Adolescent ; Adult ; Child ; Child, Preschool ; Electrocoagulation ; methods ; Female ; Humans ; Hypothermia, Induced ; Male ; Middle Aged ; Prospective Studies ; Tonsillectomy ; methods ; Young Adult

Objective:To investigate the therapeutic effect of carbon dioxide laser tonsillectomy.Method:In this prospective,randomized study, One hundred and two patients were divided into laser group or control group. Patients of laser group were cured with carbon dioxide laser tonsillectom,and the control group was cured with routine method. All operations are executed by one person. Observation index included operation time, hemorrhage in operation, ache after operation, inflammatory reaction of raw surface, repair time of raw surface, rehaemorrhagia and scar.Result:Laser group had advantages of less operation time, less hemorrhage, less ache and less inflammatory reaction of raw surface. Laser group have hemorrhage in operation (7.2±2.1)ml, while control group have hemorrhage in operation (92.0±35.0)ml. Laser group have pseudomembrane early but desquamate late.Conclusion:Carbon dioxide laser tonsillectomy is effective to relieve pain, inflammatory reaction and with less time ,it's an safe , efficient and mini-trauma operation.

Background:Nipple discharge cytology is a simple non-invasive method that may provide valuable information for detecting underlying malignancy.Several studies have investigated the diagnostic value of cytology in breast cancer patients with pathological nipple discharge,but the results have been highly variable.Herein we presented a systematic review and meta-analysis of published studies pertaining to the diagnostic capacity of nipple discharge cytology in patients with breast cancer.Methods:A systematic literature search was performed (Medline/PubMed,Embase,Cochrane Library databases,and Google Scholar) to identify studies that investigated the diagnostic capacity of cytology with regard to breast cancer in patients with pathologic nipple discharge.Two independent researchers identified articles that assessed the sensitivity and specificity of cytological evaluation for breast cancer detection in patients with pathologic nipple discharge published between January 2000 and October 2018.Articles were only included in the meta-analysis if they met predetermined criteria.The characteristics of each study and the data they yielded were summarized.Quality assessment of all articles included was performed using the Methodological Index for Non-randomized Studies Criteria (MINORS) and the Quality Assessment of Diagnostic Accuracy Study 2 (QUADAS-2).Heterogeneity was tested via Cochran Q test and the I2 statistic using Stata 12.0 and Meta-DiSc 1.4 software,and meta-analysis was performed.Results:A total of 286 articles were identified,of which 12 articles including a total of 1476 patients were deemed eligible for inclusion in the meta-analysis.A random-effects model assessing the capacity of nipple discharge cytology to predict breast cancer yielded pooled sensitivity 63％ (95％ confidence interval [CI]:53％-72％),specificity 95％ (95％ CI:87％-98％),positive likelihood ratio 12.35 (95 ％ CI:4.87-31.34),and negative likelihood ratio 0.39 (95 ％ CI:0.30-0.50).The diagnostic odds ratio was 31.88 (95％ CI:11.30-89.98).The area under the summary receiver operating characteristic curve was 0.79 (95％ CI:0.75-0.82).Conclusion:The current meta-analysis suggests that nipple discharge cytology is a useful diagnostic modality for detection of breast cancer in patients with pathological nipple discharge,with moderate sensitivity and high specificity.

OBJECTIVETo investigate the effect of four natures of medicine on therapeutic effect of acupoint sticking therapy.

METHODSSixty-one cases of primary dysmenorrhea were randomly divided into a capsaicin group (n=20), a menthol group (n=20) and a control group (n=21). They were treated respectively with capsaicin and menthol, which are extracts of Lajiao (Fructus Capsici) and Bohe (Herba Menthae) with same pungent in flavor and different cold (cool) and heat in property, and application of Tongjing Jiu Tieji (plaster for dysmenorrhea) at Shenque (CV 8). Changes of clinical symptoms before and after treatment were observed.

RESULTSAfter treatment, the cumulative scores of symptoms and the scores of pain decreased significantly in the 3 groups (P < 0.01), with no significant differences among the 3 groups (P > 0.05).

CONCLUSIONIn acupoint sticking therapy, the four natures of medicine have no obvious effect on the therapeutic effect, so the four natures of medicine should not used as main standard of medicine selection.

Acupuncture Points ; Acupuncture Therapy ; Dysmenorrhea ; therapy ; Hot Temperature ; Humans

Objective To study the level of serum lipids and body-fat content of high-fat diet induced pbesity rats(DIO).explore the relationship between intracellular caleium and ventrieufar arrhythmia.Methods Sixty male Sprague-Dawley(SD)rats were divided into control group(15)and experiment group(45),high-fat diet was administrated for 12 weeks to established obesity model,15 rats were selected into obesity group according to their body weight gain.The standard 2-lead electrocardiograph was used to detect the incidence and scores of arrhythmia induced by barium chloride(BaCl2,0.1 mg/kg)for 1 hour on every 8 rats from different groups respectively.Body-fat content.the level of serum total cholesterol(TC),triglyceride(TG),low density lipopmtein cholesterol (LDL-C) and high density lipopmtein cholesterol (HDL-C)were measured.The epididymal(EP),retroperitoneal (RE) and mesenteric(ME)white adipose pads was measured to obtain the body fat content.Single ventricular myrocytes of rats were isolated by enzymatic dissociation.The confocal laser scanning microscope was used to record basic intraceUular calcium level([Ca2+]i).Results The body-fat content in obesity group[(7.71±0.74)%] was significantly higher than control group[(4.69±0.37)%](t＝3.650,P＜0.05).The level of serum TC,TGand LDL-C were significantly higher(t＝3.801,2.778,3.536.P＜0.05) in obesity group[(1.26±0.04),(0.58±0.10),(0.51±0.04)mmol/L]than those in control group[(0.92±0.08),(0.29+0.03),(0.31±0.04) mmol/L].The level of serum HDL-C wa8 decreased gradually from control group[(0.53±0.05)mmol/L] toobesity group[(0.52±0.02)mmol/L],but there waft no significant difference between them(t＝0.186,P＞0.05).The incidence of arrhythmia induced by BaCl2(0.1 mg/kg)in obesity group was significantly higher than controlgroup(X2＝5.333,P＜0.05),and the scores of arrhythmla was increased in obesity group(2.5±0.6)too.The fluorescence intensity standing for[Ca2+]i was increased significantly(t＝2.409,P＜0.05)from obesity group(247.96±20.03)to control group (174.25±23.13).Conclusion As the free cytosolic calcium begin to accumulate,the arrhythmia morbidity is increased in obesity rats.

Ethnicity ; Forensic Medicine ; Humans ; Polymorphism, Genetic

Background and Objective: Helical tomotherapy (HT) has shown its dosimetric advantages in the radiotherapy for many cancers. To date, no published studies have performed a dosimetric evaluation of whole pelvic radiotherapy (WPRT) using HT for postoperative endometrial cancer. This study was to compare the dosimetric characteristics of HT and step-and-shoot intensity modulated radiation therapy (SaS-IMRT) for endometrial cancer patients undergoing postoperative WPRT,and to explore whether whole pelvic HT for postoperative endometrial cancer has the advantage of dosimetry. Methods: Ten patients with endometrial cancer undergoing postoperative WPRT were enrolled in this study. SaS-IMRT and HT Plans were developed for each patient. The dose distributions of the targets,organs at risk and normal tissue were analyzed and compared. Results: The mean PTV100 were 95.6% and 95.8% (P=0.72) for the SaS-IMRT and HT plans, respectively. The mean homogeneity indexes were 1.10 and 1. 07 (P=0.00). The mean conformity indexes were both 0.87. The mean doses to rectum and bladder for HT were decreased by 1.3 Gy and 3.0 Gy compared with SaS-IMRT, respectively, while the mean dose to pelvic bones was increased by 1.1 Gy. The volumes of small intestine and colon, pelvic bones receiving moderate and low dose also increased. The V_5, V_(10)and V_(20)of normal tissue were increased by 13.0%, 18.0%, and 5.0% (P=0.00). The mean dose to normal tissue was increased by 2.5 Gy (P=0.00).Conclusions: Compared with SaS-IMRT, HT resulted in more homogeneous PTV dose distribution, better sparing of rectum and bladder. The volumes of small intestine and colon, pelvic bones and normal tissue receiving moderate and low dose for HT increased. The clinical significance of the dosimetric differences needs further investigations.

AIMTo assess the psychometric properties of the Chinese Index of Premature Ejaculation (CIPE).

METHODSThe sexual function of 167 patients with and 114 normal controls without premature ejaculation (PE) were evaluated with CIPE. All subjects were married and had regular sexual activity. The CIPE has 10 questions, focusing on libido, erectile function, ejaculatory latency, sexual satisfaction and difficulty in delaying ejaculation, self-confidence and depression. Each question was responded to on a 5 point Likert-type scale. The individual question score and the total scale score were analyzed between the two groups.

RESULTSThere were no significant differences between the age, duration of marriage and educational level (P> 0.05) of patients with and without PE and normal controls. The mean latency of patients with PE and normal controls were 1.6 +/- 1.2 and 10.2 +/- 9.5 minutes, respectively. Significant differences between patients with (26.7 +/- 4.6) PE and normal controls (41.9 +/- 4.0) were observed on the total score of CIPE (P< 0.01). Using binary logistic regression analysis, PE was significantly related to five questions of the original measure. They are the so-called the CIPE-5 and include: ejaculatory latency, sexual satisfaction of patients and sexual partner, difficulty in delaying ejaculation, anxiety and depression. Receiver Operating Characteristic (ROC) curve analysis of CIPE-5 questionnaire indicated that the sensitivity and specificity of CIPE were 97.60 % and 94.74 %, respectively. Employing the total score of CIPE-5, patients with PE could be divided into three groups: mild (>15 point) 19.8 %, moderate (10-14 point) 62.8 % and severe (< 9 point) 16.7 %.

CONCLUSIONThe CIPE-5 is a useful method for the evaluation of sexual function of patients with PE and can be used as a clinical endpoint for clinical trials studying the efficacy of pharmacological intervention.

Adult ; Aged ; Algorithms ; China ; Coitus ; Ejaculation ; Humans ; Logistic Models ; Male ; Middle Aged ; Orgasm ; physiology ; Penile Erection ; physiology ; Psychometrics ; ROC Curve ; Sexual Dysfunction, Physiological ; classification ; diagnosis ; psychology ; Surveys and Questionnaires ; Time Factors

OBJECTIVETo investigate the association between transforming growth factor beta-1 (TGF-beta1) gene polymorphism and chronic allograft nephropathy (CAN).

METHODSFifty patients with failed renal allografts and clinically and histopathologically confirmed CAN were enrolled in this study along with another 50 renal transplant recipients with normal graft function. The DNA extracted from whole blood of the patients was amplified with PCR with sequence-specific primers for determining TGF-beta1 genotypes (position +869, codon 10 and position +915, codon 25). According to documented descriptions, the patients were classified into high and moderate-to-low cytokine production genotypes. The distribution frequencies of high production genotypes was then compared between CAN and non-CAN groups. To eliminate interference in the analysis of the association between TGF-beta1 polymorphism and CAN, other possible risk factors for CAN were screened, including the patients' gender, age, HLA match, delayed graft function, acute rejection, immunosuppressive regimen, cytomegalovirus infection, hypertension, and high cholesterol.

RESULTSCAN patients showed significantly greater proportion of high cytokine production genotype than the non-CAN group [70% (35/50) vs 38% (19/50), Chi(2)=10.306, P=0.001). Of the screened risk factors for CAN, only acute rejection showed some difference between the two groups, but analysis after subgrouping according to acute rejection did not suggest its influence on CAN, which supports the result that the rate of high production genotype was significantly higher in CAN group than in the non-CAN group.

CONCLUSIONMost CAN patients have high TGF-beta1 production genotype, which might be a risk factor for CAN after renal transplantation. TGF-beta1 genotyping can be of value in predicting the risk of CAN after renal transplantation.

Adult ; Female ; Genetic Predisposition to Disease ; Graft Rejection ; genetics ; Humans ; Kidney Diseases ; genetics ; Kidney Transplantation ; adverse effects ; Male ; Middle Aged ; Polymorphism, Genetic ; Risk Factors ; Sequence Analysis, DNA ; Transforming Growth Factor beta1 ; genetics ; Transplantation, Homologous

Objective To summarize the experience of long-term survival in patients after simulta- neous kidney-pancreas transplantation(SKPT)with modified enteric drainage(ED).Methods From October 2001 to July 2004,6 patients with end-stage renal disease due to Type 1 diabetes underwent SKPT with modified ED,ie,side-to-side anastomosis between the duodenum of donors and jejunum of recipients. The medication regimen included:mycophenolic acid 500 mg and tacrolimus 2 mg before operation;methyl- prednisolone(MP)1.0 during operation;and 2-dose anti-IL-2 receptor monoclonal antibody(2 cases)or antihuman thymocyte globulin(ATG)(4 cases)for immune induction therapy;MP was used on the first 3 d after transplantation,triple immunosuppressive therapy(tacrotimus,mycophenolic acid and prednisone)was used on the second d after transplantation.Anticoagulants such as low molecular heparin or alprostadil were used for 7-10 d to prevent thrombosis in pancreas graft.Somatostatin was used as prophylaxis for graft pan- creatitis.Ganciclovir was used to prevent cytomegalovirus infection when renal graft gradually recovered 3 to 5 d after transplantation.The follow-up was from 1 year and 3 months to 4 years and 1 month.Results Transplantation was successful in all 6 cases.The blood sugar levels were 6-16 mmol/L.Low-dose insulin was used for 5-10 d,then the blood sugar levels returned to normal range.One of 6 patients experienced nephrotoxicity because of high tacrolimus blood concentration at 7 d after operation;after 3 dialyses and re- duction of tacrolimus dose,the renal allograft regained normal function.Three cases experienced alimentary tract hemorrhage at 14,20 and 22 d,respectively,after operation;the bleeding was stopped after treatment. There were no complications such as pancreatic fistula,intestinal fistula and thrombosis early after operation. All the patients are now alive,specifically,1 survived over 4 years,3 over 3 years,1 over 2 years,and 1 over 1 year.All had normal blood sugar free of insulin use.Five cases had normal renal graft function,with normal sCr,and 1 had sCr＞400?mol/L. Two cases were admitted to hospital due to upper respiratory infection and furuncles in the skin of head 6 months and 2 years,respectively,after operation.They were both cured.No complications such as urinary infection,metabolic acidosis and dehydration occurred.Conclusions SKPT is effective for the treatment of end-stage renal disease due to Type 1 diabetes.SKPT with modified ED are relatively simple with physiological compatibility and fewer complications.High quality of donated organs, HLA matching,pancreatic drainage pattern,rational periopcrative medications and infection late after trans- plantation are important factors affecting the long-term survival of the patients.