Air Pollution ; Environmental Monitoring ; Mercury ; Spectrophotometry, Atomic ; Workplace

Medication has become the first-line option for the management of lower urinary tract symptoms induced by benign prostatic hyperplasia (LUTS/BPH) for its advantages in controlling the symptoms, inhibiting BPH progression, and reducing serious complications and surgical risks. Recent years have witnessed remarkable achievement in the studies of phosphodiesterase type 5 inhibitors (PDE5-Is) in the treatment of LUTS/BPH. PDE5-Is can effectively alleviate LUTS/BPH, with even better efficacy when combined with al-ARAs.
Humans ; Lower Urinary Tract Symptoms ; drug therapy ; etiology ; Male ; Phosphodiesterase 5 Inhibitors ; therapeutic use ; Prostatic Hyperplasia ; complications

Objective To evaluate the value and safety of the anterior transsphincteric operation for treating rectal villous adenoma.Methods The clinical data of 17 cases with rectal villous adenoma,including 6 cases with malignant change,operated by anterior transsphincteric approach at Changzheng hospital,from February 2000 to August 2006,were analyzed retrospectively.The distance between the anal verge and the lower margin of the tumor was 5～ 8 cm(average 7 cm).The tumors were 2～ 5 cm in diamater.Results The rectal villous adenoma was completely removed with negative resection margins in all the 17 patients.Fecal continence,urinary function and sexual function were preserved successfully in all the patients.No postoperative complications developed.The postoperative pathological stage of rectal villous adenoma with malignant change was pTisN0M0 in 3 cases,pT1N0M0 in 2,and pT2N0M0 in 1.At a median follow-up of 46 months,no patients had recurrence.Conclusions Anterior transsphincteric approach is useful and safe for operation of rectal villous adenomas and those with early mmalignant change.It is particularly valuable for large midrectal villous adenoma.

AIM: To investigate the expression kinetics of PD-L1 and PD-L2 on the surface of the resting and activated B/T cells as well as monocytes from healthy human peripheral blood.METHODS: Fluorescent antibody staining together with flow cytometry were used to detect the percentages of the resting as well as the activated B cells and T cells that expressed PD-L1 and PD-L2.Meanwhile the percentages of the resting and activated monocytes that expressed PD-L2 were determined.RESULTS: Both resting B cells and T cells did not express PD-L1 on their surface,however PD-L1 expression was significantly up-regulated on the surface of the activated B cells after 6 h stimulation with LPS or pokeweed mitogen(PWM),and the percentages of B cells that expressed PD-L1 reached a plateau at 24 h,which were(46.26?10.71)% with LPS and(43.67?6.14)% with PWM stimulation,respectively.No markedly change of PD-L1 expression on the surface of the activated T cells after stimulation with LPS was observed,but upregulation of PD-L1 expression was observed when stimulation with PWM.The percentages of T cells that expressed PD-L1 reached a plateau at 24 h,which was(25.42?9.23)%.PD-L2 expression was not found on the resting as well as the activated B cells and T cells.In addition,the resting monocytes did not express PD-L2.Combination of INF-? plus LPS markedly induced the PD-L2 expression,and the percentages of monocytes that expressed PD-L2 reached a peak at 48 h,which was(28.70?14.22)%.CONCLUSION: The activated lymphocytes only express PD-L1,reaching a plateau at 24 h.PD-L2 is expressed on the surface of the activated monocytes,reaching a peak at 48 h.

BACKGROUND:Hyperbaric oxygen (HBO) can increase oxygen diffusing capacity, thereby, improve hypoxic state of brain edema and brain tissue and promote the recovery of physiological function of brain cells in focal zone, the establishment of bypass circuit, and regeneration and repair of brain cells.OBJECTIVE: To observe the effect of hyperbaric oxygen on c-fos oncogene expression of rats at different time points following acute focal cerebral ischemia/reperfusion(I/R) injury.DESIGN : Randomized grouping animal experiment.SETTING: Department of Emergency, Tangdu Hospital, Fourth Military Medical University of Chinese PLA; Department of Laboratory Medicine, Xi'an Gaoxin Hospital;The General Hospital of the Air Force of Chinese PLA; Hyperbaric Oxygen Treatment Center, Department of Aerospace Medicine, Fourth Military Medical University of Chinese PLA.MATERIALS: This experiment was carried out in the Hyperbaric Oxygen Treatment Center, Department of Aerospace Medicine, Fourth Military Medical University of Chinese PLA in April 2002. Sixty-five 2-month-old healthy male SD rats.METHODS: The involved rats were randomized into: model group (n =20), normal control group (n =5), pure oxygen treatment group (n =20) and HBO treatment group (n =20). In the model group, following the method of Koizumi et al, rat models of middle cerebral artery (MCA) ischemia were developed. In the normal control group, only occlusion of arterial blood flow was omitted; In the pure oxygen treatment group, the operation procedure was the same as that of model group, and embolus being drawn out at ischemia for 1 hour, rats were placed in the hyperbaric cabin at 2,9,21, 45 and 69 hours after embolus being inserted, and they inhaled pure oxygen under the normal pressure; In the HBO treatment group, the operation procedure was the same as that of model group, and rats inhaled pure oxygen for 1 hour under 0.25 MPa pressure. MAIN OUTCOME MEASURES: By means of immunohistochemical and pathohistological methods, neutrophilic infiltration,c-fos oncogene protein and positive cell expression in cerebral cortex, preoptic area and corpora striatum of rats in each group were observed at cerebral I/R 5, 12, 24 and 72 hours; Neuronal necrosis degree in cerebral cortex, medial area of corpora striatum and preoptic area, and cerebrovascular leakage area of left cerebral hemisphere of rats were calculated.RESULTS: Sixty-five rats were involved in the final analysis. ① c-fos positive products mainly focused in the center of the preoptic area, but they were occasionally seen in the contralateral cortex, slightly expressed in the preoptic area and moderately expressed in the corpora striatum, c-fos positive products began to reduce in the above-mentioned area at ischemia 12 hours, and were obviously reduced at ischemia 24 hours; c-fos positive products in the cerebral cortex and preoptic area were obviously weakened in the HBO treatment group than in the simple ischemia group; At I/R 12 hours,neutrophils in the preoptic area and corpora striatum were significantly lower in the HBO treatment group than in the model group, respectively(P ＜ 0.05); At I/R 24 hours, neutrophils in the cerebral cortex, preoptic area and corpora striatum were significantly lower in the HBO treatment group than in the model group (P ＜ 0.05). ② Cerebrovascular leakage area was more significantly contracted in the HBO treatment group than in the model group (P＜ 0.05); At I/R 72 hours, the number of injured nerve cells in the optic chiasm cortex, medial area of corpora striatum and preoptic area was significantly smaller in the HBO treatment group than in the model group (P＜0.05). Neuronal damage was not found in the sham-operation group.CONCLUSION: HBO can markedly contract cerebrovascular leakage area of rats with acute focal cerebral ischemia/reperfusion injury, alleviate the symptoms of nervous system, inhibit neutrophilic infiltration and c-fos oncogene protein expression in the infarct area, and reduce neuronal necrosis in the "penumbral region".

BACKGROUND:Acute carbon monoxide (CO) poisoning may lead to delayed amnesia in rats,and which is similar to delayed neurologic syndrome caused by acute CO in human.So,this experiment is to investigate the pathogenesis of delayed neurologic syndrome by studying acute CO poisoning in the rats.OBJECTIVE:To observe the changes in delayed neuronal damage and memory after acute CO poisoning in the rats,and analyze their correlation.DESIGN:Randomized controlled animal experiment.SETTING:Department of Emergency,Tangdu Hospital,Fourth Military Medical University of Chinese PLA;Department of Laboratory Medicine,Xi'an Gaoxin Hospital;The General Hospital of the Air Force of Chinese PLA,Center for Hyperbaric Oxygen Treatment,Department of Aerospace Medicine,Fourth Military Medical University of Chinese PLA.MATERIALS:This experiment was carried out in the Laboratory of Aviation Pathology and Molecular Biology,Department of Aerospace Medicine.Fourth Military Medical University of Chinese PLA from July to November 2005.Fiftyhealthy male Sprague-Dawley(SD)rats were randomized into control group and CO poisoning group,with 25 rats each.METHODS:The awake rats in the CO poisoning group were placed in self-made jar for poisoning,then which was pumped with 0.999 volume fraction of CO.Rats in the jar inhaled the mixture of CO and air for 60 minutes.The average volume fraction of CO in the jar was 3.451×10-3.Rats in the control group were untouched.MAIN OUTCOME MEASURES:①The step down test was carried out in the rats before and 1,3,5 and 7 days after Coexposure.Escape latency was used as an index for evaluating the ability of memory retention.Shorter escape latencyindicated poor memory ability.②Pathological changes of brain tissue:After step down test was carried out following 1,3,5 and 7 days of CO exposure,6 rats were separately sacrificed in each group,and their brains were harvested.The brain tissue sections were performed haematoxylin & eosin (HE) staining for observing pathological injury degree and the amount of pyramidal neurons in hippocampal CA1 region.③SPSS 10.0 software was used to analyze the relationship of the amount of pyramidal neurons in hippocampal CA1 region and escape latency.RESULTS:Forty-eight rats were involved in the final analysis.①There were no significant differences in escape latencyon the 1"and 3"days after CO exposure between two groups. but escape latency in the CO poisoning group was significantly shorter than that in the control group on the 5th and 7th days after CO exposure(P＜0.05,0.01).②There were no significant changes in the amount of pyramidal neurons in hippocampal CA1 region on the 1st day after CO exposure between CO poisoning group and control group,but pyramidal neurons in hippocampal CA1 region in the CO poisoning group were significantly reduced on the 3rd,5th and 7th days after CO exposure,and 1 5%dead pyramidal neurons were found on the 7th day after CO exposure.③Decrease of pyramidal neurons in hippocampal CA1 region was significantly correlated with shortening of escape latency of rats in the CO poisoning group(r=0.270,P＜0.01).CONCLUSION:Acute CO poisoning leads to delayed neuronal damage,which causes delayed amnesia.

BACKGROUND: Nitric oxide (NO) plays an important role in the ischemic brain injury, and hyperbaric oxygen (HBO) can improve ischemia/reperfusion (I/R)-caused nerve injury. Whether the effect of HBO is associated with NO? Its mechanism needs to be further investigated.OBJECTIVE: To observe the changes of expression of nitric oxide synthase (NOS)-positive neurons of rats following acute focal cerebral I/R injury and HBO treatment.DESIGN: Randomized controlled animal experiment.SETTING: Department of Emergency, Tangdu Hospital, Fourth Military Medical University of Chinese PLA; Department of Laboratory Medicine, Xi'an Gaoxin Hospital; The General Hospital of the Air Force of Chinese PLA.MATERIALS : Sixty-six healthy male Sprague-Dawley rats were chosen and randomized into 5 groups: sham-operation group (n =5), sham-operation +HBO treatment group (n =5), model group (n =28), modeling +HBO treatment group (n =28). Ischemia 5,12, 24 and 72 hours four time points were set in the later 2 groups, 7 rats at each time point.METHODS: ①Rats in the model group and modeling+ HBO treatment group were created into models of middle cerebral artery ischemia according to the method from Koizum. Then, an embolus was inserted for ischemia; One hour later, the embolus was drawn out. Inserting embolus was omitted in the other two groups.②Rats in the sham operation + HBO treatment group and modeling + HBO treatment group were placed in HBO chamber at ischemia 2, 9, 21, 45 and 69 hours, separately, and given HBO treatment for 1 hour (0.25 MPa absolute pressure).MAIN OUTCOME MEASURES: The rats in each group were sacrificed at corresponding time points, and their brains were harvested. The distribution and morphology of NOS positive cells in cortical area, preoptic area, lateral and medial corpora striata of infarct region at the level of optic chiasma were observed with nicotinamide-adenine dinucleotide phosphate -diaphorase (NADPH-d) histochemical method.RESULTS: After supplement, 66 rats were involved in the final analysis. ①After ischemia, NOS-positive neurons changed in morphology, mainly presenting prominences were reduced or disappeared, neurons changed from ellipse or triangle into global shape, and shrank; Body of neuron darkly dyed; Both nucleus and cytoplasm were deeply dyed into dark blue; NOS-positive neurons with changed morphology were mostly in lateral corpora striatum, followed by preoptic area and medial corpora striatum, and those in the cortical area were few. NOS-positive neurons with changed morphology were not found in the sham-operation group and sham-operation + HBO treatment group. ②In the model group, NOS-positive neurons with changed morphology were increased with elongation of I/R time. At each time point, NOS-positive neurons in cortical area, preoptic area and medial corpora striatum in modeling + HBO treatment group were less than those in model group, but NOS-positive neurons in two groups both reached their peaks at ischemia 72 hours [Cortical area: (15.46±3.02) vs.(30.52±4.73)/visual field; Preoptic area:(28.56±4.05) vs. (68.81±7.84)/visual field; medial corpora striatum:(21.09±3.83) vs.(45.71±5.24)/visual field; all P＜0.01].CONCLUSION: HBO obviously inhibits the degeneration of NOS-positive neurons in acute focal cerebral I/R injury regions of rats, such as cortical area, preoptic area, medial corpora striatum, and so on

BACKGROUND:By using ultrasound examination, renal function was conventionally assessed through measuring the blood flow parameters of large renal arteries in all levels and the rate of the color flow area in arter ies on the cross section of kidneys, in which method great errors have been induced.OBJECTIVE: This study was designed to assess the renal blood perfusion with use of the image analysis software package in the color Doppler system.DESIGN: It was an experimental study on animals.SETTING: This study was conducted in the Department of Functional Examination of Guangzhou First People' s Hospital.MATERIALS: The study had been accomplished at the Animal Laboratory of the General Hospital of Guangzhou Military Area Command of Chinese PLA from January 1999 to Aprial 2000. Eight healthy New Zealand rabbits were selected, 4 females and 4 males and weighing 2.5-3.5 kg.Sixteen kidneys of them were examined. A self-made contrast medium, with prevailing ingredient of albumin shelled and CsF8 gas-filled microbubbles,was used in this study.METHODS: After intravenous bolus injection of a fluorocarbon contrast medium, a color Doppler energy mapping, a color flow mapping and a power Doppler harmonic imaging of renal blood flow were collected successively and a time-density curve were created with system's standard software.MAIN OUTCOME MEASURES: The time-density curve of renal blood perfusion with contrast-enhanced color Doppler was a main outcome measurement in the study.RESULTS: All of the 8 rabbits entered the analysis procedure. The contrast-enhanced time-density curve of renal blood perfusion was singlepeaked, with a rapid incline and a subsequent slow decline. Quantitative analysis of interested sections could be performed by replaying the corresponding contrast-enhanced color Doppler images at a certain time after injection.CONCLUSION: The time-density curve of color flow mapping and color Doppler energy mapping is capable of reflecting the features of renal blood perfusion effectively. It can display not only the general renal perfusion but also the segmental regions with low perfusion, and thus to delineate the functional lesions in the kidneys.

OBJECTIVETo explore the correlationship between platelet count and efficacy of traditional Chinese medicine (TCM) or Western medicine (WM) in treating rheumatoid arthritis (RA) patients.

METHODSA total of 356 patients with confirmed diagnosis of active RA from 9 clinical centers were randomly assigned to the TCM group (184 cases) and the WM group (172 cases). The TCM group was treated with basic therapy (administration of glucosidorum tripterygll totorum and Yishen Juanbi Pill) and TCM syndrome differentiation dependent treatment, while the WM group was treated with non-steroidal anti-inflammatory drugs and slow-acting anti-rheumatic drugs. The therapeutic efficacy was assessed with ACR20, the joint damage degree of both hands was evaluated by X-ray.

RESULTSThe platelet count was positively correlated to the X- ray grading of joint damage, namely, patients with a more severe joint damage often presented a higher platelet count. After treatment, in patients with joint damage of X-ray grade II or III and effectively treated with TCM, also in patients with joint damage of grade III and effectively treated with WM, the platelet count was lower than that in those treated ineffectively.

CONCLUSIONPlatelet count is closely correlated to the efficacy of drug therapy, therefore, it may be taken as an important index for judging the curative effect of therapeutic approach in treating RA patients.

Adult ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthritis, Rheumatoid ; blood ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Platelet Count ; Treatment Outcome ; Tripterygium ; chemistry

OBJECTIVETo explore the correlations between diagnostic information and therapeutic efficacy in rheumatoid arthritis (RA) with decision tree model analysis.

METHODSThree hundred and ninety seven patients came from 9 clinical centers were randomly divided into the Western medicine (WM) group (n=194) treated with non-steroidal anti-inflammatory drugs and slow-acting antirheumatic drug and the Chinese medicine (CM) group (n=203) with basic therapy and syndrome-differentiation dependant TCM treatment. TCM and WM diagnostic information were collected. The ACR 20 was used for efficacy evaluation and the information of patients before treatment was analyzed by SAS 8.2 statistical package. Through single-factor exploratory analysis, odds ratio of efficacy and variable was calculated taken P < 0.2 as the including criteria for data mining analysis with decision tree model. All data were classified into the training set (75%) and verifying set (25%) with efficacy as the variable for layering to make further verification of the data-mining analysis.

RESULTSTwenty variables were included in the CM group and 26 in the WM group in the data-mining model. In the former, 9 variables were positively correlated to the efficacy, including degree of arthralgia, tenderness and morning stiffness, number of swollen joint, and joint with tenderness, levels of IgM, rheumatoid factor (RF), C-reactive protein (CRP), and total assessment from doctor; and disease duration and degree of nocturnal polyuria were negatively correlated to that. While in the latter, 8 were positively correlated to the efficacy, including erythrocyte sedimentation rate (ESR), sour and weak waist and knees, white fur in tongue, joint ache and stiffness, swollen joint, and total assessment from doctor and patient, and red tongue with yellow fur and leucocyte count negatively correlated to it. Data mining with decision tree analysis revealed that different combinations of morning stiffness, slight red tongue, joint tenderness and nocturnal polyuria in the CM group, and those of white fur in tongue, CRP level, leucocyte count and morning stiffness in the WM group showed different efficacy, which were also verified in the randomly chosen verifying set.

CONCLUSIONTo analyze the correlations between diagnostic information and therapeutic efficacy with decision tree analysis is conformed to the theory of TCM in applying treatment according to syndrome differentiation individually, thus it would contribute to elevate the accuracy of therapy.

Adolescent ; Adult ; Aged ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthritis, Rheumatoid ; diagnosis ; drug therapy ; Decision Trees ; Diterpenes ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Epoxy Compounds ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phenanthrenes ; therapeutic use ; Phytotherapy ; Treatment Outcome