Objective To investigate the effects of Panax notoginseng saponins(PNS) on penile erection in rats with diabetes-as-sociated erectile dysfunction (ED) .Methods Ninety male Sprague-Dawley rats were established diabetic rats by injecting streptozo-tocin(STZ) ,and observing erectile phenomenon by injecting apomorphine .After 4 weeks of PNS treatment (low-dose ,medium-dose , high-dose group) ,erectile function in each group was assessed by intracavernous pressure (ICP) and mean arterial pressure(MAP) measurement .The level of nitric oxide(NO)and cyclic guanosine monophosphate(cGMP)in cavernous tissue were detected .Immu-nohistochemical staining and TUNEL were performed for detecting endothelial nitric oxide synthase (eNOS) and apoptosis ,respec-tively .Results ICP and ICP/MAP ratio were significantly increased in medium-dose and high-dose PNS treated groups compared with the diabetic untreated group(P<0 .05) .Compared with the diabetic untreated group ,the expression of eNOS and the levels of NO and cGMP were increased in medium-dose and high-dose PNS treated groups(P<0 .05) .The apoptosis ratecorpus of caverno-sum in 3 PNS treatment groups significantly decreased than the diabetic untreated group (P<0 .05) .Conclusion PNS can recovery the endothelial cell function in corpus cavernosum by adjusting the NO/cGMP pathway and controlling the accumulation of AGEs , and may be used for improving in diabetic ED rats .

Objective To evaluate the clinical value of pulmonary embolism severity index (PESI) in non high-risk acute pulmonary thromboembolism (APTE) patients treated with sequential anticoagulation.Methods Non high-risk APTE patients treated with sequential anticoagulation were divided into two groups according to PESI:high-value group and low-value group.Prognosis and treatment response was compared between two groups.Results There were 82 cases in high-value group,and 76 cases in low-value group.The rate of adverse events in high-value group was significantly higher than that in low-value group [23.2％(19/82) vs.7.9％ (6/76)] (x2 =5.0698,P =0.009),and 30 days cumulative hazard was also significantly higher than that in low-value group (P ＜ 0.05).The sensitivity of predicting adverse events by PESI was 76.0％,specificity was 52.6％,positive predicting value was 64.6％,and negative predicting value was 65.9％.The mortality in high-value group was significantly higher than that in low-value group [9.8％(8/82) vs.1.3％ (1/76)] (P =0.022).After 30 days of anticoagulation,the pulmonary artery systolic pressure,internal diameter of right ventricle in high-value group was significantly higher than that in low-value group [(39.4 ± 8.1) mm Hg (1 mm Hg =0.133 kPa) vs.(27.2 ± 5.5) mm Hg,(33.0 ± 7.8) mm vs.(21.7 ± 4.6) mm] (P =0.034,0.021),and arterial oxygen partial pressure was significantly lower than that in low-value group[(75.15 ± 12.41) mm Hg vs.(86.36 ± 9.22) mm Hg](P=0.016).Conclusions PESI can effectively predict short-term prognosis of non high-risk APTE patients treated with sequential anticoagulation.At least some of these patients might need treatment other than sequential anticoagulation.

Objective To summarize and evaluate the clinical feature and misdiagnosis of pulmonary granulomatosis with polyangitis (GPA).Methods The clinical data of 47 patients of pulmonary GPA were analyzed retrospectively.The clinical feature and misdiagnosis were summarized.Results These patients were most commonly misdiagnosed as pulmonary infectious disease (61.8％,34/55) and pulmonary malignancy (27.3％,15/55) was the next in line.70.2％(33/47) patients had nose and sinus involvement,40.4％(19/47) patients had kidney involvement,25.5％ (12/47) patients had rash,19.1％(9/47) patients had eyes involvement,6.4％ (3/47) patients had peripheral neuritis,6.4％ (3/47) patients had gastrointestinal bleeding,4.3％(2/47) patients had pericardial effusion,87.2％(41/47) patients had positive for antineutrophil cytoplasmic(cANCA),76.6％(36/47) patients had positive for proteinase-3.Conclusions Almost all pulmonary GPA patients have extra-pulmonary multi-systemic involvement.They are often misdiagnosed as pulmonary infectious diseases and malignancy.Educating doctors on GPA constantly and screening possible patients with cANCA testing may help reduce the misdiagnosis.

Objective To investigate the expression and clinical significance of mineral dust-induced gene(MDIG) in malignant pleural effusions (MPE) and tuberculosis pleural effusions (TBPE).Methods Fifty-four patients with MPE (MPE group) and 50 patients with TBPE (TBPE group) were collected.The MDIG protein was detected by enzyme-linked immunosorbent assay and the relative quantification of MDIG mRNA was measured by real-time quantitation polymerase chain reaction.The cutoff value,sensitivity and specificity of the MDIG protein and MDIG mRNA to diagnose the MPE were evaluated by receiver operating characteristic (ROC) curve analysis.By Spearman correlation analysis,the correlation of MDIG protein and MDIG mRNA was evaluated.Results The MDIG protein in MPE group was significantly higher than that in TBPE group [(304.38 ± 228.47) ng/L vs.(44.43 ± 40.57) ng/L],and there was statistical difference (P ＜ 0.01).The MDIG mRNA in MPE group was significantly higher than that in TBPE group (6.27 ± 3.54 vs.1.82 ± 0.64),and there was statistical difference (P ＜ 0.01).With a cutoff point of 114.23 ng/L,MDIG protein had a sensitivity of 77.8％ and a specificity of 94.0％ for differential diagnosis.With a cutoff point of 2.75,MDIG mRNA had a sensitivity of 88.9％ and a specificity of 92.0％ for differential diagnosis.There was a positive correction between MDIG protein and MDIG mRNA (r =0.915,P ＜ 0.01).Conclusions The MDIG protein and MDIG mRNA are highly expressed in MPE with a good sensitivity and specificity.MDIG protein and MDIG mRNA maybe a good clinical indicator in the diagnosis of malignant pleural effusions.

Objective To discuss imaging classification of blunt traumatic thoracic aortic injury (BTTAI) and weigh guideline value of its imaging classification to surgical options.Methods BTTAI in 12 patients were divided into three types in accordance with outline of aortic injury revealed by CT imaging,i.e.,type A of normal outline of aortic blood vessel but free endothelium in aortic cavity,type B of abnormal aortic outline and contrast extravasation to aortic lumen exterior but only confining to mediastina,and type C of abnormal aortic outline and contrast leakage to thoracic cavity.Significance of BTTAI morphological classification was analyzed according to data,such as systemic injury severity score (ISS),local injury sites,surgical approaches and patients' outcome.Results Multiple injuries combined with BTTAI were observed in all patients whose aortic lesion image could be all generalized by above-mentioned classification.BTTAI image showed type A in three patients,type B in seven and type C in two.Pseudoaneurysm was confirmed as the foremost common BTTAI.There were no significant differences in ISS,hypotension morbidity,treatment methods or mortality between each type of BTTAI.Conclusions BTTAI occurs mostly in multiple injuries and thus overall injury severity assessment is not only depended on aortic lesion classification.BTTAI classification in this study reflects injury severity of vessel wall,takes account to location of lesion and adjacent relations (especially length of landing zone) and hence has accurate referential value for surgical decisions.

Objective To investigate feasibility and validity of endovascular aortic repair (EVAR) of traumatic thoracic aortic injuries (TTAI).Methods A retrospective analysis was conducted on data of 13 patients with TTAI.Pathological changes were evaluated by spinal CT angiography (CTA) preoperatively and re-evaluated by digital subtraction angiography (DSA) in EVAR.CTA was performed again to confirm therapeutic effects at postoperative 3,6,12 months and annually thereafter.Results All patients had successful EVAR.Complete or partial cover of left subclavian artery was observed in four patients.Endoleak in angiography shortly after stent delivery was noticed in three patients.However,endoleak disappeared in one patient after short stent placement for twice; endoleak was evidently decreased in one patient after balloon dilation.Follow-up was performed for another patient with slight endoleak.A total of 12 patients were followed up,which showed no complications,such as endoleak,ischemia of left upper extremity,paralysis or stent-graft migration.Conclusion EVR is safe and effective in treatment of TTAI.

Objective To evaluate the efficacy of itraconazole combined with glucocorticosteroid in allergic bronchopulmonary aspergillosis.Methods The clinical characteristics and data of 11 allergic bronchopulmonary aspergillosis patients treated with itraconazole combined with glucocorticosteroid were retrospectively collected before treatment and two months after treatment.Then the clinical characteristics and data before and after treatment were compared to evaluate the efficacy of the treatment.Results The symptoms and signs got better after two months' treatment.C reactive protein,IgE and eosinophile granulocyte count after two months' treatment were significantly lower than that before treatment [(7 ±2) mg/L vs.(42± 13) mg/L,(742 ± 236) kU/L vs.(1 685 ±477) kU/L,(343 ± 112) × 106/L vs.(1 925 ± 318) × 106/L],and forced expired volume in one second percentage of predicted and arterial partial pressure of oxygen after two months' treatment were significantly higher than those before treatment [(77.5 ± 8.6)％ vs.(32.4 ± 9.1)％ and (81 ± 12) mmHg (1 mmHg =0.133 kPa) vs.(53 ± 6) mmHg],there were statistical differences (P ＜ 0.01 or ＜ 0.05).The inflammatory exudates resolved as demonstrated in pulmonary CT scan.Conclnsion Itraconazole combined with glucocorticosteroid can effectively neat allergic bronchopulmonary aspergillosis.

Objective To study the dosimetry for copper compensator in IMRT.Methods 10 patients (3 nasopharyngeal carcinoma,4 esophageal cancer,3 colorectal cancer) from IMRT plans made in Oncentra Planning System enrolled in this study.The fluence matrices of each plan were converted into compensator thickness matrices based on attenuation coefficient of copper under 6 MV radiation ray which was measured with ion chamber.While irradiating the homogenous phantom with the intensity modulated plans performed by copper compensator,film was used to measure the planar dose.In the end,γanalysis was carried out between the measured and calculated planar doses with the criteria of 3％ DD/3 mm DTA.Paired t test to MU differences of MLC plans and copper compensator plans.Results The γanalysis results showed the planar dose pass rates of 10 plans lie between 90.2％ and 98.2％,which means the IMRf technique based on copper compensator can meet the clinical needs.The MU for copper compensator IMRT plans is less than the MLC IMRT plans (873.9 vs.975.1,P =0.005).Conclusions Compared to conventional IMRT based on MLC,copper compensator has the advantage of lower requirement of hardware and lower scattering dose in patient.Copper compensator can meet the needs of clinical practice.

An oxygen-tolerant denitrifying strain designated as H1 was screened by the procedures of shallow shaking and continuous aeration cultures.With the aid of an nnrS-gfp fusion responsive to nitric oxide (NO)and acetylene inhibition-GC procedure,it was shown that strain H1 was able to produce NO and N_2O but not N_2 under denitrifying conditions.Denitrifying processes were thus determined as NO_3~-→NO_2~-→NO→N_2O,with N_2O as the end product.Strain H1 could denitrify under shallow shaking conditions as well as in the initial atmospheric oxygen concentration ranging from 0～21%.Denitrification processed normally under continuous aeration at the rate of 2 L air per min in a 150 mL medium,but stopped under high aeration rate as 5 L air per min.16S rRNA gene sequence revealed that strain H1 shared 98% similarity to its closet relative Ralstonia taiwanensis,the genus where denitrifying bacteria are frequently found.

Objective To discuss the application value of transthoracic echocardiography (TTE) and lower extremity deep venous ultrasonography in patients of pulmonary thromboembolism (PTE) combined with coronary heart disease (CHD).Methods Nine hundred and seventy-four hospitalized patients of PTE in the first hospital of China medical university between December 2010 and March 2015 was enrolled,119 cases of these were combined with CHD (12.22％),including 94 cases of unstable angina and 25 cases of myocardial infarction.To review the general information,embolism area and ultrasonic report of the patients of PTE combined with CHD.The patients were divided into two groups according to whether they were combined with left ventricular systolic or diastolic dysfunction or valvular diseases.To compare TTE parameters between the two groups with two-sample t-test and calculate the sensitivity and specificity of diagnosing imaging massive pulmonary embolism (MPE) by TTE.Results (1) Seventeen cases thrombosis (3.43％) were observed in PTE patients who underwent TTE.The majority were pulmonary artery thrombosis (11 cases).Four cases of thrombosis (5.63％) were observed in PTE patients combined with CHD.The majority were right heart embolus (3 cases).(2) Lower extremity deep venous thrombosis (LEDVT)was observed in 52.60％ of all the PTE patients and 34.62％ of PTE patients combined with CHD.The majority were on the left and the deep venous thrombosis of the calf.(3) Fouty-six cases (64.79％) were PTEindirect signs in TTE.The sensitivity of echocardiography diagnosis of MPE was 84.38％ and the specificity was 52.60％.(4) Pulmonary arterial systolic pressure [(47.90± 21.49) mmHg vs (31.18± 22.43) mmHg(1 mmHg=0.133 kPa),t=3.227,P ＜0.05] and inferior caval vein diameter [(19.66±4.41) mm vs (16.20± 3.46) mm,t=3.598,P ＜ 0.05] in CHD combined with left ventricular systolic or diastolic dysfunction or valvular heart disease were higher than the control group.The differences were statistically significant.Conclusions The proportion of CHD in hospitalized PTE patients was high.TTE could find PTE signs and had high sensitivity for diagnosis ofMPE.TTE could prompt the possibility of PTE combined with left heart disease.