Objective To explore the feasibility of gallbladder mucosal ablation by hysteroscopic rollerball electrocoagulation after cholecystostomy.Methods Under epidural or general anesthesia combined with local anesthesia,20 patients were examined and treated with hysteroscopy after cholecystostomy.After inserting a Storz endoscope,the epithelium of the proximal cystic duct and the mucosa of the gallbladder were ablated with the roller-ball and roller-barrel electrodes respectively.The electrocoagulation power was set at 60-70 W with the roller-barrel excursion rate between 10-15 mm/s,which makes the inner wall of the cyst homogenously brown-grey.Results The mean endoscopic operation time was 35 minutes(range: 25-55).Among the patients,the gallbladder lumen was completely obliterated within one month in 12 patients,and within 3 months in 5;3 patients developed retention cysts.Conclusion Endoscopic electrocoagulation of the cholecystic mucosa is feasible for obliteration of the gallbladder.

Objective To investigate the compliance with medical therapy in elderly patients with benign prostatic hyperplasia (BPH).Methods The BPH patients aged 66 to 93 treated with 5α-reductase inhibitor (finasteride) and/or α-blockers (tamsulosin,doxazosin or terazosin) were followed up for 6 months.The retrospective data,including international prostatic symptom score (IPSS),quality of life (QOL),maximum flow rate (Qmax),prostate volume (PV),the information of medical types,total number of days of medication supplied,discontinuation and switching of therapy,and adverse effects were collected and analyzed.Results In all 103 subjects,30 patients (29.1％) received α-blockers,25 patients (24.3％) received finasteride,and 48 patients (46.6％)received combination therapy.After a follow-up of 6 months,the medication possession ratio (MPR)was 0.89±0.23 with a good-compliance rate (MPR≥0.8),discontinuation rate and switching rate were 79.6％ (82 cases),5.8％ (6 cases) and 6.8％ (7 cases),respectively,while the efficacy rate,the adverse reaction rate,incidence of acute urinary retention (AUR) and incidence of BPH related operations were 73.8％ (76 cases),12.6％ (13 cases),15.5％ (16 cases) and 4.9％ (5 cases),separately.The MPR (0.90±0.24) and good-compliance rate (84.0％) in patients treated with finasteride were both greater than those with α-blockers (0.87 ± 0.25,76.7％) and combination therapy (0.89 ±0.22,79.2％),but with no significant difference.Compared with patients with badcompliance,the efficacy ratio of medical therapy was significant higher in patients with goodcompliance (81.7％ vs.42.9％),while the incidence of adverse effects and AUR were significant fewer (7.3％ vs.33.3％ and 9.8％ vs.38.1％).Conclusions Elderly patients received either monotherapy or combination therapy with finasteride and α-blockers have good-compliance,which might be associated with the good effect of medical therapy and fewer adverse effects.

ObjectiveTo search detecting urine transforming growth factor-β1(TGF-β1) of type 2 diabetes mellitus(DM) in diagnosing early diabetic nephropathy in old patients.MethodsTGF-β1,microalbumin,microglobulin α1 and microglobulin β2 in urine from 53 cases of old type 2 diabetics and 27 cases of normal controls were detected.ResultsTGF-β1 was(21.2±7.32) ng/mmolCr in diabetics whose urine albumin were normal and was(58.79±25.93) ng/mmolCr in diabetics whose urine microalbumin was abnormal(P<0.01).Both were significantly higher than that of the normal control which was(7.79±3.58) ng/mmolCr(P<0.01).TGF-β1 was direct remarkably correlative with microablumin(r=0.5415),microglobulin α1(r=0.6282) and microglobulin β2(r=0.3248)(P<0.01 respectively),but was nothing with glycohemoglobin(r=0.2304,P>0.05).ConclusionTGF-β1 detection may be used as a sensitive and reliable guideline to diagnose early diabetic nephropathy in old diabetics.

Objective To explore the impact of intermittent androgen deprivation therapy on prostate volume and lower urinary tract symptoms (LUTS) in patients with prostate cancer combined with prostatic hyperplasia (BPH),and to evaluate the clinical effect of intermittent androgen deprivation therapy as compared with conventional drug in patients with BPH.Methods Patients with prostate cancer (n=57) and BPH (n=83) were respectively treated with intermittent androgen deprivation therapy and finasteride combined with alpha-receptor antagonist.Prostate volume,international prostate symptom score (IPSS),quality of life index (QOL) and maximum urinary flow rate (Qmax) in patients were observed before and 1,3,6 and 12 months after treatment.Results The improvements in prostate volume,IPSS,QOL and Qmax were higher in prostate cancer patients treated with intermittent androgen deprivation therapy than in BPH patients treated with finasteride combined with alpha-receptor antagonist (P ＜ 0.05).Conclusions Intermittent androgen deprivation therapy can significantly reduce prostate volume and improve LUTS in patients with prostate cancer,and has a better clinical effect than finasteride combined with alpha-receptor antagonist treatment.

OBJECTIVE To investigate the feasibility and application of enzyme-linked bridging assay(ELBA)method to the pharmacokinetic evaluation of antisense strand siRNA drug. METHODS Antisense strand RNAs were diluted in LNCap cell lysates from 5 to 50 000 pmol·L-1 to construct the quantification curves. We transfected the intact double-strand siRNA at a final concentration 100 nmol·L-1 targeting Polo-like kinase into the LNCap cells and investigated the specificity of ELBA quantitating the siRNA antisense strand in cell supernatant,cell lysates and RNA-induced silencing complex( RlSC). Quantification curves were constructed and validated in biological matrices such as plasma (5-25 000 pmol·L-1 )and multiple tissues(liver,heart,spleen,and kidneys)(3-6250 pmol·L-1 ). The prostate specific membrane antigen aptamer siRNA delivery system with the intact siRNA concentration of 15 nmol·kg-1 was prepared. The siRNAs were delivered into the LNCap xenogrant tumor model in C57 mice by tail vein injection. The concentration of siRNA antisense strand was determined in plasma and tissues 30 min post administration by ELBA. RESULTS The quantitative range of antisense strand siRNA in cell lysates was 5-50 000 pmol·L-1 ,and ELBA method could quantify the siRNA antisense strand concentration from cell lysates and RlSC in LNCap cells transfected with double-strand siRNA. ln addition,ELBA could specifically reflect the single antisense strand concentration instead of intact siRNA double strands in plasma. The quantification range of siRNA antisense strand using ELBA in plasma was 5-25 000 pmol·L-1 and 3-3125 pmol·L-1 in tissues. About 30 min post administration of PSMA aptamer-siRNA,the antisense strand of siRNA was distributed mainly to the tumor,liver,kidneys,blood and spleen in sequence. The distribution profile might be attributed to the target delivery and siRNA pharma-codynamics. CONCLUSION The ELBA method is successfully applied to the siRNA antisense strand pharmacokinetic evaluation,which provides an alternative for pharmacokinetic studies of siRNA-based drugs.

ObjectiveTo investigate the risk factors for syncope in children with orthostatic intolerance (OI).Methods The clinical data from 136 children with OI were retrospectively analyzed. The children were divided into syncope group and non-syncope group based on the existence of syncope. Results Among the 136 children, 77 children (56.62%) had syncope and 59 children (43.38%) did not have syncope. The differences in BMI, prevalence of inducement of prolonged standing, prevalence of accompanied symptoms of blurred vision/ blacking out, cold sweating and pallor, prevalence of the history of motion sickness and blood flow velocity of MCA were statistically significant between two groups (P<0.05). Conclusions Children with OI who has low BMI, inducement of prolonged standing, accompanied symptoms of blurred vision/ blacking out, cold sweating and pallor, the history of motion sickness, and fast blood flow velocity of MCA, are prone to syncope.

Objective To evaluate the diagnostic and therapeutic status of lower urinary tract symptoms (LUTS) in the elderly outpatients with benign prostatic hyperplasia (BPH) in Guangzhou.Methods The investigation was conducted in outpatient departments for elderly patients in 3 hospitals of Guangzhou. The eligible male patients with LUTS/BPH were chosen from patients who came to the clinic in the process of investigation. Results The 29.7% (1824/6140) of them had history of LUTS/BPH previously or presently. In 134 patients received medical questionnaire, the proportion of LUTS/BPH patients with mild, middle and severe degree based on international prostate symptom score (IPSS) was 24.5%, 72.5% and 3.0% respectively. The abnormal percentage of PSA was 37. 3 %. The most common examinations that patients received were directeral rectun examination (96.8%), PSA (88. 7%) and transabdominal ultrasonography (84.8%). The 44.7% of cases were given the treatment of 5α-reductase inhibitor, and 24.7% of cases received a combination therapy of 5α-reductase inhibitor plus α receptor blocker. The 16.7% of cases were given a combination treatment of 5α-reductase inhibitor plus herbs. The proportion of therapy with α receptor blocker and herbs was similar (6.8% and 7.1% respectively). Conclusions LUTS/BPH is one of the most common diseases in elderly male patients. The examinations conducted by doctors are unreasonable.The doctors are easy to ignore inquirement of patient's history and IPSS. The drugs conducted by doctors are reasonable basically.

Objective To observe the changes of cerebral blood flow velocities and carbon dioxide (CO_2) reactivity of cerebral vessels in children after cardiopulmonary resuscitation,and the relationship between the changes of cerebral blood flow and outcome.Methods The waveforms,cerebral blood flow velocities of left middle cerebral artery and extracranial internal carotid artery were monitored by Transcranial Doppler (TCD) in 35 post-resuscitation children. Glasgow coma score (GCS) was estimated at the same time.They were divided into three groups according to the diastolic blood flow velocities:low perfusion group,high perfusion group and near-normal perfusion group.CO_2 reactivity of cerebral vessels was induced by hyperventilation in 26 children under ventilation.Results In both low and high perfusion groups,GCS and CO_2 reactivity of cerebral vessels were significantly lower than that of near-normal perfusion group (P＜0.05);the numbers of died and withdrawing treatment patients were significantly higher than that of near-normal perfusion group (P＜0.01).Conclusion TCD monitoring is a useful technique for estimating cerebral perfusion,outcome and CO_2 reactivity of cerebral vessels of children after cardiopulmonary resuscitation.A secondary ischemic event may be caused by a forced hyperventilation therapy in the condition without TCD monitoring in post-resuscitation patients.

Authenticity verification is a very important aspect of medical device registration quality management system verification of medical device. How to verify the authenticity of samples is a problem worth discussing. This study analyzes the methods of authenticity verification from the aspects of product retention sample, registration inspection report, traceability of records, hardware facilities and equipment. In order to provide reference for relevant supervisors and inspectors in the verification of registration quality management system.

Objective: To explore the clinical characteristics of patients with Brucella endocarditis. Methods: The clinical data of 9 patients with Brucella endocarditis admitted to Beijing Ditan Hospital from October 2008 to August 2018 were retrospectively analyzed. Through the electronic medical record system of the hospital. Through assessing the electronic medical record system of the hospital, demographic data, main symptoms, vital signs, blood culture, Rose Bengal Plate Agglutination Test, echocardiography, electrocardiogram, chest imaging and other clinical data of included patients were inquired and recorded. Patients were followed up by telephone for medication, operation and outcome. Results: The 9 patients were all Han nationality, aged from 25 to 66 years, 7 out of 9 patients were male, and they came from Hebei, Shandong, Shanxi, Inner Mongolia and Beijing. Of the 9 patients, 5 were farmers, 2 were self-employed, 1 was a technician, and 1 was unemployed. Of the 9 cases, 8 had a history of close contact with cattle and sheep, and 5 had a history of eating beef and mutton. Rose-Bengal Plate Agglutination Test and blood culture were positive in all 9 patients. Aortic valve was involved in 7 out of 9 patients, mitral and tricuspid valve was involved in 1 patient, respectively, and aortic dissection occurred in 1 patient. Condition of 1 patient rapidly deteriorated after admission and finally died during hospitalization despite antibiotic therapy, the remaining patients received long-term antibiotic treatment. A total of 7 patients who underwent valve replacement were followed up. One patient died of cerebral hemorrhage 6 months after operation, and the remaining 6 patients recovered well after valve replacement. Heart failure occurred in all 9 patients, and pericardial effusion occurred in 8 patients. Electrocardiogram showed low voltage of the QRS complex in the limb in 3 cases and poor R-wave progression in V₁-V₃ lead in 2 cases, and sinus tachycardia in 2 cases. One patient developed non-specific ST-T abnormalities. All patients had fever, 7 patients complained of weakness, and 6 patients complained of palpitations. Among the 9 patients, 7 cases had anemia, 7 patients had pneumonia, 6 had bilateral pleural effusion, 4 had thrombocytopenia. Creatinine was above normal in 4 patients, urine protein was positive in 3 patients, Delta Bilirubin was higher in 3 cases. Conclusions Patients with Brucella endocarditis often suffer from heart failure and have severe complications. Adequate antibiotic therapy in combination with valve replacement is effective for the treatment of patients with Brucella endocarditis.