasis rate and patient age,gender,tumor differentiation and tumor location,and vascular invasion and tumor invasion depth (ml-3/SM1-3) difference is statistically significant.Nodal status is proved as the independent prognostic factor(HR =2.127,95％ CI =1.219-3.713).The 5-year survival of patients with and without node metastasis is 64.7％ and 83.5％ (P =0.005).Conclusion The rate of node metastasis of SM invasion cohort is significantly higher than M invasion cohort.There was no significant difference in lymph node metastasis rate between SM1,SM2 and SM3.Lymph node metastasis(N staging) is an independent prognostic factor for stage T1 thoracic ESCC.Compared with the thoracic and abdominal lymph nodes,the cervical lymph node metastasis rate is higher,and concentrated in 101R.

Effect of urinary training on urination control of infants using nappies after birth / 中华实用儿科临床杂志

Objective To investigate the effect of urinary training on urination control in infants using nappies after birth.Methods Stratified sampling method was used to investigate the daytime urination control and the using of diapers by children in kindergartens of 6 prefecture-level cities in Henan Province,China.The survey was conducted among parents of healthy children.Results In a total of 12 250 questionnaires,11 697 had response,and 10 562 valid questionnaires were collected,and the effective recovery rate was 86.22％.After the birth of infants,the age of toilet training was divided into 6 groups (0-＜ 3 months old group,3-＜ 6 months old group,6-＜ 12 months old group,12-＜ 18 months old group,18-＜ 24 months old group and no toilet training group).Results showed that toilet training within 12 months leads to higher urinary control rate compared with toilet training after 12 months and no toilet training till the age of 2 years old,70.56％ (4 831/6 847 cases) in contrast with 59.02％ (1 545/2 618 cases) and 42.48％ (466/1 097 cases),and the differences were statistically significant (x2 =114.76,335.48,all P ＜ 0.000 1).Within 12 months,there was no statistical difference in the urinary control rate between subgroups at 2 years of age(all P ＞0.05).After 12 months,the urination control rate decreased with the start time delayed till 2 years of age,and the urinary control rate at the age of 2 years old n different groups was 59.97％ (1 314/2 191 cases) and 54.10％ (231/427 cases) respectively.The results of other ages(0.5,1.0,1.5 years old) were similar to those of 2 years old.There was no difference between the groups of different genders (all P ＞ 0.05).Conclusions The use of diapers in infants before the age of 1 year to start urinary training is conducive to the development of urinary control in infants.

Altered expression and clinical significance of plasma circulating microRNA-23b in patients with myasthnia gravis / 中华神经科杂志

Objective To evaluate the expression and clinical significance of plasma circulating microRNA-23b in patients with myasthenia gravis (MG).Methods Plasma samples from 32 MG patients and 32 healthy people were collected in the Second Affiliated Hospital of Harbin Medical University from October 2015 to August 2016. Expression of microRNA-23b was detected by quantitative reverse transcription polymerase chain reaction .The relationship among microRNA-23b expression level, clinical features and quantitative myasthenia gravis score ( QMG ) was analyzed. Results The expression of circulating microRNA-23b in plasma was significantly higher in MG patients (4.587 (3.654, 5.423)) compared with control group (2.889 (1.968, 4.027), Z=-4.169, P<0.01), meanwhile it was positively related to QMG (r=0.661,P<0.01).But the expression of circulating microRNA-23b had no statistically significant difference in MG subgroups .Conclusion Plasma circulating microRNA-23b is highly expressed in MG and has positive correlation with MG severity .

Correlation between single nucleotide polymorphisms of multi-loci and multi-genes and myasthenia gravis / 中华神经科杂志

Objective To investigate the association between myasthenia gravis (MG) and single nucleotide polymorphisms (SNPs) of PTPN22 + 1858C/T,CTLA-4 (+ 49A/G;-1772C/T;-1661A/G),KRAS(rs9226),BCL2(rs4987855) and IGF-1R(rs34804698) genes.Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was adopted to detect the gene types of SNPs in 76 MG patients who were enrolled in the Second Affiliated Hospital of Harbin Medical University from July 2011 to June 2015 and 59 healthy blood donors.Results In MG patients,the frequences of CTLA-4 +49A/G(rs231775) (57.9％) and-1772C/T (rs733618) (43.4％) were higher than that in the healthy controls (22.1％) (x2 =35.252,P =0.000; x2 =4.098,P =0.043).The frequence of CTLA-4 +49A/G in MG patients combined with thymoma (25.6％) was higher than other subgroups (thymic hyperplasia group:13.8％; normal thymus group:18.4％)(x2 =7.564,P=0.006; x2 =7.155,P=0.007).Meanwhile,the frequence of the C-1772 allele was higher in thymoma group (19.7％) compared with other two groups (thymic hyperplasia group:9.86％ ; normal thymus group:13.8％) (x2 =5.331,P =0.021 ;x2 =4.411,P =0.036).However,the other SNPs were not associated with the risk of MG.Conclusion There are associations of MG with CTLA-4 + 49A/G and-1772C/T SNPs,but not with PTPN,KRAS,BC12 and IGF-1R SNPs.

Altered expression of microRNA-27a-3p in the thymus tissue of patients with myasthenia gravis / 中华神经科杂志

Objective To investigate the expression level of thymus microRNA-27a-3p in patients with myasthenia gravis (MG) and to explore the pathogenesis of MG.Methods Thymus tissue samples from 36 cases were collected from December 2014 to February 2015 in the Second Affiliated Hospital of Harbin Medical University.Nineteen thymus tissue samples of MG group were collected from department of chest surgery,17 thymus tissue samples of control group were collected from department of chest surgery or congenital heart disease patients from department of cardiac surgery.The expression of microRNA-27a-3p in the thymus from 36 patients was determined by quantitative reverse transcription polymerase chain reaction (qRT-PCR),using U6 as housekeeping control.The Wilcoxon Rank-Sum test was used to analyze the relative expression of microRNA-27a-3p of the two groups.Spearman rank correlation was used to determine the correlation coefficient between microRNA-27a-3p and Quantitative Myasthenia Gravis Score (QMGS).Results (1) The expression level of microRNA-27a-3p in thymus was significantly higher in MG group (0.195(0.049,0.714)) compared with control group (0.045(0.004,0.088),Z =-2.646,P =0.008).(2) Nineteen MG patients were included in the study,out of which 7 were ocular myasthenia gravis (OMG) patients and 12 were generalized myasthenia gravis (GMG) patients.The expression of microRNA-27a-3p in GMG patients (0.493 (0.157,1.123)) was significantly higher than that in OMG patients (0.035 (0.008,0.103),Z =-2.620,P =0.009).(3) There was a positive correlation between the expression of microRNA-27a-3p and QMGS (r =0.576,P =0.010).Conclusions The expression of microRNA-27a-3p in thymus is significantly up-regulated in the patients with MG.MicroRNA-27a-3p may be associated with MG severity and significantly elevated in GMG patients compared with OMG patients.

Comparison of the stapled suture with the manual suture in the application of minimally invasive esophagectomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the associated anastomotic complication of cervical esophagogastric anastomosis between stapled and hand-sewn anastomosis in minimally invasive esophagectomy(MIE).</p><p><b>METHODS</b>Clinical data of 203 patients with esophageal cancer receiving combined thoracoscopic and laparoscopic esophagectomy with anastomosis in the neck in our hospital from January 2010 to November 2013 were retrospectively analyzed. All the patients were divided into stapled group(104 patients) and hand-sewn group(99 patients). The incidence of anastomotic leakage and anastomotic stricture between these two groups were compared.</p><p><b>RESULTS</b>There were no significant differences between two groups in gender, age, body mass index, total protein, albumin, and neoadjuvant chemotherapy(all P>0.05). There was no significant difference between the two groups in the incidence of anastomotic leakage [6/104(5.77%) vs. 3/99(3.03%), P>0.05], while the difference in the incidence of anastomotic stricture was significant [10/104(9.62%) vs. 2/99(2.02%), P<0.05]. The time of anastomosis, dieting and hospital stay was (15.5±5.0) min, (5.0±2.8) d and (18.3±5.9) d in stapled group, which was significantly shorter than (28.0±4.5) min, (5.9±1.2) d and (21.8±4.2) d in hand-sewn group(all P<0.05).</p><p><b>CONCLUSION</b>In the minimally invasive esophagectomy, stapled cervical esophagogastric anastomosis is simple and precise, but it is associated with increased risk of anastomotic stricture, therefore the type of anastomosis should be chosen based on the conditions of the patient.</p>

Compensation of in-plane rigid motion for in vivo intracoronary ultrasound image sequence.

Intracoronary ultrasound (ICUS) is an interventional imaging modality that is used to acquire a series of tomographic images from the vascular lumen, for diagnosis and treatment of coronary artery diseases in clinical settings. Motion artifacts caused by cardiac dynamics and the pulsatile blood flow within the vascular lumen, during continuous pullback (non-gated) ICUS image acquisition, hinder visualization of longitudinal cuts, assessment of arterial morphology and hemodynamics, and three-dimensional (3-D) vessel reconstruction. The aim of this study is to develop a method to compensate for in-plane rigid motion in non-gated in vivo ICUS sequences. The signals associated with cardiac motion are first detected from the gray-scale image sequence. They are represented with rigid motion parameters between luminal contours extracted from successive slices. Subsequently, the signals were filtered to separate the dynamic components caused by cardiac motion from those caused by the irregular morphology of the vascular lumen. Dynamic components were then compensated by performing a back transformation of related pixels within the vessel region in each frame. The method is validated by computer-simulation and using real ICUS image data. Possible sources of error are discussed based on the experimental results.

The Value of CT Perfusion Imaging for Breast Tumor / 实用放射学杂志

Objective To research the value of CT perfusion imaging in diagnosing breast tumor .Methods 21 focuses in 17 cases withbreast tumorlike pathological changes diagnosed by molybdenum target examination were scanned by CT perfusion imaging . Cine model,0.5 s/circle ,5 mm in thickness?4,120 kV,60 mA,delayed time 10 s,scan time in all 50 s ,GE 4.2 workstation and perfusion 3 software were used ,the data of creating dynamic picture and the relative informations that image intention changes with time change were analyzed and every parameters related with perfusion were studied and analyzed statistically .Results Blood flow(BF),blood volume(BV),mean transit time(MTT) and permeability surface(PS) were (36.46?17.62)ml?min-1?100 g-1,( 13.76?8.59) ml/100 g,( 28.23?15.75) s and (16.45?12.36) ml?min-1?100 g-1.In cancer group,( 17.35?10.67)ml?min-1?100 g-1,( 4.63?3.47) ml/100 g,( 25.52?12.91) s and ( 3.57?3.36) ml?min-1?100 g-1 in benign lesion group,respectively,there was significant difference between two groups in BF,BV and PS(P