Overactive bladder(OAB) is a clinical syndrome which mainly defined by urinary urgency,and it is mainly diagnosed by clinical manifestations.The pathophysiological mechanisms include detrusor overactive,urethral instability and other neurological or psychiatric factors.Obviously,the dysfunction of detrusor and urethral sphincter can not be diagnosed accurately that consequently affects the treatment significantly by clinical symptoms.Recently,the urodynamic evaluation is recommended for more precise diagnose of OAB.In addition,it has been reported that urinary nerve growth factor and autonomic nervous system function could be used to diagnose OAB in children.The updated techniques diagnosis of OAB in children are summarized in this review.

0.05 ) when two doctors measured the same group patients with the same method. The coefficient of variation of IVRTd was bigger than that of IVRTm when two doctors measured the same group patients with two different methods. In four sets of data, three ones showed significant difference(P

Objective To evaluate the technique of finger palpation in thoracoscopic localization in patients with pulmonary nodules,and to summarize its technical details,especially with exploit of chest computed tomography (CT) facilitating it.Methods 95 patients with total amount of 109 pulmonary nodes 20 mm or smaller in size shown with lung window of CT,were reviewed.They were located subpleurally,with a median depth of 8.2 mm and a median size of 10.0 mm.The value of their depth over their size (D/d value) could be used as the extent of localizing difficulty.Each node had its own radiographic fealures for being localized,which was built preoperatively.Under thoracoscopic vision,nodules were finger-palpated by index finger via the 4th or 5th intercostal space on anterior axillary line,followed by wedgectomy or lobectomy for instant histopathological diagnosis to further decide the final surgical type.The distance between the nodule and the origin of segmental bronchus (L value) were also calculated out,as it might be relevant to the way the nodule could be biopsied.Results All nodules were successfully localized and resected for biopsy goal,105 by wedgectomy,4 by lobectomy.After intraoperative diagnosis was made by the pathologist,VATS lobectomy and lymph node dissection were further performed in 55 patients.L value of 4 cases being biopsied by lobectomy ranged from 18.3 to 30.3 mm,averaging 26.1 mm.Conclusion Finger palpation is viable in any cases of pulmonary nodules.Detailed reference of CT digital information,and enough detachment of mediastinal pleura,can greatly facilitate thoracoscopic localization by finger palpation.Lobectomy or segementectomy is preferable when L value is less than 30 mm.

Objective No related training experience, no systematic training before military training, psychological negative emotions(tension and anxiety) and low frequency of physical activities(less than three times a week) have been considered as crucial risk factors of high intensive military training induced acute kidney injury.This paper aims to discuss whether these risk factors can be used for screening high risk groups.Methods Soldiers were divided into 5 groups based on the questionnaire survey:Group1 had no risk factor, Group2 had 1 risk factor, Group3 had 2 risk factors, Group4 had 3 risk factors, and Group5 had 4 risk factors.Urine samples were collected after 6 h and 24 h of 5 km armed military training.Kidney injury indicators were compared such as urine protein, urine occult blood test, urine micro-albumin ( mALB) , urine N-acetyl-β-D-glucosaminidase( NAG) among different groups.Results As the risk factors increased, the incidence of positive urinary protein 6 h after training increased (x2 =101.8,P<0.001),and the levels of mALB and NAG of urine samples were elevated as well.The analysis among moderate and high risk groups(Group3-5) showed that the levels of mALB and NAG of urine samples 24 h after training increased with the number of risk factors.The mean value of these injury indicators reached to the maximum in Group 5.Conclusion No related training experience, no systematic training before military training, psychological negative emotions( tension and anxiety) and low frequency of physical activi-ties(less than three times a week) are independent risk factors of high intensive military training induced acute kidney inju-ry,which can be used for screening high risk individuals during training.

Objective To investigate the current situation of healthcare-associated infection(HAI)organization management systems in primary medical institutions.Methods 95 primary medical institutions in 5 provinces (au-tonomous regions,municipalities)in China were investigated.Results Of 95 primary medical institutions,82 (86.32%)established HAI management groups,65 (68.42%)set up antimicrobial management departments,87 (91.58%)assigned professionals for antimicrobial management.Before 2010,only 26 antimicrobial management departments were set up,which increased to 65(68.42%)in 2015.Hospitals established rules and regulations on medical waste management (n=93,97.89%),disinfection and sterilization(n = 87,91.58%),disposable sterile medical device (n=87,91.58%),HAI prevention and control measures (n=79,83.16%),occupational health and safety protection for health care workers(n=76,80.00%),outbreak reporting system (n=73,76.84%),hand hygiene (n=69,72.63%),and monitoring on HAI (n=56,58.95%).Conclusion Current situation of HAI or-ganization management systems in primary medical institutions needs to be improved,health administrative depart-ments should strengthen supervision to improve the level of HAI prevention and control.

Objective To investigate the current situation and existing problems of healthcare-associated infection (HAI)management in primary medical institutions in Henan Province.Methods 36 primary medical institutions in 18 regions were investigated with random sampling method,development of HAI management in primary medical institutions before and after 2013 were compared.Results Among 36 primary medical institutions,31 (86.11 %) had cleaning,disinfection,sterilization,and isolation systems,13 (36.11 %)implemented HAI monitoring system, 31 (86.11 %)performed regular training on hand hygiene knowledge,6 (16.67%)allocated antimicrobial manage-ment professionals.The development rates in HAI management group,hand hygiene system,training on related knowledge among staff,HAI monitoring,and antimicrobial management in 36 primary medical institutions before 2013 were all lower than those after 2013 (41 .67% VS 75.00%;2.78% VS 30.56%;22.22% VS 69.44%;5.56%VS 33.33%;25.00% VS 66.67%,all P <0.05).Conclusion HAI management level in primary medical institu-tions has improved than before,but deficiencies still exists and needs further improvement.

Objective Endothelial dysfunction is an important link in the development of coronary heart disease. The article aimed to evaluate reactive hyperemia index(RHI) level in patients with unstable angina pectoris(UAP) complicating diabetes mellitus(DM) and investigate its relationship with the degree of coronary artery stenosis. Methods TThe patients(n=300) diagnosed as UAP by coronary angiography (CAG) in our department were chosen and divided into DM group (UAP complicating DM, n=122) and NDM group(without DM, n=178). The severity of coronary artery stenosis was evaluated using the angiographic Gensini score. RHI levels were compared between two groups. Multiple linear regression analysis was used to analyze the correlations between RHI, angiographic Gensini score and risk factors. Results RHI level of DM group was found to be lower than that of NDM group(1.58±0.39 vs 1.70±0.24,P<0.05). Angiographic Gensini score was significantly elevated in DM group compared to NDM group[Gensini score:(61.76±64.79) vs (37.00±29.79),P<0.05]. The RHI levels of patients with Gensini scores of 31-59 points(1.64±0.28)and above 60 points (1.58±0.32) were significantly lower than those with scores less than 30 points (1.78±0.23) (P<0.05). The RHI level of patients with coronary heart disease(CHD) with three or more risk factors (1.49±0.43) was significantly lower than that of CHD patients with two or less risk factors (1.63±0.29) (P<0.05). Fasting blood glucose, glycosylated hemoglobin, coronary Gensini score, smoking and risk factors in the combined group were all negatively correlated with RHI(β=-0.010；-0.001；-0.177；-0.126；-0.001). Conclusion Gensini integrals are closely co-related to the degree of endothelial dysfunction, and severe endothelial dysfunction may be one cause of exacerbated coronary stenosis in the patients with UAP complicating DM.

OBJECTIVETo compare the efficacy of intracoronary administration of combined high-dose adenosine and tirofiban versus intracoronary tirofiban during primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction.

METHODSConsecutive 258 patients with acute ST-segment elevation myocardial infarction (STEMI) underwent primary PCI, treated with thrombus aspiration and then intracoronary tirofiban, were randomly divided into adenosine group (n = 130) and control group (n = 128). Adenosine group received 2 times intracoronary adenosine (2 mg) after thrombus aspiration and after stenting of the infarct-related artery through the aspiration catheter. Control group received placebo. The primary end point was myocardial blush grade (MBG) after PCI. Secondary end points were thrombolysis in myocardial infarction (TIMI) flow grade and corrected TIMI frame count (CTFC) after PCI, ST-segment elevation resolution (STR), and major adverse cardiac events (MACE) at 30 days and 12 months.

RESULTSTIMI flow grade post PCI did not differ between the 2 groups, while CTFC favored the adenosine-treated patients [(21.6 ± 6.5) frames] compared with the placebo-treated patients [(25.1 ± 7.8) frames, P = 0.001]. MBG 3 was more frequently observed in the adenosine compared to the control group [45.1% (55/122) vs.32.0% (39/122), P = 0.035]. Patients in the adenosine group had a trend of higher rate of compete STR after the procedure compared patients in the control group [53.6% (67/125) vs. 41.9% (52/124), P = 0.065]. The incidence of MACE was comparable between patients randomized to adenosine and placebo at 30 days [12.3% (16/130) vs. 17.2% (22/128), P = 0.295] and at 12 months [12.3% (16/130) vs. 18.0% (23/128), P = 0.227].

CONCLUSIONIntracoronary administration of high-dose adenosine combined with tirofiban provides further improvement on myocardial perfusion after primary PCI but does not affect the clinical outcomes in patients with STEMI.

Adenosine ; therapeutic use ; Aged ; Angioplasty, Balloon, Coronary ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Percutaneous Coronary Intervention ; Platelet Aggregation Inhibitors ; therapeutic use ; Tyrosine ; analogs & derivatives ; therapeutic use

Aim To clarify the effect of circulating exosomes on hypertension, screen out miRNAs which plays a key role, and explore its function.Methods The plasma exosomes of spontaneously hypertensive rats were extracted and injected into Sprague Dawley rats.The blood pressure changes of rats were detected.Plasma exosomes and exosomal RNA of hypertensive patients and SHR were extracted.Real time PCR was used to verify the expression changes of the selected 8 miRNAs; Western blot was used to detect the expression changes of LKB1 and PTEN protein levels in human umbilical vein endothelial cells transfected with miR-17-5p mimics.Results The plasma exosomes of SHRs significantly increased the blood pressure of SD rats(P<0.05).The expression of miR-17-5p and miR-218-5p in the plasma exosomes of hypertensive patients and SHRs both significantly increased.miR-17-5p inhibitors significantly attenuated the effect of SHR-exos on raising blood pressure.miR-17-5p mimics down-regulated the expression of LKB1 and PTEN in HUVECs cultured in vitro.Conclusions The plasma exosomes of SHR can significantly increase blood pressure of Sprague Dawley rats.miR-17-5p may be the key miRNA.exo-miR-17-5p may promote the occurrence and development of hypertension by regulating the LKB1/PTEN signal.

Objective To improve our knowledge of primary benign tracheobronchial tumors and increase the early diagnosis rate. Method The clinical and imaging features of 22 patients with benign tracheobronchial tumors were retrospectively analyzed. The lesions were surgically or pathologically confirmed as schwannomas(n=2),lipomas(n=3),hamartomas(n=3),leiomyomas(n=9),inflammatory myofibroblastoma(n=1),and pleomorphic adenomas(n=2).The early symptoms were concealed and atypical,accompanied by misdiagnoses at different time points.The tumors were located at trachea in 5 patients and at bronchus in 17 patients.All lesions manifested as intraluminal growth with mild to moderate enhancement,without thickening of the tracheobronchial wall.They had smooth margins and wide basements.The lesions were cast-shaped and occluded the lumen in 3 cases;in the remaining 19 cases,the lesions appeared as round or oval nodules. Conclusions Primary benign tracheobronchial tumors are rare.Patients with repeated cough and expectoration that respond poorly to treatment should be screened for benign tracheobronchial tumors.On CT,the benign tracheobronchial tumors are small intraluminal nodules with the smooth surface and wide basement,without thickening of the wall.
Bronchi ; diagnostic imaging ; pathology ; Bronchial Neoplasms ; diagnostic imaging ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed ; Trachea ; diagnostic imaging ; pathology