Child ; Humans ; Masturbation ; Medicine, Chinese Traditional ; Qi ; Syndrome ; Yin-Yang

Objective To investigate the efficiency of transjugular intrahepatic portosystemic shunt (TIPS) with Fluency stent in improving the hepatic and renal function and survival rate in patients with decompensated cirrhosis.Methods The decompensated cirrhosis patients who were treated in our hospital from May 2008 to September 2011 were retrospectively analyzed.One group of patients (n =48) undergoing TIPS was randomly selected as treatment group,while another group of patients (n =48) treated by medicine and therapeutic endoscope was randomly chosen as control group.Clinical data and fellow-up data were retrospectively reviewed.There was no significant deviation in baseline characteristics (age,gender composition,etiology,renal function,hepatic function et al) among all the patients before the operations; The laboratory results of hepatic and renal function in 2 groups before and after operation (1 week,20 days,3 months,6 months,1 year,2 years,3 years) were recorded and compared with independent samples t-test or Wilcoxon rank sum test.The survival rates of two groups in 3 years were analyzed using Kaplan-Meier survival curve and compared with Chi-square test.Results Three years after the operation,there were significant differences between the treatment group and the control group in AST(70.8 vs.108.7 U/L,Z =-2.958,P ＜ 0.05) and TBIL (51.2 vs.76.2 μmol/L,Z =-2.004,P ＜ 0.05).The Cr value of the 3rd year after the treatment were (9928.2 ± 2363.8) in the the control group and (7742.1 ± 2845.6) μmol/L in the treatment group(t =-2.074,P ＜ 0.05).BUN of the 1st,2nd and 3rd years after the treatment were (2.0 ± 1.1),(2.3 ± 1.5),(2.5 ± 1.3) mmol/L in the treatment group,while it was (2.6 ± 1.1),(3.8 ±1.2),(5.4 ± 1.1)mmol/L in the control group.There was significant difference between the 2 groups (t =-2.222,-3.940 and-6.110,P ＜ 0.05).Comparing the survival rate in the 2 groups with Kaplan-Meier survival curve,the 3 year survival rate in the treatment group was 46.2％,while in the control group it was only 30.0％ (x2 =6.341,P ＜ 0.05).Conclusions Compared with medicine therapy and therapeutic endoscopy,TIPS with Fluency stent may improve the hepatic function,renal function and survival rate in liver cirrhosis patients.It is a safe and effective therapy choice for patients with decompensated cirrhosis.

The specific functions, stimulating methods and ranges of clinical application of Renying (ST 9) are explored. Because Renying (ST 9) is located in the neck which is a dangerous area, it is perilous if the acupoint is stimulated, so it is mostly forbidden in the past dynasties. In recent years, the main stimulating methods for Renying (ST 9) include acupuncture and press. The keys of acupuncture are to apply correct technique of needle insertion and control the depth and direction of needle. The keys of press are focused on strength and time of press. Renying (ST 9) is effective for vertigo, palpitation, asthma, hemiplegia, aphasia, hysteria, acute attack of pain, hyperplasia of mammary, continuous hiccup, disorder of throat and so on. As long as the acupoint location is accurate, manipulation is careful and stimulating method is correct, not only the safety could be guaranteed, but also the function can be well-played in clinical application.
Acupuncture Points ; Acupuncture Therapy ; history ; China ; History, Ancient ; Humans ; Medicine in Literature

Objective To analysis the diagnostic values and characteristics of ultrasound and ultrasound guided fine needle aspiration cytology (FNAC) in patients with papillary thyroid carcinoma (PTC) before operation. Methods The data of ultrasound and ultrasound guided FNAC in 129 patients (including 148 PTC nodules) with PTC were collected from January 2014 to February 2017, and the diagnostic reports and feature descriptions of ultrasound and ultrasound guided FNAC were analyzed retrospectively. Results Among the 148 PTC nodules, the ultrasonographic imaging showed that 84.5% (125/148) with low echo-level solid nodules, 61.5% (91/148) with echo heterogenicity, 77.7% (115/148) with a ratio ≥ 1 in longitudinal/breadth, 69.6 % (103/148) with fuzzy boundary, 75.0% (111/148) with microcalcification in nodules, 97.3% (144/148) without or with incomplete aureole, 64.9% (96/148) with rich blood flow and 7.0% (9/129) with enlargement of cervical lymph nodes. The FNAC diagnosis showed that 78.4% (116/148) was diagnosed with suspected papillary carcinoma, 1.4% (2/148) was diagnosed with malignent tumor, 11.5% (17/148) was diagnosed with atypia of undetermined significance (AUS), 1.4% (2/148) was diagnosed with benign lesion, 0.7% (1/148) was diagnosed with follicular neoplasm and 6.7% (10/148) could not be diagnosed. If the suspected papillary carcinoma and malignent tumor were defined as cytodiagnosis, the diagnostic accordance rate with intraoperative pathology was 79.7%. Conclusion The preoperative accuracy rates of ultrasound diagnosis and ultrasound guided FNAC diagnosis for patients with PTC are high, and the characteristics of the both are also typical. The two examinations before operation are helpful for early diagnosis and treatment formulation for patients with PTC.

Objective: To explore the factors affecting the prevalence of HIV-associated neurocognitive disorders (HAND) among HIV/AIDS patients, so as to provide insights into developing HAND prevention measures. Methods: HIV/AIDS patients aged 18 years and above in the Infection Department of Nanjing Second Hospital were selected.Demographic data, treatment regimen and blood biochemical indicators were collected. Depression was evaluated using Patient Health Questionnaire Depression Scale, frailty was evaluated using Chinese version of Tilburg Frailty Indicator, and HAND was evaluated by Montreal Cognitive Assessment Scale. Factors affecting HAND were analyzed using a multivariable logistic regression model. Results: Totally 440 questionnaires were allocated and 426 valid questionnaires were recovered, with an effective rate of 96.82%. The median age of patients investigated was 33.00 (interquartile range, 10.00) year. There were 407 males, accounting for 95.54%; 232 patients with bachelor degree or above, accounting for 54.46%; 171 patients with HAND, accounting for 40.14%. Multivariable logistic regression analysis showed that educational level (bachelor degree or above, OR=0.291, 95%CI: 0.157-0.541), depression (OR=2.499, 95%CI: 1.530-4.083), frailty (OR=2.121, 95%CI: 1.307-3.441) and treatment regimen including efavirenz (OR=2.223, 95%CI: 1.367-3.615) were the influencing factors for HAND among HIV/AIDS patients. Conclusion Educational level, depression, frailty and use of efavirenz may be associated with HAND risk.

Objective One typical case with stress cardiomyopathy was reported and the current knowledge of the syndrome was reviewed to improve relevant knowledge.Methods A 71-year-old female patient presented dyspnea and chest pain due to emotional stress.ECG,echocardiography,selective coronary artery angiography,left ventriculography,~(99)Tc~m-MIBI single photon emission computed tomography (SPECT),~(18)F-FDG SPECT and MRI were performed.Results Electrocardiogram at admission showed ST segment elevation and T wave inversion in leads V1—V4.Pathological Q wave occurred 1 week later,it disappeared 1 month later however and severe T wave inversion occurred.Normal or slightly elevated cardiac enzymes in the blood were found during the course.Left ventriculogram at admission showed left ventricular apical ballooning with LVEF of 30%.The ballooning volume was about 3/4 of left ventricular volume, without any corresponding coronary artery diseases found in coronary angiogram.The abnormal apical ballooning decreased significantly in the follow-up left ventriculogram performed one month later.The LVEF rose up to 63.6%.~(99)Tc~m-MIBI and ~(18)F-FDG SPECT showed mismatch of perfusion and metabolism in the corresponding region,indicating presence of viable myocardium.MRI showed left ventricular apical ballooning without perfusion defect and late enhancement,indicating viability of corresponding myocardium. Conclusions Emotional stress can cause transient left ventricular apical ballooning called"stress cardiomyopathy".Either ~(99)Tc~m-MIBI SPECT associated with ~(18)F-FDG SPECT or delayed enhancement MRI plays an important role in identification of myocardial viability,which can efficiently guide clinical treatment.

OBJECTIVETo investigate the effect of ursolic acid (UA) on the alloxan-induced myocardial fibrosis in mice and discuss the possible mechanism.

METHODSDiabetes was produced by a single injection of alloxan (70 mg/kg, i.v.) in mice. The mice were randomly divided into four groups: normal control group, model group, ursolic acid group (UA, 35 mg/kg, p.o.) and benazepril group (5 mg/kg, p. o.), and continuous administrated for 8 weeks. The blood glucose was measured 24 hours after the last administration. Detected the specific biochemical of myocardial tissue: superoxide dismutase (SOD), malondialdehyde (MDA) and hydroxyproline(HYP). Using masson staining to observe the morphology of the myocardial tissue. Immunohistochemistry was employed to determine the protein levels of TGF-beta1.

RESULTSCompared to normal group, the blood glucose, heart index, myocardial tissue MDA, HYP level were increased, and SOD activities were decreased in the diabetic mice, Masson stain showed that myocardial cells disarranged, myocardial collagen fibrosis hyperplasia. Meanwhile, the protein expression of TGF-beta1 was increased in model group. The UA group improved all the above significantly.

CONCLUSIONUA improves the myocardial collagen fibrosis in diabetic mice induced by alloxan, its mechanism may be related to inhibiting the expression of TGF-beta1 and antioxidation.

Animals ; Blood Glucose ; Collagen ; metabolism ; Diabetes Mellitus, Experimental ; metabolism ; pathology ; Fibrosis ; Hydroxyproline ; metabolism ; Male ; Malondialdehyde ; metabolism ; Mice ; Mice, Inbred Strains ; Myocardium ; metabolism ; pathology ; Oxidative Stress ; Superoxide Dismutase ; metabolism ; Transforming Growth Factor beta1 ; metabolism ; Triterpenes ; pharmacology

0.05).Conclusion Compared with multi-breath hold GRAPPA technique,single breath hold TSENSE technique is a fast,accurate and reproducible method and can be an substitute for GRAPPA to evaluate ventricular function.

Objective To investigate the feasibility of using low volume of low concentration isotonic contrast medium for 320 row coronary CT angiography.Methods 64 patients whose heart rate 70 beats per minute or less,normal cardiac rhythm,BMI≤24 kg/m2 were scanned using a 320 row dynamic volume CT with the tube voltage of 100 kVp and injection of contrast medium with a concentration 270 mg I/mL.Prospective ECG gating technique and adaptive iterative dose reduction algorithm reconstruction were used.In group A,22 patients were injected 50 mL contrast medium by a rate of 5.0 mL/s.In group B,21 patients were injected with the dosage of contrast medium calculated by 0.7 mL/kg and injection rate was 4.5 mL/s.In group C,21 patients were injected with the dosage of contrast medium calculated by 0.6 mL/kg and the injection rate was 4.0 mL/s.The attenuation value,signal-to-noise(SNR),con-trast-to-noise ratio(CNR),image quality and iodine intake between three groups were compared using One-Way ANOVA .Results There was no significantly statistical difference of age,sex ratio,BMI,heart rate between the three groups (P >0.05).However,the dosage of the contrast agent and different injection time had statistical significance (P <0.05).The attenuation value from group A to group B and then to group C was on the decline,the CT value of group A was obviously higher than that of group B and group C,and the differences were statistically significant (P <0.05),and there was no significantly statistical difference between the group B and group C (P >0.05).The image quality,SNR and CNR in three groups did not have significant difference (P >0.05).The total iodine and iodine injection rate were lowest in group C.Conclusion In 320 row coronary CT angiography with 100 kVp tube voltage and iterative reconstruction algorithm,the patients whose heart rate 70 beats per minute or less,BMI≤24 kg/m2 injected the low concentration of contrast medium by 0.6 mL/kg dose injection can give a good image quality which can meet the diagnostic requirement.Mean-while,it can also reduce the iodine intake and the risk of contrast induced nephrology (CIN).

Objective To assess the clinical safety and effectiveness of transcatheter arterial embolization by using liquid medical glue ( FLA ) and super-selective catheterization technique in treating renal artery pseudoaneurysm. Methods During the period from Oct. 2009 to Jun. 2014, a total of 23 patients with angiography-proved renal pseudoaneurysm were treated with transcatheter arterial FLA embolization at authors’ hospital. The clinical data were retrospectively analyzed. A total of 28 pseudoaneurysms were detected in the 23 patients, which was caused by iatrogenic injury(18 cases, 21 lesions) or trauma(5 cases, 7 lesions). Super-selective catheterization with 3F micro-catheter was carried out. The micro-catheter was inserted into the parent artery of the pseudoaneurysm, which was followed by angiography. Once the pseudoaneurysm was confirmed by angiography, the mixture of FAL and iodized oil (1 ∶ 1) was injected into the pseudoaneurysm through the micro-catheter. The technical success rate, postoperative hematuria and renal function were determined. Results Successful embolization was achieved for all 28 pseudoaneurysms in 23 patients. The average volume of FAL used in embolization was 0.4 ml (0.2-1 ml). Ectopic embolization of the third-level vessel branches near the parent artery occurred in three cases , while no embolization of second-level vessel branch was observed. Persistent hematuria was seen in one patient even at two days after the treatment, whose pseudoaneurysm’s diameter was >2 cm, and embolization treatment with steel coil had to be performed, and bleeding stopped after the second treatment. During the follow-up period lasting for 3 months, no recurrence of hematuria was seen in the remaining patients. Mild elevation of serum creatinine after the treatment was observed in 4 patients. Conclusion The results of this study indicate that FAL together with the help of micro-catheter super-selective catheterization can effectively and reliably obstruct renal pseudoaneurysm with higher technical success rate and lower re-bleeding rate.