Objective To evaluate the clinical signifi ca nce of retroperitoneoscopic ureterolithotomy for upper ureteral calculi. Methods Retroperitoneoscopic ureterolithotomy was carried out in 22 p atients with upper ureteral calculi. The operation was performed in the retroper itoneal space. After the upper ureter and calculi were exposed, a scalpel was ut ilized to cut the ureter longitudinally for the removal of calculi. A double-J t ube was inserted into the ureter routinely and the ureterotomy closure was perfo rmed with sutures. Results A conversion to open surgery was needed in 1 patient because the calculi had moved into the kidney. One patient e xperienced urinary leakage at 500～800 ml/d postoperatively, and received an ope n surgery of double-J tube insertion 3 days later. Of the remaining 20 patients, the procedure was successfully accomplished, with the operation time of 50~240 min (mean, 110 min) and the blood loss of 30~100 ml (mean, 50 ml). The time to t he recovery of intestinal functions was 12~30 h (mean, 18 h).The postoperative h ospital stay was 5~8 days (mean, 6.8 days). Follow-up with B-ultrasonography and intravenous urethrography for 1~12 months in the 20 patients found no residual calculi or ureteral stricture. Hydronephrosis disappeared in 15 patients and mil d hydronephrosis was detected in the rest of 5 patients. Conclusions Retroperitoneoscopic ureterolithotomy is a safe and effective option for upper ureteral calculi. It may be considered as the first-line treatment for re latively large-sized upper ureteral calculi.

OBJECTIVE:To establish capillary electrophoresis method for the determination of imperatorin and isoimperatorin in Yuanhu zhitong tablet. METHODS:The separation was performed on a uncoated fused silica capillary (55 cm?75 ?m ID,effective length of 47 cm) with 20 mmol?L-1 NaH2PO4+100 mmol?L-1 SDS+80%formamide as buffer solution (pH=7.12). The separation voltage was 15 kV and the sample was injected by gravity (5 s,15 cm). The detection wavelength was 254 nm. RESULTS:The linear range of imperatorin and isoimperatorin were 8.0～40.0 ?g?mL-1(r=0.998 7) and 4.0～20.0 ?g?mL-1(r=0.999 0). The average recovery was 101.3% for imperatorin (RSD=3.24%,n=6) and 100.2% for isoimperatorin(RSD=1.44%,n=6). CONCLUSION:The method is convenient,rapid and accurate for the quality control of Yuanhu zhitong tablet.

Objective: To explore influence of rehabilitative exercise on left ventricular hypertrophy (LVH), diastolic function and blood pressure in patients with hypertension.Methods: A total of 120 patients diagnosed as essential hypertension complicated LVH in our hospital were enrolled.They were randomly and equally divided into routine treatment group (received routine antihypertensive treatment) and rehabilitative exercise group (received rehabilitative exercise based on routine antihypertensive medication).Blood pressure control rate on four, eight and 12 weeks after treatment, color Doppler echocardiographic outcomes before and 12 weeks after treatment were compared between two groups.Results: Blood pressure control rate after 12 weeks in rehabilitative exercise group was significantly higher than that of routine treatment group (76.7% vs.58.3%, P=0.03).Echocardiography indicated that compared with before treatment, there were significant improvements in left ventricular diastolic function and LVH indexes except left ventricular end-diastolic dimension in both groups after treatment, P<0.01 all;but there were no significant difference in left ventricular diastolic function and LVH indexes between two groups after treatment, P>0.05 all.Conclusion: Rehabilitative exercise training can significantly improve blood pressure control rate in patients with essential hypertension.Short-medium term exercise training fails to significantly improve left ventricular hypertrophy and diastolic function than routine treatment group, the effect of long-term training needs to be confirmed by more researches.

OBJECTIVE: To observe the effect of lidocaine on respiratory failure and the airway peak pressure in patients with severe asthma. METHODS: The severe bronchial asthma patients treated with mechanical ventilation were randomly divided into treatment group and control group. The change in airway peak pressure, man-machine counteraction, and the correcting time of respiratory failure of the two groups were recorded. RESULTS: The average airway peak pressure was(41.18?10.66) cmH2O in the control group vs.(29.23?9.07) cmH2O in the treatment group; the incidence of man-machine counteraction was 100% for the control group vs. only 40% for the treatment group; the correcting time of respiratory failure was(6.42?1.73) h for the control group vs.(3.31?1.08) h for the treatment group. There were significant differences between the two groups in the above mentioned indexes(P

OBJECTIVE:To investigate the possible association between the gene ALOX5AP encoding 5-lipoxygenase activating protein (FLAP)and coronary artery disease(CAD)in the Han population of North China.METHODS:A total of 680 cases underwent selective coronary angiography(SCA)from Shenyang General Hospital of Chinese PLA was recruited from January 2006 to September 2007.According to the results of SCA.680 cases were divided into CAD group with angiography positive(n=336)and control group with angiography negative or the stenosis of coronary arteries<50%(n=344)without evidence of cardiac ischemia.Single nucleotide polymorphisms of ALOX5AP gene was screened in 48 unrelated Han individuals of North China by polymerase chain reaction fPCR)-Re-sequencing method and 7 polymorphisms were found.The genotype and allele distribution of T(-1340)G polymorphism between two groups was determined by polymerase chain reaction and restriction fragment Iength polymorphism(PCR-RFLP)analysis in CAD and controI subjects.RESULTS:The genotype frequencies of TT,TG and GG in the ALOX5AP T(-1 340)G polymorphism were 26.79%,51 179%and 21.43%in CAD patients,33.72%,47.38%and 18.90%in the controls,respectively(x~2=3.90,P>0.06).The genotype distribution between two groups was in accordance with hardy-weinberg equilibrium.There are no significant differences in the distribution of three genotypes between the two groups.The frequencies of ALOX5AP G allele in cases and controls were 47.32%,42.59%,respectively(x~2=3.08,P>0.05).Subsequent stratified analysis by gender also showed no statistical significance in the genotype frequencies and allele frequencies between the two groups.CONCLUSION:The result suggests that T(-1340)G polymorphism of the ALOX5AP gene might not be associated with CAD in the Han population of North China.

BACKGROUND:Embryonic stem cells (ESCs) serve as a major cell source for smooth muscle cells,but the heterogeneity of cells derived from ESCs result in difficulty to obtain high purity smooth muscle cells.OBJECTIVE:To construct a double expression vector of puromycin resistance (pac) gene and enhanced green fluorescence protein (EGFP) gene driven by smooth muscle specific SM22α promoter (pSM22α-PAC-IRES2-EGFP),in addition,to detect its availability and specificity in ESCs.DESIGN,TIME AND SETTING:The observational experiment of gene level was performed at the Cardiovascular Institute,General Hospital of Shenyang Military Region from April 2007 to September 2008.MATERIALS:ESCs line R1 with number SCRC-1011TM was purchased from American ATCC Company.The pSM22α-EGFP vector was constructed by our laboratory.And the pIRES2-EGFP,pSM2C and pSuper.basic vectors were purchased from Invitrogen Company.METHODS:SM22α promoter was cloned from pSM22α-EGFP by polymerase chain reaction.CMV promoter of pIRES2-EGFP vector was replaced by SM22 promoter to establish pSM22α-IRES2-EGFP.Pac gene,excised from pSM2C by HindⅢ/Clal digestion,was sub-cloned into pSuper.basic to establish pSuper-PAC.After BgⅢ/Accl enzyme digestion of pSuper-PAC,pac gene fragment was obtained,which was further sub-cloned into pSM22α-IRES2-EGFP to produce pSM22α-PAC-IRES2-EGFP.ESCs were transfected with pSM22α-PAC-IRES2-EGFP using lipofectamine.Positive clones were selected by G418 and induced to differentiate and further identified by amplification of pac gene by RT-PCR.Differentiated cells were immunostained by SM α-actin,and expression of SM α-actin and EGFP was observed simultaneously under fluorescence microscope.MAIN OUTCOME MEASURES:Sequencing result of pSM22α-PAC-IRES2-EGFP;Amplification of pac gene;EGFP expression;as well as SM α-actin immunostaining.RESULTS:Three segments of 261 bp,664 bp,and 5000 bp were obtained by HindⅢ/Clal digestion,which was coincident with expectation,and the sequencing results showed that pSM22α-PAC-IRES2-EGFP vector was successfully constructed.Amplification of pac gene identified 4 ESCs clones successfully transfected.After induction of differentiation,partial portion of differentiated cells expressed EGFP,accompanied by positively stained by SM α-actin antibody.CONCLUSION:pSM22α-PAC-IRES2-EGFP vector was successfully constructed.ESCs clones transfected with this vector expressed pac gene and EGFP gene,and the expression of EGFP is smooth muscle specific.

Objective: To investigate the prevalence of diabetes among individuals at high risk of diabetes in Baoshan District, Shanghai Municipality, so as to provide insights into community-based diabetes management. Methods: Permanent residents at ages of 35 years and older were sampled from Baoshan District using a multistage stratified cluster sampling method, and residents at a high risk of diabetes were screened using the Form for Risk Assessment of Diabetes among Community Residents in Shanghai Municipality. Participants' demographics, disease history and history of medication were collected using questionnaire surveys, and height, body weight, waist circumference, hip circumference, and blood pressure were measured. Diabetes was screened using fasting blood glucose and glucose tolerance test. The factors affecting the development of diabetes were identified among high-risk residents for diabetes using a multivariable logistic regression model. Results: A total of 3 107 residents at a high risk for diabetes were enrolled, including 1 165 men (37.50%) and 1 942 women (62.50%) with a mean age of (63.58±9.77) years. The prevalence of diabetes was 21.69% among the study subjects, and multivariable logistic regression analysis showed that men (OR=1.689, 95%CI: 1.357-2.104), age (40 years-, OR=4.833, 95%CI: 1.036-22.553; 50 years-, OR=2.627, 95%CI: 1.432-4.819; 60 years-, OR=1.551, 95%CI: 1.119-2.150; 70 years and older, OR=1.579, 95%CI: 1.232-2.025); high school/technical secondary school (OR=2.677, 95%CI: 1.636-4.380), overweight/obesity (OR=1.891, 95%CI: 1.447-2.472), hypertension (OR=1.306, 95%CI: 1.049-1.626), dyslipidemia (OR=1.428, 95%CI: 1.114-1.831), history of impaired glucose regulation (OR=15.161, 95%CI: 11.827-19.434) and family history of type 2 diabetes mellitus (OR=2.092, 95%CI: 1.619-2.704) caused an increased risk of diabetes among residents at a high risk diabetes. Conclusions The prevalence of diabetes was 21.69% among high-risk populations of diabetes in Baoshan District. Gender, age, educational level, overweight/obesity, hypertension, dyslipidemia, history of impaired glucose regulation and family history of type 2 diabetes mellitus are factors affecting the development of diabetes among high-risk populations.

Objective:To investigate the preoperative diagnostic value of 99Tc m-methoxyisobutylisonitrile (MIBI) planar imaging and SPECT/CT imaging for primary hyperparathyroidism (PHPT), and analyze the relevant factors affecting the imaging results. Methods:From June 2016 to September 2019, a total of 62 patients (15 males, 47 females, age range: 27-80 years) confirmed as PHPT by postsurgical pathology in Affiliated Hospital of Qingdao University were retrospectively enrolled. The diagnostic efficacies of 99Tc m-MIBI planar imaging and SPECT/CT imaging were compared using χ2 test. The differences of preoperative serum parathyroid hormone (PTH), Ca and the maximum diameter of lesion between the positive and negative groups of planar imaging were analyzed using independent-sample t test and Mann-Whitney U test. The region of interest (ROI) method was applied to calculate the uptake ratio of lesions to normal tissues at the early phase (T/Ne) and delayed phase (T/Nd) in positive cases of planar imaging. Pearson or Spearman correlation analysis was used to evaluate the correlation of T/Ne, T/Nd with preoperative serum PTH, Ca and the maximum diameter of lesion. The receiver operating characteristic (ROC) curves of preoperative serum PTH, Ca and positive planar imaging were drawn and the cut-off values were obtained. Results:The sensitivity of planar imaging and SPECT/CT imaging was 69.35%(43/62) and 87.10%(54/62) respectively ( χ2=5.729, P=0.017). The preoperative serum PTH, Ca levels and the maximum diameter of lesion in patients with positive planar imaging (253.32(107.00, 331.70) ng/L, 2.78(2.51, 2.87) mmol/L, (2.01±0.88) mm) were higher than those with negative planar imaging ((111.86±44.29) ng/L, (2.59±0.21) mmol/L, (1.42±0.55) mm; z values: -2.802, -1.978, t=3.300, all P<0.05). T/Ne was positively correlated with preoperative serum PTH ( rs=0.511, P<0.001) and the maximum diameter of lesion ( r=0.381, P=0.012), and T/Nd was positively correlated with preoperative serum PTH ( rs=0.538, P<0.001), Ca ( rs=0.348, P=0.022) and the maximum diameter of lesion ( r=0.463, P=0.002). The area under the ROC curve between preoperative serum PTH, Ca and planar imaging was 0.725 and 0.646, respectively. Preoperative serum PTH had a better predictive value with the optimal cut-off value of 150.4 ng/L. Conclusions:Preoperative serum PTH, Ca and the maximum diameter of lesion are positively correlated with 99Tc m-MIBI uptake in PHPT patients with positive planar imaging results. When preoperative serum PTH is lower than 150.4 ng/L, planar imaging is prone to false negative. SPECT/CT imaging has a significant value in preoperative diagnosis and the combination of PTH and CT can improve the positive rate.

OBJECTIVETo compare quantitatively the enhanced thin CT section with pathologic findings in pulmonary carcinoma, pulmonary inflammatory pseudotumor (IPT) and pulmonary tuberculoma so as to demonstrate the relation of degree of enhancement and the vascular structure within the lesion with special emphasis on pulmonary carcinoma.

METHODSEnhanced thin CT sections were obtained in 35 cases with nodular or patchy lesions in the peripheral lung field which are difficult to differentiate clinically. There were pulmonary carcinoma 21, inflammatory pseudotumor 7 and tuberculoma 7. The number of small vessels (inner diameter 0.02 approximately 0.1 mm), relatively large vessels (inner diameter > 0.1 mm) and their vascular bed areas were analyzed by computed image analyzing system. The relation between CT average attenuation and the number of vessels or the vascular bed areas were statistically evaluated.

RESULTS1. The differences of average attenuation in carcinoma, inflammatory pseudotumor and tuberculoma were statistically significant (P < 0.05). 2. The differences in number of small vessels, relatively large vessels and vascular bed areas among these three types of lesion were also significant (P < 0.05). 3. A positive correlation was found in the average CT affenuation of lung carcinoma and its number of small vessels and relatively large vessels and 4. A positive correlation was found between the average CT attenuation in these three lesions and the relatively large vessels, total vascular amount and vascular bed areas.

CONCLUSIONS1. The average degree of attenuation, being divided into four degrees, is of practical value in the differentiation of lung carcinoma, inflammatory pseudotumor and tuberculoma. 2. The average CT attenuation of lung carcinoma, inflammatory pseudotumor and tuberculoma is in direct proportion to the number of vessels and vessel bed areas and 3. The characteristic CT enhancement in lung carcinoma reflexes the condition of vessels and blood supply within the tumor.

Adult ; Aged ; Female ; Humans ; Lung ; blood supply ; diagnostic imaging ; pathology ; Lung Neoplasms ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Plasma Cell Granuloma, Pulmonary ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; methods ; Tuberculoma ; diagnostic imaging ; pathology ; Tuberculosis, Pulmonary ; diagnostic imaging ; pathology

Objective:To investigate the prevalence and risk factors of diabetic retinopathy (DR) in patients in Tibet.Methods:A total of 239 patients with DR who received treatment in Department of Endocrinology and Metabolism, Hospital of Chengdu Office of People's Government of Tibet Autonomous Region from December 2017 to December 2018 were included in this study. They were divided into Han nationality and Zang nationality groups according to ethnicity. The condition of DR was evaluated with nonmydriatic ocular fundus photography according to the staging criteria of the severity of retinopathy.Results:The prevalence of DR in Tibet was 18.0％. The prevalence of DR in Tibetan and Han patients with diabetes was 17.5% and 19.2%, respectively. There was no significant difference in the prevalence of DR between Tibetan and Han patients with diabetes ( χ2 = 0.10, P = 0.754). Logistic regression analysis revealed that the risk factors of developing DR in Tibet included diabetes duration ( OR = 1.14, 95% CI: 1.05-1.24, P < 0.05), insulin therapy ( OR = 2.74, 95% CI: 1.09-6.89, P < 0.05), fasting plasma glucose ( OR = 1.37, 95% CI: 1.07-1.75, P < 0.05) and hypertension ( OR = 1.98, 95% CI: 1.02-3.86, P < 0.05). Diabetes duration and fasting plasma glucose are independent risk factors of DR. However, although elevated glycated hemoglobin levels were high in Tibet, they could not be used to predict the risk for developing DR ( OR = 1.01, 95% CI: 0.82-1.25, P > 0.05). Conclusion:Hyperglycemia is an important risk factor of developing DR in Tibet. However, elevated glycated hemoglobin levels cannot be used to predict the risk of developing DR in Tibet. Findings from this study fill the gap in the research on DR prevalence and ethic difference of DR prevalence, providing scientific evidence for prevention and treatment of DR in high-altitude areas.