Objective To observe the pollution states of environmental estrogen-alkyl pheols in tap water of Shenyang. Methods With solid phase extraction and gas chromatography/mass spectroscope (GC/MS) ionic selective methods, the concentration of pollutants of alkyl pheols were measured in 21 tap water samples of water works of Shenyang. Results The main pollutants of alkyl pheols in tap water of water works in Shenyang were 4-t-octyl phenol, nonyl phenol and bisphenol A. The respective maximum concentration was 690.5 ng/L (ranged 29.5-690.5 ng/L), 2 791.6 ng/L (ranged 212.1-2 791.6 ng/L) and 161.0 ng/L (ranged 14.7-161.0 ng/L). The varieties and concentrations of pollutants of alkyl pheols showed a significant difference among water samples from different water works and the seasonal changing of them was demonstrated in the waters made in the same water works. Conclusion The problem on the drinking water contamination with alkyl pheols in Shenyang should be paid more attention by government.

Objective To investigate the correlations of plasma B-type natriuretic peptide (BNP) and carbohydrate antigen 125 (CA125) levels in elderly patients with chronic heart failure (CHF) and to evaluate the clinical value.Methods A total of 124 elderly patients diagnosed as chronic heart failure were recruited.Patients with CHF were divided into the stage Ⅱ group,stage Ⅲ group and stage Ⅳ group according to the New York Heart Association (NYHA) classification.35 health subjects were randomly enrolled as the control group.The plasma levels of BNP and CA125 between different groups were compared.The correlations of the plasma BNP and CA125 levels with chronic heart failure were analyzed.60 cases with clinical improvement by aggressive treatment were followed up and the plasma levels of CA125 and BNP in them were tested.The changes in heart failure indicators were analyzed before and after treatment.Results The plasma BNP and CA125 levels were higher in patients with CHF than in control subjects (all P＜0.01).The plasma BNP and CA125 levels were gradually increased in the stage Ⅱ,Ⅲ and Ⅳ group (all P＜0.01).The plasma levels of BNP and CA125 were negatively correlated with left ventricular ejection fraction and positively correlated with left ventricular end-diastolic diameter (r=-0.75,-0.73,0.72,0.63,respectively,both P＜0.01).There were no significant differences in the plasma levels of BNP and CA125 between patients with or without atrial fibrillation (both P ＞0.05).Conclusions Plasma BNP and CA125 levels are correlated with NYHA classification in CHF,which can be used as indexes for the diagnosis,treatment and prognosis of CHF.

Acupuncture Therapy ; Humans ; Randomized Controlled Trials as Topic ; methods ; Single-Blind Method

Objective To explore the value of tracheal intubation guided by fiberoptic bronchoscopy in children snoring disease operation.Methods A total of 50 patients underwent tracheal intubation guided by fiberoptic bronchoscope or laryngoscope from August 2015 to June 2016.There were 25 cases of fiberoptic bronchoscopy assigned into group A, 25 cases of laryngoscopy into group B.The intubation time, success rate and adverse reactions of the two groups were compared and analyzed.Results All the intubation in group A succeed at the first time.The intubation time was (20.1±4.3) s and the position was right.There was no need for replacement during the operation.Three cases in group B succeed at the second time because the tonsil was too big to expose the pharynx.The intubation got out of the pharynx in 3 cases in group B and were adjusted to the right position.The intubation time was (50.7±6.9) s and the success rate at the first time was 76% (19/25).Groups A behaved better than group B in aspects of the success rate of signal intubation and intubation time (Fisher''s Exact Test, P=0.022;t=-18.725, P=0.000).There were no adverse reactions in group A, such as pharyngorrhagia, odontoseisis or loss of tooth, laryngospasm and so on.There were 3 cases of hemorrhage from throat after intubation, 3 cases of loss of tooth in different degrees and 1 case of laryngospasm at second intubation time in group B.There was no significant difference in adverse reactions between the two groups (P>0.05).ConclusionFiberoptic bronchoscopy can be used for children snoring disease with good safety as well as rare adverse reactions.

Objective:To explore the risk factors of recurrence after laparoscopic myomectomy and provide references for clinical prevention and treatment.Methods:The clinical data of 216 patients who underwent laparoscopic myomectomy in Ningjin County People′s Hospital from June 2016 to December 2018 were analyzed retrospectively. The recurrence rate at 12 months after the operation was followed up, and the risk factors influencing the recurrence after laparoscopic myomectomy were screened by univariate analysis and multivariate Logistic regression model.Results:After followed up for 12 months after the operation, 24 cases had recurrence, with a recurrence rate of 11.11%(24/216). Univariate analysis showed that the recurrence after laparoscopic myomectomy was significantly correlated with surgical age, age at menarche, number of fibroids, uterine size, and gonadrotropin releasing hormone agonist (GnRH-a) treatment after the operation ( P<0.05), but was not significantly correlated with body mass index, fibroid size, fibroid type, and pregnancy after the operation ( P>0.05). Multivariate Logistic regression analysis showed that surgical age ≥ 35 years old ( OR=1.289, 95% CI 1.013-1.641), age at menarche <13 years old ( OR=1.765, 95% CI 1.167 - 2.669), and number of fibroids ≥ 2 ( OR=2.487, 95% CI 1.442 - 4.288) were independent risk factors for recurrence after laparoscopic myomectomy ( P<0.05), while GnRH-a treatment after the operation ( OR = 0.696, 95% CI 0.510-0.951) was its protective factor ( P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve of surgical age ≥ 35 years old, menarche age <13 years old, and number of fibroids ≥ 2 for predicting recurrence after laparoscopic myomectomy was 0.641 (95% CI 0.573 - 0.705), 0.719 (95% CI 0.654 - 0.778) and 0.622 (95% CI 0.554 - 0.687), and age at menarche had the greatest diagnostic efficiency. Conclusions:Surgical age ≥ 35 years old, age at menarche <13 years old, and number of fibroids ≥ 2 are independent risk factors for recurrence after laparoscopic myomectomy. Intraoperative ultrasound and postoperative GnRH-a treatment can help reduce the risk of postoperative recurrence.

Large vestibular aqueduct syndrome (LVAS) is one of common non-syndromic hearing disorders. With the rapid development of medical imaging, audiology, molecular biology, genetics, cochlear implant surgery, we have made remarkable achievements in the diagnosis and treatment of large vestibular aqueduct syndrome. This article reviewed related researches of the large vestibular aqueduct syndrome.
Cochlear Implants ; Hearing Disorders ; genetics ; Humans ; Vestibular Aqueduct ; abnormalities ; Vestibular Diseases ; genetics

Objective To investgate the value of various parameters obtained from monoexponential, biexponential, and stretched exponential diffusion?weighted imaging models in the differential diagnosis of breast lesions. Methods A retrospective study performed in 54 patients with pathologically confirmed malignant tumors(n=30), benign lesions(n=34) and normal fibroglandular tissues (n=30). All patients underwent T1WI, T2WI, dynamic enhancement and diffusion weighted MRI with multi?b values at a 3.0 T magnetic resonance imaging unit. All parameters were measured at a workstation. ADC was calculated by using monoexponential analysis(b=0, 800 s/mm2). Slow apparent diffusion coefficient (ADC?slow), fast apparent diffusion coefficient (ADC?fast), and perfusion fraction (f) were calculated using the biexponential model. Distributed diffusion coefficient (DDC) and water molecular diffusion heterogeneity index (α) were obtained from diffusion?weighted images using the stretched exponential model. All parameters were statistically compared among normal fibroglandular tissues, benign lesions and malignant tumors using Kruskal?Wallis rank sum test. Mann?Whitney U test were used for further comparisons between specific group pairs. ADC values were compared with ADC?slow and DDC for different groups by paired Wilcoxon test. Correlations between ADC?value, ADC?slow and DDC were assessed by using Spearman rank correlation coefficient. Receiver operating characteristic curve was used to analyze and compare the ability of these parameters in differentiation of benign and malignant breast lesions. Results The ADC, ADC?slow, f, DDC and α values were significantly different among the normal fibroglandular tissues, benign tumors and malignant tumors (P<0.05). Further differential comparisons of the four parameters between each pair showed that the ADC, ADC?slow, f, DDC and α values were significantly lower in malignant tumors than both in normal fibroglandular tissues and benign tumors(P<0.016 7). The ADC values of normal fibroglandular tissues, benign tumors and malignant tumors were significantly higher than ADC?slow and DDC (P<0.05). The f and DDC had higher area under the receiver operating characteristic curve (0.688 and 0.657 respectively). The optimal cutoff values for ADC, ADC?slow, f, DDC and α were 1.235 × 10-3mm2/s, 0.428 × 10-3mm2/s, 57.8%, 1.175 × 10-3mm2/s and 0.721, respectively. Theαvalue showed higher specificity (65.5%) and the f value had higher sensitivity (82.9%). Conclusion The parameters derived from biexponential and stretched exponential DWI could be helpful for differentiation between benign and malignant breast tumors.

Objective To investigate the effect of lycopene (Lyc) on H9c2 cell apoptosis induced by angiotensin Ⅱ (Ang Ⅱ).Methods Using Ang Ⅱ (10 μmol/L) to stimulate H9c2 cells,we observed the protective effect of Lyc on H9c2 cells apoptosis.The H9c2 cells viability induced by different consideration of Lyc or Ang Ⅱ or both was detected by CCK8 assay.The expression levels of Bax and Bcl-2 in H9c2 cells were determined by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR).Western blot was conducted to detect the protein expressions of Bax,Caspase 3,Caspase 9 and Bcl-2 in H9c2 cells.The apoptotic ratio of H9c2 cells was observed by TUNEL assay.Results Compared with control group,Ang Ⅱ could decrease the viability of H9c2 cells to (92.87±4.37)％.The result of RT-PCR showed that Ang Ⅱ decreased the expression level of Bcl-2,and Bax level was increased under the stimulation of Ang Ⅱ (P＜0.05),while the expression level of Bcl-2 was increased and Bax level was decreased under the co-stimulation of Ang Ⅱ and Lyc in a concentration dependent manner,which indicated that Lyc ameliorated the apoptosis of H9c2 cells.The result of western blot showed that the protein expressions of Bax,Caspase 3 and Caspase 9 were increased,but Bcl-2 was decreased after the stimulation of Ang Ⅱ (P＜0.05).While these phenomenon reversed apparently under the co stimulation of Ang Ⅱ and Lyc.A large number of apoptotic cells were observed under the stimulation of Ang Ⅱ through TUNEL assay.But the number of apoptotic cells reduced significantly under the co-stimulation of Lyc and Ang Ⅱ (P ＜0.05).Conclusions Lyc ameliorates the H9c2 cell apoptosis induced by Ang Ⅱ,which indicates that Lyc may have an important role in the treatment of various cardiovascular diseases.

Objective To assess and analyze the current status of clinical guidelines for hypertension in the world by using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument.Methods The clinical guidelines for hypertension were identified and approved by searching China hownet,WANFANG database,PUBMED database,MEDLINE,Embase and related institutions and authorization web site from 1995 to January 2012,and relevant Web sites of agencies and organizations that produce and/or endorse guidelines.Names of the guidelines,published years and organizations,methodology of development and reference number were descriptively analyzed.AGREE instrument was used to evaluate the qualities of latest edited clinical guidelines for hypertension in countries all over the world.Results Nine guidelines were enrolled.The results showed that the hypertension guidelines scored the highest average of 88.4％ for clarity of presentation and reliability field; for applicability fields,scored an average of 86.1％; the scope and goal field scored an average of 83.8％; participants field scored an average of 71.7％; editorial independence field scored an average of 64.1％ ; rigor of development field scored the lowest average of 62.9％.The overall assessment showed that NICE 2011,Canada 2012,ESC 2009,Australia 2010 editions were the positively recommended guidelines,JNC7,Japan 2009,China Taiwan 2010,China 2010,South Africa 2011 editions were the recommended guidelines (still need to supplement and improve).No recommend or uncertain guide was found.Conclusions The quality of the hypertension guidelines is higher in general,but some common deficiency in the rigor of development and editorial independence in Asian and African guidelines formulated by the states still exists.There still exist certain gaps in evidence-based medical requirement.And the contents and quality are needed for further regulating and enhancing.A set of scientific systemic hypertension clinical guidelines evaluation system should be established.

Objective To analyze clinical characteristics of patients with juvenile myoclonic epilepsy in China. Methods Eighty-seven patients were retrospectively studied in the aspects of family history, febrile seizures, clinical features, EEG, treatment effect. Results There was a female preponderance of incidence. In contrast to the earlier studies we found a high incidence of febrile seizures and a low incidence of family history. myoclonic seizures began at age of ( 13.1?3.4) years. That combined with generalized tonoclonic seizures began at age (14.3?3.8) years. Absence seizures began at age (10.0?3.3) years. The correct diagnosis was delayed at a mean of 2.2 years from onset of the disease. The incidence of abnormal EEG discharge could be enhanced by hyperventilation, photic stimulation and sleep. Sixteen patients who had received carbamazepine or phenytoin were experienced aggravation of seizures. Forty-five patients who received monotherapy with sodium valproate remained seizure-free in a follow-up longer than 0.5 years. Conclusions Failure to recognize JME may result in uncontrolled seizures, and even aggravated of seizures by using antiepilepsy drugs. Effective treatment was achieved with small doses of sodium valproate.