Objective Isobaric tag for relative and absolute quantitation (iTRAQ) was applied for the quantitative analysis of serum protein in psoriasis vulgaris patients with damp heat syndrome and healthy volunteers to explore the differentially expressed proteins, thus to reveal the nature of damp heat syndrome from the proteomics level.Methods The serum from 15 psoriasis vulgaris patients with damp heat syndrome and 10 healthy volunteers was purified and treated with removal of abundance. After separation with sodium dodecyl sulfate polyacrylamide gel electropheresis (SDS-PAGE) and hydrolysis of peptide specific iTRAQ marker enzyme, the differentially expressed proteins of serum samples were identified by tandem mass spectrometry. Results A total of 787 proteins were identified, and 718 proteins had the functional annotation showed by gene ontology ( GO) in psoriasis vulgaris pa tients with damp heat syndrome. A total of 651 differentially expressed proteins were identified by compared with healthy volunteers ( P<0.05) , and markedly significant difference was shown in 418 proteins ( P<0.01) . Conclusion Psoriasis vulgaris patients with damp heat syndrome have differentially expressed proteins which are different from those in the healthy volunteers, but which kind of protein being specific for damp-heat psoriasis vulgaris as well as the relation between the damp heat symptoms and proteins still need to be further studied.

Objective To evaluate and compare the diagnosis and treatment quality of 15 tertiary hospitals in Beijing with the quality-evaluation model of STEMI.Methods The quality-evaluation model has been formatted with the document analysis method and expert consultation method,with the indicators weighted by analytic hierarchy process.By collecting the data of 15 hospitals,we can get the values of indicators,then synthetically evaluate and compare the diagnosis and treatment quality at these 15 hospitals with the method of WRSR.Results In the diagnosing and treating the cases of STEMI at the hospitals,gaps are found between the clinical guidelines and the tests,patient evaluation,reperfusion treatment and drug therapy,with some indicators falling even below 22％.Also,there are significant differences in the diagnosis and treatment quality among hospitals.All hospitals are consistent on the five dimensions-tests,patient evaluation,reperfusion treatment,drug therapy and prognosis.Conclusion The quality-evaluation model of STEMI can comprehensively reflect the diagnosis and treatment quality of cardiovascular medicine,and partly reflect hospital's overall management level,so as to provide operating methods in improving hospital diagnosis and treatment quality.

BACKGROUND: Urological complication is one of common surgical complications following transplantation and severely threatens renal function, even patient's lives. Urological complications following renal transplantation mainly contain urinary fistula,ureteral obstruction and ureter backflow.OBJECTIVE: To retrospectively analyze the incidence and management of urological complications following kidney transplantation.METHODS: A total of 1 223 patient times following kidney transplants were selected at the Department of Urology, Institute of Surgery Research, Daping Hospital, Third Military Medical University of Chinese PLA from December 1993 to April 2007.According to ureter of donor kidney and the urinary tract of recipients, ureteroneocystostomy was used for urinary tract reconstitution in 948 patient times, and end-to-end ureteroureterostomy in 275 patient times. Urological complications such as urinary fistula, ureteral obstruction and vesicoureteral reflux (VUR) were treated by the different methods on the basis of the different causes, mainly by surgical procedures. Reason of urological complications, surgical management of urologicalcomplications and its clinical outcome, the 3-year survival rate of grafted kidney were measured.RESULTS AND CONCLUSION: In a total of 1 223 patients, urological complications were encountered in 92 cases (7.5%), including 43 cases of urinary fistula (3.5%), 35 ureteral obstruction (2.9%), 14 VUR (1.1%). 35 cases of urinary fistula, 29 ureteral obstruction, 6 VUR were cured by surgical procedures including ureteroureterostomy in 35 patients (50%), revision of ureteroneocystostomy in 18 (25.7%), endourology in 11 (15.7%) and other operation in 6 (9.6%). All recipients with urological complications regained normal graft function except one undoing transplanted nephrectomy due to the pelvis and urteral necrosis. There was no grafted kidney and recipient loss secondary to these complications in the present series. The 3-year survival rate of graft with urological complications and without urological complications did not show significant difference (P > 0.05). These indicated that most of urological complications following kidney transplantation request surgical management, and ureteroureterostomy are frequently used. The long-term graft survival is not affected by a correctly treated urological complication.

Objective To investigate the clinical efficacy and safety of flexible ureteroscopic lithotripsy ( FURL) using holmium laser for medullary sponge kidney stones. Methods A flexible ureteroscope was placed into renal calyx via a ureteral access sheath ( UAS) . The stones underlying the mucosa were found,and then broken by holmium laser following incision of renal papillary mucosa. The stone fragments were washed or clamped out. The remission of clinical symptoms and incidence of perioperative complications were observed,and a KUB plain film was rechecked postoperatively. Results Stones underlying mucosa were found and broken successfully in all 14 patients and there was no serious bleeding. Back pain symptoms of patients were relieved in 3 to 7 days postoperatively or after the removal of double J stent. The stone fragments were mainly discharged spontaneously. The rechecking KUB showed the amount of stones of most patients was significantly re-duced three months after operation. Conclusion FURL using holmium laser is effective for the treatment of medullary sponge kidney stones as it can significantly reduce the loads of stones without serious complications. It’ s a minimally invasive,effective,safe and suitable way which is suitable for further spread of clinical application.

1 313 patients who received renal transplantations at Department of Urology, Research Institute of Field Surgery, Daping Hospital, Third Military Medical University of Chinese PLA from December 1993 to October 2008 were selected in the experiment. Urinary fistula occurred in 68 patients of them after renal transplantation. In order to make diagnosis more standard, 68 patients was classified in accordance with diagnostic classification standards after renal transplantation. The 68 patients were divided into simple and complex urinary fistulas in accordance with lesion degree. They were divided into low, high and multiple fistulas in accordance with the position and etiology. 47 (69.1%) of 68 cases were simple urinary fistulas: 42 cases were because of terminal ureteral necrosis; 4 cases were because the anastomosis was mended unsuitably; 1 case was because of poor healing of anastomosis due to infections. 21(30.9 %) cases were complex urinary fistulas. The position of orificium fistula: orificium fistula located at renal pelvis, ureter and anastomosis were 2, 2 and 11 cases, respectively. 6 cases had ureteral necrosis longer than 2 cm. The times of repair: 11 cases had 1 time, 5 cases had 3 times, 3 cases had 3 times and 2 cases had 4 times. 2 cases (2.9%) died because of severe pulmonary infection caused by urinary fistula. Result suggests that there are two advantages of dividing urinary fistula into the simple and complex types after renal transplantation: one is that the diagnosis of urinary fistula is more carefully and standardized, and the other is that doctors can make the best choice for treatment in order to get the best efficacy.

Objective To evaluate clinical efficiency and quality-of-life outcomes in treatment of severe pelvic organ prolapse by the Xiehe pelvic floor reconstruction surgery. Methods From Jun. 2006 to Dec. 2008, 277 severe pelvic organ prolapse patients with stage Ⅲ to Ⅳ from 8 hospitals in China were enrolled in this prospective study. Pelvic organ prolapse quantitative examination (POP-Q) and anatomic improvement in these patients after surgery were analyzed in this interim study. Comparisons of pelvic floor impact questionnaire-short form 7 (PFIQ-7) and pelvic floor distress inventory-short form 20 (PFDI-20) in these patients before and after surgery was used to evaluate quality of life. Comparison of pelvic organ prolapse-urinary incontinence sexual questionnaire (PISQ) in these patients before and after surgery was used to evaluate quality of sexual life. Results With a median follow-up of 14. 0 months (6 -28 months),twenty-three patients showed recurrent prolapse (8. 3%, 23/277), and anatomical success ( ＜ stage 2 in the treated compartment) was 91.7% (254/277). In this series, mesh exposure or erosion rate was 6. 9% (19/277). The postoperative de novo stress incontinence rate was 6. 5% (18/277). The scores for PFIQ-7 and PFDI-20, and its subscales were significantly improved, the scores of before treatment were lower than those after treatment (P ＜0. 01 ). And there was no significant difference in the average score of PISQ before and after the surgery (76. 6 ± 15.4 versus 75.5 ± 14. 5 versus 73.6 ± 12. 6, P ＞0. 05 ), but the rate of de novo dyspareunia was 11% (9/80). Conclusions Xiehe pelvic floor reconstruction surgery was safe and efficacy in treatment of pelvic organ prolapse. It could improve quality of life remarkably with less cost when compared with the traditional total pelvic floor reconstruction surgery.

Objective: To analyze the epidemiological characteristics of coronavirus disease 2019 （COVID-19） cases reported in Ningbo from January 22 to February 22, 2020, so as to provide guidance for the prevention and control of the COVID-19 epidemic. Methods: The confirmed cases of COVID-19 reported by Ningbo were selected from National Diseases Prevention and Control Information System to analyze the epidemiological characteristics by descriptive epidemiological method, including time, spatial and population distribution, clinical symptoms and exposure history. Results: A total of 157 confirmed cases of COVID-19 were reported and there was no death. The first confirmed case was reported on January 22. On the incidence curve, the peak was from January 22 to February 4, with a maximum of 15 cases in a single day. The incidence curve presented sustained human-to-human transmission. The number of the cases showed a declining trend from February 5. The confirmed cases were reported in all 10 counties（cities or districts）,among which 69（43.95%）cases were reported in Haishu District. The confirmed cases were mainly 30-69 years old,accounting for 78.34%;were mainly farmers,household workers and retired people,accounting for 59.87%;and were mainly clinically mild,accounting for 87.90%.There were 51 imported cases, accounting for 32.48%. The initial confirmed case was a local case. In the early stage of the epidemic, local cases and imported cases prevalent together,which was due to the outbreak caused by the large-scale buddhist activity on January 19.This event resulted in 67 confirmed cases and 15 asymptomatic cases. There totally reported 22 clusters with 138 （87.90%）confirmed cases. Conclusions In the early stage of the COVID-19 epidemic in Ningbo, the imported cases and local cases prevalent at the same time. Most of the cases were female, aged from 30 to 69 years, and their occupation were farmers, household workers and retired people. With comprehensive measures taken, the epidemic of COVID-19 in Ningbo have been under control.

Objective:To investigate the safety and feasibility of the occipital condyle screw and evaluate the safepath parameters for the occipital condyle screw.Methods:Data of 64 patients with upper cervical computed tomographic angiograms from September 2016 to September 2018 were retrospectively collected. Excluded occipito-cervical injury, tumor, and vertebral artery course variation. Mimics software was used to reconstruct the occiput, atlas and vertebral artery. Three candidate entry points were placed for each occipital condyle, the midpoint of posterior of occipital condyle as middle entry point, and the medial and lateral entry points were located 3 mm medial and lateral to the middle entry point. The vertebral artery-occipital bone distance (VOD) of each entry point were measured on sagittal plane, and the minimum feasible value was determined to be 4mm. After that 3.5 mm diameter virtual screw was inserted into each candidate entry point with VOD>4 mm, each screw with maximum and minimum cranial angulation was combined with appropriate medial angulation to get the maximum screw length. Then, the screw placement parameters were measured by 3-Matic, and the safe range of cranial angulation and the success rate of screw placement were calculated.Results:The VOD of medial and middle entry point were 8.07±2.13 mm and 7.70±2.19 mm respectively, and the feasibility rate of screw placement of those entry point were 97.7% and 96.1%, respectively. There were significant differences inVOD and feasibility rate of screw placement between medial and middle entry point. The VOD of lateral entry point was 5.63±1.66 mm, and the feasibility rate was only 78.9%, which was significantly lower than that of medial and middle entry point. The lateral entry point could obtain a larger medial angulation, which was supplemented by a longer screw length. The medial angulation and length of screw gradually decreased with the inward movement of the entry point. There were significant differences in medial angulation and screw length among groups. The safe range of cranial angulation of medial, middle and lateral entry points were 8.17°±2.55°, 12.58°±4.23° and 12.09°±3.83°, respectively, and the difference were statistically significant. Among the screw entry point that could accommodate screw fixation, the maximum screw placement success rate can be obtained by adding 5° cranial angulation to the lateral and middle entry point, which were 98.02% and 98.37%, respectively,while 100% success rate of screw placement could be obtained at the medial entry point at 3° cranial angulation.Conclusion:In the selection of the entry point in the horizontal direction, middle and medial entry points have higher success rate of screw placement and wider safe range of cranial angulation because of less affection of horizontal segment of the vertebral artery. However, the screw length of medial entry point is much shorter than middle and lateral entry point. As a result, the middle entry point may be an optimal entry point for the occipital condyle screw.

OBJECTIVE: To improve the diagnostic and therapeutic efficiency for secondary laryngeal tuberculosis through an analysis on the clinical features of patients with this disease. METHOD: A retrospective study was made among 49 cases with laryngeal tuberculosis treated in Tibetan General Hospital of Chinese PLA, and the clinical data were carefully analyzed to summarize the clinical experience of this disease. RESULT: Of 49 patients, 24 cases had 1 year history, 11 cases had 1 to 3 years, 9 cases had 3 to 5 years, 5 cases had 5 years or more. Thirty-eight patients had the history of tuberculosis and 11 had none. Thirty-four patients had taken anti-tuberculosis drugs but none had standard therapy as demanded. All cases had mild general symptoms (mild fever, night sweats, weight loss, et al) and atypical local symptoms (hoarseness, sore throat). Therefore, 42 cases were misdiagnosed as non-specific chronic laryngitis, of which 15 cases got worse after oral administration or inhaling of steroid hormones. Seven persons were misdiagnosed as laryngeal cancer. All patients were confirmed pulmonary tuberculosis by X ray exam or CT scanning. Twelve cases had strong positive PPD tests and 2 cases were detected positive by sputum smear. All patients was treated by standard systematic and local chemical therapy against tuberculosis (inhaling of antituberculosis drugs for 1 to 2 months). All were cured but one died in a road accident, and none had recurrence after 1- to 9- year follow-up. CONCLUSION All of those the patients with long period hoarseness and sore throat should take chest CT scan or X-ray exam for the highest incidence of pulmonary tuberculosis at high altitudes. CT scanning is the prefer for its high resolution. Pathological biopsy and diagnostic therapy should be taken to make accurate diagnosis. Usually steroid hormones should not be recommended.
Adolescent ; Adult ; Aged ; Altitude ; Child ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tibet ; Tuberculosis, Laryngeal ; diagnosis ; drug therapy ; Young Adult