OBJECTIVETo investigate the effect and safety of extracorporeal shock wave (ESW) in the treatment of pain symptom of type III B prostatitis.

METHODSWe treated 50 cases of type III B prostatitis by ESW once a week for 4 weeks. Then we evaluated the clinical effect and safety of the therapy based on the NIH-CPSI scores, visual analogue scale (VAS) scores, IIEF-5 scores, prostate volume and morphous, state of urination, color of urine, results of routine semen analysis, and changes of cytokines (IL-6, TNF-α and IL-1β) in expressed prostatic secretion (EPS).

RESULTSAll the patients successfully accomplished the treatment. Compared with the baseline, decreases were observed after 4 weeks of cytokine treatment in the pain scores (14. 61 ± 1. 82 vs 9. 36 ± 1. 47, P <0. 01), urination symptom scores (4. 59 ± 1. 01 vs.4. 66 ± 0. 89, P >0. 05) , quality of life scores (6. 51 ± 1. 03 vs 4. 56 ± 1. 02, P <0. 01), NIH-CPSI (25. 43 ± 1. 72 vs 18. 28 ± 2. 32, P <0. 01 ), and VAS (6. 59 ± 1. 10 vs 3. 02 ± 1. 07, P < 0. 01). The concentration of IL-6 in the EPS was significantly increased ([55.82 ± 6. 28] vs [86.59 ± 4. 55] ng/ml, P <0. 01) , while the level of TNF-α ([3.89 ± 0. 12] vs [3. 19 ± 0.22] ng/ml, P<0.01) and that of IL-1β ([3.21 ± 1.01] vs [1.48 ± 0.95] ng/ml, P< 0. 01) remarkably reduced after treatment. However, there were no statistically significant differences in IIEF-5 scores (18. 58 ± 2. 03 vs 18. 51 1. 89, P >0. 05) or various sperm parameters before and after treatment (P >0. 05). And no significant changes were observed in the prostate volume, morphous or internal echoes.

CONCLUSIONThe ESW therapy is effective and safe for the pain symptom of type III B prostatitis.

Adult ; Body Fluids ; Humans ; Interleukin-1beta ; metabolism ; Interleukin-6 ; metabolism ; Male ; Middle Aged ; Pain ; etiology ; metabolism ; Pain Management ; methods ; Prostatitis ; complications ; metabolism ; therapy ; Quality of Life ; Spermatozoa ; physiology ; Tumor Necrosis Factor-alpha ; metabolism ; Ultrasonic Therapy ; methods ; Urine

Aged ; Humans ; Male ; Middle Aged ; Mycoses ; complications ; Nasal Septal Perforation ; complications ; microbiology ; Sinusitis ; complications ; microbiology

Adolescent ; Adult ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Hepatitis B, Chronic ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy

Objective To evaluate the value and the significance of 16-slice spiral computed tomography angiography(MSCTA) in identifying the vertebral artery course variation.Methods MSCTA data in 22 patients with anomalous path of vertebral artery were retrospectively analyzed,13 of them had undergone DSA examinations,and 5 of them had also undergone MRI examinations.Multi-planar reconstruction(MPR),curved MPR,thin-slab maximum intensity projection(MIP),volume rendering(VR) or slab VR(cut-plane VR) were used to assess the anomalous path of the vertebral artery and its relationship with the adjacent large vessels.Virtual endoscopy(VE) was used to evaluate the orifice of the vertebral arteries and its relationship with the aortic arch and the ostia of the adjacent large vessels.Different views of vertebral artery were analyzed on DSA.MSCTA and DSA images were analyzed in blinded fashion for the accuracy of anomalous vertebral artery path and origin detection.Results were compared in a secondary consensus evaluation.Results The anomalous path of the vertebral artery in all 22 patients were correctly displayed on MSCTA,7 of them had anomalous origin of vertebral artery,the anomalous of ostia showed clearly.The vertebral arteriae with course variation were all going up at the front of the foramen transversarium of C6,then bended into the C5,C4 or C3 foramen transversarium.DSA could only be detected the anomalous origin in 13 patients undergone DAS.5 patients indirectly showed having course variation of vertebral artery by MRI.Conclusion MSCTA is superior to DSA in showing the anomalous path and orifice of vertebral artery,it should be considered as a non-invasive imaging tool for these diseases.

BACKGROUND: Sleep deprivation cannot only cause learning and memory impairment of animal and human, but also lead to increased content of nitric oxide in brain tissue of rats. Melatonin has the effects of antifreeradical and antioxidation. It has been reported that melatonin can improve aluminum chloride and morphine abstinence induced learning and memory impairment of animal, however, whether it has influence on sleep deprivation induced learning and memory impairment is not very clear. OBJECTIVE: To observe the effect of melatonin on memory of rats after sleep deprivation and analyze its possible mechanism. DESIGN: Randomized controlled trial.SETTING: Teaching and Experiment Center of Basic Medicine and Department of Nursing, the Fourth Military Medical University.MATERIALS: The experiment was performed in Teaching and Experiment Center of Basic Medicine of the Fourth Military Medical University in January 2005. A total of 24 adult male Sprague Dawley rats were selected and randomly divided into 3 groups, namely, control group, small dosage of melatonin group and large dosage of melatonin group, with 8 in each group on the basis of random digits table.METHODS: To rats in small dosage of melatonin group and large dosage of melatonin group, the dosage of melatonin was 5 mg/kg and 15 mg/kg respectively, which was made into 2 mL solution and intraperitoneally injected into the rats at 17:00 o'clock every day, while rats in control group were injected with 2 mL physiological sodium at the same time, once a day for continuous 7 days. Then a 3-day sleep deprivation was given to the rats; melatonin or physiological sodium were also given according to different groups during these days. Rat model of sleep deprivation was established by "Flower Ppot" technique; water maze was used for detecting the memory of rats after 48-hour and 72-hour sleep deprivation; took escape latency (s) as indicator of changes of learning and memory of rats; the shorter the escape latency, the better the spacial memory of rats. When sleep deprivation was finished, all the rats were put to death and hippocampus and cerebral cortex were taken out in ice bath. The content of nitric oxide in cerebral cortex and hippocampus was detected with the method of nitrate reduction, and malondialdehyde (MDA) with the method of thiobarbital acid.MAIN OUTCOME MEASURES: Results of escape latency after 48hour and 72-hour sleep deprivation. Contents of nitric oxide and MDA in cerebral cortex and hippocampus of rats.There was significant difference in escape latency in water maze after 48-hour and 72-hour sleep deprivation among each group (F=11.886, P=0.000)and (F=5.440, P=0.012); the escape latency after 48-hour and 72-hour sleep deprivation remarkably decreased both in small and large dosage of melatonin groups as compared with control group, and the latency after 48-hour sleep deprivation was shorter in large dosage group than that in small ide and MDA in brain of rats among each group, namely, nitric oxide in cerebral cortex (F=14.038, P=0.000), MDA in cerebral cortex (F=27.414,P=0.000), nitric oxide in hippocampus (F=22.692, P=0.000), MDA in hippocampus (F=14.316, P=0.000). Compared with control group, the contents of nitric oxide and MDA in cerebral cortex and hippocampus in the two experimental groups decreased significantly, and there was obvious difference in the content of nitric oxide in hippocampus between large and small dosage groups, which showed a dose-effect relationship.CONCLUSION: Melatonin can improve memory impairment of rats after sleep deprivation, which may be closely related to the effect of inhibiting the increase of nitric oxide and MDA in their cerebral cortex and hippocampus.

Objective To explore the effect of early goal-directed therapy (EGDT) according to pulse indicated continuous cardiac output (PiCCO) on septic shock patients.Methods Eighty-two septic shock patients in Subei People's Hospital of Jiangsu Province from January 2009 to December 2012 were enrolled and randomly divided into two groups using a random number table,standard surviving sepsis bundle group (n=40) and modified surviving sepsis bundles group (n =42).The patients received the standard EGDT bundles in standard surviving sepsis bundle group.PiCCO catheter was placed in modified surviving sepsis bundles group.Fluid resuscitation was guided by intrathoracic blood volume index (ITBVI) with the aim of 850-1 000 mL/m2.Dobutamine was used to improve the heart function according to left ventricular contractile index (dPmax) and stroke volume index (SVI).The mean arterial blood pressure (MAP) was maintained 65 mmHg (1 mmHg=0.133 kPa) or above with norepinephrine.Extra-vascular lung water was monitored for the titration of liquid and diuretics.The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,sequential organ failure assessment (SOFA) score,the number of patients needed vasopressor,serum procalcitonin (PCT),lactic acid and lactate extraction ratio,the amount of fluid resuscitation,duration of mechanical ventilation,duration of intensive care unit (ICU) stay,hospital mortality were recorded in both groups.Results After treatment,the APACHE Ⅱ score,SOFA score and the number of patients needed vasopressor were gradually reduced in both groups,and those in modified surviving sepsis bundle group were significantly lower than those of standard sepsis bundle group at 72 hours (APACHE Ⅱ score:13.1 ± 6.5 vs.20.9 ± 7.5,SOFA score:8.8 ± 4.3 vs.14.6 ± 4.9,the number of patients needed vasopressor:8 vs.17,all P＜0.05).Arterial blood lactate clearance rate was gradually increased after treatment in both groups.Lactate clearance rate in modified surviving sepsis bundle group was significantly higher than that of standard surviving sepsis bundle group [6 hours:(18.2 ± 8.3)％ vs.(10.8 ± 7.5)％,t=-6.036,P=0.001 ; 12 hours:(22.6 ± 7.3)％ vs.(12.4 ± 8.1)％,t=-4.536,P=0.001 ; 24 hours:(27.8 ± 5.6)％ vs.(16.4 ± 9.5)％,t=-5.882,P=0.000].The amount of fluid resuscitation within 6 hours in modified surviving sepsis bundle group increased significantly compared with standard surviving sepsis bundle group (mL:3 608 ± 715 vs.2 809 ± 795,t=-3.865,P=0.033).The amount of fluid resuscitation within 24,48 and 72 hours in modified surviving sepsis bundle group was significantly less than that of standard modified surviving sepsis bundle group with the nadir at 72 hours (mL:918 ± 351 vs.1 805 ± 420,t=5.907,P=0.037).Duration of mechanical ventilation (hours:98.4 ± 20.3 vs.143.3 ± 29.6,t=9.766,P=0.001) and ICU stay (days:7.1 ± 3.1 vs.9.5 ± 2.5,t=2.993,P=0.004) were significantly reduced in modified surviving sepsis bundle group compared with standard surviving sepsis bundle group.The hospital mortality in modified surviving sepsis bundle group was slightly lower than that in standard surviving sepsis bundle group [16.7％(7/42)比 17.5％(7/40),x2=0.010,P=0.920].Conclusions Modified surviving sepsis bundle treatment according PiCCO can reduce the severity of disease in patients with septic shock,can make more accurately guide fluid resuscitation,and can reduce lung water and duration of mechanical ventilation and ICU stay.It has great clinical significance.

Objective To investigate the clinical effects of the pulse indicator continuous cardiac output (PiCCO) in goal-optimized fluid management on patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure.Methods A total of 71 AECOPD patients with respiratory failure who were hospitalized in department of Critical Care Medicine in our hospital were selected from October 2010 to September 2013.The PiCCOtechnology was applied to monitor intrathoracic blood volume index (ITBI) and extravascular lung water index (ELWI).We compared the relationship of ELWI with ITBI and oxygenation index,and a simple correlation analysis was used for statistical analysis.Results A significantly negative correlation was found between ELWl and oxygenation index (r=-0.743,P＜0.01).ELWI =14 ml/kg was defined as the cutoff value for the subgroup analysis.A negative correlation still was found between ELWI and oxygenation index in the subgroup with ELWI ＜ 14 ml/kg,but it had no significant difference (r=-0.533,P=0.080),while a significantly negative correlation was found in the subgroup with ELWI≥14 ml/kg (r=-0.961,P＜0.01).There was no significant correlation between ELWI and ITBI (r=0.477,P=0.072).ITBI=1 000 ml/m2 was defined as the cutoff value for the subgroup analysis.There is no significant correlation between ELWI and ITBI in the subgroup with ITBI＜1 000 ml/m2(r=0.338,P=0.116),but in the subgroup with ITBI≥1 000 ml/m2,a significantly positive correlation between ELWI and ITBI was found (r=0.677,P＜ 0.01).Conclusions The results suggest that when ELWI is higher than 14 ml/kg,ELWI becomes an important influencing factor for oxygenation,which can be decreased to improve oxygenation in patients with AECOPD,and when ITBI≥ 1 000 ml/m2,ITBI can be reduced by decreasing ELWI.PiCCO has an important clinical significance on a goal-optimized fluid management in AECOPD patients with respiratory failure.

AIM: To observe the effects of puerarin on blood pressure(BP),serum lipid in a rat model of insulin resistance and the mechanism.METHODS: Adult SD rats were maintained on high-fat-sugar-salt diet for 12 weeks.Puerarin was administered to the rats from 9th week for 4 weeks by intramuscular injection.BP was measured at the end of 0,8th,12th week.The levels of serum glucose,serum lipid,fasting serum insulin and the levels of MDA,TNF-?,plasma rennin,angiotensinⅡ(AngⅡ) and the activity of SOD were measured and the insulin-sensitivity index was also calculated at the end of the experiment.RESULTS: High and middle dosage of puerarin significantly decreased blood pressure,reduced the levels of serum lipid and AngⅡ,and also increased insulin-sensitivity index.The levels of MDA and TNF-? were significantly decreased by high dosage of puerarin.The activity of SOD was increased significantly.CONCLUSIONS: Puerarin possesses the effects of decreasing the blood pressure and serum lipid in a rat model of insulin resistance,which may be concerned with the changes of rennin-angiotensin system,the levels of oxygen-derived free radicals and TNF-?.

Objective To understand the mortality rate and cause of the injury in Hebei province in order to provide scientific theoretical basis for drawing up effective prevention measures.Methods The injury deaths data was collected from 18 surveillance spots in Hebei province during 2004—2005,and the injury was classified with ICD-10 and the corresponding mortality rates were calculated.Results The average injury mortality rate was 54.02/100 000(the age-adjusted rate was 51.62/100 000).It was the 5 th-ranked cause of death.The leading five causes of injury were traffic injury by motor vehicles, traffic injury by non-motor vehicles,suicide,poisoning and fall,which accounted for 23.96%,22.05%,13.10%,11.99%, 5.62%,respectively.The average injury mortality rate in rural(58.48/100 000)was higher than in urban(31.60/100 000)(?~2= 255.82,P

·AIM: To evaluate the recurrence rate and safety of amniotic membrane transplantation (AMT) augmented with mitomycin C (MMC) compared with amniotic membrane transplantation alone during the pterygium excision.·METHODS: We took a meta-analysis on this program.Pertinentstudieswereselectedthroughextensive searches of the Cochrane Library, MEDLINE, EMBASE,CBMdisc, CNKI. Pooled estimates were carried out in RevMan software V4.2.·RESULTS: Six trials reported postoperative recurrence rate of pterygium, included 882 eyes, three trials reported the complications. The results of meta-analysis showed that recurrence rate of AMT plus MMC group was 5.41％,AMT alone group was 16.89％, relative risk (RR) was 0.32, 95％CI ranged from 0.19 to 0.56, Zwas 4.06, P< 0.001. Two trials reported early complication as punctata keratitis, the incidence rate of AMT plus MMC group and AMT alone group were 17.14％ and 0.00％, RR was 12.11,95％CI ranged from 1.62 to 90.76.·CONCLUSION: Amniotic membrane transplantation with MMC is associated with lower recurrence rate compared with amniotic membrane transplantation alone in pterygium excision,whether accompanied a higher risk with adverse events need more investigation.