Objective To evaluate open surgery vs transurethral management for bladder outlet obstruction (BOO) caused by benign prostatic hyperplasia (BPH) of small volume. Methods From May 1993 to June 2002,50 patients were surgically treated.Of them 22 underwent open surgery and 28 underwent TURP plus transurethral incision of bladder neck(TUIBN).There was no statistically significant difference between the 2 groups in age,disease course,preoperative prostate weight and the excised prostate weight.All the surgical procedures were conducted by the same urologist.The efficacy of open surgery and TURP plus TUIBN was comparatively evaluated by IPSS,Qmax and post void residual urine volume(PVR) and hospitalization days. Results The IPSS of those undergoing open surgery decreased from 24.6?3.8 of preoperation to 15.2?3.4 of postoperation ,and the Qmax increased from (8.3?2.9)ml/s to (9.5?3.6)ml/s,and the PVR decreased from(220.0?30.0)ml to(90.0?20.0)ml,and the postoperative hospital stay was 14.2 days.The IPSS of the patients undergoing TURP plus TUIBN decreased from 24.9?4.2 to 5.8?2.7,and the Qmax increased from (8.0?3.1)ml/s to (23.2? 3.8)ml/s,and the PVR decreased from(230.0?28.0)ml to(15.0?4.0)ml,and the postoperative hospital stay was 8.5 days.The postoperative improvement was much greater in the patients undergoing TURP plus TUIBN than those undergoing open surgery as assessed by IPSS,Qmax and PVR (all P

Objective:To study the cytotoxic effects on tumor cell lines Hela,BGC823,MCF-7,L342,H9101,D6 induced by Fas ligand and anti-human DR5 monoclonal antibodies(Anti-DR5 mAb) and the underlying mechanism.Methods:Fas/DR5 mRNA were detected by RT-PCR. Cytotoxicity exerted by FasL/Anti-DR5 mAb on tumor cell lines was measured by MTT colorimetry and the induced apoptosis was determined by agarose gel electrophoresis.Results:The expression of DR5 on BGC823 and Hela cells were higher and DR5 didn’t express in D6. The expression of Fas on H9101 and L342 were higher and Fas didn’t express in D6. Cell line H9101 and L342 were sensitive to Anti-DR5 mAb and FasL in a dose dependent manner; Cell line MCF-7 and BGC823 were sensitive to FasL but were partially sensitive to Anti-DR5 mAb; Cell line Hela was partially sensitive to FasL but was sensitive to Anti-DR5 mAb; Cell line D6 was insensitive to two apoptosis inductions.Conclusion:Apoptosis induced by Fas ligand and Anti-DR5 mAb vary among tumor cell lines. The underlying mechanism may be relevant to Fas/DR5 mRNA expression,the release of Caspase-8 and Bcl-2.

Objective To investigate and evaluate the diagnostic value of transcranial doppler ultrasound (TCD) on brain death in patients with severe craniocerebral injury.Methods Forty-two cases of severe craniocerebral injury from Affiliated Hospital of Jining Medical University were divided into brain death group and survival group,according to the clinical prognosis.TCD was conducted to examine brain blood flow numerical and changed characteristics of the spectrum.Average blood flow velocity (Vm),pulse index (PI),diastolic blood flow in reverse (reverberating flow) and small systolic peaks in early systole (wave of spikes)were documented.TCD parameters were compared between the two groups with t test.Results In the brain death group,frequency of reverberating flow was 86.67％ and frequency of wave of spikes was 13.33％.In survival group,frequency of reverberating flow was 14.81％ and no wave of spikes was recorded.The difference in frequencies of reverberating flow and wave of spikes between the two groups was significant(x2 =28.25,P ＜0.01).The average speed of bilateral middle cerebral artery blood flow in brain death group((20.02±13.96) cm/s) was significantly reduced compared with survival group((56.81± 16.84) cm/s,t=2.30,P＜0.05).Pulse index (PI) values in brain death group (4.02±3.49)were significantly increased compared with survival group (1.24±1.03) (t=2.10,P＜0.05).Conclusion Reverberating flow or wave of spikes is an important marker for brain death in patients with severe craniocerebral injury.TCD may be applied to clinically confirm the diagnosis of brain death.

Objective To observe the efficacy of modified Tianma?Sanqi Decoction on hypertension patients with anxiety. Methods Totally 64 hypertension patients with anxiety patients were randomly divid?ed into control group (32 cases) and treatment group (32 cases).The control group with standard medica?tions for hypertension and treatment group with addition of Tianma?Sanqi Decoction, and both groups were continuously treated for 8 weeks. The changes of 24 hours ambulatory blood pressure and SAS scores were compared.Results ( 1) After treatment in the control group and treatment group of 24 h mean systolic blood pressure (24 hSBP) ((130.13±3.81)mmHg,(123.56±4.37)mmHg) (1 mmHg=0.133 kPa) were lower than before treatment((145.36±7.17) mmHg,(145.16±6.77) mmHg) and the difference was statisti?cally significant( P<0.01).(2) After treatment in the control group and treatment group 24 h systolic pres?sure standard deviation,diurnal systolic pressure standard deviation and nocturnal systolic pressure standard deviation((12.19±3.21) mmHg,(11.16±2.26) mmHg,(10.49±3.76) mmHg and (10.95±2.35) mmHg, (10.08±2.67) mmHg,(10.12±3.78)mmHg) were lower than before treatment ((14.53±3.65) mmHg, (13.81±4.04) mmHg,(12.47±4.23) mmHg and (16.73±7.90)mmHg,(16.06±4.14)mmHg,(13.65± 4.92)mmHg),and the difference was statistically significant( P<0.01 or P<0.05).After treatment in the treatment group, 24 h systolic pressure standard deviation, nocturnal systolic pressure standard deviation ((10.95±2.35) mmHg,(10.08±2.67) mmHg) were lower than control group((12.19±3.21) mmHg, (11.16±2.26) mmHg) and the difference was statistically significant.( P<0.01).(3) After treatment in the treatment group,SAS scores (36.68±3.88) points were lower than before treatment (58.66±3.13) points and the difference was statistically significant(P<0.01).After treatment the SAS score ((36.68±3.88) points) in the treatment group was lower than control group((51.86+2.62) points).Conclusion The hypertension patients with anxiety treated with Tianma?Sanqi Decoction and benazapril can improve blood pressure variability and the symp?toms of anxiety.

Objective To investigate the relationship between infarct location and prognosis after emergency percutaneous coronary intervention (PCI) treatment in patients with acute myocardial infarction.Methods Consecutive 121 patients with ST elevation myocardial infarction (STEMI) who underwent primary PCI were divided into 3 groups according to the infarct location.Their clinical,ECG,echocardiography and coronary angiography features were analyzed,and the follow-up was made. Results Compared with inferior wall infarction group and inferior wall infarction combined with right ventricular infarction group,anterior wall myocardial infarction group had higher CPK-MB and cTnT,less frequent collateral,reduced ST-segment resolution,higher mortality rates in hospitalization and one year after discharge.On the other hand,inferior infarction combined with right ventricular infarction group had more occurrences of shock and atrial vetricular block or ventricular arrhythmia,more incidence of multivessel disease and thrombus,and higher readmission rate.Conclusion Patients with anterior wall myocardial infarction and inferior wall in

Objective:To investigate the expression status of Sonic Hedgehog signaling genes and molecules in human hepatocellular carcinomas(HCC),and to explore the relationship between these genes and clinical prognosis.Methods:HCC tissue and adjacent normal tissue from 29 HCC patients were assayed for the expression of hedgehog signaling genes by reverse transcription-polymerase chain reaction chain reaction(RT-PCR) techniques and for the expression of hedgehog signaling molecules by immunohistochemistry.The expressions of Shh,Ptch,Smoh,Gli-1 mRNA were assayed as well as Shh,Ptch proteins in 29 cases of HCC and in 29 liver tissues adjacent to the tumor.Results:Expression of Shh mRNA was detectable in about 51% of HCCs examined.Consistent with this,hedgehog target genes Ptch,Smoh and Gli-1 mRNA were expressed in over 68%,48% and 62% of the tumors,respectively,and the expressions of Shh and Ptch proteins in HCC tumor tissues correlated with those of Shh and Ptch mRNA in tumor tissues(P=0.041 and P=0.035).This suggested that the hedgehog pathway was frequently activated in HCCs.The simultaneous expression of Gli-1 in HCC and liver tissues adjacent to the tumor had significantly relationship with poor prognosis.Conclusion:Hedgehog signaling activation is an important event for development of human HCCs.It also suggests that markers for hedgehog signaling activation may be useful for the determination of prognosis.

[ ABSTRACT] AIM:To investigate the characteristics of the intestinal microbial flora in the pregnant women with congenital heart disease fetus ( PW group) and normal pregnant women ( NW group) .METHODS: Stool samples were collected from 15 NW and 17 PW cases.The bacterial genomic DNA was extracted.The 16S rDNA was amplified by PCR, and the second generation of Illumina sequencing was conducted.RESULTS: We obtained 2 696 276 ( NW group) and 2 445 530 ( PW group) optimized sequences.The coverage was greater than 97%.We obtained 77 243 operational taxono-mic units ( OTUs) in NW group and 75 600 OTUs in PW group after a 97%similarity merge.In NW group, the Chao 1 in-dex and the Shannon index were greater than those in PW group.The diversity analysis of microbial population indicated that they were mainly composed of Firmicutes, Proteobacteria and Actinobacteria.In family, the Bifidobacteriaceae and Cori-obacteriaceae were significantly different through analysis of variance.CONCLUSION: The Bifidobacteriaceae and Cori-obacteriaceae may play an important role in the occurrence of congenital heart disease.

Objective:To analyze the clinical features and CYP17A1 gene mutation of 17α-hydroxylase/17, 20-lyase deficiency (17OHD). Methods:The clinical data, laboratory examination and genetic results of 6 children with 17OHD in the Department of Endocrinology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from March 2014 to December 2019 were enrolled and analyzed retrospectively.Meanwhile, the clinical types of all congenital adrenocortical hyperplasia (CAH) patients were calculated and then the incidence of 17OHD was calculated.Results:The 6 cases were from 5 families, and the age at diagnosis was ranged from 1 year and 6 months to 15 years old, in which 2 cases were 46, XX and 4 cases were 46, XY.Their gender were all female.Three cases presented with hypertension (50.0%), 4 cases with hypokalemia (66.7%), and 1 case with labia mass (16.7%). The gonad developed into a testis in patients with 46, XY, and patients with 46, XX had ovarian hypoplasia.The laboratory tests revealed an decrease in the cortisol at 8 AM in all cases, ranging from 0.62 to 5.93 mg/L.Five cases displayed an increase in adrenocorticotropic hormone (ACTH) in the range of 84-271 ng/L, and 1 patient with normal ACTH (58 ng/L) had a peak cortisol of 1.75 mg/L after the ACTH challenge test.Elevated progesterone was detected in 6 patients with a normal 17 hydroxyprogesterone level.Further results proved low levels of testosterone and estradiol, and high levels of luteinizing hormone (LH), and follicle stimulating hormone (FSH). CT scan showed mild adrenal hyperplasia in all cases.Among 114 CAH patients during the same period, the incidence of 17OHD came second at 5.3%.The CYP17A1 gene mutation results indicated that 2 unrelated patients were homozygous mutation for p. Y329fs (c.985_987delTACinsAA), 2 siblings were compound heterozygous mutations for p. Y329fs and exon 1-7 deletion, 1 patient was compound heterozygous mutations of p. Y329fs and p. R416C (c.1246C>T), and 1 patient was homozygous mutations for p. L465P (c.1394T> C), which was first reported in China. Conclusions:17OHD is not rare in CAH.Female children with hypokalemia, hypertension, and hypogonadism can lead to diagnostic suspicion of 17OHD.The p. Y329fs mutation in Chinese 17OHD children is a hotspot.The p. L465P (c.1394T>C) mutation is a new mutation in China and it could enrich the mutant spectrum of CYP17A1 gene in China.

Objective: To construct the expressing vector of the extracellular domain of death receptor 5 (DR5), express it E.coli, identify the purified DR5 protein, and study its biological activity. Methods: The extracellular domain of DR5(eDR5) was assembled by overlapping PCR. The expression vector pET-22b(+)/ DR5 was constructed and transformed into E.coli BL21(DE3). The expression of eDR5 protein was induced by IPTG and purified by Ni 2+ -affinity chromatographic column. The purity and specificities were detected by SDS-PAGE and ELISA, respectively. The blocking effects of purified eDR5 on FMU1.5-induced apoptosis of U343, U373 cells were observed. Results: The extracellular domain of DR5 was obtained by overlapping PCR. The eDR5 protein was expressed in both supernatants and inclusion bodies with a yield more than 30% of total bacterial proteins. The purity of eDR5 was more than 95% and the yield reached 9 mg/ml. The result of ELISA showed the purified protein was eDR5. Purified eDR5 partially blocked the apoptosis of U343 cells induced by FMU1.5 and TRAIL. Conclusion: The successful construction, expression, and purification of the extracellular domain of DR5 protein lays a foundation for further study of DR5 function.

Objective To determine the effect of inhaling rosemary compound essential oil on learning and memory and the expression of choline acetyl transferase (ChAT) in the CA1 region of the hippocampus in rats with vascular dementia (VD).Methods A modified 2-VO method was used to induce permanent brain hypoperfusion,and thus VD,in 60 male SD rats aged 2 months.They were then randomly divided into a normal control group (n =10),a sham-operation group (n =10),a model group (n =10),a rosemary compound essential oil group (n =10) and an edaravone group (n =10).The rosemary compound essential oil group inhaled a compound of the essential oils of rosemary,eugenol and peppermint once a day; the edaravone group was given a daily injection of edaravone injecta.Both the interventions lasted for 65 days.A water maze was used to test their learning and memory abilities.Morphological damage in the CA1 region of the hippocampus and the expression of ChAT were also observed.Results The learning and memory abilities of the model group were significantly weaker compared with the sham-operated group and the normal controls.The rats in the rosemary compound essential oil and edaravone groups were obviously better than those in the model group,but there was no significant difference between rosemary compound essential oil group and the edaravone group.The morphological damage observed in the hippocampus and striatum of the model group was significantly greater,on average,than that observed in the rosemary compound essential oil group and the edaravone group.The average number of ChAT positive units in the CA1 region of the hippocampus was significantly greater in both the rosemary compound essential oil group and the edaravone group compared with the model group,but there was no significant difference between the rosemary compound essential oil group and the edaravone group.Conclusions Inhaling rosemary compound essential oil can improve the learning and memory abilities of rats with VD caused by permanent chronic brain hypoperfusion.It decreases the damage to the neurons of the hippocampus,increases the expression of ChAT,and shows a therapeutic effect on VD,at least in rats.