Objective To explore the clinicopathological characteristics of non-muscle-invasive bladder cancer patients association with chronic kidney disease (CKD).Methods Between Jan 2009 and Dec 2010,536 patients (390 males and 146 females with mean age of 63 years) underwent surgical treatment at our institute for pathologically proven non-muscle-invasive bladder cancer.The clinical and pathological data of these patients were reviewed,and the relationships of these factors and CKD were analyzed.Presence of CKD was confirmed in patients with estimated glomerular filtration rate (eGFR)＜ 60ml/(min · 1.73 m2)calculated using the Modification of Diet in Renal Disease Study equation.Results Of the 536 consecutive cases,57 patients (10.6％) had CKD.Compared to the patients without CKD,there were more females and older patients in the patients with CKD (52.6％ vs 24.2％ and 69 years vs 62 years,both P ＜ 0.05).The patients with CKD proned to have multiple bladder tumor (71.9％ vs 50.9％,P ＜ 0.05) and synchronous upper urinary tract urothelial carcinoma (7.0％ vs 2.3％,P ＜0.05).The history of bladder cancer and upper urinary tract urothelial carcinoma were also predominated in these patients (43.9％ vs 29.0％ and 40.4％ vs 6.5％,both P ＜ 0.05).ConclusionConcurrent CKD in non-muscle-invasive bladder cancer patients is associated with greater risk of multiple tumors in urinary tract,particularly in female patients.

Objective: To investigate the epidemiological characteristics of pulmonary tuberculosis ( PTB ) incidence and mortality in Zhejiang Province from 2016 to 2020, so as to provide the evidence for formulating the PTB control strategy. Methods: The data regarding the PTB patients in Zhejiang Province from 2016 to 2020 were collected from the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System. The reported cases and deaths of PTB cases were descriptively analyzed by time, population and regions. Results: A total of 129 985 PTB cases were reported in Zhejiang Province from 2016 to 2020, and the overall reported incidence rate of PTB was 45.81/105, with a tendency toward a decline in the reported incidence ( χ2trend=298.899, P<0.001 ) and an annual decline rate of 3.72%. The prevalence rates of rifampicin resistance, positive etiological tests, negative etiological tests and no etiological results were 1.51%, 47.17%, 46.67% and 4.65%, respectively. A total of 546 PTB deaths occurred in Zhejiang Province from 2016 to 2020, and the reported mortality of PTB was 0.19/105, with a tendency towards a decline ( χ2trend=10.818, P<0.001) and an annual decline rate of 11.99%.The prevalence rates of rifampicin resistance, positive etiological tests, negative etiological tests and no etiological results were 1.83%, 82.97%, 13.37% and 1.83%, respectively. The highest reported incidence ( 92.18/105 ) and mortality ( 1.19/105 ) of PTB was found in patients aged 65 years and older, and farmer was the predominant occupation of PTB cases (60 774 cases, 46.75%) and dead PTB cases ( 345 cases, 63.19% ). In addition, the top three cities with the highest incidence of PTB included Quzhou City ( 66.43/105 ), Jinhua City ( 64.24/105 ) and Lishui City ( 53.91/105 ), and the top three cities with the highest mortality of PTB included Quzhou City ( 0.67/105 ), Lishui City ( 0.27/105 ) and Jiaxing City ( 0.26/105 ). Conclusions Both the reported incidence and mortality of PTB appeared a tendency towards a decline in Zhejiang Province from 2016 to 2020; however, the proportion of positive etiological tests increased. Higher attention should be paid to the elderly aged 65 years and older and and farmers, and active screening and health education are recommended; in addition, PTB control requires to be intensified in highly prevalent regions, including Quzhou City, Jinhua City and Lishui City.

Objective To investigate the bladder function in primipara and bipara within 1 week after delivery using urodynamic study.Methods Investigations on urodynamic changes were performed in 36 primipara volunteers and 12 bipara volunteers according to the recommendations of the International Continence Society(ICS).Fourteen women with upper urinary tract diseases but having normal lower urinary tract function,who had not experienced parturation were included as controls.Results Functional bladder volume(FBV)of primipara and bipara after delivery and normal desire cytometric capacity (NDCC)were respectively lower than those of control group(437?193)ml and(338?120)ml,however FBV and NDCC between primipara and bipara(310?154),(215?90)ml vs(243?141),(225?115) ml were not significantly different.The static Pure.max and Pure.clos.max of primipara and bipara were respectively higher than those of control group(87?7)cm H_2O(1 cm H_2O=0.098 kPa)and(78?8) cm H_2O(P

Objective To explore surgical treatment of gliomas involving the motor eloquent area. Methods Twelve cases of gliomas involving precentral gyrus were underwent awake surgery procedures assis- ted with neuronavigation and brain functional mapping by cortical electrical stimulation.Results Eleven ca- ses acquired accurate location of both lesions and eloquent areas by neuronavigation and direct cortical stimula- tion.7 cases of motor cortices and 2 cases of motor speech centers were confirmed during the operation.Re- section,verified by postoperative MRI,was total in 8 cases (66.7%) and subtotal in 4 patients.Histological examination revealed an infiltrative glioma in all cases (8 low grade astrocytomas,2 high grade astrocytomas and 2 glioblastoma).Four patients had no postoperative deficit,while the other 8 patients were impaired, with,in all cases except one,complete recovery in 7 days to one month.Conclusion Direct cortical elec- trical stimulations and awake surgery offer a reliable,precise and safe method,allowing functional mapping es- pecially useful in case of infiltrative cerebral tumors in eloquent areas.This technique allows improvement in the quality of tumoral resection and concurrently a minimization of the risk of definitive postoperative neurologi- cal deficit.

In order to characterize the molecular epidemiology of HFMD-associated Coxsackievirus A6 (CVA6) in Fujian Province, a total of 1340 specimens from non-EV71 non-CVA16 HFMD patients were collected during 2011-2013. Isolated virus strains were identified and subtyped. Full-length coding regions for the VP1 gene of the predominant serotype CVA6 isolates were amplified and sequenced. Among the 375 non-EV71 non-CVA16 HFMD cases confirmed by virus isolation and molecular subtyping, 182 (48.5%) were found to be caused by CVA6, accounting for 7.9%, 16.2% and 39.6% HFMD-associated enteroviruses in FujianProvince during 2011, 2012, and 2013, respectively. Compared with general features observed in the HFMD epidemic, no difference in CVA6-specificity or severity rates was observed between geographical origins, gender, or age groups. Nucleotide sequence analyses of VP1 genes revealed high diversity levels of 16.2%-18.6% among CVA6 strains from Fujian Province, in contrast to the prototype CVA6 strain, and showed low levels of diversity in the amino acid sequences (4.3%-6.2%). Phylogenetic analysis also indicated that CVA6 isolates from Fujian Province were distinct from the prototype strain and other isolates from abroad; however, it was homologous to domestic strains, although the Fujian isolates clustered into multiple branches. These results suggested that significant changes in the pathogenic spectrum of HFMD in Fujian Province occurred during 2011-2013, as CVA6 was one of the predominant serotypes of HFMD. CVA6 isolates from Fujian Province were co-circulating and co-evolving with other domestic strains as multiple closely related CVA6 transmission chains were observed in Fujian Province overall and within each prefecture.
Child ; Child, Preschool ; China ; epidemiology ; Enterovirus A, Human ; classification ; genetics ; isolation & purification ; Evolution, Molecular ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; virology ; Humans ; Infant ; Male ; Molecular Epidemiology ; Molecular Sequence Data ; Phylogeny

OBJECTIVETo explore the predictive value of QT interval dynamicity for sudden death in patients with idiopathic dilated cardiomyopathy (DCM).

METHODSFifty-five patients with DCM (DCM group) and 27 healthy subjects (Control group, Con) were enrolled. Investigations included history collection, clinical examination, echocardiography, electrocardiogram and 24 h ambulatory electrocardiogram. Following indexes were determined: left ventricle end diastolic dimension (LVEDD), left ventricle ejection fraction (LVEF), QT dispersion (QTd), SDNN, the slope of QT/RR plots of the linear regression, ventricular premature beats (VPB) and non-sustained ventricular tachycardia (NSVT). Primary end point for patients with DCM was all cause death.

RESULTSLVEDD, QTd, VPB/24 h, NSVT/24 h, QTe/RR slope and QTp/RR slope were significantly higher while LVEF and SDNN were significantly lower in DCM group than in Con group (all P < 0.05). LVEDD, LVEF, QTd, SDNN, QTe/RR slope and QTp/RR slope were significantly different among DCM sudden death group, DCM non sudden death group and Con group (P < 0.05). LVEF, SDNN, QTe/RR slope and QTp/RR slope were significantly different between DCM sudden death and non sudden death group (P < 0.05). LVEF, QTd, VPB/24 h, QTe/RR slope and QTp/RR slope were significantly different between DCM with NSVT and DCM without NSVT group (P < 0.05). The sudden death rate of DCM patients with QTe/RR slope ≥ 0.210 was significantly higher than DCM patients with QTe/RR slope < 0.210 (54.5% vs. 21.1%, P < 0.05). Sudden death rate of QTp/RR slope ≥ 0.190 was also higher than those < 0.190 (52.2% vs. 21.9%, P < 0.05). The sudden death rate of DCM patients with both LVEF ≤ 35% and NSVT+ was 62.5%. Combining QTe/RR ≥ 0.210 with NSVT+ or LVEF ≤ 35%, the sudden death rates were 62.5% or 66.7%. Combining QTp/RR ≥ 0.190 with NSVT+ or LVEF ≤ 35%, the sudden death rates were 66.7% or 61.5%. Combining QTe/RR ≥ 0.210 or QTp/RR ≥ 0.190 with NVST+ and LVEF ≤ 35%, the sudden death rates were 77.8% or 70.0%.

CONCLUSIONSHigh QT/RR slope is a risk factor for sudden death of DCM patients. QT/RR slope is a useful predictor for sudden death in DCM patients either independently or combined with NSVT or LVEF.

Adult ; Aged ; Aged, 80 and over ; Cardiomyopathy, Dilated ; complications ; diagnosis ; physiopathology ; Case-Control Studies ; Death, Sudden, Cardiac ; etiology ; Electrocardiography, Ambulatory ; Female ; Heart Rate ; Humans ; Long QT Syndrome ; complications ; diagnosis ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Risk Factors

OBJECTIVETo evaluate the initial clinical characteristics, the response to treatment, and the outcome in adult patients with Evans syndrome.

METHODSThe clinical data of 84 adult patients (20 males, 64 females) with Evans syndrome diagnosed at our center between 1984 and 2007 were retrospectively analyzed.

RESULTSThe patients were followed up for a median duration of 17.5 (0.03 - 140) months. All the patients initially received intravenous steroids with or without intravenous immunoglobulin (IVIG). Forty-seven patients were treated with corticosteroids alone initially. Complete remission (CR) and partial remission (PR) were achieved in 38 of the patients, but 92.1% of them relapsed during a median follow-up of 12 months. Twenty-eight patients who were resistant to corticosteroids therapy or with severe bleeding were subsequently administered immunosupressive agents. CR and PR were obtained in 89.3% of them. Within a median follow-up of 8 months, 84% of these patients relapsed.

CONCLUSIONSEvans syndrome is a chronic and easy to recurrent disease, which is often refractory to conventional therapy. Treatment with combination agents might be a useful therapeutic approach to the patients.

Adrenal Cortex Hormones ; Adult ; Anemia, Hemolytic, Autoimmune ; Follow-Up Studies ; Humans ; Remission Induction ; Retrospective Studies ; Treatment Outcome

BACKGROUNDIn recent years, the incidence of unexplained sudden death has risen significantly across the world. However, it occurred suddenly, often in young apparently healthy individuals and almost 50% of the patients did not have any warning signals or symptoms. Therefore, the prodromal symptoms before the incident are extremely important for early prediction of sudden death. In this article, we aimed to explore the value of prodromal symptoms for unexplained sudden death and whether the prodromal symptoms have a predictive function to unexplained sudden death (USD) without underlying diseases.

METHODSA total of 208 sudden death cases were selected for the survey in the Emergency Department of Peking University Third Hospital from January 2006 to December 2009 and their medical records were reviewed. The patients were divided into two groups, 65 patients had underlying diseases while 143 had not underlying diseases. In the meantime, their prodromal symptoms were collected and compared, prodromal symptoms including chest distress, dyspnea, syncope, fever, headache, vomiting, etc.

RESULTSPatients with underlying diseases were compared to those without underlying diseases associated with sudden death; there was no significant difference in gender and age distribution. Among the 208 cases, 39 cases (18.75%) had prodromal symptoms, patients with underlying diseases had prodromal symptoms in 12 cases (18.46%), while patients without underlying diseases had prodromal symptoms in 27 cases (18.88%). The difference between the two groups with prodromal symptoms was not statistically significant (P > 0.05).

CONCLUSIONSProdromal symptoms are extremely important warning signals in the occurrence of USD. It has equally important predictive value for patients both with and without underlying diseases, especially in predicting sudden death caused by cardiopulmonary and neurological diseases.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Death, Sudden ; epidemiology ; etiology ; Female ; Humans ; Male ; Middle Aged ; Prodromal Symptoms

To look for the toxicity fraction of Euphorbia pekinensis and discuss the vinegar processing mechanism. The level of intestinal edema, water content of intestine and stool, IC50 values of IEC-6 were applied to evaluate the toxicity of different fractions. RT-PCR was employed for detecting AQP1, AQP3 mRNA expression. The petroleum ether (PE) fraction and ethyl acetate (EtOAc) fraction could significant cause intestinal edema in mice, increase the water content of duodenum, colon and stool, inhibited the mRNA expression of AQP1 and increased the mRNA level of AQP3 in colon, and the petroleum ether (PE) fraction was more poisonous. After the petroleum ether (PE) fraction was processed with vinegar, the level of intestinal edema, water content of duodenum, colon, stool and inhibition ratio of cells line were reduced. And we compared the composition change after vinegar processing, finding that the conpekinensis.
Acetic Acid ; chemistry ; Animals ; Cell Line ; Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; chemistry ; toxicity ; Euphorbia ; chemistry ; toxicity ; Male ; Mice ; Mice, Inbred ICR ; Molecular Structure