BACKGROUND: Microcirculation disturbance of pharynx may be one of the pathogenesis base caused recurrent attacks of chronic pharyngitis. The negative pressure can improve the microcirculation of inflammary target organs by biomechanical changes.OBJECTIVE: To explore the therapeutic effect of oral negative pressure on patients with chronic pharyngitis and nail fold microcirculation.DESIGN: A randomized single blind controlled observation.SETTING: Department of Pathophysiology of Hebei North University.PARTICIPANTS: A total of 65 patients with chronic pharyngitis and course of disease about 1-3 years admitted to Department of Neurology,First affiliated Hospital of Hebei North University from January to September 2002 were selected. They were randomly divided into treatment group (n=35) and control group (n=30), including 36 cases with chronic pharyngitis (18 cases from the treatment group, 18 cases from the control group), 29with chronic hypertrophied pharyngitis (17 cases from the treatment group,12 cases from the control group).METHODS: The Hices oral negative pressure instrument was used and the negative pressure exert equipment was put into the optimal position of the patients' mouth to keep the negative pressure of (0.05±0.01) Mpa, 10minutes once (the first therapy time was 5 minutes), once daily and the time was fixed, 5 days as a period of therapy for three periods. Patients in the control group were also given the negative pressure exerts equipment,but no negative pressure was exerted.MAIN OUTCOME MEASURES: ① Observation and evaluation of nail fold microcirculation: The nail fold microcirculation was observed by the XTL- Ⅱ microcirculation micro-television system, and the first row nail fold of the left ring figure was checked conventionally to record the state of microvessel, state of micro-bloodstream and peri-loop. The degree of microcirculatory disturbance was quantitatively analyzed according to Tian Niu's weighing integral method, the lower the scores, the better the microcirculation. ②The improvement of chronic pharyngitis after treatment of 3courses.RESULTS: Totally 65 patients with chronic pharyngitis entered the stage of result analysis. ①After 1 course of treatment, the symptoms of 1/3 of the patients in the treatment group were significantly improved; after 3 courses of treatment, except there was no obvious changes of hypertrophied morphology such as lymphatic follicle proliferation on posterior wall of throat and hypertrophy on side cable of throat, the pathological signs and prevalence of mucosa congestion were obviously lower than those before treatment and the control group (P ＜ 0.05-0.01) effective rate was 88.6%.②) Improvement of microcirculation disturbance with chronic pharyngitis was evident, restoring to basically normal from medium degree abnormality before treatment, the total score values reduced to 1.941 ±0.165 from 4.836±0.242 (P ＜ 0.01).CONCLUSION: Oral negative pressure can significantly release or eliminate the symptoms and signs of chronic pharyngitis, which may relate to improvement of microcirculation disturbance.

PURPOSE: We performed a meta-analysis to evaluate the efficacy and safety of mirabegron add-on therapy to solifenacin for patients with overactive bladder (OAB). METHODS: We conducted a systematic literature review to identify all randomized, double-blind, controlled trials (RCTs) of this combination (mirabegron and solifenacin) for OAB. Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials were searched. A manual search was also performed to investigate relevant references from the retrieved studies. RESULTS: Four publications describing 5 RCTs that compared combination therapy with solifenacin, including a total of 3,309 patients, were analyzed. The mean number of micturitions per 24 hours (mean difference [MD], -0.45; 95% confidence interval [CI], -0.65 to -0.26; P < 0.00001), number of episodes of incontinence per 24 hours (MD, -0.71; 95% CI, -0.14 to -0.02; P=0.04), volume voided per micturition, and number of urgency episodes per 24 hours demonstrated that combination therapy was more effective than solifenacin therapy alone. Safety assessments, including common treatment-emergent adverse events (odds ratio, 1.09; 95% CI, 0.95–1.27; P=0.23) and discontinuations due to adverse events (P=0.30), demonstrated that the combination therapy was well tolerated. CONCLUSIONS: This meta-analysis suggests that mirabegron therapy as an add-on to solifenacin provides a satisfactory therapeutic effect for OAB symptoms with a low occurrence of side effects.
Humans ; Solifenacin Succinate* ; Urinary Bladder, Overactive* ; Urination

BACKGROUND: Tension headache means contraction headache or oppressive headache in bilateral occipital-cervical part or whole head. Its pathogenesy bas not been completely known yet, which may be related to many factors and the conventional therapy is drug heteropathy but the effects are different, especially on patients with chronic disease and side effects will be induced by long-time intake of drugs.OBJECTIVE: To explore the curative effect of oral negative pressure on patients with tension headache and its mechanism of ameliorating microcirculation disturbance.DESIGN: Case-control observation.SETTING: Department of Pathophysiology of Hebei North University.PARTICIPANTS: Twenty patients with tension headache in the Department of Neurology, First Affiliated Hospital of Hebei North University from December 2001 to June 2002 including 12 females and 8 males,aged 18-28 (mean 23.4) with the disease course of 1-6 years, were randomly divided into therapeutic group and control group with 10 patients in each group.METHODS: The oral negative pressure instrument was applied. Put the negative pressure exerting equipment in the optimal position of mouth, adjusted the negative pressure to (0.05±0.01) MPa. The therapeutic time was 10 minutes each time (5 minutes for the first time) once a day with the time fixed. There were 5 days in one course and totally 3 courses. Put the negative pressure exerting equipment into mouth of patients in the control group for 10 minutes each time without exerting negative pressure. Quantitative evaluation on pain was performed with visual analogue scale (VAS)method, excellent as the VAS score decreased above 70%, effective as the VAS score decreased between 30% and 70%, invalid as the VAS score decreased below 30%. XTL- Ⅱ type microcirculation micro-television system was used to observe the changes of nailfold microcirculation by magnifing 260 times. The first row nailfold of left ring figure was checked conventionally, state of microvessel, micro-bloodstream and peri-loop were recorded and degree of microcirculatory disturbance was quantitatively analyzed according to TianNiu 's weighing integral method.MAIN OUTCOME MEASURES: The therapeutic effect after three courses and results of microcirculation observation.RESULTS: Totally 20 included patients were involved in the analysis of results. VAS scores of 7 patients in the therapeutic group decreased above 70% (70%), while no patient in the control group; VAS scores of 2 patients in the therapeutic group decreased from 70% to 30% (20%) and one patient in the control group (10%); VAS scores of one patient in therapeutic group decreased below 30% (10%) and nine patie nts in the control group (90%). Negative pressure could obviously ameliorate the microcirculation disturbance and enable it to recover from moderate before treatment to nearly normal with the total score decreased from (4.18±0.68) points to (1.97±0.41) points (P ＜ 0.01).CONCLUSION:Oral negative pressure has a significant curative effect on patients with tension headache. Its mechanism may relate to the improvement of microcirculation and the adjustment of nervous functional disturbance.

AIM: To observe the effects of shock lymph on apoptosis relative gene expressions of pulmonary micro-vascular endothelial cells(PMVECs),and explore its mechanism.METHODS: The model of severe hemorrhagic shock was established by maintaining the blood pressure of rats in the condition of sepsis,mesentery lymph and shock portal vein blood was taken out.As control,mesentery lymph,portal vein blood of normal rats was taken out.The primary PMVECs of passages 3 were treated by different treatment factors,respectively.The apoptosis rate was analyzed by flow cytometry,and the expressions of relative genes of apoptosis such as fas,fas L,bcl-2 and bax were detected by RT-PCR.RESULTS: The apoptosis rate of PMVECs was 9.86%?3.24% after exposed to shock lymph at the final concentration of 4% for 4 hours and significantly higher than that in control(P

Objective: To explore the clinical efficacy of female urethral diverticulum resection and reconstruction under the folding position. Methods: Retrospective analysis of 22 female patients with urethral diverticulum was performed from September 2010 to December 2018. There were 12 cases of simple diverticulum, 6 cases of horseshoe diverticulum, 4 cases of circumferential diverticulum, aged from 26 to 72 years, with an average of 46.2 years, whose BMI ranged from 24.2 to 34.8 kg/m², with an average of 30.4 kg/m². Eleven cases (50%) presented with dysuria, 10 cases (45.5%) with repeated urinary tract infections, 7 cases (31.2%) with difficulty of voiding, 10 cases (45.5%) with urethral secretion, 9 cases (40.1%) with difficulty of sexual intercourse, and 4 cases (18.2%) without symptoms. Unlike the traditional surgical procedure under the lithotomy position, the folding position was used to expose the vagina and separate the vaginal mucosa by longitudinal incision, and the diverticulum was completely removed to the neck. The peri-operative complications and efficacy were recorded. Results: All 22 cases underwent successful procedures, and were followed up for 25.2 months on average (ranged 8 to 42 months). One of them suffered from weak stream 2 months after operation, with residual urine volume of 100ml by ultrasonography. Her symptoms improved after dilatation of the urethra. Two cases suffered from different degrees of lower urinary tract storage symptoms 1 month after the operation (1 case of mild dysuria and 1 case of urinary tract infection), who improved after oral administration of levofloxacin tablets for 3-5 days. All patients had no urethral diverticulum recurrence 3 months later by ultrasonography, half a year by cystoscopy, and every six months by ultrasonography. Conclusions Surgical treatment is still the best choice for patients with urethral diverticulum. The success rate of transvaginal urethral diverticulum reconstruction with a Jackknife position is high, postoperative recurrence rate is low, and postoperative complications are few.

Objective: To investigate the safety and efficacy of needle-tract assisted standard percutaneous nephrolithotomy (PCNL) for the treatment of complicated upper urinary tract calculi. Methods: The clinical data of 1 562 patients with complicated upper urinary calculi who received standard PCNL from December 2013 to December 2017 at Department of Urology, the First Affiliated Hospital of Xiamen University were retrospectively analyzed. There were large residual stones in 256 patients through B-ultrasound exploration after standard PCNL, could′t be detected with nephoscope in standard PCNL tracts. 16 F mini PCNL tract were established in 120 cases for treatment of residual stones, while needle-tract were established in order to guide nephroscope to find residual stones in 126 cases. Needle-tract were transferred to 16 F mini PCNL tract for treatment of residual stones in 10 patients if these residual stones could′t be detected through needle-tract. Operation time, change of hemoglobin level after operation, incidence of postoperative complications, time of hospitalization and rate of stone clearance were measured in two groups. The statistical methods used included t test, Wilcoxon rank sum test, and χ² test. Results: There were 1 to 3 mini tracts (M(Q_R): 1(1)) established in the mini tracts group and 1 to 7 needle-tracts (M(Q_R): 3(2)) established in the needle-tract group (Z=-10.57, P=0.000). Compared with mini tract group, the operation time ((62.0±18.0) minutes vs. (84.0±15.5) minutes, t=10.242, P=0.000), hospitalization time ((4.40±0.86) days vs. (5.20±0.81) days, t=7.570, P=0.049), hemoglobin dropped ((1.31±0.47) g/L vs. (2.74±0.63) g/L, t=20.12, P=0.000), and incidence of postoperative complications (7.9% (10/126) vs. 19.2% (23/120), χ²=6.674, P=0.01) of needle-tract group were lower, while postoperative stone clearance rate was higher (89.7% vs. 76.7%, χ²=7.497, P=0.006). No perioperative severe complications such as pleural injury, pneumatothorax, perforation of renal, trauma of abdominal organ occurred in two groups. Conclusion Needle-tract assisted standard PCNL for the treatment of complicated upper urinary calculi can significantly improve stone clearance rate, reduce operation time, decrease risk of kidney and surrounding organs damage.

Objective To investigate the manifestation of facioscapulohumeral muscular dystrophy (FSHD) in oral and maxillofacial region.Methods A total of 12 patients diagnosed as FSHD and 20 healthy volunteers were included in the study.Their medical history was collected from these patients.The decayed missing filled teeth (DMFT),calculus index-simplified (CI-S),occlusal relationship,maximal opening of mouth and maximum bite force were recorded.The impressions were taken to measure the maximal hight of palate and the width of palate.The lateral cephalometric radiographs were also taken to measure the mandibular plane-frankfurt horizontal plane angle (MP-FH).They finally received oral and maxillofacial region MRI examination to observe the masseter muscle,medial pterygoid muscle and lateral pterygoid muscle.The data were analyzed by t-test or Wilcoxon signed ranks test.Results There was no significant gender difference in FSHD group.The average age of treatment was (27.5±8.1) years and the average age of onset was (15.7±7.5) years.Nine patients liked to eat soft foods,4 patients had difficulties of closing eyes,8 patients had difficulties of cheek-bulging,10 patients showed pouty lips and 9 patients had mesio-malocclusion.DMFT (4.0±2.3),CI-S (5.8±2.1),male maximal hight of palate (20.5±2.1) mm,female maximal hight of palate (17.9±1.6) mm,MP-FH (31.8°±2.2°) of FSHD group were greater than those of the control group.Male width of palate (34.8±1.4) mm,female width of palate (33.7±1.5) mm,male maximum bite force (451.7±39.0) N,female maximum bite force (326.7± 21.6) N,maximal opening of mouth (3.5±0.4) cm of FSHD group were less than those of the control group (P ＜ 0.05).Maxillofacial MRI showed muscle asymmetr in 11 cases of masseter and 6 cases of medial pterygoid muscle,5 cases of lateral pterygoid,and these muscle showed mild fatty infiltration mainly concentrating in the grade 0,grade 1 and grade 2.Conclusions The FSHD patients have poor oral hygiene,low masticatory function,limited mouth opening,high palate and narrow arch and different degree of malocclusion.The patients' masseter muscle,medial pterygoid muscles and lateral pterygoid muscles exhibit asymmetrical atrophy and fatty infiltration.

Talent training is the core and foundation of public health system construction. Shortage of talents in the field of disease prevention and public health exposed by COVID-19 pandemic highlights the importance of developing preventive medical education. This article analyzes the challenges of medical education in the dilemma of "separation of medical treatment and prevention", and the new requirements for preventive medical education in the construction of New Medicine under the Healthy China strategy. Four aspects including stepping up the resource allocation and investment, educating responsible public health professionals, the education of all medical students who implement the core competence of public health, and the establishment of a continuing education system for preventive medicine have been considered. A series of specific suggestions are put forward including the establishment of a full-chain closed-loop research system to support the cultivation of top-notch innovative public health talents, strengthening the assessment of core public health capabilities for clinical medical professional admission, formulating a "medical and preventive integration" training program for primary health personnel, and implementing "combination of peace and war" public health personnel reserve system, with the purpose of providing reference for the reform and development of preventive medical education in China.

Talent training is the core and foundation of public health system construction. Shortage of talents in the field of disease prevention and public health exposed by COVID-19 pandemic highlights the importance of developing preventive medical education. This article analyzes the challenges of medical education in the dilemma of "separation of medical treatment and prevention", and the new requirements for preventive medical education in the construction of New Medicine under the Healthy China strategy. Four aspects including stepping up the resource allocation and investment, educating responsible public health professionals, the education of all medical students who implement the core competence of public health, and the establishment of a continuing education system for preventive medicine have been considered. A series of specific suggestions are put forward including the establishment of a full-chain closed-loop research system to support the cultivation of top-notch innovative public health talents, strengthening the assessment of core public health capabilities for clinical medical professional admission, formulating a "medical and preventive integration" training program for primary health personnel, and implementing "combination of peace and war" public health personnel reserve system, with the purpose of providing reference for the reform and development of preventive medical education in China.

Objective To analyze the infiltration of inflammatory cells under the mucosa of female cystitis glandularis and the different inflammatory infiltration in different clinical pathological types of cystitis glandularis.Methods Immunohistochemical method was used to detect the bladder mucosal tissue samples of 10 female patients confirmed cystitis glandularis admitted from June 2016 to October 2016.The results of immunohistochemical staining were collected and statistically analyzed by the automatic microscopy and image analysis system.In addition,the clinical data and tissue sample of 49 cases of cystitis glandularis treated from December 2006 to August 2017 were collected.Age of 49 patients was (34.4 ±7.5) years old and BMI was (21.9 ± 4.2) kg/m2.There were 19 cases of hypertension and 18 cases of diabetes.According to the cystoscopic manifestations,follicular edema type,papilloma type,and intestinal adenomatosis type were defined as high risk.Chronic inflammatory type and mucosa unchanged type were defined as low risk.Immunohistochemical staining was used to detect tissue samples,to compare the general data of different types of cystitis glandularis and the degree of infiltration of bladder mucosal inflammatory cells.Results T lymphocytes were highly expressed in 10 patients,and B lymphocytes and plasma cells were not expressed or extremely low (P ＜ 0.01).Of the 49 patients,29 were high risk type cystitis glandularis (follicular edema type,papilloma type,and intestinal adenomatosis type),and 21 were low risk type (chronic inflammatory type and mucosa unchanged type).The age of the high-risk group was (34.4 ± 7.5) years old with BMI of (21.9 ±4.2) kg/m2,8 cases of hypertension and 8 cases of diabetes.The age of the low-risk group was (38.2 ±8.5) years old with BMI of (20.8 ±4.0) kg/m2,11 cases of hypertension and 10 cases of diabetes.There was no statistically significant difference between two groups (P ＞ 0.05).The OABSS of high-risk group(10.4 ± 2.6) was significantly higher than that of low-risk group (7.1 ± 2.1,P ＜ 0.01).QOL of high-risk group (4.9 ± 0.9) was significantly higher than that of low-risk group (4.1 ± 0.8,P ＜ 0.01).Qmax of high-risk group was (11.4 ± 3.6) ml/s,significantly lower than that of low-risk group[(15.8 ±3.8) ml/s,P ＜0.01].The positive number of T lymphocytes of high-risk group was (173.5 ± 26.8),which was significantly higher than that of low-risk group(119.5 ± 21.2,P ＜ 0.01).Conclusions T lymphocytes infiltration is the major phenomenon in bladder submucosa of female patients with cystitis glandularis.The inflammatory infiltration by T lymphocytes could be associated with patient's symptom and bladder's pathological changes.