Coronary Stenosis ; diagnostic imaging ; Humans ; Ultrasonography, Interventional ; methods

A cluster sampling method was used to select 5 Huaihai communities of Shanghai.All individuals were aged ≥60 years.Visual acuity without correction and presenting acuity with their habitual distance correction were measured separately for each eye.The prevalence of blindness and low vision was 0.49％ and 1.65％ respectively.The leading causes of blindness in a descending sequence included macular degeneration,cataract and retinal vascular disease.

Child ; Drug-Related Side Effects and Adverse Reactions ; etiology ; Humans ; Male ; Neostigmine ; poisoning

Objective To analyze the clinical and pathological characteristics of children with lupus nephritis(LN).Methods The data of 116 inpatients from Mar.2000 to Nov.2008 with LN were retrospectively analyzed.The clinical,immunochemical and pathological data were recorded.Renal tissue was observed by light microscopy and electron microscopy after HE,PAS,Masson and PASM staining according to WHO standards.Follow-up results showed complete remission,partial remission,disease activity,renal insufficiency and death.Results Of the 116 cases of LN,there were 27 male and 89 female with a ratio of male to female 1.03.3,and the mean age was(12.0?2.2) years.The incidence of nephrotic syndrome was 63.8 %(74 cases),and acute nephritis was 21.5%(25 cases).Class Ⅳ LN was the most frequent type(14 cases,50%) and classⅢ was next(25 cases,21.5%).In view of the outcome,rapidly progressive glomerulonephritis and class Ⅳ LN were the worst.LN was initially controlled in 96.5% of the patients.Relapses of LN were most caused by the intermittent treatment.Totally 32 cases showed different renal injury,and 6 cases progressed to death.Conclusions Renal biopsy is important to diagnosis,treatment and prognosis evaluation of LN.Long and regular treatment is important for children with LN.

Drug-Eluting Stents ; Humans ; Percutaneous Coronary Intervention ; methods ; Platelet Aggregation Inhibitors ; therapeutic use ; Time Factors

BACKGROUND: Medicine treatment of chronic respiratory failure achieved little effect. Interfering chronic respiratory failure of chronic cor pulmonale with noninvasive positive pressure ventilation (NIPPV) may be an effective measure to eliminate symptom and physical sign of patients.OBJECTIVE: To investigate the effect of nocturnal noninvasive positive pressure ventilation (NIPPV) on respiratory muscle function, pulmonary function of chronic respiratory failure patients with stable chronic cor pulmonale at high altitude area (HACCP).DESIGN: A completely randomized grouping design and randomized control trial.SETTING: Center of Respiratory Medicine, the 4th Hospital of Lanzhou Military Area Command of Chinese PLA.PARTICIPANTS: Totally 60 HACCP patients with chronic respiratory failure in stable stage, 38 male and 22 female, were admitted to Department of Respiratory Disease, the 4th hospital of Chinese PLA from October 2002 to November 2004. All cases, after informed consent was obtained,were randomly divided into two groups, including treatment group and control group with 30 cases in each group.METHODS: [1] Treatment group: Fitted with ventilator with pressure support ventilation (PSV) mode or positive end-expiratory pressure (PEEP)mode from 22:00 to next 7:00 every night. Before and after 5 weeks therapeutics, pulmonary function, arterial blood gas, respiratory muscle function and 6-minute walking distance (6MWD) were measured. Control group:Those were either assessed in inpatient objects stabled at least 1 week as control group before discharged and 5 weeks thereafter. [2] 6-minute walking distance (6MWD) test: Patients made their effects to walk 6 minutes in20 meters long corridor, or could not go on because of dyspnea, walking distance was determined. Using electronic diaphragmatic function meter,oral maximal inspiratory pressure (PImax) and maximal expiratory pressure(PEmax) were determined, then maximal transdiaphragmatic pressure (Pdimax) was measured with airway block method. With blood gas analyzer,partial pressure of oxygen in arterial blood (PaO2) and partial pressure of carbon dioxide in arterial blood (PaCO2) were assessed. With electronic spirometre, forced expiratory volume in one second (FEV1) expressed as percentage predicted (FEV1%), FEV1 forced vital capacity (FVC) ratio(FEV1/FVC) were assessed. [3] Differences between the groups in response to rehabilitation were identified using the unpaired Student's t test, while changes within groups were measured using the paired Student's t test.MAIN OUTCOME MEASURES: Respiratory muscular function, pulmonary function, arterial blood gas and 6-minute walking distance in two groups before and after intervention.RESULTS: All 60 chronic respiratory failure patients with stable chronic cor pulmonale were involved in-the analysis of results. Every parameters of blood gas and pulmonale function in two groups were similar before intervention (P ＞ 0.05). After 5-week intervention, PaO2, FEV1%, FEV1/FVC,PImax, PEmax, Pdimax and 6MWD were higher than before in treatment group and those in control group (P ＜ 0.05-0.01). PaCO2 after therapy was lower than before in treatment group and that in control group after treatment (P ＜ 0.01).CONCLUSION: Nocturnal NIPPV can markedly improve the arterial blood gas and pulmonary function, and increase respiratory muscle strength.

Objective To observe the effect of bronchial asthma combined with allergic rhinitis by azelastine hydrochloride nasal spray.Methods Eighty-seven cases of bronchial asthma combined with allergic rhinitis patients were divided into treatment group(45 cases)and control group (42 cases) by random number table method,both groups were given the treatment of bronchial asthma according to the guidelines for regulating,treatment group on the basis was combined with azelastine hydrochloride 1 spray per side,2times per day,for 3 months.Observe two groups of asthma symptoms within 3 months control situation,the number of antibiotics and hospitalization for acute exacerbation.Results Treatment group total effective rate,asthma control test score,number of antibiotics and due to the number of exacerbations hospitalization were superior to control group [93.33％(42/45) vs.76.19％(32/42),(23.80 ± 2.15)scores vs.(22.05 ±3.16) scores,13.3％ (6/45) vs.35.7％ (15/42),11.1％ (5/45) vs.33.3％ (14/42)] (P ＜ 0.05 or ＜ 0.01).Conclusion Combined by azelastine hydrochloride nasal spray may make a good control,reduce the use of antibiotics for acute attack and times of hospitalization,worthy of clinical application.

Objective To investigate the clinical characteristics,diagnosis,treatment and prognosis of malignant ovarian germ cell tumors(MOGCT)with lung metastasis.Methods Fifteen patients of MOGCT with lung metastasis treated in Peking Union Medical College Hospital from Jan.1982 to Dec.2010 was retrospectively analyzed.Results(1)Clinical characteristics: the average onset age of these 15 patients is(23 ± 11)years old(6-48 years).The majority of these patients presented with abdominal pain(8/15)or irregular vaginal bleeding(4/15)as their initial symptoms.The primary tumor located in the left ovary in 8 cases,right ovary in 6 cases,and both sides in only 1 case.Metastatic lesions were confined to the lung in 12 patients,while the other 3 patients were found to have multi-site distant metastasis.(2)Diagnosis:all 15 cases included 9 pure non-gestational ovarian choriocarcinoma(NGOC),3 MOGCT containing choriocarcinoma component(one mature teratoma with choriocarcinoma component,one endodermal sinus tumor with embryonal carcinoma and choriocarcinoma components,one choriocarcinoma with dysgerminoma component),2 embryonal carcinoma,one immature teratoma.Only one patient in these 15 cases was correctly diagnosed before surgery.(3)Time of lung metastasis: of 12 MOGCT with choriocarcinoma component,11 patients were found to have lung metastasis in the course of their primary treatment,only 1 had lung metastasis 2 months after the synthetic treatment finished.Three MOGCT patients without choriocarcinoma component were all found to have lung metastasis when tumor relapsed in the advanced stages of the disease.(4)Treatment:all 15 patients received multi-agent chemotherapy combined with surgery.The mean courses of chemotherapy for these patients were 16 courses(5-43 courses).(5)Prognosis:of these 15 cases,complete remission was obtained in 10 patients of NGOC or mixed ovarian germ cell tumors with choriocarcinoma component,3 patients(one NGOC,one endodermal carcinoma and one immature teratoma,respectively)died in the course of treatment as result of tumor progression,2 progressed cases(one NGOC and one endodermal carcinoma respectively)abandoning therapy were lost to follow up.Conclusions MOGCT with lung metastasis are more often to found in NGOC patients.These patients could obtain high complete remission rate after standard multi-agent chemotherapy combined with surgery.The prognosis of MOGCT with lung metastasis containing choriocarcinoma component are better than that of those without containing choriocarcinoma component.

Objective To explore the prevalence,subtype,distribution characteristics and risk factors of IBS met ROME Ⅲ criteria in local adult residents of Shanghai Songjiang area.Methods With multi-stage,stratified cluster random sampling method,from April to May in 2010,residents of45 shanghai Songjiang communities were interviewed by questionnaire survey.IBS diagnosis was based on Rome Ⅲ criteria,and the subtypes were according to Bristol stool scale.Self-rating anxiety scale (SAS),self-rating depression scale (SDS) and Athens insomnia scale (AIS) were also simultaneously finished. Results There were 7648 individuals who completed the survey with qualified questionnaires; the efficient rate was 90％. The sample size accounted about 1.62％ of total population in Shanghai Songjiang area.Total 970 patients were detected,who met the Rome Ⅲ criteria,of those 492 males and 478 females.The adjusted prevalence of IBS was 13.1％,13.8％ in males and 12.7％ in females.The ratio of male to female was 1 ∶ 0.92.There was no significant difference in detection rate between males and females (P＞0.05).The prevalence was highest in the 18 to 29 years age group (18.2％,P=0.000).IBS unsubtyped (IBS-U) was the most common type in patients who met the Rome Ⅲ criteria (45.3 ％),IBS with diarrhea (IBS-D) type was more common in male (27.0％) and IBS with constipation (IBS-C) was more common in female (19.5％).The IBS prevalence of obesity group (x2 =4.046,P=0.044),higher education group (x2=31.210,P=0.000),mental group (x2 =8.409,P =0.015),unmarried group(x2 =26.933,P =0.000) and no abdominal surgery history group(x2 =5.894,P=0.015) was higher than that of control group.The risk of IBS prevalence in those who had the history of gastrointestinal infection,abdominal surgery,taking antibiotics or analgesics increased by 5.105,3.388,2.949 and 2.811 times respectively(P=0.000).Multivariate analysis indicated that the risk of IBS prevalence was increased by 1.69 times if took more spicy food,however high-protein diet was a protective factor (OR=0.900,P=0.000).Anxiety (OR=2.452,P=0.000) and insomnia (OR=1.923,P=0.000) were also risk factors of IBS.Conclusion IBS is a common and frequently occurring disease in Shanghai Songjiang community.The history of gastrointestinal infection,abdominal surgery,taking antibiotics or analgesics,intake of more spicy food,anxiety and insomnia may be risk factors of IBS.

Objective To observe whether immature Brain Derived Neurotrophic Factor (proBDNF)can affect the activities of OPCs in the fields of cell proliferation and migration after SCI,and to investigate the relationship between proBDNF and p75NTR signal pathway on OPCs.Methods OLN-93 cell line was cultured and maintained for in vitro experiments.Immunofluorescence were used to check the expression of endogenous proBDNF,p75NTR and sortilin on OPCs.MTT assay was used to illustrate the inhibitory effect of proBDNF.The effects of anti-proBDNF was also observed by BrdU staining to find a probably signal pathway for proBDNF on OPCs.The Sprague-Dawley rats were administered for T9 spinal cord injury animal model.BBB score was applied to observe the situation of functional recovery after treated by anti-proBDNF.BrdU staining was managed to observe the situation of OPCs proliferation and migration after SCI.Results Endogenous proBDNF inhibited proliferation and migration of OPCs after SCI.BrdU staining showed that population of proliferative OPCs in lesion site of spinal cord was less in proBDNF in treated group than that in control group and anti-proBDNF group.While anti-proBDNF could inhibit proBDNF specifically and might induced a better functional recovery which was illustrated by BBB scores.The in vitro experiments found the inhibitory effect of proBDNF is dose-dependent and can be neutralized by anti-proBDNF properly.Moreover,the expression levels of p75NTR and sortilin are down regulated by proBDNF antibody treated group.This indicated that proBDNF may inhibit OPCs via p75NTR pathway.Conclusion Endogenous proBDNF can inhibit cell proliferation of OPCs after SCI and can be neutralized by specific antibodies of proBDNF.This kind of detrimental effect may be induced by p75NTR-sortilin pathway.Furthermore,proBDNF antibody treatment is effective to block proBDNF and promote the functional recovery.