ObjectiveTo investigate the effects of pre-infusion of hypertonic sodium chloride hydroxyethyl starch 40(HH40)injection in prevention for transurethral electroresection of the prostate syndrome(Tuns).MethodsSixty patients with benign prostate hyperplasia(ASA)grades Ⅱ toⅢwere recruited in the study and randomly divided into two groups,one injected intravenously with HH40 at dose of 5 ml/kg by drip after sursical operation a8 experiment and the other injcoted with the same volume of Ringer's solution as control Mcan arterial pressure,heart rate,saturation of blood oxygen(SaO2)and central venous pressure were monitored for all the patients.In addition.serum concentrations of sodium,potassium,chloride and serum osmolality were determined before(T0)and 30 min(T30)and 60 min(T60) after operation,respectively,as well as pH valRe and partial pressure of carbon dioxide(PgCO2)in the gastric mucosa were determined by a Tonocap monitor.Occurrence of TURS and use of atropine,ephedrine and rinse solution were documented.Resuits TURS occurred in four patients in the eontrol group during surgical operation,whereas uo TUns occurred in experimental group.Serum sodium concentration was (126.5±13.3)mmoL/L at T60 in control group,significantly lower than that in experimental group(P＜0.05),while intragastric pH value and PgC02 level were(7.26±0.04)and(54±9)mm Hg[(7.2±1.2)kPa],respectively in controls,significantly higher than those in experimental group(P＜0.05).ConclusionsPre-infusion with HH 40 can improve tissue perfusion and prevent effectively from TURS in patients with transurethral electroresection of the prostate.

After a description of the background of hierarchical diagnosis and treatment in China, the total frame-work of hierarchical diagnosis and treatment system in the Internet+era was proposed by analyzing its needs in the Internet+ era, and the main functions of its data center, information system, clinical professional collaboration and public health service were elaborated in order to promote medical health actions and construction of hierarchical diagnosis and treatment system in China.

Objective:To analyze and evaluate population health informatization development of China. Meth-ods:Through this investigation, 8 578 copies of a questionnaire designed for all levels of health administration and parts of primary hospitals were collected. These collected data, were analyzed to evaluate the population health infor-matization development of China through the evaluation index system established for population health informatization development and comprehensive evaluation model. Results:The results of this empirical study indicate that the popu-lation &Health Informatization overall has rapid development , but still has regional differences, and total score of the top 10 provinces are Zhejiang, Shanghai, Jiangsu, Liaoning, Beijing, Chongqing, Tianjin, Hunan, Henan and Gan-su. A statistical difference (p<0. 05) exists in regional development on population & health informatization of Chi-na, therefore serval provinces have obvious weakness or advantage in the construction of informatization. Discussion& suggestions:Government of China should pay attention to evaluation during the construction of informatization;pro-mote a balanced and sustainable development by strengthening financial support and optimizing the input pattern;up-grade regional population health informatization overall according to the information resources as the core;and develop the key priorities of population health informatization depending on practical situation and developing trend.

Objective To investigate the effect of dipeptidyl peptidase-4 (DPP-4) inhibitor on lipopolysaccharide (LPS)-induced changes in the mass and function of pancreatic β-cells.Methods RINm cells were cultured and treated with LPS alone or combined with different concentrations of sitagliptin for 24 h.The proliferation of RINm cells was detected by CCK-8 assay.Apoptotic rate was determined by Annexin V-fluorescein isothiocyanate (FITC)/propidium iodide flow cytometry.Insulin secretion was measured by enzyme-linked immunosorbent assay.The expression of IL-6 mRNA was displayed by RT-PCR.Results LPS significantly stimulated the proliferation of RINm cells (0.89 ± 0.04 vs 1.14 ± 0.08,P＜0.01),while LPS+sitagliptin showed no significant difference compared with LPS group.The cell apoptotic rate in LPS + 10-1 mmol/L sitagliptin group was significantly lower than that in LPS group.There were no significant differences in basal insulin secretion among all groups,but after the high/low glucose stimulation,LPS increased insulin secretion as compared with the control.The IL-6 mRNA expression in LPS+sitagliptin group was significantly lower than that in LPS group (0.77 ± 0.33 vs 1.30 ± 0.41,P =0.006).Conclusions DPP-4 inhibitor has no influence on LPS-induced proliferation of pancreatic β-cell,but it can inhibit LPS-induced apoptosis and insulin secretion,and IL-6 may be involved in the process.

Objective To investigate the effect of tube voltage and iodine concentration of contrast medium (CM) on abdominal dynamic enhanced CT image quality.Methods Six miniature pigs underwent repeated upper abdomen dynamic contrast-enhanced CT scans in 4 scanning protocols with different concentration of CM and tube voltage,namely,protocol 1,CM with iodine concentration of 270 milligrams iodine per milliliter (mg/ml) and 80 kV tube voltage;protocol 2,270 mg/ml and 120 kV;protocol 3,370 mg/ml and 80 kV and protocol 4,370 mg/ml and 120 kV.The same iodine dose (600 mg/ml) and iodine delivery rate (IDR) (920 mg/s) were used in all protocols.The CM with iodine concentration of 270 mg/ml were injected at a flow rate of 3.4 ml/s,and 370 mg/ml CM injected at 2.5 ml/s.Image reconstruction was performed with iterative reconstruction (iDose4) in protocol 1 and 3,filtered back projection (FBP) was used in protocol 2 and 4.A subjective scoring system for image quality,image noise and sharpness was conducted by 2 radiologists independently.The measured values (peak of enhanced CT values,image noise of aorta,inferior vena cava,portal vein,hepatic vein and liver parenchyma) as well as the calculated values [their time-to-peak,signal-to-noise (SNR) and contrast-to-noise (CNR) ratios] were compared between among 4 protocols.The CT volume dose index (CDTIvol) and dose length product (DLP) were recorded from the CT console after each scanning.Factorial designed ANOVA was used for comparison of enhanced CT values of vessels and liver parenchyma,noise,SNR and CNR.The Kruskal-Wallis test was used for comparison of values among the 4 protocols,including the time-to-peak enhancement of vessels and liver parenchyma,the subjective scores of image quality indices.Result There was no significant differences in subjective scores of the image quality,image noise and image sharpness (P＞0.05).The scored were more than 3,and the images with 4 scanning protocols were all acceptable for diagnosis.There was no significant differences between protocol 1 and 3,protocol 2 and 4 in the peak enhancement CT values of aorta [(729±46) HU vs.(707±59)HU,(515±84)HU vs.(513±53)HU],inferior vena cava [(366±95)HU vs.(368±92)HU,(282±39)HU vs.(262 ± 67)HU],portal vein [(213± 18)HU vs.(201 ±29)HU,(180±21)HU vs.(176±27)HU],hepatic vein [(207±18)HU vs.(193±10)HU,(179±24)HU vs.(170±14)HU] and liver parenchyma [(128±7) HU vs.(127±4) HU,(135±5)HU vs.(135±6)HU] (P＞0.05).But the CT values of vessels (aorta,inferior vena cava,portal vein and hepatic vein) in protocol 1 and 3 were significantly higher than those in protocol 2 and 4 (P＜0.05),the CT values of liver parenchyma in protocol 1 and 3 were significantly lower than values in protocol 2 and 4 (P＜0.05).The image noises of vessels were higher in protocol 1 and 3 than noises in other protocols (P＜0.05),but there was no significant difference in liver parenchyma noise among protocols (P＞0.05).No significant differences were observed on the peak times,SNR and CNR in aorta,inferior vena cava,portal vein,hepatic vein and liver parenchyma among 4 protocols (P＞0.05).The CDTIvol and DLP were 199.67 mGy,1 597.4 mGy· cm respectively in protocol 1 and 3,585.12 mGy and 4 680.9 mGy· cm in protocol 2 and 4 (scanning with 120 kV).Conclusions CM with different iodinated concentration could achieve the same enhancement in the abdominal vessels and liver parenchyma by using the proper scan protocols,which have the same IDR and iodine dose per kilogram body weight.Higher vessel enhanced peak values were achieved when using the protocols with 80 kV tube voltage than 120 kV.By using a low dose protocol of 80 kV tube voltage with the iterative reconstruction algorithm,the quality of image can be warranted.

Objective:To investigate the clinical features and prognosis of patients with pancreatic metastasis from clear cell renal cell carcinoma(CCRCC).Methods:From Jan 2000 to May 2020, the clinical data of patients pathologically diagnosed as CCRCC with pancreatic metastasis and admitted in Cancer Institute and Hospital of Tianjin Medical University were analyzed retrospectively. The gender, age, metastasis time, relapse time, metastatic sites, numbers of metastatic lesions and whether metastatic pancreatic lesions should be surgerically removed were recorded and the influencing factors were analyzed.Results:Among the 20 patients, there were 12 males and 8 females. The median age of diagnosis was 50 years. There were 12 patients(60%) of left renal carcinoma and 8 patients(40%)of the other side. 12 cases(60%) had single pancreatic metastatic lesion and the other 8 cases(40%) had multiple metastatic lesions. Seven patients(35%) had other organs metastasis besides pancreatic metastasis. Two patients(10%) had simultaneous pancreatic metastasis and renal cancer, and the other eighteen patients(90%) had pancreatic metachronous metastasis after being diagnosed as renal cancer. The median time from the diagnosis of CCRCC to pancreatic metastasis was 102 months. Thirteen patients(65%)had recurrences within 10 years and the other seven patients(35%)had recurrences after 10 years. Pancreatectomy was performed in nine patients(45%) and targeted therapy was conducted in thirteen patients. The mean follow-up was 122.9 months (1-256 months). Three patients (15%) died and 17 patients (85%) survived. The median overall survival was 75.9 months, and the 5 year-survival rate was 66.7%. Simultaneous metastasis and extra-pancreatic metastasis were prognostic factors in patients with CCRCC with pancreatic metastasis.Conclusions:Pancreatic metastases from renal clear cell carcinoma were rare, but the prognosis was good, especially in patients with only pancreatic metastases several years after renal carcinoma was diagnosed.

A multiplex PCR method was developed to detect the main pathogens of Qinghai Tibetan sheep endometritis. First, the genomes of five standard bacterial strains were extracted and specific primers were selected; the multiplex PCR method was established by using the genome of the standard strain as a template. The samples were collected by sterile cotton swab from Tibetan sheep uterus, and then placed in LB medium and numbered. After 48 h, the genomes of cultured bacteria were extracted and detected by single PCR method, then the positive samples were recorded. The positive samples detected by single PCR were selected for multiplex PCR detection and recorded again. The coincidence rate between these two methods was calculated to measure the accuracy of multiplex PCR. In order to identify the species of the pathogen, 30 positive samples verified by single and multiplex PCR were randomly selected for bacterial isolation and identification. In the 600 samples, the infected ratio of Streptococcus agalactiae (GBS) was 47.33%, Escherichia coli 34.83%, Staphylococcus aureus 6.5%, Salmonella and Trueperella pyogenes were negatively detected. Among the positive samples detected by multiplex PCR, the positive ratio of GBS was 45.50%, E. coli 33.50%, S. aureus 6.5%. Comparison of two detection results, Multiplex PCR detection coincidence rate is more than 95%. The isolated pathogens were identified as E. coli, GBS and S. aureus, which was consistent with the results of two methods. The multiplex PCR method was successfully established and the main pathogens of endometritis in Qinghai Tibetan sheep were GBS, E. coli and S. aureus.
Animals ; Bacteria ; genetics ; isolation & purification ; Bacteriological Techniques ; methods ; Endometritis ; microbiology ; veterinary ; Female ; Multiplex Polymerase Chain Reaction ; standards ; Polymerase Chain Reaction ; veterinary ; Sensitivity and Specificity ; Sheep ; Sheep Diseases ; microbiology ; Tibet