Objective To assess whether AECOPD patients can breathe independently at the PIC window and thus whether NPPV was necessary after extubation.Methods We performed a prospective observational study, we used the spontaneous breathing trial (SBT)to assess whether each patient could breathe independently at the PIC window,then performed extubation.Patients who passed the SBT received oxygen therapy only,whereas those who failed received NPPV.However,if the former showed respiratory distress,they also received NPPV.The primary out-come variables were SBT pass/fail,the demand for NPPV and rate of reintubation within 72h following extubation. Results In all,23 patients were enrolled,15cases(65.2%)of which passed the SBT.Of these,12cases (80.0%) patients developed respiratory distress after extubation and required NPPV (one of whom required reintubation).Of the eight patients that failed,one received reintubation after NPPV.The reintubation rates within 72h following extuba-tion of SBT-pass(7.0%)and SBT-fail (13.0%)(χ2 =1.476,P>0.05)patients were comparable.Conclusion Most AECOPD patients can breathe independently at the PIC window,but nonetheless develop respiratory distress and thus require NPPV following extubation.

OBJECTIVE:To prepare epirubicin hydrochloride solid lipid nanoparticle(EPI-SLN) and investigate its physicochemical property. METHODS: EPI-SLN was prepared by ultrasonic dispersion technique with glyceryl behenate as matrix,and the appearance,particle size,? electric potential,and entrapment efficiency of the SLN were evaluated and its stability at 3 month storing at 4 ℃ was investigated. RESULTS: EPI-SLN assumed spherical shape with a particle diameter of (212.8?6.2) nm,? electric potential of (-24.7?0.3) mV and entrapment efficiency of 82 %. The EPI-SLN at 4 ℃ was stable after storing for 3 months,showing no marked change in mean diameter,? electric potential or entrapment efficiency. CONCLUSION: The prepared EPI-SLN is up to the standard.

0 05)between AD and aging c ontrol subjects or MCI patients. Conclusions Episodic memory impairment and semantic memory impairment beside the immediat ely recall and naming are the earliest and most pervasive memory deficit in mild AD patients, and episodic memory impairment is more specific than semantic memo ry impairment for the diagnosis of AD.

Objective To explore the clinical features and diagnostic method of primary natural killer( NK)/T cell meningeal lymphoma. Methods An unusual case of a 19-year-old male with primary NK/T cell meningeal lymphoma was reported. His clinical presentation and laboratory findings were discussed. The related literatures have been reviewed. Results The patient presented with diplopia,headache, vomiting and facial drooping at the onset, followed by progressive pain and weakness of the four limbs. Cerebrospinal fluid showed significant increase in pressure, leukocytes number, levels of protein,normal glucose and adenosine deaminase, negative tuberculosis antibody and sterile staining. In cerebrospinal fluid cytological analysis, May-Grunwald-Gimsa staining showed large number of atypical lymphocytes with irregular nucleus and nuclear fission, Ki-67 immunostaining showed extensive proliferative activity of the lymphoid cells. Flow cytometric immunophenotypic analysis of cerebrospinal fluid indicated 97. 98 percent of cells expressed surface CD3, CD7, CD56, CD2, CD5, and partially expressed CD8. This was a rare immunophenotype for NK/T-cell. Cranial MRI with gadolinium showed thickening of the trigeminal nerve with slight enhancement and diffuse leptomeningeal enhancement. CT of the chest and abdomen and bone marrow biopsies were negative. He was diagnosed as primary NK/T cell meningeal lymphoma based on the clinical features and related examination. Conclusions Primary NK/T cell meningeal lymphoma is a rare type of primary central nervous lymphomas which has special immunophenotype. The clinical features include progressive raised intra-cranial pressure, multiple cranial and spinal nerve involvements. Cerebrospinal fluid cytological analysis and flow cytometric immunophenotypic analysis are key work-up for diagnosis. It has poor response to chemotherapy and radiotherapy.

Objective To detect the expression of urinary nuclear matrix protein 22(NMP22) and cytokeratin 20(CK20) mRNA in the monitoring of bladder tumor recurrence ,and to explore the clinical value of combined detection of urinary NMP22 and CK20 mRNA in the monitoring of bladder tumor recurrence .Methods Enzyme‐linked immunosorbent assay(ELISA) and nested reverse transcriptase polymerase chain reaction(Nested RT‐PCR) were used to detect the expression of NMP22 and CK20 mRNA in the u‐rine of 46 patients with recurrent bladder cancer tumor (recurrent group) ,66 patients without recurrent tumor (no‐recurrent group) and 40 healthy volunteers(control group) respectively .Results The expression of NMP22 and CK20 mRNA in the urine of control group were negative .There was statistically significant difference between the positive expression rate of NMP 22 and CK20 mRNA in the urines of the recurrent group[78 .3% (36/46) ,80 .4% (37/46))] and that of the no‐recurrent group[6 .1% (4/62) , 6 .1% (4/62)] and the control group respectively (P<0 .01) .There was no statistically significant difference between the no‐recur‐rent group and the control group(P>0 .05) .The expression level of NMP22 in recurrent tumor increased obviously along with the progression of the pathological grade and clinical classification of tumor (P<0 .05) .The positive rate of CK20 mRNA expression in the recurrent group increased obviously along with the increase of the tumor number (P<0 .05) .The sensitivity and specificity of NMP22 for monitoring bladder cancer recurrence were 78 .3% and 93 .9% ,of CK20 mRNA were 80 .4% and 93 .9% .Combined de‐tection of both sensitivity and specificity were 95 .7% and 92 .4% .Statistical significance was observed between combined sensitivi‐ty and that of single detection(P<0 .05) .No significant difference was observed between combined specificity and that of single de‐tection(P>0 .05) .Conclusion The positive expression of CK20 mRNA may also indicate tumor multiplicity .Combined detection of NM P22 and CK20 mRNA significantly increases the sensitivity and specificity in clinical detection .

Objective To analyze the clinical and pathological characteristics of Alport syndrome in children. Methods Clinical and pathological information gathered from 62 patients during March 1989 to August 2012 was retrospectively analyzed. Results Four autosomal recessive Alport syndromes (AR-AS) and 58 X-linked Alport syndromes (XL-AS) were analyzed. Of the XL-AS, 47 were boys and 11 were girls. Most of patients induced by upper respiratory tract infections, and onset with hematuria and proteinuria. There was no signiifcant gender difference in family history, impaired renal tubular proteins, hypertension, im-paired renal function, hearing loss, ocular abnormalities or renal pathological changes under light microscopy. However, extensive lamination and split of glomerular basement membrane (GBM) dense layers were found in 83.0%male and 18.2%female patients (P=0.000) and the rest patients were presented with limited distribution of typical GBM changes. Proteinuria progressed signiif-cantly with age in XL-AS males (r=0.501, P=0.000). Five XL-AS patients developed to end stage renal disease (ESRD) between 11 to 16 years old. Conclusions XL-AS is the main inherited type and severe changes of GBM are common in XL-AS males. Proteinuria increases remarkably with age. The detection of type IV collagen in renal tissue or skin is helpful to diagnose Alport syndrome and conifrm inheritance modes.

Objective To study the influence of let-7b on cell proliferation and aerobic glycolysis of human melanoma cell A375.Methods Transfect A375 cell line with hsa-let-7b oligonucleotide or antisense.Glucose and lactate in medium were determined by spectrophotometry at 24 h and 48 h time point after transfection.The cell proliferation was determined by methylthiazol tetrazolium (MTT) assay.Results Over expression of let-7b in melanoma cell reduced cell proliferation notably,compared to the other groups by MTT(P ＜0.05).However,the glucose consumption and lactate production differences were not observed during 24 h or 48 h ( P ＞ 0.05 ),the blank control group transformed about 57％ and 43％ glucose to lactate during 24 h and 48 h.Conclusions Melanoma cell line A375 has notably aerobic glycolysis hallmark,let-7b could inhibit proliferation of melanoma cell line A375,but it may has no influence on glucose metabolism.

Objective:To investigate the prevalence of overactive bladder (OAB) in Chinese boys and risk factors, and to evaluate the psychological and behavioral status of OAB patients.Methods:Cross-sectional study.From October 2020 to July 2021, 2 800 boys aged 6-15 years from 6 primary and secondary schools in a county of Henan Province were selected by stratified random cluster sampling method.An anonymous questionnaire was used to investigate the epidemiological situation of OAB, including the basic information, lower urinary tract symptoms, Overactive Bladder Score Scale (OABSS) scores, pediatric sleep questionnaire (PSQ) and strengths and difficulties questionnaire (SDQ). In addition, the correlation between OAB and residence, body mass index (BMI), nocturnal enuresis (NE), overuse of diapers, history of urinary tract infection, abnormal stool, phimosis, redundant prepuce, and concealed penis by Chi- square test, Logistic multivariate regression analysis, and t-test. Results:A total of 2 333 valid questionnaires were collected.The overall prevalence of OAB in boys was 6.0%(141/2 333 cases). NE, history of urinary tract infection, abnormal stool, overuse of diapers, phimosis, redundant prepuce, concealed penis were risk factors for OAB in boys ( OR>1, P<0.05), while BMI was not a risk factor for OAB in boys ( OR<1, P>0.05). The emotional symptoms[ (7.64±2.03) scores vs.(6.51±2.53) scores], conduct problems [(8.14±1.62) scores vs.(7.31±1.88) scores], hyperactivity[(5.64±2.27) scores vs.(4.98±2.03) scores], peer communication problems [(7.16±1.63) scores vs.(6.59±1.60) scores], difficulty scores[(30.26±6.48) scores vs.(27.69±6.44) scores] and PSQ scores [(5.36±3.00) scores vs.(3.94±2.53) scores] in OAB group were significantly higher than those of non-OAB group ( t=-5.117, -5.005, -3.310, -4.056, -4.553, -5.006, respectively, all P<0.05). Conclusions:OAB in boys is common and affects mental health and sleep quality.Meanwhile, NE, history of urinary tract infection, abnormal stool, overuse of diapers, phimosis, redundant prepuce, or concealed penis are the risk factors for OAB in boys.

Objective:To examine differences in urodynamic changes between central neurogenic bladder(CNB)and peripheral neurogenic bladder(PNB)in elderly patients.Methods:A total of 57 elderly patients over 60 years old with neurogenic bladder(NB)were divided into a CNB group and a PNB group based on the types of nerve injuries.Data on urodynamic parameters recorded for the two groups were compared and analyzed.Results:The rate of detrusor overactivity(DO)in the CNB group was significantly higher than that in the PNB group [66.7%(16/24)vs.36.4%(12/33), χ2=5.105, P=0.024]. There were significant differences between the two groups in maximum bladder capacity(MCC)[(277.8±101.1)in the CNB group vs.(481.4±110.2)ml in the PNB group, t=-7.149, P=0.001]and in safe bladder capacity(SBC)[(283.2±28.8)ml in the CNB group vs.(348.6±33.9)ml in the PNB group, t=-7.636, P=0.000]. There was no significant difference between the two groups in the maximum urine flow rate, residual urine volume, urination volume, leak point pressure, or detrusor pressure at the maximum urine flow rate(all P>0.05). In the CNB group, 8 patients had normal bladder sensation, 4 had disappeared bladder sensation, 10 had decreased sensation, and 2 had increased sensation.In the PNB group, 9 patients had normal bladder sensation, 4 had disappeared bladder sensation, 14 had decreased sensation, and 2 had increased sensation.There was no statistical significance in SBC between different sensation levels within each group( P>0.05). Conclusions:There are differences in urodynamic characteristics between the elderly patients with CNB and those with PNB.Decreases in MCC, SBC and DO are more likely to occur in CNB.

【Objective】 To investigate the value of urodynamic study (UDS) in guiding the treatment of lower urinary tract dysfunction (LUTD) in elderly patients with ischemic stroke (IS) during convalescence, in order to provide reference for clinical treatment. 【Methods】 A total of 50 LUTD patients with IS who were admitted to the First Affiliated Hospital of Xinxiang Medical University during Jan.2020 and Jan.2022 were selected.Oral tolterodine was administered to patients with detrusor overactivity (DO), clean intermittent catheterization (CIC) to those with no detrusor reflex and symptomatic increased residual urine, and oral administration of tamsulosin to those with functional obstruction of bladder outlet.The lower urinary tract symptoms (LUTS) relief rate, UDS parameters and quality of life (QoL) scores were compared before treatment and 3 months after treatment. 【Results】 The UDS examination results showed that 25 cases (50.0%) had simple DO, 9 cases (18.0%) had DO with impaired detrusor muscle contraction function, 5 cases (10.0%) had DO with bladder outlet functional obstruction, 4 cases (8.0%) had no detrusor reflex, and 7 cases (14.0%) had simple bladder outlet functional obstruction.After 3 months of treatment, the symptoms of LUTS, including frequent urination, urgent urination, incontinence, dysuria and urinary retention were significantly improved (P<0.05).The maximum urine flow rate and urine output were significantly increased, the residual urine volume was significantly reduced, QoL scores were significantly reduced, with significant differences (P<0.001). 【Conclusion】 UDS is significant in guiding the treatment of LUTD in elderly patients with IS during convalescence.