Objective To investigate the detecting ability of single photon emission computed tomography (SPECT) and CT in skull base invasion in nasopharyngeal carcinoma. Methods Sixty three patients with nasopharyngeal carcinoma were examined by whole body and skull base SPECT and CT of nasopharynx and skull base before radiotherapy. The results were double blind compared and evaluated. Results The overall positive rates of skull base invasion detected by SPECT and CT were 63.5% and 25.4%. In patients with headache, cranial nerve palsy and both, they were 87.9%,93.3%,92.3% and 42.4%,46.7%,46.2%. In patients with T 1+T 2 and T 3+T 4 lesions, they were 37.5%,90.3% and 0.0%,51.6%. In patients with N 0+N 1 and N 2+N 3 lesions, they were 63.9% ,63.0% and 19.4%,33.3%. The positive rates of SPECT were higher than those of CT (McNemar Test, P

To compare two enrichment and preservation methods of urinary proteins, stored in polyvinylidene difluoride (PVDF) membrane (Urimem) or direct freezing, we examined the differences between the two methods in time, space, costs of supplies and electricity, degree of protein degradation and convenience of the sample handling. The urimem method is superior in the storage space, the cost of electricity and the clinical convenience compared to the direct freezing method. However, the direct freezing method is superior in the time and the cost of supplies to the urimem method. The enrichment and preservation of urinary proteins using urimem have more cost-effective benefits compared to those of the direct freezing method.
Cost-Benefit Analysis ; Freezing ; Humans ; Polyvinyls ; Preservation, Biological ; methods ; Proteins ; chemistry ; Urine ; chemistry

Objective To investigate the ability of single photon emission computed tomography (SPECT) and MRI in detecting skull-base invasion in nasopharyngeal carcinoma. Methods Sixty-one patients with nasopharyngeal carcinoma received whole body and skull-base tomography SPECT, and nasopharynx and skull-base MRI before radiotherapy. The results were double-blind compared and evaluated. Results The overall positive rates of skull-base invasion detected by SPECT and MRI were 51% and 46% (P=0.508). In paitents with headache, cranial nerve palsy or both, the rates were 83% and 86% (P=1.000) ,80% and 80% (P=1.000), 88% and 94% (P=1.000), respectively. In patients with T1+T2 and T3+T4lesions,the rates were 22% and 0(P=0.031) ,74% and 82% (P=0.250) ,repectively. In patients with N0+N1and N2+N3lesions,they were 50% and 48% (P=1.000) ,53% and 40% (P=0.500) ,respectively. The conformation rate between SPECT and MRI was 85%. Binary Logistic regression analysis showed that T stage was a risk factor for positive SPECT(χ2=4.23,P=0.040, OR=3.04). Headache tended to be a risk factor for both positive SPECT and positive MRI (χ2=3.13, P=0.077, OR=4.54;χ2=3.64,P=0.056,OR=12.00). Conclusions The detection sensitivity of SPECT in skull-base invasion in nasopharyngeal carcinoma is equivalent to that of MRI. The consistency between SPECT and MRI is good. Moreover, there is a good correlation between SPECT and symptoms, signs and stage. SPECT of skullbase tomography is necessary for patients with severe headache, negative CT and those who can not receive MRI. When SPECT result is positive,skull-base should be considered to be invaded and should be defined as gross tumor volume in radiotherapy planning.

Objective To observe the clinical effects of tibial locking multidirectional interlocking intramedullary nail (TLMIIN) for tibial plateau fractures. Methods 38 cases with closed tibial plateau fractures treated by TLMIIN from October 2008 to May 2012 were retrospectively analyzed. There were 22 males and 16 females, with an average age of 48.7 years (range, 28-67 years). There were 24 fractures on the left side while the other 14 factures were on the right side, which were all fresh frac?tures. According to AO/OTA classification of tibial plateau fractures, there were 4 cases of B1, 1 case of B2, 14 cases of B3, 8 cas?es of C1, 5 cases of C2 and 6 cases of C3. Close reduction were performed on 4 cases (10.5%of all cases). Open reduction were performed on the other 34 cases. The limited incision was decided by the distribution of the fragments and fracture line. Hohl?Luck evaluation system was applied for the follow?up. Results The mean follow?up period was 18.1 months (range, 11-23 months). All fractures were healed at an average period of 87.4 days (range, 48-131 days). The average time from operation to full weight?bearing was 108.9 days (range, 80-128 days). Hohl?Luck evaluation system was used in the final follow?up. The excellent and good rate of functional score was 94.7%(36/38), including 28 cases excellent, 8 cases good and 2 cases fair from functional as?pect. The excellent and good rate of radiological score was 84.2%(32/38), including 23 cases excellent, 9 cases good and 6 cases fair from radiological aspect. No complications such as infection, breakage and loosening of the screw, malunion, nonunion oc?curred at the time of the latest follow?up. 6 cases with serious swelling of the knee joint and the soft tissue of crus were cured by an?ticoagulation, dehydration and physiotherapy treatments after operation. The 2 cases with a little exudates and incrustation was bacterial cultured negative and healed after 16 days and 18 days on the incision. 1 case had lost of reduction due to weight?bearing 1 week after operation, who had 25 degree of varus deformity, which was left dispose, and the bone healing and joint function were unaffected. Conclusion The intramedullary support, restrictive and non?restrictive multidirectional tridimensional fixation of TLMIIN technology had satisfactory effects in treating plateau fractures. It can supply a new therapeutic method, with little dam?age of soft tissues when taking out the internal fixation and reduce some postoperative complications.

Objective To assess the long-term surgical outcomes,patient's satisfaction and functional results of correction for patients with penile curvature by 16-dot minimal tension plication.Methods Between August 2004 and December 2010,92 patients with penile curvature underwent surgical correction of penile curvature by 16-dot minimal tension plication.Of them,86 patients (53 patients with congenital penile curvature and 33 patients with Peyronie's disease (PD)) were reached for long-term follow-up.Indications for operation included patients with 30 to 90 degrees of penile curvature,penile length greater than 10 cm and patients who had one or more symptoms,such as difficulty or inability to vaginal penetration and partner discomfort during sexual intercourse.Patients were excluded from study if they had severe penile curvature (greater than 90 degrees),hourglass deformities or large plaques.Preoperative evaluation included international index of erectile function 5 (IIEF-5) questionnaire score,pain on erection and physical examination.Patients were recommended daily low dose phosphodiesterase type 5 (PDE-5) inhibitors 2 weeks after surgery and maintained for 2 to 3 months.At follow-up,recurrence rate,complications,erectile function,patients and partner's satisfaction with the surgery were assessed.Results The mean time of follow-up was 79 months (range,35-107 months).Of 86 patients who had been reached for long-term follow up,82 patients (95.3％) and 77 partners (89.5％) reported overall satisfaction after the surgery.Complete penile straightening was achieved in 79 patients (91.8％).Slight residual curvatures were observed in 7 patients,but did not affect their sexual intercourse.Postoperative penile length shortening (median penile length loss 1.3 cm) was noted in 35 patients (40.7％),which did not affect their sexual intercourse.In addition,no de novo erectile dysfunction was observed,and sexual function was significantly improved evidenced by the IIEF-5 scores,especially in the patients who had received PDE-5 inhibitors for 2 to 3 months.There were no surgery-related complications,such as hematoma,urethral injury,or infection.Conclusion The longterm results demonstrate that correction of penile curvature using 16-dot plication is a simple and safe method to achieve cosmetic and functional satisfaction in patients with mild to moderate penile curvature.

Objective: To investigate the epidemiological characteristics of influenza in Yuhang District, Hangzhou City from 2019 to 2023, so as to provide the reference for formulating influenza prevention and control measures. Methods: Influenza case data with current address in Yuhang District was collected through the Chinese Disease Prevention and Control Information System from 2019 to 2023. Influenza-like illness data was collected through the Hangzhou Epidemiological Investigation System. Time distribution, population distribution and pathogen detection of influenza-like illness were descriptively analyzed. Results: There were 118 319 influenza cases reported in Yuhang District from 2019 to 2023, with an average annual reported incidence rate of 2 316.80/105. The highest incidence rate was seen in 2023, with a reported incidence rate of 5 736.82/105. The peak incidence of influenza occurred from November to March of the following year, presenting the winter and spring epidemic. The cases were mainly distributed in the age groups of 7 to 14 years and 25 to 59 years, with 31 310 and 34 470 cases, accounting for 26.46% and 29.13%, respectively. Influenza cases were reported in all 12 towns (streets) in Yuhang District, with the top two being Wuchang Street and Liangzhu Street, with the average annual incidence rates of 17 346.08/105 and 14 945.80/105, respectively. From 2019 to 2023, there were 103 868 cases of influenza-like illness, and 1 482 throat swab samples were collected. Among them, 260 positive samples of influenza virus were detected, with a positive rate of 17.54%. The peak detection period for positive specimens was from November to March of the following year, with 222 influenza virus positive specimens detected. The influenza virus types included H1N1, H3N2, and Victoria B, accounting for 25.77%, 38.85% and 35.38%, respectively. Conclusions The peak of influenza outbreak in Yuhang District from 2019 to 2023 was in winter and spring, with children and adolescents being the main affected objectives. H1N1, H3N2 and Victoria B were alternately prevalent. Prevention and control measures such as influenza vaccination should be strengthened.

OBJECTIVETo evaluate the efficacy of antioxidants in the treatment of non-alcoholic fatty liver.

METHODSThe Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE or PUBMED (1978-2011), EMBASE (1978-2011), ISI, OVID Database (1978-2011), CNKI Net and WANFANG database (1978-2011) were searched for relevant randomized controlled trials, with also manual search of the bibliographies of the retrieved articles. The data were synthesized to assess the histological response of the patients (hepatic steatosis, inflammation and fibrosis) and hepatic biochemical changes after the treatments (alanine aminotransferase responses).

RESULTSFourteen trials involving 1284 patients were included in the Meta-analysis. The quality of the trials was inconsistent. The data were extracted for meta-analysis or descriptive analysis, which did not yield sufficient evidence that antioxidants could improve hepatic steatosis, inflammation, fibrosis or alanine aminotransferase responses.

CONCLUSIONSThe current data do not support a positive therapeutic effect of antioxidants on nonalcoholic fatty liver, and antioxidants are therefore not recommended in the clinical treatment of the condition.

Objective To study the the causes, management and preventive measures for complications of holmium laser ureterolithotripsy. Methods Three hundred and seven cases of uteteral calculi from Jan. 2006 to Jan. 2010 were reported (203 men and 104 women, age ranged from 18-83 years,mean age 51.6 years). One hundred thirty-three patients had calculi in the lower ureter,94 in the middle part and 80in the upper ureter. Results The overall comminution rate was 89.9% (276/307 cases). sixteen cases (5.2%) were followed by ESWL due to the shift of the stones to the renal pelvis. The operation failed in 9 cases(2.9%), 3 cases(1%) had perforation,and recoveried after open operation. Deep infection was found in 3(1%)cases,which recoveried after anti-infective therapy. Conclusions Holmium laser ureterolithotripsy is an effective method for treating ureteral calculi, with advantage of high efficiacy,safety and minimal invasion. To master the operating induction, to raise operating technique and to take correct measure could reduce complications effectually.

Objective:To investigate the effect of Superfine Cordyceps militarisv Powder on the immune functions of the mice,and to provide basis for improving the utilizable ratio of Cordyceps militaris.Methods:A total of 40 mice were randomly divided into negative control group,low dose (0.166 5 g·kg-1),middle dose (0.333 3 g·kg-1),and high dose (0.999 9 g·kg-1) of Superfine Cordyceps militaris Powder groups,and there were 10 mice in each group.The mice in different doses of Superfine Cordyceps militaris Powder groups were administered with the Superfine Cordyceps militaris Powder for 30 d by intragastric infusion respectively,whereas,the mice in negative control group were administered with the same volume of water for 30 d by intragastric infusion.The body weights,the spleen indexes and thymus indexes of the mice in various groups were measured;the lymphocyte transformation abilities of the mice in various groups were observed by lymphocyte transformation experiment;the levels of delayed-type hypersensitivity reaction of the mice were examined with toe incrassation;the number of antibody forming cells,phagocytic rate and phagocytic index of chicken erythrocytes phagocytized by peritoneal macrophages of the mice were detected.Results:Compared with negative control group,the body weights,the spleen indexes a nd thymus indexes of the mice in different doses of Superfine Cordyceps militaris Powder groups had no significant differences (P>0.05).The lymphocyte transformation abilities of the mice in middle and high doses of Superfine Cordyceps militarisPowder groups were higher than that in negative control group(P<0.05).The levels of delayed-type hypersensitivity reaction of the mice in middle and high doses of Superfine Cordyceps militaris Powder groups were higher than those in low dose of Superfine Cordyceps militaris powder group and negative control group(P<0.05).The numbers of antibody forming cells of the mice in low,middle and high doses of Superfine Cordyceps militaris Powder groups were higher than that in negative control group(P<0.05).The phagocytic rates and phagocytic indexes of chicken erythrocytes phagocytized by peritoneal macrophage of the mice in low,middle and high doses of Superfine Cordyceps militaris Powder groups were higher than that in negative control group(P<0.05).Conclusion:Superfine Cordyceps militaris Powder can strengthen the immune functions of the mice,and the recommended doses are 0.333 3 and 0.999 9 g·kg-1.

Objective To investigate the clinical features of pneumocystis pneumonia (PCP) in patients with chronic kidney disease. Methods Clinial data of 21 cases of the primary and secondary kidney diseases complicated with PCP,excluding renal transplantation,were analyzed retrospectively. Results Twenty-one cases consisted of 6 cases of primary renal diseases and 15 eases of secondary renal diseases.Twenty patients (95.2%) were receiving immunesuppressive therapy at the PCP onset.Main manifestations were fever,progressive dyspnea,cough with no or seldom sputum.Twenty patients presented obvious hypoxemia and 12 of them were type I respiratory failure.X-ray and CT imaging of 20 patients revealed diffuse pulmonary interstitial shadows or ground glass opacities in both lungs.All the patients were treaed with trimethoprim-sulfamethoxazole.Eleven patients died accounting for 52.3%.Compared with the survivors,elder age (60.91±15.08 vs 44.50±14.83,P＜0.05),lower blood oxygen pressure at onset [(48.11±19.05)mm Hg vs (65.91±13.13)mm Hg,P＜0.01],higher percentage of respirator application and other secondary lung infection were found in dead patients.No PCP relapsed after average 16-month follow-up in the survival patients. Conclusions PCP is a severe complication with high mortality during immunosuppressive therapy in patients with chronic renal disease.Early diagnosis and proper treatment are important to improve prognosis.