Objective To study the effects of vasopressin on genes involve in vesicle-mediated transport in the rats' inner ear and to identify the possible mechanism of hydrolabyrinth induced by vasopressin.Methods 16 Wistar rats were divided into experimental group and controled group.Wistar rats of experimental group were intraperitoneally injected with 50 ?g/kg arginine vasopressin once a day for one week.Rats of controled group were injected with the same doses of physiologic saline.Then bullae both groups were immediately dissected out for total RNA extraction.cDNA were synthesized from total RNA of the inner ear by reverse transcription and labeled with Cy3 or Cy5.The BiostarR-40s cDNA microarray was hybridized with the above cDNA.The changes of mRNA expression intensity in the rats' inner ear induced by vasopressin injection were analyzed.Results Seven differentially expressed genes related to vesicle-mediated transport were screened out in the rat inner ear induced by vasopressin injection by use of cDNA microarray.Ap2b1,Arf1,Arf6,Dnch1,Mlc3 and Rab7 were increased by 2-fold or more,and Stx7 was decreased to 0.5-fold or less.Conclusion Vasopressin may disturb fluid homeostasis in the inner ear via vesicle-mediated transport resulting in hydrolabyrinth.

Objective To study the expression of aquaporins(AQPs) in the inner ear of normal guinea pig and guinea pigs with endolymphatic hydrops, and to investigate the mechanism and significance. Methods The guinea pigs were divided into two groups randomly: model group and control group. The guinea pigs in model group were given desmopressing 4 ?g?kg-1?d-1 introperitoneally for 1 week, while the guinea pigs in control group were given saline. After one week, the expression of AQPs in the inner ears of all guinea pigs was evaluated.Results Expression of AQP0, 1, 2, 3, 5, 7 and 8 were found in the ears of normal guinea pigs. Weak expression of AQP0 was found in stria vascularis and spiral ganglion. The distribution of AQP1 consisted of cellular lining the bony labyrinth, fibrocytes lining in the endolymphatic duct and sac, cells under the basilar membrane, fibrocytes of the spiral ligament and the spiral limbus, Corti's organ, inner and outer spiral sulcus, stria vascularis, saccular and utricular wall, and spiral ganglion. AQP2 were found in stria vascularis, Corti's organ, spiral ganglion and endolymphatic sac. AQP3, 7 and 8 were distributed in a similar manner as the surrounding membranous labyrinth, including Corti's organ, inner and outer spiral sulcus, stria vascularis, fibrocytes of the spiral ligament and the spiral limbus, saccular and utricular wall, endolymphatic sac and spiral ganglion. AQP5 was found at Corti's organ, inner and outer spiral sulcus, spiral ganglion and fibrocytes in spiral ligment. The AQP2 in stria vascularis and endolymphatic sac was stronger in the inner ears with ELH than that in normal ears.Conclusion There are various AQPs in inner ears of normal guinea pigs, and their distributions are overlapping and without obvious regional specificity. Desmopressing induces the expression of AQP2 in the inner ears of guinea pigs. The results indicate that ELH may correlate to upregulation of AQP2, but the mechanism remains unclear.

Objective To explore the experiences of the diagnosis and treatment of urothelial tumor in multiple organs.Methods Clinical data of 10 patients with urothelial tumor in multiple organs were retrospectively reviewed.Urothelial tumors were found in two or more organs at the same time by B ultrasound,IVU,R-P,CTU,MRU,cystoscopy,ureteroscopy and so on before operation.Results 6 cases were operated by radical total nephroureterectomy and partial cystectomy,3 cases were operated by radical total nephroureterectomy and cystectomy with urinary diversion,1 case was operated by partial ureterectomy and total cystectomy.8 of them were alive,1 case was operated by total urethrectomy because of tumor recurrence in the posterior urethra,one died of metastasis tumor 18 months after operation,and the other died 32 month after operation.Conclusions Combined use of various kinds of the diagnostic means (ultrasound,IVU,R-P,CTU,MRU,cystoscopy,ureteroscopy) are important for the diagnosis of urothelial tumor in multiple organs.It needs to select the operate mode according to the tumor staging and grade and the patient's condition.Reinforcement surveillance and close follow up is required after operation.

ObjectiveTo review the major complications in patients after transurethal electrovaporization of the prostate (TUVP) and transurethal plasmakinetic resection of the prostate (PKRP) retrospectively and to analyze the causes and management.MethodsClinical data of 92 cases of patients after TUVP and 226 cases after PKRP were reviewed retrospectively.The patients' relevant circumstances including subjective symptoms,objective indexes and the major long-term complications were followed up about 1-,3-,and 5-year after operation.Different therapeutic methods were chosen according to different causes of the complications.ResultsThere were no significant differences (P ＞ 0.05 ) between TUVP group and PKRP group in IPSS (7.3±2.8,7.2±2.5),QOL (2.6±0.7,2.7 ±0.5),Qmax[ (25.2±3.5),(25.5 ±3.8) ml/s] and PVR [(18.7 ±5.4),(17.8 ±6.3)ml].The incidences of bladder neck restriction was about 1.1％,3.3％,and 2.3％ after 1,3,and5 years in patients after TUVP,and 0.9％,2.7％,and 1.8％ after PKRP accordingly.For urethral stricture,it was about 3.3％,2.2％,and 1.1％ after TUVP,and 3.1％,2.2％,and 0.9％ after PKRP.For residual prostatic hyperplasia,it was about 1.1％,2.2％,and 4.5％ after TUVP,and 1.3％,2.7％,and 3.7％ after PKRP accordingly.ConclusionsTUVP and PKRP are effective and safe treatment options for BPH.The major long-term complications after TUVP and PKRP are bladder neck restriction,urethral stricture and residual prostatic hyperplasia.Regular and long-term follow-up is required for patients after TUVP and PKRP.Different therapeutic methods should be chosen according to different causes of the complications after operation.

Objective To evaluate the efficacy and safety of solifenacin in the treatment of overactive bladder (OAB) syndrome in patients who have undergone transurethral resection of the prostate (TURP). Methods According to the Overactive Bladder Symptom Score (OABSS), 64 cases with OAB symptoms after TURP were randomly assigned into study and control groups with 32 cases in each group. Patients in the study group were treated with solifenacin (5 mg once daily) for a two week period beginning the first day after catheter removal. Patients in the control group were not treated with solifenacin. The mean urgency episodes, micturition episodes, nocturia, urge incontinence, volume voided per micturition, Qmax and OABSS scores were recorded on the 7th and the 14th day after catheter removal. Treatment-emergent adverse events with solifenacin in the study group were recorded and evaluated as well. All cases were followed-up for 8 weeks after catheter removal. Results There were statistically significant differences (P<0.01) in favor of the study group over the control group in the aspect of urgency, micturition episodes, nocturia, urge incontinence, volume voided per micturition and OABSS scores. The incidences of treatment related adverse events were 12.5% (4/32) in the study group with no serious adverse event observed. Conclusions Solifenacin is effective in the treatment of OAB syndrome after TURP and is well tolerated as well. Application of solifenacin should be recommended earlier after TURP.

Objective To investigate the effect of predictive nursing intervention on prevention of pressure sore in liver transplantation.Methods Eighty patients undergoing liver transplantation were randomly divided into two groups.Patients in the control group were given traditional nursing care.Patients in the experimental group were treated with predictive nursing intervention.Anxiety, depression, compliance, quality of life, stress indicators, infection rate, pressure sore rate and nursing satisfaction were compared.Results Compared with the control group, the scores of SAS and SDS in the experimental group were significantly higher than those in the control group;the compliance score and the QOL score group were significantly higher, the MDA level was significantly lower, SOD level was higher and the rate of infection and pressure ulcer was significantly lower than that of the control group, there were significant differences between the two groups(P<0.01).Conclusion Predictive nursing intervention is effective in prevention of pressure sore in liver transplantation and it can improve the satisfaction and has reference significance.

Objective To investigate the effect of predictive nursing intervention on prevention of pressure sore in liver transplantation.Methods Eighty patients undergoing liver transplantation were randomly divided into two groups.Patients in the control group were given traditional nursing care.Patients in the experimental group were treated with predictive nursing intervention.Anxiety, depression, compliance, quality of life, stress indicators, infection rate, pressure sore rate and nursing satisfaction were compared.Results Compared with the control group, the scores of SAS and SDS in the experimental group were significantly higher than those in the control group;the compliance score and the QOL score group were significantly higher, the MDA level was significantly lower, SOD level was higher and the rate of infection and pressure ulcer was significantly lower than that of the control group, there were significant differences between the two groups(P<0.01).Conclusion Predictive nursing intervention is effective in prevention of pressure sore in liver transplantation and it can improve the satisfaction and has reference significance.

Objective: To investigate the significance of lymphatic markers in the differential diagnosis of angiokeratoma corporis diffusum (ACD) and angioma serpiginosum (AS) . Methods: Totally, 9 patients with ACD and 6 with AS were enrolled from Department of Dermatology, Xijing Hospital between 2006 and 2017, and their clinical and histopathological features were retrospectively analyzed. Skin sections from all the patients were stained for CD31, D2-40 and Prox1. Results: In the 9 patients with ACD, abnormal vessels were weakly positive or negative for CD31, and positive for Prox1. Endothelial cells in abnormal vessels were locally positive for D2-40 in 4 patients with ACD, but negative for D2-40 in the other 5 patients. In the 6 patients with AS, the endothelia of hyperplastic small vessels were positive for CD31, but negative for D2-40 and Prox1. Conclusion The clinical features of a few patients with ACD are similar to those of patients with AS, and lymphatic markers have definite significance in the differential diagnosis of the two diseases.

Objective:To investigate the efficacy of therapeutic plasma exchange with continuous renal replacement therapy in patients with early septic shock.Methods:A total of 55 patients with septic shock admitted to ICU of Mindong Hospital Affiliated to Fujian Medical University from December 2017 to December 2020 were retrospectively analyzed. The patients were divided into the therapeutic plasma exchange group ( n=29) and standard-therapy group ( n=26) according to whether plasma exchange combined with hemofiltration was used. Patients in both groups were treated according to the 2016 Surviving Sepsis Campaign guidelines. No hemofiltration or/and plasma exchange therapy was performed in the standard-therapy group. In the therapeutic plasma exchange group, hemofiltration was performed immediately after plasma exchange within 24 h. The inflammatory indexes, hemodynamic indexes, organ function scores and 28-day mortality were monitored before and 24 h after treatment. χ2 test was used for counting data, t-test was used for measurement data, and Kaplan-Meier curve was used to evaluate 28-day survival status. Results:(1) There were no differences in sex, age, underlying diseases, acute physiology and chronic health evaluationⅡ (APACHEⅡ) score and sequential organ failure assessment (SOFA) score before treatment between the two groups. (2) There were no significant differences in PCT, CRP and IL-6 between the two groups at enrollment. After treatment, PCT, CRP and IL-6 in the therapeutic plasma exchange group were significantly lower than those in the standard-therapy group [PCT (ng/mL): (50.07±14.54) vs. (57.93±13.42), P=0.043; CRP (mg/L): (85.71±46.05) vs. (115.10±44.42), P=0.042; IL-6 (pg/mL): (5 957.45±2 344.48) vs. (7 522.94±3 218.94), P=0.043], but there was no significant difference in WBC between the two groups. (3) There were no significant differences in norepinephrine dose, mean arterial pressure, heart rate, systemic vascular resistance index (SVRI), extravascular lung water index (EVLWI) and Lactate level between the two groups. After treatment, the norepinephrine dose, lactate level and EVLWI in the therapeutic plasma exchange group decreased significantly, while SVRI increased significantly {norepinephrine dose [μg/(kg·min): (0.76±0.39) vs. (0.54±0.39), P=0.044; lactate (μmmol/ L): (7.74±4.22) vs. (4.51±1.62), P<0.001; EVLWI (mL/kg): (10.04±2.77) vs. (8.23±2.23), P=0.008; SVRI (dyn·s/cm 2): (1 103.14±364.94) vs. (1 403.31±264.46), P=0.001}. Compared with the standard-therapy, the 24-h intravenous infusion volume was significantly decreased [(3 852.07±686.43) mL vs. (4 474.81±572.71) mL, P=0.001]. (4) There were no significant differences in APACHEⅡscore and SOFA score between the two groups at enrollment. After treatment, the APACHEⅡscore and SOFA score of the therapeutic plasma exchange group were significantly lower than those of the standard-therapy group [APACHEⅡscore: (14.07±4.30) vs. (19.23±5.44), P<0.001; SOFA score: (9.93±1.16) vs. (11.69±1.81), P<0.001)]. There were no significant differences in ICU mortality and 28-day mortality between the two groups ( P>0.05). Conclusions:Therapeutic plasma exchange with continuous renal replacement therapy can reduce the inflammatory response and improve hemodynamics in patients with septic shock. However, 24 h treatment did not improve the mortality of patients.

The first-line nucleos(t)ide analogs (NAs) based antiviral drugs can effectively inhibit HBV replication and slow down the progression of chronic hepatitis B. However, about 20% of patients receiving standard NAs antiviral therapy will still develop low-level viremia (LLV). Therefore, understanding the occurrence mechanism of LLV will help to optimize antiviral treatment regimens and improve the prognosis of patients with chronic hepatitis B. This article systematically summarizes the possible mechanisms of LLV occurrence, and the important factor of NAs failure. Taking into account the unique limitations of NAs competitive inhibition of virus replication, weakening host's immune response is not enough to directly eliminate infected hepatocytes. This makes it difficult to achieve a complete virological response in some patients with the active compensatory proliferation of residual infected hepatocytes and the accompanying effective removal or dilution of covalent, closed, circular DNA (cccDNA) pools. Therefore, it is speculated that activating host immunity can eliminate infected liver cells and may be more conducive to address LLV.