AIM: To evaluate the changes of serum total prostate specific antigen (T-PSA), free prostate specific antigen (F-PSA) and the ratio of F-PSA to T-PSA (F/T) in patients with prostate cancer (PCa) and its clinical significance. METHODS: The concentrations of T-PSA and F-PSA in serum were measured by micropartical enzyme immunoassay (MEIA) using AxSYM System, and the F/T ratio was calculated. RESULTS: Before operation, the concentrations of T-PSA and F-PSA in patients with PCa were much higher and F/T ratio was significantly lower than that in patients with benign prostate hyperplasia (BPH). T-PSA and F-PSA levels decreased, but F/T ratio increased after operation in PCa and BPH. F/T ratio in 83.5% PCa and 6.5% BPH was less than 0.16. To diagnosis PCa, the sensitivity of F/T ratio was 83.5%, and the specificity was 86.7%. CONCLUSION: Serum T-PSA, F-PSA and F/T ratio are important parameters for the early diagnosis of prostate cancer. [

Objective To study the effects of HIF-1α expression on the growth of subcutaneously implanted human hepatocellular carcinoma (HCC) cell lines in nude mice. Methods A nude mouse model of subcutaneously implanted HCC cell line HepG2Tet-on-HIF-1α was established. This cell lines characterizes the inducible expression of HIF-1α by doxycycline (Dos). The impact of HIF-1α expression induced by Dox on the growth of subcutaneously implanted HCC cell lines in the nude mouse model was observed. Results The mRNA and protein expression of HIF-1α were significantly up-regulated in the nude mouse model by oral administration of Dox. Compared with that model in which Dox was not administrated ie Dos( - ) group, the tumor volume(513.545 ± 276. 229) mm3 vs. ( 166. 506 ± 110. 142) mm3 ( P < 0. 05 ), tumor weight ( 1.251 ± 0. 438 ) g vs. (0. 640 ± 0. 296) g ( P < 0. 05 ), and tumor growth velocity were significantly enhanced in Dox ( + ) group, while tumor necrosis was inhibited ( 31. 360% ±2. 728% vs. 36. 640% ± 3. 804% ) (P<0. 05). The weight loss of nude mice was larger in Dox( + )group( P < 0. 01 ). There was no liver or lung metastasis in either group. Conclusion The expression of HIF-1αin subcutaneously implanted HCC in a nude mouse model is up-regulated by oral Dox. High grade expression of HIF-1α promotes the growth of implanted HCC.

Objective To evaluate the efficacy of arthroscopic debridement combined with microfracture on management of chronic enthesiopathy of Achilles tendon.Methods Fifteen cases of chronic enthesiopathy of Achilles tendon were enrolled in this study from January 2013 to January 2016.There were 11 males and 4 females,with an average age of 55.5±8.9 years.Five were in left side,and 10 in right side.All the patients failed to recover after conservative treatments for 18 months to 10 years.Pathological tissue was eliminated by blade.Then microfracture was made.Arthroscopic awls (1.5 or 2 mm in diameter) were used for making multiple holes at the footprint of achilles tendon.These holes were made far enough (3-4 mm) apart so they do not break into each other.Fat droplets and bleeding from the marrow cavity were seen when the appropriate depth (approximately 5 to 10 mm) has been reached.The patients were evaluated preoperatively and postoperatively using American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scores and visual analogue scale (VAS) scores.Results Average operation time and length of stay were 30.6± 15.4 min and 6.2±2.8 d,respectively.Postoperative incisions were Ⅰ stage healing for all patients.There were no perioperative and postoperative complications related to the procedure,such as rupture of achilles tendon,blood vessel and nerve injury.No infection and recurrence was found in all cases.All patients were followed up for an average time of 13.5 months.No rupture of achilles tendon or relapsing symptom was found.Average VAS scores before surgery,6 month after surgery and at the lattest follow-up were 7.3± 1.6,2.4± 1.3,and 2.3± 1.3,respectively.Average AOFAS Ankle-Hindfoot scores were 38.5± 7.8,92.9±6.9,and 91.6±7.1,respectively.Average postoperative VAS scores and AOFAS Ankle-Hindfoot scores were significantly improved compared with those before surgery.There was no statistically significant difference among all check point after operation in VAS scores and AOFAS Ankle-Hindfoot scores.At the latest follow-up,all patients were satisfied with the degree of painful relief.According to AOFAS Ankle-Hindfoot scores,overall excellent and good rate was 93.3％ (excellent in 10 cases,good in 4 cases,and fair in 1 case).Conclusion Clinical results of arthroscopic debridement combined with microfracture for treatment of chronic enthesiopathy of Achilles tendon are good.This technique is easy and safe to perform.

Dysarthric patients often present velopharyngeal incompetence (VPI), characterized nasalization articulation for hypernasality,which seriously impaired their communication. Research of evaluation of VPI is mainly about cleft palate and postoperative, few about the dysarthria. Some approaches, such as physiologic approach to rehabilitation, have been used to correct hypernasality, and prosthesis,such as palatal lift prosthesis (PLP) and nasal speaking valve (NSV), are also proved effectively. PLP has been widely used for hypernasality oversea, but fewer in China.

Objective To compare radiation doses to patients between rotational angiography and standard angiography.Methods According to different modes,our experiment was divided into RA (Dual-axis Rotational Angiography) group and SA (Standard Angiography) group.The latter was divided into 3 subgroups (SA1,SA2 and SA3) in terms of different time of cine.The procedure time and the position were controlled by the order preset into the machine.Each group consisted of 10 repeated operations with a unique phantom to simulate the true patients.The radiation doses were measured by using dose meter provided by the machine and TLD system; the means of the data were compared.Results The mean of total accumulated DAP and AK in group RA were 3 061.6 mGy·cm2 and 64.2 mGy,respectively,compared with group SA1 (4 213.9 mGy·cm2 and 85.5 mGy),SA2 (6 436.0 mGy·cm2 and 112.2 mGy),SA3 (12 810.4 mGy·cm2 and 243.7 mGy).The mean of accumulated dose in group RA was 37.70 mGy,higher than group SA1 (26.56 mGy) but lower than group SA2 (46.86 mGy) and SA3 (77.79 mGy).The gap between highest dose and lowest dose in RA group was insignificant whereas significant in the subgroups of SA.Conclusions In comparison with conventional angiography,the dual-axis rotational angiography has the potential to reduce radiation exposure of patients significantly so as to prevent skin radiation injures.

Objective: To observe whether an Xingnaojing 醒脑静 injection could improve the prognosis of patients, by increasing rifampicin penetration through the blood-brain barrier. Methods: Patients with severe tuberculous meningitis were enrolled in this study. The concentrations of Xingnaojing in cerebrospinal fluid and blood in patients treated with Xingnaojing and control were determined by high performance liquid chromatography. The changes in cerebrospinal fluid and the improvement of clinical symptoms and signs, were evaluated two weeks after admission. The long-term prognosis of the patients in the two groups were evaluated by the Glasgow Outcome Scale (GOS). Results: The concentration of rifampicin in cerebrospinal fluid was significantly higher in the Xingnaojing group (1.77±0.17 μg/mL), than in the control group (1.27±0.16 μg/mL, p<0.05). The difference in concentration of rifampicin in the blood was not significant (P>0.05). The short-term effective rate of the Xingnaojing group was 92.5% (37/40), which was significantly higher than that of the control group (80%, 32/40, p<0.05). After 6 months, 75% (30/40) of the Xingnaojing group had good prognosis according to the GOS score, whereas that of the control group was 50% (20/40) showing significantly better long-term treatment effect of the Xingnaojing group compared to the control group (P<0.05). Conclusion: Xingnaojing injection improved rifampicin penetration into the central nervous system. The increase in rifampicin concentration in cerebrospinal fluid improved outcomes in patients with severe tuberculous meningitis.

Objective To analyze the clinical techniques of renal artery control in laparoscopic donor nephrectomy.Methods 211 relative living renal transplantations were performed from June 2003 to June 2012,and 136 donors underwent laparoscopic donor living nephrectomy (LDN) since 2007.Forty donors were subjected to the Hem-o-lock clips for renal artery control by open surgery,87 donors to the Hem-o-lock clips for renal artery control by laparoscope,5 donors to the Endo GIA stapler for renal artery control by laparoscope,and 4 donors to the Hem-o-lock clips by laparoscope combined with hand-assisted suture transfixion for renal artery control.Results The warm ischemia time of renal artery control was shortest (1.1 ± 0.3 min) by Hem-o-lock clips in open surgery,and longest (3.2 ± 0.8) min by the Hem-o-lock clips with laparoscope.There was significant difference in the warm ischemia time of renal artery between open group and other groups,the differences (P＜0.05).The comparison of prognostic factors in the transplant renal outcome showed no significant difference among groups.The renal arterial stump-rrhexis-caused massive secondary bleeding occurred in 1 case subject to Hem-o-lock clips for renal artery control by laparoscope,with conversion to open surgery urgently,the operation was successful at last.Other renal artery control ways were all safe without any adverse reaction.Conclusion The warm ischemia time of renal artery control by Hem-o-lock clips in open surgery was shortest in laparoscopic donor nephrectomy.The renal artery control way by Endo GIA stapler in laparoscope or by Hem-o-lock clips with hand-assisted suture transfixion is safest.The utilization of Hem-o-lock clips should be careful in high risk population such as severe atherosclerosis etc.

Objective To observe the clinical safety of dual axis rotational coronary angiography (DARCA) in the diagnosis of coronary artery disease in Chinese population.Methods From March to December in 2010,74 patients undergoing diagnostic DARCA were enrolled.The improved isocentering technique was adopted in 34 of the patients at the end of the study during DARCA.Blood pressure,heart rate and symptoms were recorded immediately before-and-after contrast injections.Contrast dose,radiation exposure and procedure time for DARCA were recorded.Continuous variable data were analyzed using Student＇s t test,if normality assumption was violated,rank sum test would be used.Categorical variables were analyzed using x2 test.Results ( 1 ) Clinical safety:There was no chest pain documented during or immediately post-injection for all patients.Only 1 patient ( 1 ％ ) had an attack of ventricular tachycardia immediately after the contrast injection and then relieved automatically.Pre and post-injection systolic blood pressure values of left coronary artery were statistically different [ ( 116 ± 20 ) mm Hg vs.( 111 + 18) mm Hg( 1 mm Hg =0.133 kPa),t =3.303,P =0.001 ],and heart rates differed,too [ 73 ( 65- 84)bpm vs.71(64-78) bpm,Z =-4.789,P =0.001 ],but that imposed no clinical significance.(2)Contrast dose,radiation dose and procedure time:The mean contrast utilization,radiation dose and procedure time for DARCA were 28 (25-34) ml,8979 ( 6733-12 363 ) mGycm2 and 200 (164-270) s.Compared with conventional DARCA,improved isocentering technique during DARCA had less radiation exposure and procedure time in left coronary artery angiography and the whole coronary artery angiography [ left coronary artery angiographic radiation exposure:4004 (2932-5772) mGycm2 vs.5808 (4798- 8838) mGycm2,Z =-3.471,P =0.001 ;total radiation exposure:(8116 +2493) mGycm2 vs.( 11 371 ±4122) mGycm2,t =-4.176,P =0.001 ; left coronary artery angiographic procedure time:120 ( 80-180)s vs.150(126-214) s,Z =- 2.836,P =0.005; total procedure time:180 (139-240) s vs.220( 186-308 )s,Z =-3.004,P =0.003 ],but there was no statistically difference in contrast utilization [30(25-35) ml vs.27(25-34)ml,Z=-0.906,P=0.365].Conclusion This study demonstrates clinical safety of DARCA in the diagnosis of coronary artery disease in Chinese population.Compared with conventional isocentering technique of DARCA,improved isocentering technique can significantly reduce radiation exposure and procedure time on the basis of simplified operation,and replace the conventional isocentering technique,but randomized double-blind controlled studies should be conducted.

OBJECTIVETo study the distributional feature and clinical characteristics of infectious diarrhea caused by enterohemorrhagic Escherichia coli O157:H7, and to understand its pollution to the environment and the carrier status among livestock and poultry.

METHODSTo describing the incidence of diarrhea, to isolate and culture the pathogenic bacteria from samples of the patients with diarrhea and livestock or poultry with methods of microbiology, molecular biology and cytology, and then to determine the toxic factors.

RESULTSIn the first epidemic area in Suixian county, Henan province, 35 cases had been found during 17 March and 6 July with 91% of them above age of 60. Of them, 32 were complicated with acute renal failure, including 28 death (death rate: 87.50%). One hundred and seven strains of O157:H7 were isolated from the samples of livestock or poultry and 48 strains were isolated from patients. It was found that 67 strains having toxic gene through microbiological, molecular biological and cytological technologies. Five types of toxic factors were found.

CONCLUSIONThe main factor causing death was the complicated acute renal failure from diarrhea infected by E. coli O157:H7. The pathogen from livestock or poultry with high carrying rate might infect people through polluted water, food flies and close contacts. The outbreak of acute hemolytic uremic syndrome in Suixian county was caused by Enterohemorrhagic Escherichia coli O157:H7 infection.

Acute Kidney Injury ; etiology ; Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Diarrhea ; epidemiology ; Disease Outbreaks ; Escherichia coli Infections ; complications ; epidemiology ; Escherichia coli O157 ; isolation & purification ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo analyze the risk factors of nonspecific low back pain in community populations.

METHODSTwo community populations were investigated using questionnaires in this case-control study. The questionnaire was designed to collect data including age, gender, body weight, marriage, education, income, occupation, labor intensity, smoking, alcohol drinking and social mental status. The subjects with low back pain constituted the case group and those without low back pain served as the control group, and the data was analyzed by a Logistic regression model.

RESULTSA total of 1747 community residents participated in this survey, among whom 398 subjects had low back pain and 1126 subjects without low back pain were selected as the control group. Of all the latent risk factors of low back pain in Logistic regression model, gender was the most relevant factor (OR=3.5522) followed by education (OR=1.958), labor intensity (OR=1.956), marital status (OR=1.612), vibration source exposure (OR=1.491), BMI (OR=1.127) and age (OR=1.060).

CONCLUSIONGender, education, labor intensity, marriage, vibration source exposure and BMI are risk factors of nonspecific low back pain in community populations, and exercises and mental status can be protective factors against low back pain.

Case-Control Studies ; Humans ; Logistic Models ; Low Back Pain ; epidemiology ; Risk Factors ; Surveys and Questionnaires