Clinical data of 23 patients with T2a bladder cancer admitted from March 2008 to August 2013 were retrospectively analyzed.Among 23 patients,11 cases were treated with transurethral resection (TURBT) plus arterial catheterization chemotherapy (study group) and 12 cases were treated with radical cystectomy (control group).The overall survival time and recurrence free survival time of two groups were compared.Patients in study group were followed up for 20-68 months,recurrence occurred in 5 cases (5/11),including 4 cases of invasive recurrence;patients in control group were followed up for 2 ～86 months,1 case had superficial recurrent and underwent TURBT,2 cases dead due to bladder tumor.During the course of chemotherapy,the main adverse effects were digestive reaction (7/11),fever (4/11),bone marrow suppression (2/11),symptomatic treatment was given,which was tolerated.There were no significant differences in overall survival time and recurrence free survival time between two groups (P ＞ 0.05).The quality of life of study group was better than that of control group (P ＜ 0.05).It is suggested that the arterial interventional chemotherapy combined with transurethral resection for T2a stage invasive bladder cancer has a certain curative effect with the advantage of preservation of bladder function and higher quality of life.

Objective Urinary protein is closely related to the development and progression of major vascular lesionsin diabetic patients.This study was to investigate the correlation between brachial-ankle pulse wave velocity(baPWV) and urinary protein in patients with type 2 diabetes mellitus ( T2DM) . Methods According to the level of 24-hour urinary albumin ( UAL) , 142 T2DM patients were divided into three groups:control (UA<30 mg, n=84), microalbuminuria(UAL<300 mg, n=26), and clinical albuminuria group ( UAL≥300 mg, n=33) .All the patients underwent examination offasting blood glucose, blood lipid, renal function, HbA1c, islet func-tion, C-reactive protein, blood pressure, and BMI.Their baPWV was determined with an Omron atherosclerosis detector and the correla-tion of baPWV with other factors evaluated by Pearson analysis and multivariate linear regression analysis. Results The baPWVwas significantly higher in themicroalbuminuria([1649.19±229.36]cm/s) and clinical albuminuria ([1759.21±291.05]cm/s) than in the control group ([1522.33±248.37]cm/s) (P<0.05).Pearson analysis showed a positive correlation between 24-hour UAL and baPWV ( r=0.347, P<0.01) and multivariate linear regression analysis manifested the same correlation ( P<0.05) . Conclusion The level of urinary protein is closely correlated with baPWV in T2DM patients.

Objective To investigate and compare the argumentativeness and attitudes towards thinking and learning between clinical nurses in general adult wards and wards for patients requiring particularity healthcare for the identification and development of core communication skills.Mettods “Argumentativeness Scale” and “Attitudes toward Thinking and Learning Survey” in Chinese were used to measure a convenience sample of 504 clinical nurses in seven hospitals.Results The scores in items reflecting rationality,positivism,empathy and acceptance in 247 nurses in wards for particularity heahhcare were significantly different from those nurses working in internal medical wards for adults with internal medical problems.Conclusions To develop harmonious interpersonal relationships in nurses,we should strengthen competencies in emotional regulation and rational thinking in nurses in wards for adults with in-ternal medical problems.

AIM:To evaluate the percentage of cutting fluctuations of central corneal thickness (CCT) intraoperative used low concentration (0.02%) mitomycin C (MMC) after laser-assisted subepithelial keratomileusis (LASEK).METHODS:In this prospective study, low and medium myopia group(spherical equivalent≤6.0DS) has 138 patients (276 eyes).Low concentration MMC used topically in 69 patients(138 eyes)randomized after excimer laser ablation;the another traditional LASEK as control.High myopia group(6.0DS

Objective:To determine the changes of the main components after compatibility of compound Mailuqishen(MLQS), and to explore its anti-tumor effect in the H22 tumor-bearing mice.Methods:The contents of ginsenoside and amino acid in MLQS were detected by HPLC, and the content of polysaccharide was detected by phenol-sulfuric acid.A total of 144 female Kunming mice were randomly divided into normal control group, model group, positive control group, low dose of MLQS group, medium dose of MLQS group, high dose of MLQS group, ginseng geng group, ginseng group and antler plate group (n=16).Except normal control group, the mice in the other eight groups were used to establish the H22 tumor-bearing mouse models, then the mice were treated with drugs at next day.The tumor weights, inhibitory rates of tumor, spleen and thymus indexes of the H22 tumor-bearing mice were detected 10 d after administration.The morphological changes of tumor and spleen tissue were examined by HE staining, and the apoptotic rates of H22 tumor cells were tested by flow cytometry.Results:As calculation with the ginseng and antler plate single herb, the contents of ginsenosides, polysaccharides and amino acids in MLQS were significantly higher than those of single herbs (P<0.05).Compared with model group, the inhibitory rates of tumor in various administration groups were significantly increased(P<0.01);the spleen indexes and thymus indexes of the mice in different doses of MLQS groups were significantly increased(P<0.01);the apoptotic rates of tumor cells were markedly increased(P<0.05).Compared with model group, the tumor tissue of the mice in various administration groups was destroyed, the cells were sparse and irregular, and the tumor presented necrotic lesions;the morphology of spleen tissue was normal with discernible fringe, and the lymphocytes arranged densely.Conclusion:The contents of ginsenosides, polysaccharides, and amino acids in compound MLQS are significantly increased compared with those of single herbs, and its anti-tumor effect is stronger than the single herbs.

ObjectiveTo evaluate the value of intraoperative frozen section examination (IFS) in the diagnosis and surgical procedures selection for renal occupying lesions. MethodsFrom January 2006 to December 2010,IFS was used in 114 men and 81 women with renal occupying lesions.The mean age was 52 years (range 17 -78).In 104,89,and 2 patients,lesions were in the right,left and bilateral kidneys,respectively.All patients underwent physical examination,129 were asymptomatic at presentation while clinical symptoms were observed in 66.The largest dimension of the tumors were 4 cm or less in 128 patients,4- 7 cm in 49,and larger than 7 cm in 18,respectively.The outcomes between IFS and postoperative routine paraffin section examination were compared.In cases with renal tumors nephrectomy or partial nephrectomy was performed.The results of IFS were compared between the 2 groups. ResultsThe sensitivity and specificity of IFS for renal malignant lesions was 96.6％ and 100％,respectively.The total accuracy rate of IFS for renal occupying lesions was 97.4％.By subgroup analysis,the accuracy rate of clear cell carcinoma,papillary cell carcinoma,chromophobe cell carcinoma,sarcomatoid cancer,nephroblastoma,benign tumor and urothelial cancer was 94.3％,25.0％,16.7％,0,0,97.6％ and 100.0％,respectively.Partial nephrectomy and nephrectomy were performed in 57 and 123 patients with renal tumors,respectively.The surgical procedures selection was significantly associated with the lesion size (4 cm or less for 80.7％ vs 62.6％,P =0.015) and the malignant lesion diagnosed by IFS (31.6％ vs 93.5％,P＜0.001). Conclusion The accuracy of frozen section analysis for renal malignant lesions during surgery is reliable and significantly high,and the results can exert an important impact on surgical procedures selection.

Hemochromatosis ; metabolism ; Humans ; Iron Overload ; Liver ; metabolism ; Male ; Middle Aged

OBJECTIVE: To evaluate effects of septoplasty on bilateral nasal cavities with acoustic rhinometry and rhinomanometry objectively. METHOD: Twenty-two patients who underwent septoplasty were examined with rhinomanometry and acoustic rhinometry before and 6 to 12 months after surgery. Of the 22 patients, 1 patient whose rhinomanometry and acoustic rhinometry datum were not available for the bilateral nasal obstruction, 3 patients with bilateral turbinectomy and 2 patients with unilateral turbinectomy wide nasal cavities were excluded. Finally, 18 narrow side nasal cavities and 16 wide side nasal cavities were analyzed. RESULT: Rhinomanometry: nasal resistance on the deviation side decreased significantly (P < 0.05), whereas on the contralateral side decreased slightly (P > 0.05). Acoustic Rhinometry: the predecongestion nasal minimal cross-sectional area (NMCA) and 0-5 cm NCV on the deviation side increased significantly due to the operation (P < 0.01). The corresponding postdecongestion increased were the same. Whereas on the contralateral side NMCA decreased and 0-5 cm NCV increased slightly before decongestion and after decongestion (P > 0.05). Only slight median increases were noted in the bilateral assessment postoperatively in NCV (P > 0.05) before and (P < 0.05) after decongestion. CONCLUSION The nasal patency on the deviation side is undoubtedly increased after septoplasty, and the airway on the wide side is not worsened after the operation.
Adolescent ; Adult ; Airway Resistance ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; physiopathology ; Nasal Obstruction ; physiopathology ; surgery ; Nasal Septum ; abnormalities ; surgery ; Postoperative Period ; Pressure ; Rhinomanometry ; Rhinometry, Acoustic ; Rhinoplasty ; Young Adult

Objective To explore the association between the different forms of in vivo ghrelin—Acyl ghrelin( AG) ,Des-acyl ghrelin( DAG) and AG/DAG with insulin resistance( IR) in patients with type 2 diabetes mellitus. Methods From June 2017 to November 2017,eighty-three patients with type 2 diabetes hospitalized in (group T2DM) and 40 healthy subjects (group NC) were hospitalized in Jinling Clinical Medicine were selected. Height body mass,blood pressure,blood lipid,glycated hemoglobin ( HbA1c) and fasting blood glucose (FPG),fasting insulin (FINS),and fasting C peptide (F-C-p) were measured,and all subjects were left with fasting serum,and the concentration of AG and DAG were measured by enzyme linked immunosorbent assay (ELISA). The body mass index (BMI),total gastric starvation (T-ghrelin) level,AG/DAG,insulin resistance index ( HOMA-IR) , insulin sensitivity index ( HOMA-IS ) and islet beta cell function ( HOMA- beta ) were calculated. The differences of the above indexes between the two groups were compared, and the relationship between AG,DAG,T-ghrelin,AG/DAG and FPG,HOMA-IR,HOMA-IS and HOMA- beta in T2DM patients were analyzed. Results ( 1) There were no significant difference in SBP、DBP、TC、LDL-C、AG between group NC and group T2DM(P>0. 05). Compared with NC group,the age、TG、BMI、HbA1c、FPG、FINS、HOMA-IR、HOMA-β、AG/DAG were significantly higher in T2DM group ( t=2. 690,-1. 990, 0. 873, 14. 257, 10. 528, Z=2. 885,-3. 483,-2. 284;P<0. 01,P<0. 05) . The HDL-C,F-C-p,HOMA-IS,HOMA-beta,DAG and T-ghrelin in group T2DM were lower than those of NC group( t or Z=0. 477,-3. 812,-3. 395,-4. 4,-2. 916,-2. 834;P<0. 05 or P<0. 01) . ( 2) The correlation analysis showed that there was a positive correlation between AG and FPG in T2DM group (r=0. 252,P<0. 05),DAG and T-ghrelin were negatively correlated with HOMA-IR (r=-0. 394,-0. 384,P<0. 05),and AG/DAG was positively correlated with HOMA-IR (r=0. 394,0. 384,P<0. 05),but is negatively correlated with HOMA-IS (r=-0. 292,P<0. 05). (3) multivariate linear regression analysis showed that FPG in T2DM patients were the influencing factors of AG ( t=2. 865,P<0. 05) ,while FINS and BMI were the influencing factors of DAG( t=-2. 808、-0. 330,P<0. 05) andT-ghrelin( t=-2. 725、-0. 330, P<0. 05) . HOMA-IR and BMI are the influencing factors of AG/DAG ( t=3. 718,3. 069,P<0. 05) . Conclusion The levels of DAG and T-ghrelin in group T2DM were significantly lower than those in the normal population, and was negatively correlated with the insulin resistance index,and the ratio of AG/DAG was closely related to insulin resistance,and the level of AG was mainly affected by fasting blood glucose.

AIDS-Related Opportunistic Infections ; diagnostic imaging ; drug therapy ; etiology ; Adult ; Bone Marrow Examination ; CD4 Lymphocyte Count ; Female ; Humans ; Male ; Middle Aged ; Mycoses ; diagnostic imaging ; drug therapy ; etiology ; Penicillium ; isolation & purification ; Prognosis ; Radiography