Catheter Ablation ; Cold Temperature ; Cysts ; congenital ; Humans ; Tongue ; pathology ; surgery

Objective To explore the signal-to-noise ratio loss (SNR loss) of the people with normal pure-tone audiograms .Methods A group of 10 patients were recruited into the study ,who complained they could not hear speech clearly in the real world environment but had normal pure-tone audiograms ,immittance and word rec-ognition score (WRS) results .The Mandarin hearing in noise test (M-HINT ) was administered to them and the results were compared to the normal ranges published in the journal .Results All of them had SNR loss when noise (speech spectrum) came from front of them ,but 9 patients had SNR loss when noise came from 90 degree left or 90 degree right of them .Conclusion The current study showed the patients had speech hearing loss in the noisy envi-ronment ,regardless of whether they had normal audiograms ,immittance and WRS results .So we should pay atten-tion to such patients and adopt some special tests (eg M-HINT) .It is better for us to communicate and counsel with them .

Objective To investigate the prevalence and risk factors of hyperuricemia (HUA) in rural residents of Gaoyou City,Jiangsu Province.Methods A total of 4504 rural residents were investigated in a cross-sectional study.Questionarre survey and physical examination were used for the stndy.Fatsing venous blood samples were collected for biochemical examination.T-test,chi-square test for multiple-group data comparison and logistic regression analysis were used for statistical analysis.Results The prevalence of HUA was 11.9％,15.7％ in male,which was significantly higher than 8.6％ in the female (P＜0.01),the risks of HUA in male was 1.98 times higher than in female.The average value of serum uric acid in this population was higher than.that of female.The prevalence of HUA in female increased with age.Non-conditional logistic regression analysis showed WHR,Cr,Tg,hypertension were the independent risk factors of male patients with HUA.Age,BMI,Cr,Tg,hypertension were independent risk factors of HUA in female.Conclusion The prevalence of HUA can be affected by age and sex.Weight control,keeping blood pressure and blood lipid profiles in normals levels are important for the prevention of HUA.

In this study, the effect of pH regulator meglumine(MEG)on the dissolution behavior of indomethacin(IND)amorphous solid dispersions was evaluated. The amorphous solid dispersion was prepared by hot-melt extrusion using IND and Kollidon® VA64 at a weight ratio of 1∶4, and extrudates were characterized using differential scanning calorimetry(DSC)and X-ray powder diffraction(PXRD). The dissolution behaviors of solid dispersions with or without MEG were investigated in three kinds of pH media. The effect of infiltration rate of media, microenvironmental pH(pHM)and recrystallization of drugs on drug dissolution were evaluated by designing the appropriate experiments. The results showed that the presence of MEG could accelerate the dissolution of IND from solid dispersions through providing an alkaline microenvironment, but in different dissolution media, the intensity and duration of alkaline microenvironment, recrystallization of local drug molecules and infiltration rate of media showed an obvious difference, and the above factors simultaneously affected the dissolution behavior of drugs from solid dispersions.

Coronary artery disease (CAD) is a multifactorial disease in which inflammation plays a central role.This study aimed to investigate the association of inflammatory markers such as the neutrophil to lymphocyte ratio (NLR),the Global Registry of Acute Coronary Events (GRACE) score with in-hospital mortality of elderly patients with acute myocardial infarction (AMI) in an attempt to explore the prognostic value of these indices for elderly AMI patients.One thousand consecutive CAD patients were divided into two groups based on age 60.The laboratory and clinical characteristics were assessed retrospectively by reviewing the medical records.The NLR and GRACE score were calculated.In the elderly (≥60 years),patients with non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI) had significantly higher NLR than did those with unstable angina (UA) and stable angina pectoris (SAP) (P＜0.01).The NLR was considerably elevated in older AMI patients compared with their younger counterparts (＜60 years) (P＜0.05).In elderly AMI patients,the NLR was considerably higher in the high-risk group than in both the low-risk and medium-risk groups based on the GRACE score (P＜0.05 and P＜0.01,respectively),and the NLR was positively correlated with the GRACE score (r=0.322,P＜0.001).Either the NLR level or the GRACE score was significantly higher in the death group than in the surviving group (P＜0.05).By curve receiver operator characteristic curve (ROC) analysis,the optimal cut-off levels of 9.41 for NLR and 174 for GRACE score predicted in-hospital death [ROC area under the curve (AUC) 0.771 and 0.787,respectively,P＜0.001].It was concluded that an elevated NLR is a potential predictor of in-hospital mortality in elderly patients with AMI.

The major clinical risk of atherosclerosis (AS) lesion is instability and vulnerability of plaque.Intraplaque vasa vasorum (VV) has structure defects with the characteristics of immature,irregular,fragile,and prone to extravasation and intraplaque hemorrhage due to the compromised structural integrity.It stimulates inflammatory reaction and provides channel for hemocyte and blood soluble composition entering into the plaque.Intraplaque VV can promote AS plaque formation and is closely related to the intraplaque hemorrhage,plaque rupture and occurrence of clinical cardiovascular events.In-depth study of VV function and key signaling pathways related to AS pathological process are promising to fundamentally prevent vulnerable plaque development,unstable plaque rupture and its complications.This article summarized the effect and mechanism of VV in pathological process of AS and related treatment,in order to provide theoretical basis for stabilization of AS vulnerable plaque.

This study was aimed to observe the effect of Si-Miao Yong-An (SMYA) decoction intervention in atherosclerosis (AS) vulnerable plaque,and to further explore the action mechanism from the entry point of vasa vasorum (VV) neovascularization.Male ApoE-/-mice were randomly divided into the model group,simvastatin group and SMYA group.High-fat diet added 1.1％ L-methionine was fed for 8 weeks to establish the AS vulnerable plaque model.The C57BL/6 mice were used as control.After 8 weeks' continuous medication,mice were sacrificed.HE staining were used to observe the pathological changes of mice aorta;immunohistochemical staining was used to observe the VV density in AS plaque and aortic adventitia;macrophage infiltration in plaque was also detected;the blood-lipid changes of TC,TG,LDL-C and HDL-C were detected;western blot was used to detect essential proteins of HIF-1α-Apelin/APJ signal pathway.The results showed that SMYA decoction decreased the plaque area and the ratio of plaque area and lumen area,increased the minimum thickness of fibrous cap,which significantly improved the pathological feature of aortic plaque in mice.The function of increasing the minimum thickness of fibrous cap was obviously superior to simvastatin.SMYA decoction effectively suppressed the VV neovascularization and decreased the macrophage content.SMYA decoction effectively decreased the serum level of TC,TG and LDL-C;however,it had no effect on HDL-C.SMYA decoction decreased the protein expression of HIF-1α.Its function was obviously superior to simvastatin.SMYA decoction can down-regulate the protein expressions of Apelin,APJ,Phospho-MEK1/2 (Ser217/221),Phospho-p44/42 MAPK (Erk1/2) (Thr202/Tyr204) and Phospho-p70 S6 Kinase (Thr421/Ser424).It was concluded that SMYA decoction regulated the HIF-1α-Apelin/APJ signal pathway,suppressed VV neovascularization and stabilized AS vulnerable plaque.

AIMTo modify the structure of dehydroepiandrosterone (DHEA).

METHODSUsing hairy root cultures of Anisodus tanguticus to perform biotransformation of DHEA, using chromatographic and spectral techniques to isolate and identify the products.

RESULTS(1) The MS medium without plant hormone was suitable for the growth of the hairy root. (2) DHEA was converted into five products: androst-4-ene-3, 17-dione (I); 6alpha-hydroxyandrost-4-ene-3, 17-dione (II); 6alpha, 17beta-dihydroxyandrost-4-ene-3-one (III); androst-4-ene-3, 6, 17-trione (IV) and 17beta-hydroxyandrost-4-ene-3-one (V).

CONCLUSIONIt is the first time to use hairy root cultures of Anisodus tanguticus for the biotransformation of DHEA and five DHEA-related compounds were obtained.

Androstenedione ; chemistry ; isolation & purification ; Androstenes ; chemistry ; isolation & purification ; Biotransformation ; Culture Media ; Dehydroepiandrosterone ; chemistry ; metabolism ; Molecular Structure ; Plant Roots ; metabolism ; Plants, Medicinal ; metabolism ; Solanaceae ; metabolism ; Tissue Culture Techniques

OBJECTIVETo observe the performance of liver metastases with contrast-enhanced ultrasound (CEUS) and assess its clinical application.

METHODSTwenty-one patients with 21 untreated liver metastases underwent CEUS with low mechanical index imaging. The characteristic appearances of CEUS in different vascular phases were observed.

RESULTSOf 21 metastases, 19 (90.5%) were identified as fast-in and fast-out enhancement pattern. In the arterial phase, all the 21 lesions showed enhancement but with varied appearances: 12 (57.1%) showed early diffuse enhancement, 8 (38.1%) showed ring-like enhancement, and the remaining one lesion of large size showed slowly enhomogenous minor enhancement. In the late phase, sharp defects were found in 20 lesions (95.2%), and more lesions were detected in 3 patients (14.3%).

CONCLUSIONCEUS can show the characteristic appearance of liver metastases, and can be used for the screening and diagnosis of liver cancers.

Contrast Media ; Humans ; Liver Neoplasms ; diagnostic imaging ; secondary ; Ultrasonography

OBJECTIVETo evaluate the safety of stapled transanal rectal resection (STARR) for the treatment of obstructed defecation syndrome(ODS).

METHODSA retrospective study was performed in 112 female patients with ODS eligible for STARR. The short-lerm and long-term postoperative complications were recorded and assessed.

RESULTSShort-term postoperative complications and adverse events were reported in 18 patients (16.1%) including fecal incontinence (4.5%), anastomotic bleeding (2.7%), staple line partial dehiscence (0.9%), anal fissure (2.7%), acute urinary retention (1.8%), thrombosed external hemorrhoid (1.8%), hematoma of the rectovaginal septum (0.9%) and fecal impaction (0.9%). Reoperation was required in 2 patients (1.8%) due to the short-term postoperative complications. The median length of follow-up was 24 months. There were 6 patients with long-term postoperative complications (5.4%) including fecal incontinence (1.8%), defecatory urgency (0.9%), chronic pain due to anastomotic inflammation (1.8%), and chronic pain due to anal rectal diverticulum (0.9%). Three patients (2.7%) were reoperated.

CONCLUSIONSTARR appears to be a safe technique for patients with obstructed defecation.

Defecation ; Digestive System Surgical Procedures ; Female ; Humans ; Postoperative Complications ; Rectal Diseases ; surgery ; Reoperation ; Retrospective Studies ; Surgical Stapling ; adverse effects ; Treatment Outcome