Objective: To evaluate the effects of percutaneous balloon pulmonary valvuloplasty ( PBPV) for pulmonary valve stenosis (PS) by single-balloon, double-balloon and Inoue-balloon methods. Methods: PBPV was performed in 42 patients with PS. The systolic right ventricular pressure (SRVP) , systolic right ventricular outflow pressure and systolic pulmonary arterial pressure ( SPAP) were contrasted before and after the procedure. Systolic transpulmonary valve pressure gradient (TVPG) and total pressure gradient from right ventricular to pulmonary arterial after the procedure were compared among the three gropes. Results:SRVP, SRVOP were decreased from (14. 69?6. 01 )kPa, (12. 16?3. 48)kPa to (8.14?5.26)kPa, (5.39?2.21)kPa and PAP increased from (1.57?0.56)cm to (17. 16? 2.16)cm after PBPV, respectively. TVPGs were (2. 40?2. 05) kPa, (3. 29?2. 25 ) kPa, (2.52? 1.95)kPa and TPGs were (2. 40?2. 05)kPa, (4.98?4.26)kPa, (6.16?6.93)kPa, (5.65?4.75) kPa after PBPV by single balloon, double balloon and Inoue balloon methods, respectively. During the follow-up period (2. 5?1. 6) years, bloodflow velocity at pulmonary valve measured by supersonic Doppler decreased from (2. 38?1. 89) m/s immediately after PBPV to (2.22?1. 96) m/s, further TVPG decreasing was indicated. Conclusion: The short and long term results of PBPV for PS by each of the three methods were excellent. Inoue balloon may be the first choice for elder children and adults, while for younger children, single balloon method may be preferred. Double balloon method can be remained as the second choice when Inoue method failed.

Objective To evaluate the efficacy of combination therapy with finasteride and doxazosin in benign prostatic hyperplasia/ lower urinary tract symptoms (BPH/LUTS) patients with intravesical prostatic profusion (IPP).Methods A total of 322 BPH/LUTS patients who accepted combination therapy with finasteride and doxazosin were enrolled in this study.Patients were divided into 4 groups according to the degree of IPP:group Ⅰ(IPP＞10 mm),group 2 (IPP between 5 mm and 10 mm),group 3 (IPP＜5 mm),control group (without IPP).All patients were received inasteride 5 mg once per day and doxazosin 4 mg once per day for 6 months.International prostate symptom score (IPSS),prostatic specific antigen(PSA),ultrasonographic and urcdynamic evaluation were compared before and after treatment.The correlations between the above factors and IPP were estimated by Logistic regression analysis.Results After 6 month of treament,the changes of IPP degree and the maximal urinary flow rate (Qmax) had no significant differences in group 1,group 2 and group 3 as compared with before treatment (all P＞0.05).The IPSS in group 1 was not significantly different before and after treatment (P＞0.05).There were significant differences in the PSA level,IPSS,total prostate volume (TPV),transition zone volume (TZV),residual urine volume (PVR) in the 4 groups before and after treatment (all P＜0.05).Logistic regression analysis showed that PVR and Qmax had positive and negative correlations with IPP (P＜0.001 and P=0.024),respectively.Conclusions Combination therapy with finasteride and doxazosin can significantly improve the symptoms of LUST and reduce the total prostate volume in patients with BPH/LUTS,but for BPH patients with IPP,the combination therapy can not effectively alleviate the degree of IPP.The increase of residual urine volume and decrease of Qmax may enhance the risk of bladder outlet obstruction in BPH patients with IPP.

Objective To evaluate the clinical value of pulmonary embolism severity index (PESI) in non high-risk acute pulmonary thromboembolism (APTE) patients treated with sequential anticoagulation.Methods Non high-risk APTE patients treated with sequential anticoagulation were divided into two groups according to PESI:high-value group and low-value group.Prognosis and treatment response was compared between two groups.Results There were 82 cases in high-value group,and 76 cases in low-value group.The rate of adverse events in high-value group was significantly higher than that in low-value group [23.2％(19/82) vs.7.9％ (6/76)] (x2 =5.0698,P =0.009),and 30 days cumulative hazard was also significantly higher than that in low-value group (P ＜ 0.05).The sensitivity of predicting adverse events by PESI was 76.0％,specificity was 52.6％,positive predicting value was 64.6％,and negative predicting value was 65.9％.The mortality in high-value group was significantly higher than that in low-value group [9.8％(8/82) vs.1.3％ (1/76)] (P =0.022).After 30 days of anticoagulation,the pulmonary artery systolic pressure,internal diameter of right ventricle in high-value group was significantly higher than that in low-value group [(39.4 ± 8.1) mm Hg (1 mm Hg =0.133 kPa) vs.(27.2 ± 5.5) mm Hg,(33.0 ± 7.8) mm vs.(21.7 ± 4.6) mm] (P =0.034,0.021),and arterial oxygen partial pressure was significantly lower than that in low-value group[(75.15 ± 12.41) mm Hg vs.(86.36 ± 9.22) mm Hg](P=0.016).Conclusions PESI can effectively predict short-term prognosis of non high-risk APTE patients treated with sequential anticoagulation.At least some of these patients might need treatment other than sequential anticoagulation.

Adolescent ; Adult ; Child ; Disasters ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Sunburn ; Young Adult

OBJECTIVETo seek an effective drug for treatment of human hyperplastic scar through studying the effects of curcumin on fibroblast growth and collagen synthesis.

METHODSFibroblasts derived from scar tissue and from normal epidermal tissue were isolated and cultured separately with tissue-block method, their morphology were observed under invert phase contrast microscope, their growth curve was drawn respectively to determine the speed of growth. Then, fibroblasts from scar were stimulated with curcumin in different concentrations (0, 12.5, 25, 50 and 100 micromol/L) for detecting the inhibitory effect of curcumin on growth of fibroblasts using MTT methods and that on activity of procollagen alpha-1 gene transcription in fibroblast was detected by RT-PCR.

RESULTSThe cell growth curve showed that double-multiplying time was 5 days in fibroblasts from scar and 4 days in those from normal dermis, showing significant difference between them (P < 0.05). MTT showed that curcumin in 12.5 micromol/L showed a cell proliferation enhancing trend, and its absorbance value was significantly higher than that in the normal group, but the effect turned to inhibition when concentration increased to over 25-100 micromol/L, and became significant inhibition at concentration of 50 and 100 micromol/L. Besides, curcumin also showed markedly inhibition on collagen type I synthesis in fibroblasts (P < 0.01).

CONCLUSIONHigh concentration curcumin can inhibit effectively the fibroblast proliferation and collagen I synthesis in hyperplastic scar, therefore, may has therapeutic effect on the disease in human being.

Cell Proliferation ; drug effects ; Cells, Cultured ; Cicatrix, Hypertrophic ; metabolism ; pathology ; Collagen Type I ; biosynthesis ; Curcumin ; pharmacology ; Fibroblasts ; drug effects ; metabolism ; pathology ; Humans

Objective To evaluate the value of cough test in the tension-free vaginal tape (TVT)procedure.Methods A cohort of 85 women with stress urinary incontinence underwent the TVT procedure with cough test (n =41) or without cough test (n =44).Patients in cough test group were performed according to the Ulmsten’s method strictly,with the stress of tape adjusted in light of cough test; whereas in other 44 operations,the tape was placed on the urethral tract without stress,and no cough test was performed.The urine catheter was removed after 48 hours postoperatively and follow-up evaluation was carried out at 12 month postoperatively.Results TVT procedure was carried out successfully in all patients by a single experienced surgeon.Four cases of urinary retention and 5 cases of voiding difficulty were observed in the cough test group.However,urinary retention or voiding difficulty was not detected in the nun-cough test group.Based on the twelve-month follow-up results,the cure rate was 92.6％ (38/41) in the cough test group and 93.1％ (41/44) in the non-cough test group.Flow-pressure study indicated that 11 cases in cough test group were in the obstruction zone,while only 3 cases in the obstruction zone were detected in the non-cough test group.Conclusions TVT is a safe as well as effective minimally invasive surgical procedure to treat female stress urinary incontinence.However,Adjusting stress of tape in accordance with cough test during the TVT may potentially increase the incidence of urinary dysfunction postoperatively.Therefore,no convincing evidence was gained to support the efficacy of cough test during TVT in terms of preventing postoperative voiding dysfunction.

Objective To evaluate the efficacy of itraconazole combined with glucocorticosteroid in allergic bronchopulmonary aspergillosis.Methods The clinical characteristics and data of 11 allergic bronchopulmonary aspergillosis patients treated with itraconazole combined with glucocorticosteroid were retrospectively collected before treatment and two months after treatment.Then the clinical characteristics and data before and after treatment were compared to evaluate the efficacy of the treatment.Results The symptoms and signs got better after two months' treatment.C reactive protein,IgE and eosinophile granulocyte count after two months' treatment were significantly lower than that before treatment [(7 ±2) mg/L vs.(42± 13) mg/L,(742 ± 236) kU/L vs.(1 685 ±477) kU/L,(343 ± 112) × 106/L vs.(1 925 ± 318) × 106/L],and forced expired volume in one second percentage of predicted and arterial partial pressure of oxygen after two months' treatment were significantly higher than those before treatment [(77.5 ± 8.6)％ vs.(32.4 ± 9.1)％ and (81 ± 12) mmHg (1 mmHg =0.133 kPa) vs.(53 ± 6) mmHg],there were statistical differences (P ＜ 0.01 or ＜ 0.05).The inflammatory exudates resolved as demonstrated in pulmonary CT scan.Conclnsion Itraconazole combined with glucocorticosteroid can effectively neat allergic bronchopulmonary aspergillosis.

Adolescent ; Adult ; Environmental Exposure ; Female ; Humans ; Inhalation Exposure ; Male ; Middle Aged ; Nasopharynx ; pathology ; Sulfuric Acid Esters ; poisoning ; Young Adult

Objective To evaluate the value of preoperative ultrasonographic parameters in predicting the outcome of TURP.Methods A total of 202 patients with symptomatic benign prostatic hyperplasia (sBPH) entering our department for surgical therapy were prospectively recruited,with mean age of (65.5 ± 8.1) years,international prostate symptom score (IPSS) of 16.6 ± 8.1 and quality of life (QOL) score of 5 (3,6).Preoperative combined test of ultrasonography and urodynamics has found total prostate volume (TPV),transitional zone volume (TZV),transitional zone index (TZI),intravesical prostatic protrusion (IPP),resistive index (RI),postvoiding residue (PVR),detrusor wall index (DWT),ultrasonic estimation of bladder weight (UEBW) and maximum flow rate (Qmax) to be (75.0 ±38.5) ml,(49.9 ± 32.4) ml,0.59 ±0.14,(17.2 ±5.0) mm,0.63 ±0.12,(132.7 ±97.8)ml,(16.3 ±7.9)mm,(44.8 ± 7.1)g and (6.1 ± 6.0)ml/s respectively.A 6-monthsfollow-up after standard TURP were applied including re-measurement of IPSS,QOL score and Qmax.The patients were classified into 2 groups of effective and ineffective after the recovery being stratified into 4 levels of none,fair,good and excellent.The influence of preoperative ultrasonographic parameters on surgical outcome was analyzed by logistic regression and receiver operating characteristic (ROC) curve.Results The group of effective has 149 patients,with the preoperative TZI,IPP,RI,DWT and UEBW of 0.65 ± 0.27,(18.3 ± 3.1) mm,0.77 ± 0.18,(19.0 ± 5.0) mm and (46.6 ± 7.1) g,which were significantly higher than that of the group of ineffective (P ＜ 0.05) Lower RI,DWT and UEBW were found to be risk factors of unfavorable surgical efficacy (P ＜ 0.05) from multivariable analysis.The area under curve (AUC) of RI,DWT and UEBW in outcome prediction was 0.816,0.732 and 0.723 respectively from ROC curve,indicating the good predictive value of the 3 parameters with combined positive predictive value (PPV) of 96.3％.Conclusion RI,DWT and UEBW have favorable value in predicting TURP outcome.Measuring these parameters by preoperative ultrasonography might aid in determining the need for surgical intervention in sBPH patients.

A site-directed mutant DNA fragment was synthesized and transfected into clinical Neisseria gonorrhoeae (NG) stains to construct the transformants that contained the corresponding mutagenesis of regulation region of mtrR gene. According to the technique of gene splicing by overlap extension (SOEing), a DNA segment with specific mutagenesis was constructed by two-step polymerase chain reaction (PCR). The mutation fragments EF could be used for the next experiment in which the mutation NG strains were induced. By comparing the recombinant EF fragments to the corresponding DNA fragments of clinical NG strains, 2 of these were not compatible completely. The results of sequencing revealed that there was a 9 bp deletion between the 45 to 54 inverted repeat sequence localized within the mtrR promoter. It can be confirmed that the fragments EF are the specifically designed mutant fragments.
Bacterial Proteins/*genetics ; DNA Fragmentation ; DNA, Bacterial/genetics ; Mutagenesis, Site-Directed ; Neisseria gonorrhoeae/*genetics ; Neisseria gonorrhoeae/metabolism ; Recombination, Genetic ; Repressor Proteins/*genetics ; Sequence Deletion ; Transfection ; Transformation, Bacterial