Environmental Monitoring ; methods ; Noise, Occupational ; statistics & numerical data

Objective To analyze the technique and clinical effect of percutaneous nephrolithotomy combined with endoscopic balloon dilation in the treatment of upper ureterostenosis with recurrent renal calculi.Methods From February 2009 to May 2012,20 ureteral stenosis patients with the history of ureteral open surgery,postoperative residual or recurrent kidney renal calculi were treated.Fifteen cases were with hydronephrosis of 2-4 cm,4 cases were with hydronephrosis of 5-6 cm and 1 case was with hydronephrosis ＞ 6 cm.Subsequent calculi size ＜ 1 cm was found in 16 cases,1-3 cm in 3 cases,＞ 3 cm in 1 case.All patients were treated with percutaneous nephrolithotomy ultrasonic lithotripsy combined with balloon dilatation.The calculi clearance rate,hydronephrosis changes,complications,intraverous urography (IVP) and CT urography (CTU) situation before and after surgery were analyzed.Results All the 20 cases were completed surgery successfully.There was 1 case with renal hemorrhage 3 d after surgery and controlled with DSA hemostasis.There was 1 case accepted adjusting double-J tube by ureteroscopy.Seventeen patients'calculi were completed removed.Two cases with residual calyceal calculi size ＜ 5 mm was not further treated.There was 1 case treated with nephrectomy because of renal calculi with infection.The patients were followed up for 6-39 (12.5 ± 1.9) months.Hydronephrosis improved significant changes [2.1-4.0 (2.2 ±0.9) cm vs.2.5-7.5 (3.9 ± 1.2) cm,P ＜ 0.05].All patients achieved significant improvement in IVP and CTU comparing of preoperative and postoperative data.Conclusion The use of percutaneous nephrolithotomy combined with endoscopic balloon dilation is a safe and effective treatment option in the treatment of kidney calculi with ureteral stenosis.

According to many years,clinical experience,professor GUO Zhi-yuan proposed four methods of treating chronic hepatitis B: pay attention to nourishing yin,removing blood stasis,expelling phlegm and treatment based on fi ve zang viscera differentiation.The four methods have achieved satisfactory curative effects in clinics.

In recent years, the incidence rate of breast cancer has increased year by year, and gradually tends to be younger. Neoadjuvant chemotherapy (NACT) has become the standard treatment for locally advanced breast cancer (LABC). Therefore, it is of great clinical significance to evaluate the efficacy of neoadjuvant chemotherapy in early and effective manner. Multimodal ultrasound plays an important role in evaluating the response of neoadjuvant chemotherapy. This article will review the recent research progress of three-dimensional multimodal ultrasound in the evaluation of neoadjuvant chemotherapy for breast cancer .

Cough ; diagnosis ; Disease Management ; Humans

Objective To explore the expression of aquaporin (AQP)-4 in white matter of spinal cord after spinal cord contusion (SCC). Methods 88 adult Sprague-Dawley rats were assigned randomly to sham operation group and SCC group. The model was established by Al-len's method. BBB sore was used to assess the motor function of rats. The relative expression of AQP-4 mRNA was determined by Q-PCR technique. The localization of AQP-4 was observed by immunohistochemistry. Results BBB score showed motor dysfunction in SCC group, and it increased 7 and 14 days after SCC (t>5.061, P<0.001). The level of AQP-4 mRNA decreased on the 1st and 3rd days (t>50.44, P<0.001), and increased on the 5th day (t=-3.968, P=0.001), and lasted until the 28th day (t=-4.227, P=0.001) compared with that on the 3rd day. The immunohistochemistry showed AQP-4 was located on the process of glial cell and vascular endothelial cells in white matter of spi-nal cord. Conclusion AQP-4 may play various roles at different stages in SCC.

Objective To investigate the cognitive function of patients with prostate cancer after maximal androgen blockade therapy and its influenced factors,and to provide a new way for early prevention strategy.Methods Montreal cognitive assessment (MoCA),hospital anxiety depression scale (HAD),social support rating scale (SSRS) and self-designed questionnaire were used in 56 cases treated with maximum androgen blockade therapy for more than six months and 37 cases who underwent radical prostatectomy treatment to evaluate their cognitive function and collect the observation indexes between January 2013 and October 2015.Based on MoCA score,all patients were divided into cognitive dysfunction group (n =40) and normal cognitive function group (n =53).The observation indexes in two groups were compared and cognitive function with different treatment in two groups were analyzed.The changes on the influencing factors of cognitive function in patients were filtered using multivariable logistic regression analysis.Results In the cognitive dysfunction group and normal group,the proportion of MAB treatment was 80.0％ (32/40) vs.45.3％ (24/53),the age was 73.7 vs.73.7 years,the proportion of solitary was 32.5％ (13/40) vs.13.2％ (7/53),the proportion of depressive symptoms was 87.5％ (35/40) vs.62.3％ (33/53),the social support level was 32.5 vs.41.1 and the proportion of testosterone decreased was 95.0％ (38/40) vs.45.3％ (24/53).All events showed statistically significant differences (P ＜0.05).Compared MAB treatment group with radical surgical treatment group,the testosterone level was (0.27-±O.15) vs.(12.14 ± 1.86) nmol/L,visual space and executive function score was 4.18 ±0.79 vs.4.54 ±0.56,attention score was 4.73 ±0.99 vs.5.16 ±0.79,delayed memory score was 3.75 ± 1.21 vs.4.30 ± 1.05 and MoCA score was 26.13 ± 1.48 vs.27.27 ± 1.39,which all showed the statistically significant difference (P ＜ 0.05).The results of multiple regression analysis showed that age (OR =1.183,95％ CI 1.135-1.223),depressive symptoms (OR =1.092,95％ CI 1.047-1.149),social support (OR =0.897,95％ CI O.838-0.956),testosterone (OR =2.105,95％ CI 1.369-4.083) were the influenced factors of cognitive dysfunction.Conclusions The incidence of cognitive dysfunction in patients with prostate cancer after maximal androgen blockade therapy more than six months was higher than others.Age,depression,social support level and testosterone levels were related to the occurrence of cognitive dysfunction.

Objective To improve the understanding of drug-induced lupus (DIL) and the differences from systemic lupus erythematosus (SLE).Methods Clinical manifestation and treatment of patients with definite DIL were retrospectively analyzed.Results Six patients with DIL were enrolled in this study,including 4 females and 2 males.Two patients were diagnosed after receiving interferon,one after soluble tumor necrosis factor receptor fusion protein,one after propylthiouracil,one after penicillamine,and one after levofloxacin.High titer of antinuclear antibody was identified in all six patients,including 3 with positive anti-dsDNA antibody.One patient had positive anti-Sm antibody.One patient had positive anti-RNP antibody.One patient had anti-nucleosome antibody.One patient had anti-histone antibody.One patient had antimitochondrial antibodies-M2,and one patient had anticardiolipin antibodies.Conclusion Patients with DIL are not as severe as those with SLE.After cessation of suspected drugs and administration of standard treatment,the clinical outcome of DIL is satisfying.

Objective To explore the best cut-off value of serum human epididymis protein 4(HE4)in the diagnosis of ovarian cancer,and analyze the clinical significance of combined detection of HE4,carbohydrate antigen 125 (CA125)and D-dimer for early screening and diagnosis of ovarian cancer.Methods A total of 49 patients with ovarian cancer,63 patients with benign tumor and 47 healthy women were collected.The content of CA125,HE4 and D-dimer were detected by chemical luminescence immunoassay and turbidimetric inhibition immunoassay,respectively.Results The new cut-off value of HE4 was 54.31 pmol/L.The serum levels of HE4,CA125 and D-dimer in the ovarian cancer group were all significant higher than those in the ovarian benign tumor group and the healthy group(P＜0.05).No significant difference between the healthy group and benign disease group was found in CA125 and D-dimer content(P=0.293,0.359),while a significant difference in HE4 level(P＜0.01).The sensitivity and specificity of combined detection of the HE4+CA125 increased to 91.8％,85.4％,which was higher than that of the diagnosis detection of the three indicators respectively.The sensitivity and specificity of combined detection of the HE4 +CA125 +D-dimer were 95.0％,76.5％,which was higher than the combined detection of the HE4+CA125.Conclusion The combined detection of CA125+HE4+D-dimer could improve the sensitivity for early diagnosis and screening of ovarian cancer.

Objective To investigate the clinical features of macrophage activation syndrome (MAS) associated with systemic lupus erythematosus (SLE).Method The clinical data of 15 patients with SLE-induced MAS diagnosed in Peking Union Medical College Hospital from July 2011 to December 2014 were retrospectively analyzed.Results Fourteen patients were female.The average age was 28.07.When MAS occurred,the average duration of SLE was 20.47 months,and the average SLE disease activity index (SLEDAI) was 18.4.All 15 patients developed fever,hematocytopenia and impaired liver function in the course of MAS,while patients with splenomegaly,coagulation disorders and neuropsychiatric symptoms were 11,14 and 8,respectively.All 15 patients presented leukocpenia and thrombocytopenia.Hypofibrinogenemia,elevated ferritin and hemophagocytosis in bone marrow were respectively observed in 7,11 and 12 patients.Glucocorticoids were used in all patients,among whom eight received pulse methylprednisolone therapy.Thirteen patients were treated with immunosuppressants,including cyclosporine A,tacrolimus,cyclophosphamide and mycophemolate mofetil.Complete remission was achieved in 14 patients.One patient died of MAS.Conclusions In patients with SLE,MAS was most commonly seen in young females with short SLE duration and active disease.Fever,splenomegaly,hematocytopenia,coagulation disorders and liver damage are the most remarkable clinical manifestations.Early diagnosis and intensive therapy are the key parts to improve clinical outcome.