Adult ; Arterio-Arterial Fistula ; therapy ; Cardiac Catheterization ; Coronary Vessels ; pathology ; Heart Ventricles ; pathology ; Humans ; Male

Adult ; Fever ; etiology ; Gastrointestinal Hemorrhage ; etiology ; Humans ; Male ; Polyps ; complications ; Stomach Diseases ; complications

Objective To comparing the diagnostic and therapeutic strategies for patients with benign prostatic hyperplasia(BPH) between doctors in general hospitals and community hospitals,and to provide scientific clues for the standardization in medical practice.Methods General and community hospitals in urban China were selected via the stratified sampling.127,325 outpatients in these hospitals from December 2011 to December 2012 were randomly recruited.Results The average age of patients was(67.82±8.62) years.There were significant differences in I-PSS,prostate volume,urinary flow rate(UFR) and result of digital rectal examination(DRE) between patients in general and community hospitals.The rates of diagnostic applications were different between doctors in the two kinds of hospitals except I-PSS.Compared with community hospitals,DRE was more frequently applied while ultrasonic inspection and UFR test were less used in general hospitals in North China.A totally opposite situation was observed in East China as compared with the north.The application rates of DRE and UFR test were lower and ultrasonic inspection rate was higher in community hospitals than in general hospitals in South China.Pharmacotherapy was the most common treatment for BPH patients in both types of hospitals(97.53 ％).The rates of drug combinations were statistically different but both were close to 75％ in the two types of hospitals.In community hospitals,the percentage of patients receiving watchful waiting with severe symptoms and signs were lower than that of patients receiving watchful waiting with moderate symptoms and signs,but the percentage of patients receiving operation was not significantly increased.On the contrary,the percentage of patients receiving operation with severe symptoms and signs was higher than that of patients receiving operation with moderate symptoms and signs in general hospitals,but the percentage of patients receiving watchful waiting was not decreased.Conclusions Applications of diagnostic methods are significantly different between doctors in general hospitals and community hospitals and vary among regions.Therapeutic strategies are correlated with the severity of obstructive symptoms or signs.The medication strategy is similar between the two types of doctors.

Objective To determine the cerebral protective effect of different concentrations of desflurane anesthesia during craniotomy.Methods Twenty two patients, scheduled for selective craniotomy for resections of supratentorial mass lesions, were anesthetized by inhalation of desflurane. When the concentrations of desflurane were maintained at 0.7,1.0 and 1.3 mean alveolar concentration (MAC) for 30 min during removing the tumor, venous blood samples which were drawn through internal jugular bulb were analyzed. Mean arterial pressure (MAP), heart rate (HR), and jugular bulb pressure (JBP) were recorded during the craniotomy.Results Jugular bulb oxygen saturation (SjO2) was significantly declined at 1.0 and 1.3 MAC compared with that at 0.7 MAC (P<0.05 and P<0.01 respectively). There was no significant changes in SjO2 between 1.0 and 1.3 MAC (P>0.05). MAP declined dose dependently, and decreased more significantly at 1.3 MAC (P<0.01).HR and JBP increased slightly with the raising concentration of desflurane but there were no significant changes at any MAC of desflurane (P>0.05).Conclusion Desflurane anesthesia at 1.0 MAC shows cerebral protection effect during craniotomy with stable hemodynamics and improved cerebral oxygen supply and demand.

OBJECTIVETo investigates the mechanism of hypooglycemic effect of conduritol A of stems of Gymnema sylvestre.

METHODFourteen days later after administration, observation is taken on the change of these mice and rats weight, the FBG, TG, CHO, SOD, MDA, INS, TNF in serum were also detected with enzymology method and Radioimmuoassay method. Take the liver to determine the disposal of glucose. Take the pancreas to do the HE and immunohistochemistrial staining, and show pancreas islet beta-cell. Calulate thymus, pancreas, splenica index.

RESULTCompared with diabetic model mice, high and middosage of conduritol A could remarkably reduce fasted blood sugar in diabetic rats induced by alloxan (P < 0.01). Significantly increase the level of serum insulin (P < 0.05). Activity of SOD was obviously increased, and amount of MDA was obviously decreased (P < 0.05). The amount of conduritol A disposal of glucose was obviously increased (P < 0.05). Significantly increase thymus, pancreas, splencia index (P < 0.01 or 0.05); inhibited the atrophy of thymus, pancreas, splencias of the diabetic rats induced by alloxan. Compared with diabetic model group, cell structure and form of conduritol A had been some way improved. The immunohistochemistry results showed that beta-cells numbers of pancreas in each conduritol A group were more than those in the model group.

CONCLUSIONConduritol A could have an effect on regulating the metabolism of blood lipid, free-radical scavenging, enhancing the antioxidant ability, potentiating immune function. Promoting synthesis of hepatic to decrease fasted blood suger.

Animals ; Blood Glucose ; drug effects ; Diabetes Mellitus ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Female ; Gymnema sylvestre ; chemistry ; Humans ; Hypoglycemic Agents ; pharmacology ; Male ; Models, Animal ; Random Allocation ; Rats ; Rats, Wistar

Medical imaging is an interdisciplinary subject closely related to clinical and pathological subject. Its clinical reading skills' training has become the focus of postgraduate teaching. In the process of clinical teaching, the interactive reading mode of problem-based learning (PBL) combined with multi-disci-plinary team (MDT) was introduced into clinical reading meeting. The tutors chose the reading cases proved by pathology; designed in-depth issues step by step for execution of PBL teaching; guided postgraduates to delineate imaging signs and propose the diagnostic results, evidences and differential diagnoses according to the step from localizing to qualitative and then to pathological diagnosis;then guided postgraduates to attend in-depth case analysis of MDT and analyze the correlation or inconsistency between the imaging diagnosis and clinical and pathological diagnosis; exercise document retrieval and verbalization, multimedia design, and writing level of the records of the reading cases and papers. The interactive reading mode of PBL com-bined with MDT has achieved significant effects, which is worthy of further exploration and promotion.

Objective To evaluate the clinical effects of CT guided percutaneous aspiration and sclerotherapy in treatment of hepatic cysts.Methods Sixty three patients with single(n=41)and muttiple(n= 22)hepatic cysts were undertaken CT guided pereutaneous aspiration and sclerotherapy with injection of absolute alcohol.Results Sixty three patients underwent follow-up for 3-15 months after the operation showing effective indexes as grade 0 for 4(6.39%),gradeⅠfor 8(12.69%),gradeⅡfor 23(36.51%)and gradeⅢfor 28(44.44%)cases.The total effective rate reached 93.61%.No serious complications occurred. Conclusion Sclerosing therapy with absolute alcohol is safe,economic,simple and effective for treating hepatic cysts.(J Intervent Radiol,2007,16:850-852)

Objective To investigate the genotype of metallo-?-lactamases (MBL) produced by carbapenem resistant Pseudomonas aeruginosa in pediatric patients.Methods 59 strains of resistance to imipenem or meropenem were collected from December 2003 to November 2005 in Beijing children's hospital.Isolates were further evaluated for MBL production by two screening methods.MBL Etest strips were used to screen the phenotype of MBL production.Molecular screening for blaVIM,blaIMP,blaSPM and blaGIM was carried out using primers targeting the conserved regions of the MBL genes.The PCR fragments obtained with integron primers were sequenced on both strands.The nucleotide sequences were compared with sequences available over the Internet.Results Of the 59 carbapenem resistant Pseudomonas aeruginosa included in this study,29 (49.2%)were MBL positive using Etest methods,and 39 (66.1%) of these tested positive for MBL genes by PCR.35 (89.7%) were positive for blaIMP genes and 4 (10.3%) were positive for blaVIM genes.All isolates were negative for SPM and GIM DNA sequencing revealed that the IMP-1 was detected in 35 IMP-producing isolates,and VIM-2 was detected in 4 VIM-producing isolates.Conclusions This study has demonstrated that MBL-producing strains in pediatric are more common than in adult.IMP-1-producing strains are the main in pediatric,and VIM-2-producing strains concurred.The production of MBL is one of the important reasons of carbapenem resistant Pseudomonas aeruginosa in pediatric.It is very important to monitor the production of MBL.

Objective:To investigate the factors and mechanisms in forming uric acid stones in patients with type 2 diabetes (T2DM).Methods:106 patients with diabetes were divided into observation group and control group according to the combination of urinary calculi,53 cases in each group,The differences of clinical data and biochemical indexes between the two groups were compared,The relationship between type 2 diabetes mellitus and urinary stones was analyzed by multi factor regression analysis.Results:There were no significant difference in observation group and control group in age,sex,SBP,DBP,TC,FBG,2hPBG and HbA1C (P＞0.05),and there were of statistical difference significance in BMI,urinary pH,HOMA-IR,SUA,TUA in the two gruops (P ＜0.05) and the Logistic regression analysis showed blood uric acid,the urinary pH,HOMA-IR,SUA were independent risk factors in urolithiasis in T2DM (P ＜ 0.05).Conclusion:High uric acid hematic disease,high uric acid excretion,insulin resistance,overweight or obesity,high blood triglycerides in patients with type 2 diabetes is risk factors for urinary stone formation,in which blood uric acid,urinary pH,HOMA-IR is the independent risk factor for type 2 diabetic patients with urinary calculi.