Objective:To investigate the current status of chronic respiratory disease (chronic obstructive pulmary disease, bronchial asthma and obstructive sleep apnea) management capacity in community health centers in Beijing Miyun district.Methods:From November 21 to 22,2018,nineteen community health centers and 65 general practitioners in Miyun district of Beijing were selected to participate in a questionnaire survey. The self-designed questionnaire was divided into two parts: the questionnaire for medical institutions(institution questionnaire)and questionnaire for general practitioners(doctor questionnaire). The institution questionnaires were distributed by the Miyun District Health Commission,and filled in by the person in charge of the institution; the knowledge questionnaires were sent to all general practitioners of 4 community health service centers. The two independent sample t test was used to compare the measurement data in accordance with normal distribution between the two groups, and analysis of variance was used for multi group comparison. Results:Nineteen institution questionnaires were sent to all centers in the district and all 19 valid questionnaires were recovered. Among them, 18 centers thought that chronic respiratory diseases should be included in the management of chronic non-communicable diseases, and health records should be established to achieve regular follow-up monitoring, but only one center had put asthma in the record. Nine centers purchased pulmonary function instrument; 8 centers were equipped with inhaled glucocorticoid, and 1 center was equipped with β 2-receptor agonists. The effective recovery rate of knowledge questionnaire was 100.0% (65/65). There was no significant difference in the knowledge scores of three kinds of chronic respiratory diseases (chronic obstructive pulmary disease, bronchial asthma, obstructive sleep apnea) among general practitioners [(63±19), (64±23), (62±21), F=0.087, P>0.05]. The scores of general practitioners with different ages and professional titles were (57±15), (66±13), (42±16) and (54±19), (67±12), (68±11) respectively. There were significant differences in the knowledge scores of general practitioners with different ages and professional titles ( F= 8.582 and 6.079, all P<0.05). The average scores of general practitioners with age>50 years or junior professional title were lower than others. Conclusions:The leaders of each center in Miyun district have a clear understanding of the necessity of diagnosis and treatment of chronic respiratory diseases, but there are still some problems, such as insufficient attention to chronic respiratory system, insufficient investment in disease management infrastructure, and lack of professional knowledge of chronic respiratory diseases among general practitioners. It is hoped that in the future, chronic respiratory diseases can be introduced into public health service projects, investment in related disease infrastructure will be strengthened, and comprehensive respiratory knowledge and ability training courses suitable for grass-roots general practitioners can be popularized as soon as possible.

OBJECTIVE: Anatomic variation of renal artery existed in donor kidney, and whether the variation would affect clinical effects is unconfirmed. This paper is aimed to study the outcomes of in vitro reconstruction of malformed renal blood vessels on outcome of kidney transplantation. METHODS: Patients treated with kidney transplantation at Department of Urology, Lanzhou General Hospital of Chinese PLA were selected; including 27 cases underwent kidney transplantation with malformed blood vessels. Seventeen of them had accessory renal artery, 10 of them with two or three renal arteries. Additional 22 patients transplanted with normal kidney during the same period were selected as the control group. Bench surgery with microsurgical techniques was employed for the repair of the vessels, which included 11 cases of end to end anastomosis of arteries, 6 cases of end to side anastomosis of arteries, 6 cases of side to side conjoined anastomosis of arteries, and 4 cases of renal artery lengthening with an interposition of donor or recipient iliac artery. The hemorrhage, hypertension, renal arterial stenosis, delayed graft function, incidence rate of acute rejection, and the serum creatinine level were followed up.RESULTS: Totally 49 cases were received a mean 2-year follow-up, and no death occurred in both groups. Two cases in the experimental group, and 3 cases in the control group were suffered hypertension or hypertension aggravated, the difference had no significant (P =0.673). No arterial stenosis occurred during the follow up. In the experimental and control groups, the incidence of delayed graft function was 20% and 14%, the incidence of acute rejection was 13% and 5%, and mean serum creatinine at 2 year was (119±11) and (127±8) μmol/L, respectively, the difference was not significant between two groups (P=0.179, 0.385, 0.658).CONCLUSION: Donor kidneys with malformed vascular can be used for transplantation after bench reconstruction, which do not influence the outcome of kidney transplantation.

No abstract available.
Abscess*

A case of histiocytosis X with the involvement of pituitary stalk in a 5 year old boy was described. He presented with diabetes insipidus and the endocrinological study showed growth hormone deficiency. On computerized tomography and magnetic resonance imaging, the pituitary stalk was abnormally thick. Overlooking of the skull lesion on plain X-ray film led to an erroneous diagnosis of germ cell tumor'. Gross total removal of the lesion and chemotherapy were performed. In the differential diagnosis of suprasellar masses, this disease entity should be included. The importance of histological diagnosis of the infundibular lesion in cases of central diabetes insipidus is also emphasized.
Child, Preschool ; Diabetes Insipidus ; Diabetes Insipidus, Neurogenic ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Germ Cells ; Growth Hormone ; Histiocytosis* ; Histiocytosis, Langerhans-Cell* ; Humans ; Magnetic Resonance Imaging ; Male ; Pituitary Gland* ; Skull ; X-Ray Film

Patent ductus arteriosus (PDA) is one of the most common congenital heart diseases. A rare complication occurring after its surgical treatment is the development of an aneurysm, and we report the radiologic findings in a case in which this occurred after surgical ligation.
Aneurysm* ; Ductus Arteriosus, Patent* ; Heart Diseases ; Ligation*

In order to investigate electrolyte changes in serum and urine diuretic therapy, we studied 98 patients with hypertension not optimally controlled by previous treatment. After we divied the patients into three gorups in randomized trial, group A were given Amiloride 10mg/day, group B were given Dihydrochlorothiazide 50mg/day, group C were given Amiloride 5mg/day combined with Dihydrochlorothiazide 25mg/day for 7 days. Blood pressure and electrolyte changes in serum and urine after diuretic theraphy for 7 days were as follows. 1) Serum sodium concentrations were not significantly changed in all three groups(P>0.05). 2) Serum potassium concentrations were increased in group A and C (P<0.05), but there were no significant changes in group B(P<0.05). 3) Urinary sodium exceretions were increased in all three groups(P<0.05). 4) Urinary potassium excretion were decreased in group A and C (P<0.05), but there were increased in group B (P<0.05). 5) Blood pressure were decreased in all three groups(P<0.05).
Amiloride ; Blood Pressure ; Diuretics* ; Electrolytes* ; Humans ; Hydrochlorothiazide ; Hypertension* ; Potassium ; Sodium

A 28-year-old female with a 1-year history of ketamine abuse developed ketamine-associated urinary symptoms that were refractory to conservative treatment after the complete cessation of ketamine use. Smooth voiding with increased bladder capacity and minimal postvoid residual urine volume were achieved by performing an augmentation enterocystoplasty. An uneventful pregnancy with the vaginal delivery of a healthy baby occurred postoperatively.
Adult ; Cystitis* ; Delivery, Obstetric ; Female ; Humans ; Ketamine* ; Pregnancy* ; Urinary Bladder

PURPOSE: The urinary bladder (UB) is innervated by both sensory and autonomic nerves. Recent studies have shown that sensory neuropeptides induced contractions in the detrusor muscle. Therefore, in a mouse model, we investigated the presence of interactions between the submucosal sensory nerves and the autonomic nerves that regulate the motor function of the detrusor muscle. METHODS: UB samples from male C57BL/6 mice were isolated, cut into strips, and mounted in an organ bath. Dose-response curves to norepinephrine and phenylephrine were studied in UB strips with and without mucosa, and the effects of preincubation with a receptor antagonist and various drugs on relaxation were also studied using tissue bath myography. RESULTS: Phenylephrine-induced relaxation of the UB strips showed concentration-related effects. This relaxation appeared in both mucosa-intact and mucosa-denuded UB strips, and was significantly inhibited by lidocaine, silodosin, and guanethidine (an adrenergic neuronal blocker). Meanwhile, phenylephrine-induced relaxation was inhibited by pretreatment with propranolol and calcitonin gene-related peptide (CGRP)–depletory capsaicin in UB strips with and without mucosa. CONCLUSIONS: The present study suggests that phenylephrine activates the α-1A adrenergic receptor (AR) of the sensory nerve, and then activates capsaicin-sensitive sensory nerves to release an unknown substance that facilitates the release of norepinephrine from adrenergic nerves. Subsequently, norepinephrine stimulates β-ARs in the detrusor muscle in mice, leading to neurogenic relaxation of the UB. Further animal and human studies are required to prove this concept and to validate its clinical usefulness.
Adrenergic Neurons ; Animals ; Autonomic Pathways ; Baths ; Calcitonin Gene-Related Peptide ; Capsaicin ; Guanethidine ; Humans ; Lidocaine ; Male ; Mice ; Mucous Membrane ; Myography ; Neuropeptides ; Norepinephrine ; Phenylephrine ; Propranolol ; Receptors, Adrenergic ; Receptors, Adrenergic, alpha-1 ; Relaxation ; Urinary Bladder*

Background/Aims: Hypopharyngeal multichannel intraluminal impedance-pH (HMII-pH) technology incorporating 2 trans-upper esophageal sphincter impedance channels has been developed to detect pharyngeal reflux. We used the HMII-pH technique to validate the candidate pharyngeal acid reflux (PAR) episodes based on the dual-pH tracings and determined the interobserver reproducibility. Methods: We conducted a cross-sectional study in tertiary centers in Taiwan. Ninety patients with suspected laryngopharyngeal reflux and 28 healthy volunteers underwent HMII-pH test when off acid suppressants. Candidate PAR episodes were characterized by pharyngeal pH drops of at least 2 units and reaching a nadir pH of 5 within 30 seconds during esophageal acidification. Two experts manually independently identified candidate PAR episodes based on the dual-pH tracings. By reviewing the HMII-pH tracings, HMII-pH-proven PAR episodes were subsequently confirmed. The consensus reviews of HMII-pH-proven PAR episodes were considered to be the reference standard diagnosis. The interobserver reproducibility was assessed. Results: A total of 105 candidate PAR episodes were identified. Among them 84 (80.0%; 95% CI, 71.0-87.0%) were HMII-pH-proven PAR episodes (82 in 16 patients and 2 in 1 healthy subject). Patients tended to have more HMII-pH-proven PAR episodes than healthy controls (median and percentile values [25th, 75th, and 95th percentiles]: 0 [0, 0, 3] vs 0 [0, 0, 0], P = 0.067). The concordance rate in diagnosing HMII-pH-proven PAR episodes between 2 independent observers was 92.2%. Conclusion Our preliminary data showed that 80.0% (71.0-87.0%) of the proposed candidate PAR episodes were HMII-pH-proven PAR episodes, among which the interobserver reproducibility was good.

PURPOSE: To evaluate the lung changes in healthy smokers, as seen on inspiratory and expiratoryhigh-resolution computed tomography (HRCT). MATERIAL AND METHODS: Twenty-seven healthy smokers (light smokers,below 20 pack-years, n=16; heavy smokers, above 20 pack-years, n=11) and 25 nonsmokers underwent inspiratory andexpiratory HRCT. All healthy smokers had normal pulmonary function and chest radiography. Parenchymal andsubpleural micronodules, ground-glass attenuation, centrilobular and paraseptal emphysema, bronchial wallthickening, bronchiectasis and septal line were evalvated on inspiratory scan and by air-trapping on expiratoryscan. RESULTS: On inspiratory scan, parenchymal micronodules were observed in one of 25 nonsmokers(4%), two of 16light smokers(13%) and five of 11 heavy smokers(45%); subpleural micronodules in two(8%), four(25%), two(18%);ground-glass attenuation in 0(0%), one(6%), three(27%); centrilobular emphysema in 0(0%), one(6%), three(27%);paraseptal emphysema in three(12%), 0(0%), five(45%); bronchial wall thickening in 0(0%), two(13%), one(9%),bronchiectasis in 0(0%), one(6%) two(18%) and septal line in one(4%), four(25%), two(18%). On expiratory scan,air-trapping was detected in 0 of 15 nonsmokers(0%), two of 17 light smokers(12%), and five of 11 heavysmokers(45%). Statistically significant differences between these three groups were found in parenchymalmicronodules(P=0.006), ground-glass attenuation(P=0.008), centrilobular emphysema(P=0.018), paraseptal emphysema(P=0.005) and air-trapping(P=0.013) between these three groups. CONCLUSION: According to the findings of HRCT,heavy smokers had higher frequency of parenchymal micronodules, ground-glass attenuation, centrilobular andparaseptal emphysema, and air-trapping than nonsmokers and light smokers.
Bronchiectasis ; Bronchiolitis ; Emphysema ; Lung* ; Pulmonary Emphysema ; Radiography ; Thorax