Objective To investigate the changes of serum vascular endothelial growth factor (VEGF) and its effects on pathoge nesis in children with Henoch - Schonlein purpura(HSP). Methods Serum VEGF was detected by sandwich ELISA in 20 children with HSP in acute phase and 15 children in remission phase and 16 normal children. Results The serum VEGF levels in children with HSP in acute phase(533.85? 127.63) ng/L were significantly higher than those in remission phase (160.47 ? 37.39) ng/L and normal control (68. 93 ? 19. 16) ng/L. One - way analysis of variance between them was significant difference ( F = 158. 86 P

Objective:To assesss the effectiveness of dapoxetine in the treatment of premature ejaculation.Methods:Both English and Chinese studies involving men with prematrue ejaculation who were treated with dapoxetine from the Cochrane Library,MEDLINE,EMBASE and CNKI,CBM,VIP between 1979 and 2009.were included in the randomized controlled trials(RCTs) and the data processed by RevMan.Results:Five RCTs involving 4433 patients were included in the Meta analysis,of which 3 were of grade A and 2 were of grade B according to the quality evaluation of methodology.Intravaginal ejaculatory latency time(IELT),patient-reported global impression of change(PGI),satisfaction with sexual intercourse(SWSI),perceived control over ejaculation(PCOE),personal distress related to ejaculation(PDRE) were used for assessment.Meta analysis based on included studies of patients having been treated with dapoxetine for 9-24 weeks showed that:(1) the difference of the patients' IELT between treatment group and control group was statistically significan [P

Objective Serum glycated albumin (GA) is associated with the levels of blood glucose and short term glycemic fluctuation. The aim of this study was to investigate the associations between GA and arterial stiffness in a health screening population. Method A total of 11 014 participants (men, 56.2%;mean age, 46.8±7.8 years) who attended physical examination were invited and had completed standardized questionnaires. Serum GA and homocysteine (HCY), brachial-ankle pulse wave velocity (baPWV), and central systolic blood pressure (cSBP) were measured. A series of single and multiple factor analyses and stratified analysis were performed. Result The mean level of serum GA was lower in men (13.69 ± 2.69) than in women (13.82 ± 1.92) (t=2.78, P=0.005). The values of baPWV (men: F=53.9, P for trend<0.001;women:F=37.7, P for trend<0.001) and cSBP (men:F=10.3, P for trend<0.001;women:F=13.5, P for trend<0.001) increased with quartiles of GA levels in both men and women. After adjustment for age, history of hypertension, diabetes, family history of diabetes, smoking status, body mass index, waist circumference, blood pressure, blood lipids, kidney function, fasting glucose, postprandial glucose, and hemoglobin A1c, GA was positively associated with baPWV (βestimate, 0.019;95%CI:0.002-0.036;P=0.032) and cSBP (βestimate, 0.251; 95% CI: 0.107-0.394; P=0.001) in men. Stratified analysis also showed that the positive associations of GA with baPWV and cSBP remained significant in men both with and without diabetes or hypertension (P<0.05). However, the association between GA and HCY was not significant in multifactor analysis and stratified analysis. The above results were similar in women. Conclusion Serum GA levels were positively associated with baPWV and cSBP not only in patients with diabetes or hypertension but also in participants without diabetes or hypertension after adjusting for conventional factors and glucose markers. The findings suggest that GA may help detect the development of arterial stiffness in the health screening population.

Objective To investigate the pathological and physiopathological difference between the ruptured” and the “degenerated” typed lumbar disc herniation (RDH and DDH) by measurement of the pressure of the herniated lumbar disc both in the herniated site and in the nucleus pulposus during the surgery, combined with the clinical,light microscopical and immunohistochemical properties. Methods Fifty seven cases of lumbar disc herniation undergone operation in the Tianjin Medical University Hospital were included in this study. The patients were divided into 2 groups. 1) Rupture typed lumbar disc herniation in which the herniated chip of the lumbar disc separated from the parent disc and was squeesed or drew out easily when the superficial posterior longitudenal ligament and anulus fibrosis were opened in the herniated site. 2) Degenerated typed lumber disc herniation in which no herniated chip of the lumber disc escaped; the herniated material can not be taken out unless the disc was resected by the instrument. Before the herniated disc was incised, the intervertebral disc pressure was measured using GENERAA710 multifunctional monitor. Both the light microscopical and the immunohistochemical difference between the RDH and the DDH was studied. Results 1) In the herniated site, the pressure in the RDH is higher than that in the DDH(P0.05). 3) In the RDH, the pressure in the herniated site is higher than that in the nucleus pulposus (P0.05). 5) The“lumbar pain score”and the pressure have obviously relationship in all of 35 patients(r=0.539,P

OBJECTIVETo sum up the experience in diagnosis and treatment of Fournier's gangrene and find an optimal evaluation tool for its prognosis by comparing currently used prognostic scoring systems.

METHODSWe retrospectively analyzed 16 cases of Fournier's gangrene diagnosed and surgically treated in our hospital between 2004 and 2012. Using Fournier's Gangrene Severity Index (FGSI), Uludag Fournier's Gangrene Severity Index (UFGSI), Age-Adjusted Charlson Comorbidity Index (ACCI), and Surgical Apgar Score (sAPGAR) , we obtained the prognostic scores of the patients and made comparisons among different scoring systems.

RESULTSFGSI, UFGSI, ACCI, and sAPGAR were all clinically used scoring systems. Statistically significant differences were found in the scores of ACCI and UFGSI but not in those of FGSI and sAPGAR between the death and survival groups, with the maximum area under the ROC curve and minimum standard error for the ACCI score.

CONCLUSIONBoth ACCI and UFGSI are useful for evaluating the prognosis of Fournier's gangrene. However, ACCI is even better for its higher sensitivity and specificity and easier clinical collection.

Age Factors ; Aged ; Fournier Gangrene ; diagnosis ; mortality ; surgery ; Humans ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Severity of Illness Index

0.05). CONCLUSION The secar of oropharynx can be regarded as a predictive index for OSAHS severity and guideline for operation, but the change of secar after operation can not be used as a predicitive index for therapeutic effectiveness.

Objective To definite the correlation of hip muscle density with proximal femoral fracture in the elderly.Methods The study included 41 proximal femoral fracture cases [14 males and 27 females,at age of (64.1 ±5.1)years] and 14 normal cases [4 males and 10 females,at age of (64.8 ± 3.9) years] that underwent CT examination for hip joint.In fracture group,19 cases sustained femoral neck fracture and 22 intertrochanteric fracture.CT imaging data were reviewed to analyze the correlation of age with hip muscle density at the level of ischium tubercle.Hip muscle density was compared between fracture side and healthy side in fracture group and between control group and fracture group.Results Hip muscle density showed a downward trend with increased age (P ＜ 0.05).Hip muscle density did not differ significantly between fracture side and healthy side in fracture group (P ＞ 0.05).Regardless of age,gender and other factors,hip anterior muscle density [(34.8 ± 4.1) Hu] and posterior muscle density [(22.1 ±5.5) Hu] were lower in fracture group than in control group [(44.4 ±5.7)Hu,(39.2 ±5.3)Hu respectively,P ＜ 0.05] but there was no significant difference in hip medial muscle density between the two groups (P ＞ 0.05).Conclusions Hip muscle density decreases with age and has no strong correlation with fracture.Deadline of the hip muscle density may be a risk factor to proximal femoral fracture in the elderly.

ObjectiveTo evaluate the intermediate term efficacy of posterior stabilized (PS) total knee arthroplasty(TKA) and posterior cruciate-retaining(CR) TKA and explore the clinical related problem.MethodsThe clinical data of 84 patients (87 knees) who treated with primary TKA from May 1992 to May 2006 were analyzed retrospectively.The intermediate term efficacy was compared between PS TKA (PS group,41 cases with 43 knees) and CR TKA (CR group,43 cases with 44 knees).ResultsAll the patients were followed up for 5-10(7.6 ± 1.5 ) years,no infection,dislocation or neurovascular injury occurred in both groups.But 1 knee occurred intraoperative posterolateral femoral condyle fracture in PS group.The lateral retinacular release rate was 2.3％ ( 1/43 ) and 2.3％ (1/44) in PS group and CR group,respectively.The incidence of anterior knee pain was 4.7％(2/43 ) and 4.5％(2/44) after 6 months surgery in PS group and CR group.The incidence of anterior knee pain was 0 at the end of follow-up in both groups.There was no significant difference in the lateral retinacular release rate and the incidence of anterior knee pain between two groups (P ＞0.05).The range of motion and American knee society score(KSS) was similar and no statistical difference was found between two groups(P ＞ 0.05 ).The incidence of patellar tilt or subluxation in X-ray was 2.3％ (1/43) and 2.3％ (1/44) at the end of follow-up in PS group and CR group.There was no significant difference between two groups (P ＞ 0.05 ).At the end of follow-up,no osteolysis,X-ray radiolucent zone and prosthesis loosening were found in both groups.There was no revision owing to loosening or other reasons.ConclusionsThe intermediate term efficacy of PS TKA and CR TKA is near a tie.However,the future efficacy still need further follow-up.

Myeloid-derived suppressor cells (MDSCs) are a heterogeneous group of immunosuppressive cells derived from bone marrow stem cells.MDSCs can not only strongly inhibit the anti-tumor immune reactions mediated by T cells,but also directly accelerate angiogenesis,tumor progression and metastasis.Nonresolving inflammation (NRI),a major driving factor in the occurrence and development of tumor,and MDSCs are present in tumor microenvironment and become hot topics in recent years.However,the relationships between MDSCs and NRI,especially in the relevant molecular regulatory networks,have not been fully elucidated.The relationships between MDSCs and NRI,the molecular regulatory networks,the key regulatory points and the strategies for targeted treatment are reviewed in this paper based on the current literatures and the work achieved by our research team.

Objective To explore the ultrasound images features of breast infiltrating ductal carcinoma. Methods Retrospective analysis of operation pathology ,55 patients diagnosed preoperatively infiltrating ductal carcinoma of color Doppler ultrasound diagnostic information. Results Before operation, 55 patients with breast tumors had color Doppler shows in 49 cases,no color doppler showed 6 cases,color Doppler shows with pathologic diagnosis is 89.1%. An infiltrating ductal carcinoma ultrasound image characteristics:the larger mass was irregular form,no coated, posterior acoustic attenuation,burr levy ,and crabs foot shape more inside,bump such change for not uniformity hypoechoic,with tiny clusters of calcified or irregular flare,shadow,blood flow distribution after silent for AlderⅡmore performance level Ⅲ,axillary lymph node enlargement,a different level hilus structure was clear,the peak systolic velocity in 12-80cm/s (average 35.1 cm/s ) , resistance index in 0.62-0.92 (average for 0.79 + 0.10). Conclusion Color doppler ultrasonography had important value in early diagnosis of infiltrating ductal carcinoma.