Objective To investigate the relationship of blood pressure variability(BPV) and heart rate variability(HRV) with prostatic volume (PV) in patients with benign prostatic hyperplasia (BPH).Methods A total of 133 patients admitted to our department between January 2011 to April 2013 were analyzed retrospectively.The patients were divided into BPH group and non-BPH group according to the PV value.The ambulatory blood pressure monitoring was used to measure the blood pressure parameters,including 24-hour systolic blood pressure (SBP),24-hour diastolic blood pressure (DBP),day time systolic blood pressure(DSBP),day time diastolic blood pressure (DDBP),night systolic blood pressure (NSBP),night diastolic blood pressure(NDBP),the standard deviation of DSBP(DSBPSD),DDBPSD,NSBPSD,and NDBPSD.At the same time,heart rate variability was measured by 24 hours Holter monitor.The ambulatory electrocardiogram was used for calculating normal to normal intervals (SDNN),standard deviation of the averages of R-R internals in all 5-minute segments(SDANN),rate mean square of the differences of successive RR intervals(RMSSD),percentage of RR intervals differing ＞50 ms (PNN50％).The differences of the ambulatory blood pressure parameters or heart rate variability were compared between the two groups.Results The levels of 24-hour SBP,DSBP,and DSBP-SD were higher in the BPH group than in the non-BPH group[(126.03±14.66)mmHg (1 mmHg=0.133 kPa) vs.(118.88 ±10.79) mmHg,(126.97±14.46)mmHg vs.(119.94±11.24)mmHg,(12.52±3.85)mmHg vs.(11.04±2.44)mmHg,all P＜0.05].All the parameters of HRV were significantly different between the two groups [(97.22±38.14)mmHg vs.(119.23±36.16)mmHg、(90.11±34.4)mmHg vs.(107.1144.4)mmHg、(19.11±2.76)mmHg vs.(31.96±21.10)mmHg、(2.31±2.87)％ vs.(5.02±4.88)％,all P＜0.05]Conclusions The BPV and HRV are the important influencing factors for PV in BHP patients.

Objective To observe the influence of diabetes educationon the treatment compliance and quality of life (QOL) of diabetics and to find out the influencing factors of diabetics' QOL. Methods This study applied the questionnaire of compliance and the SF-36 to make an investigation on diabetics. Ninety diabetics who participated in the course of diabetes education during the period from October 2008 to March 2009, and 205 diabetics who were seen in the first affiliated hospital of China Medical Universitybut never participated in the course of diabetes education during the period from September to October of 2008. By comparing the data with control group and using self-paired comparison, the influence of diabetes education on the treatment compliance and the QOL of diabetics was studied. The factors influencing the QOL of each dimension were analyzed by means of single or multiple regressions. Results The treatment compliance of patients was improved with the number of times that these patients participated diabetes education was increased (P<0.05). The treatment compliance of the patients in hospital who had not participated in diabetes education was improved temporarily. However, 2 weeks after these patients were discharged the treatment compliance of these patients had began to decline. The treatment compliance would be declined if patients discontinued participating education for a long time. After 24 weeks intevention, the total score of compliance of intervention group (42.44±4.10) was higher than control group (35.60±3.90), and also higher than the intervention group before intervention (34.56 ± 4.34) (all P<0.01). The scores of 5 dimensions were significantly different (P<0.05 or 0.01). Of 8 dimensions of intervention group, the scores of vitality, social functioning, role-emotional and mental health were all increased after intervention, with significant differences except for role-emotional (P<0.05). The mental health index of patients with long-term health education was increased to a certain degree. Conclusion Long-term health education plays an active role in treatment. Insisting on taking part in health education regularly can improve the quantity of mental health.

Objective To investigate the clinical values of brain natriuretic peptide (BNP) in combination with TDI in diagnosing left ventricular hypertrophy (LVH) and impaired diastolic function in elderly hypertensive patients. Methods The 140 elderly hypertensive patients were divided into LVH group (n=69) and NLVH group (n=71). Control group consisted of 50 normal subjects. Plasma BNP level and index of echocardiography, including mitral peak flow velocity during early and late diastole (E, A), ratio of E/A, average peak velocities of six LV wall sites at mitral annuluses during early and late diastole (MEm, MAm), ratios of MEm/MAm and E/MEm were measured in all patients. The correlation of plasma BNP level with cardiac ultrasonographic findings was also examined. Results The level of BNP [(61.64±37.18)ng/L, (138. 65±30. 23)ng/L] and the ratio of E/MEm (11.3±1.83, 15.7±1.45) were significantly higher in NLVH group and LVH group than in normal group (P＜0. 05 or P＜0. 01). MEm [(6.32±0. 94)cm/s, (4.29±0. 91)cm/s]and MEm/MAm (0.76±0.19, 0.51±0. 11) were significantly lower in NLVH and LVH group than in normal group (P＜0.05 or P＜0. 01). The BNP level was negatively correlated with E/A, MEm and MEm/MAm (r=- 0. 294, r= 0. 387 and r= 0. 422, all P＜0. 01), and was positively correlated with LVMI and E/MEm (r=0.342, r=0.501, all P＜0.01). Conclusions Left ventricular diastolic function is impaired in elderly hypertension patients regardless of LVH or NLVH.Plasma BNP level in combination with echocardiography parameter is accurate to evaluate the LVHand impaired diastolic function in elderly hypertensive patients.

Objective To evaluate the effect of ultra-low dose naloxone on postoperative hyperalgesia caused by large-dose remifentanil.Methods Forty ASA Ⅰ-Ⅲ adult patients,scheduled for gastrointestinal surgery,were randomly assigned into 2 groups (n =20 each):large dose remifentail group (group R) and ultra-low dose naloxone group (group N).Anesthesia was induced with iv injection of remifentanil,propofol and cisatracurium and maintained with inhalation of sevoflurane and infusion of remifentanil.The patients were tracheal intubated and mechanically ventilated.In group R,remifentanil was infused at a rate of 0.25 μg· kg-1 · min-1 starting from the beginning of skin incision.The infusion rate was adjusted according to hemodynamics during operation and subsequently increased/decreased by 0.05 μg· kg-1· min-1 each time.In group N,naloxone was infused at 0.1 μg·kg-1· h-1 while infusing remifentanil,naloxone infusion was stopped at the beginning of peritoneum closure and the other treatments were similar to those previously described in group R.All patients were sent to post-anesthesia care unit after surgery and stayed there for 90 min.Morphine was given when need.The patient-controlled intravenous analgesia was used for postoperative analgesia after leaving post-anesthesia care unit.The first pain time was calculated.The morphine consumption and complications such as nausea,vomiting and pruritus were recorded at 15,30,60 and 90 min and 2,6,24,48 and 72 h after surgery.Results Compared with group R,the morphine consumption was significantly reduced at each time point after surgery,the first pain time was prolonged,and incidence of nausea was decreased (P ＜ 0.05),while no significant change was found in the incidence of vomiting and prutirus in group N (P ＞ 0.05).Conclusion Infusing ultra-low dose naloxone (0.1μg· kg-1 ·h-1) during operation can attenuate postoperative hyperalgesia caused by large-dose remifentanil in patients.

Objective To investigate the correlation between brain natriuretic peptide(BNP)and left ventricular diastolic function in the elderly patients with diabetes mellitus and hypertension.Methods 128 elderly patients with diabetes mellitus were divided into diabetes without hypertension (n=63)and with hypertension(n=65),and other 62 normal subjects were selected as control group.Plasma BNP levels and indexes of echocardiography,including left ventricular mass index(LVMI),the mitral peak flow velocity during early(E)and late diastole(A),ratio of E/A,average peak velocities at mitral annuluses of six sites in left ventricular wall during early(MEm)and late diastole (MAm),and relative E/MEm were measured in all patients.Results LVMI,E/MEm and the levels of BNP were significantly higher in groups of diabetes without and with hypertension[(91.6 ±17.3)g/m2 and(116.7±20.5)g/m2,(10.3±1.8)and(12.5±1.4),(47.7±29.4)ng/L and(105.7±32.5)ng/L]than in control group[(78.7±19.5)g/m2,(8.9± 1.6)and(20.8±11.63)ng/L,respectively](F=11.54,13.83 and 9.75,all P＜0.05),while MEm in two diabetes groups[(6.8±1.0)and(5.4±0.9)cm/s]were decreased as compared with control group[(8.0± 1.1)cm/s,F=11.26,P＜0.05].The BNP levels were negatively correlated with E/A and MEm(r =-0.42 and -0.51,all P＜0.01),and positively correlated with LVMI and E/MEm(r=0.48 and 0.58,all P＜0.01).Conclusions Left ventricular diastolic function is impaired in diabetes mellitus and more severely impaired in diabetic patients with hypertension.A combination of plasma BNP and echocardiography parameter may be helpful to accurately evaluate left ventricular diastolic function in the elderly patients with diabetes mellitus and hypertension.

Objective To explore the influence of DaHuang on renal expression of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in diabetes mellitus rats. Methods After the DM rat model was made, 24 DM rats were selected randomly and divided into a model group (12 DM rats) and a Rhubarb group group were given pure water in equal amount every day. 8 weeks later, kidney was cut to make pathological slice and method of SP immunohistochemistry was adopted for staining. Observed the expression of ICAM-1 and VCAM-1. Result The renal expression of ICAM-1 and VCAM-1 in the rhubarb group and the model group were obviously increased compared with the normal group (P<0.05). The renal expression of ICAM-1 and VCAM-1 in the rhubarb group was obviously weaker than the normal group(P<0.05). Conclusion Rhubarb could obviously inhibit the renal expression of ICAM-1 and VCAM-1 in diabetes mellitus rats and protect kidney of diabetes mellitus rats.

ObjectiveTo assess the left ventricular systolic and diastolic function in patients with type 2 diabetes mellitus(DM) using quantitative tissue velocity imaging(QTVI) ,and to provide reliable evidence for early diagnosis and prevention in diabetic cardiomyopathy.MethodsOne hundred and twenty one type 2 DM patients were divided into two DM 1 groups (61 patients without microangiopathy) and DM2 group (60 patientswith microangiopathy).Fifty normal subjects were enrolled as control group.The index of echocardiography,including the LVEF, FS and mitral peak flow velocity during early and late diastole (E/A) were measured by conventional echocardiography,and the ratio of E/A was calculated.The average peak velocities of six LV wall sites at mitral annuluses during systole, early and late diastole(MEm, MEm, MAm) were measured by QTVI, and the ratio of MEm/MAm was calculated.Results Compared with the normal group, MSm ([7.13 ± 1.42])cm/s vs.([6.49 ± 1.29]cm/s), MEm ([6.22 ± 1.39]cm/s) vs.([4.53 ± 0.94]cm/s) and MEm/MAm ([0.79 ±0.17]vs.[0.59 ± 0.19]) in DM patients were significantly decreased(F = 5.32,8.01 ,4.89 ; Ps ＜0.05).There was no significant differences among three groups in the comparisons of LVEF ([67.45 ±5.47]％),([65.91 ±4.83]％),([68.01 ±6.16]％) and FS([38.84±4.23]％,[37.82±5.43]％),([40.17 ± 4.53]％)(F = 1.89 and 2.46 respectively, P ＞ 0.05) .In addition, E/A of DM2 group (0.71 ±0.21)decreased more dramatically than DM1 and normal (0.91 ± 0.18,1.02 ± 0.24)(F = 4.71, P ＜ 0.05)ConclusionCompared with EF,FS and E/A obtained by conventional echocardiography,QTVI-derived MSm,MEm and MEm/MAm are more sensitive indexes to defect early LV dysfunction.The functional disorder appears early than microangiopathy, and the left ventricular systolic and diastolic function gets worse along with the microangiopathy.

Objective To investigate the protection effect of inferior vena cava filter on pulmonary embolism in patients with deep venous thrombosis(DVT) of lower extremities. Methods Inferior vena cava filters were placed in 55 patients with DVT. Simon Nitiol filter(SNF) was used in 25 cases,Trap Ease filter(TEF) in 13 cases and Antheor Temporal filter(ATF) in 17 cases.10 patients with DVT were treated by non operation therapy,45 patients by operation and transluminal angioplasties.Whether patients occurred pulmonary embolism was observed clinically,and the form and site of SNF and TEF were monitored by periodic fluoroscopy . Results Inferior vena cava filter was placed successfully in all patients.Symptoms and signs of DVT disappeared in all the patients after treatment . None of the putients occurred pulmonary embolism in this series. One case occurred inferior vena cava thrombolism in 16 months after SNF placement. Thrombus attached to ATF after the ATF taking off from inferior vena cava was found in 17 cases.Conclusions Inferior vena cava filter placement is a simple, safe and efficient method to prevent pulmonary embolism in a short period.But its long term complications should be considered and investigated.

Objective Cerebral venous sinus thrombosis (CVST) is easily misdiagnosed for lack of specificity in its pathogenesis and clinical symptoms and characteristics.This study was to investigate the association of the clinical features of CVST with the time of diagnosis and the impact of diagnostic delay on the prognosis of the disease.Methods We retrospectively studied the clinical data about 94 cases of CVST treated in our hospital from March 2004 to August 2016.According to the interquartile-range time of diagnosis, we divided the patients into four groups, <5 d, 5-9 d, 10-16 d, and >16 d, and analyzed the correlation between the time of diagnostic delay with the clinical characteristics of the patients.The primary and secondary endpoints were the modified Rankin Scale score (mRS) ≤1 and ≤2 respectively at 3 months after discharge.Results Papilledema, isolated intracranial hypertension syndrome, and Glasgow Coma Score of 14-15 were associated with a longer diagnostic delay than seizure and hemorrhagic or infarction lesions (P<0.05).A significantly higher rate of earlier diagnosis was found in patients with lower levels of albumin and total protein, longer thrombin time, and a higher level of C-reaction protein (P<0.05).However, no significant correlation was observed between the time of diagnostic delay and the prognosis CVST.Conclusion The symptoms and laboratory indexes of the CVST patients at admission can be used as markers for the diagnosis of CVST, which may provide some new idea for its early diagnosis.

Objective:To investigate the application value of laparoscopic duodenum-preserving pancreatic head resection (LDPPHR).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 25 patients undergoing LDPPHR in the Second Hospital of Hebei Medical University from November 2016 to November 2020 were collected. There were 7 males and 18 females, aged from 14 to 66 years, with a median age of 29 years. All the 25 patients underwent LDPPHR. Observation indicators: (1) surgical situations; (2) postoperative histopathological examination; (3) follow-up. Follow-up was conducted using outpatient examination or telephone interview to detect the recovery of patients up to March 2021. Measurement data with skewed distribution were represented as M (range) and count data were descripted as absolute numbers. Results:(1) Surgical situations: all the 25 patients underwent LDPPHR successfully, including 23 cases undergoing total pancreatic head resection and 2 cases undergoing subtotal pancreatic head resection. The operation time and volume of intraoperative blood loss of 25 patients were 310 minutes (range, 207 to 540 minutes) and 200 mL (range, 50 to 800 mL), respectively. Of the 25 patients, 1 case was infused with 4 U of red blood cells and 400 mL of plasma, 1 case was infused with 500 mL of plasma, 1 case was infused with 600 mL of plasma and the remaining 22 cases were not infused with red blood cells or plasma. Of the 25 patients, 3 cases with pancreatic fistula of class B were discharged after drainage, 4 cases had biliary fistula including 2 cases undergoing symptoms disappeared after implantation of common bile duct stent by endoscopic retrograde cholangiopancreatography, 1 case recovering well with drainage, 1 case with postoperative perihepatic effusion undergoing symptoms disappeared after the treatment of drainage and common bile duct stent implantation, and the remaining 18 cases had no complications. The duration of postoperative hospital stay was 17 days (range, 9 to 27 days) of the 25 patients. (2) Postoperative histopathological examination: the tumor volume of the 25 patients was 6.0 cm×5.0 cm×2.0 cm (range, 1.0 cm×2.0 cm×1.5 cm to 10.0 cm×9.0 cm×8.0 cm). Results of the postoperative histopathological examination showed that there were 12 cases with pancreatic solid pseudopaillary neoplasm, 4 cases with intraductal papillary mucinous neoplasm, 3 cases with serous cystadenoma, 2 cases with mucinous cystadenoma, 1 case with neuroendocrine neoplasm, 1 case with pancreatic true cyst, 1 case with cholesterol crystals combined with calcification in the center of pancreatic nodules and 1 case with cavernous hemangioma of pancreas. (3) Follow-up: all the 25 patients were followed up for 4 months to 48 months, with a median follow-up time of 27 months. During the follow-up, 1 case of the 25 patients with postoperative diabetes controlled blood glucose in the normal range after regular injection of insulin, 1 case with fatty diarrhea had symptoms improved after oral supplement of pancreatic enzyme preparation, 1 case with preoperative intermittent dizziness, weakness of both lower limbs and hypoglycemia had the level of blood glucose returned to normal without any special treatment after operation, and the remaining 23 cases had no metabolic complications. None of the 25 patients had tumor malignant transformation, recurrence or death. No long-term complications such as delayed gastric emptying, bile duct stones or stricture occurred to the 25 patients.Conclusion:LDPPHR is safe and feasible for the treatment of benign or low-grade malignant tumors of the pancreatic head, with the advantage of preserving the integrity of digestive tract.