Objective To explore the efficacy and safety of greenlight photoselective vaporization of prostate (PVP) in high-risk elder patients with benign prostatic hyperplasia (BPH). Methods A total of 120 high-risk elder patients with BPH underwent PVP procedure. The operating time, blood 1oss, indwelling catheterization and operation-related complications were monitored. The variables such as international prostate symptom score (IPSS), Quality of life (QOL) score, maximum urinary flow rate (Qmax) and residual urine volume (RUV) were recorded and compared pre- and post-operatively. Results All the 120 patients had a good peri-operative condition. The mean operating time was (52. 6 ± 5.8 )min, intraoperative blood loss was (20.4 ±9.5) ml. Among the 120 cases,26 did not received postoperative catheterization. In the other 94 cases received postoperative catheterization, the mean catheterization time was (24. 5 ± 15.9) hour. IPSS and QOL scores decreased from (28.5 ± 3.8) and (5.0 ± 0.8) preoperatively to (7.2 ± 1.8) and (1.5 ± 0.6)postoperatively. Qmax increased from ( 5.2 ± 3.1 ) ml/s to ( 15.2 ± 4.3 ) ml/s, and RUV decreased from ( 118.6 ± 15.2) ml to ( 16. 5 ± 4. 6) ml. There was significant difference for these parameters before and after the operation (Ps ＜ 0. 05 ). Conclusion The PVP is considered to be a safe, effective and minimally invasive procedure to treat BPHin high-risk elder patients. It is easy to manipulate, with advantages of shorter operating time,less blood loss, better tolerance and rapid recovery, especially for high-risk elder patients with BPH.

Endoscopy ; methods ; Humans ; Intestinal Diseases ; diagnosis ; diagnostic imaging ; Intestine, Small ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; methods

Objective:To explore the mechanism of the embolism and sclerotherapy of fibrin glue combined with bleomycin (FG/BLM) for the treatment of cervicofacial vascular malformations by color doppler ultrasound.Methods:10 patients with venous malformation(VM) and 10 patients with arterio-venous malformation(AVM) were included.All patients underwent embolism and sclerotherapy of FG/BLM guided by ultrasound.Color doppler ultrasound was used to record the real-time two-dimensional ultrasonography and color doppler image.The flow and distribution of FG/BLM after injection into the lesions were observed.Results:Two-dimensional ultrasonography showed clumps or flake strong echo after immediate injection of FG/BLM into the cavity of VMs,then floated in the abnormal venous lumen and diffused throughout the cavity.At the later stage the lesions were filled by a large number of flocculent and netted low echo,and patchy strong echo.The volume of VMs cavity expanded dramaticlly,and the blood flow signal was significantly decreased.After injection of FG/BLM into the lumen of AVMs,clumps or flake strong echo were observed,then most of the snowflake strong echo rapidly filled or scattered along with blood stream to the distal part of the vessels.The color doppler showed significantly decrease of blood flow signal.Conclusion:FG/BLM injection can embolize and block the draining vein of VM,and play a role on the storage of sclerozing agent.FG/BLM injection can embolize both the dilated blood vessels and capillary network of AVM.

Objective:To discuss the etiology, clinical manifestations and renal pathological features of acute interstitial nephritis (AIN) in children.Methods:The etiology, clinical manifestations, pathological characteristics, clinical effects and outcome of the children with AIN diagnosed by renal biopsy from January 2010 to December 2019 in Nanjing Jinling Hospital were analyzed retrospectively. The Kaplan-Meier method was used to evaluate the kidney survival rate. Cox regression model was built to analyze the risk factors for developing end-stage renal disease (ESRD) at baseline in AIN children.Results:A total of 51 children with AIN were diagnosed by renal biopsy, including 36 males and 15 females. The age was (12.94±2.55) years old (2-17 years old). The clinical manifestations of AIN in children were various and lack of specificity. Only 2 cases (3.92%) had triad. All of the 51 children with AIN showed acute renal injury (AKI), accompanied by increased serum creatinine and decreased estimated glomerular filtration rate. The stage of AKI was mainly stageⅢ(33 cases, 64.71%). Infection was the main cause (38 cases, 74.51%) and drug factor was the second cause (27 cases, 52.94%) in children with AIN. Nonsteroidal antiinflammatory drugs (NSAIDs) were the main inducers of drug-induced AIN (18 cases, 35.29%). The interstitial inflammatory cell infiltration or interstitial edema was found in 51 children. The infiltration of inflammatory cells was mainly mononuclear cells (46 cases, 90.20%). After 4 weeks of treatment, 32 cases (62.75%), 11 cases (21.57%) and 8 cases (15.69%) showed complete, partial and no recovery of renal function, respectively. After 12 weeks of treatment, 49 cases (96.08%), 0 cases (0) and 2 cases (3.92%) showed complete, partial and no recovery of renal function, respectively. After an average follow-up of 4.0(2.0-15.0) months, 2 case (3.92%) patients developed ESRD. The cumulative survival rates of ESRD at 1 year and 2 years after renal biopsy both were 100%, and renal survival rates at 5 years and 10 years were 96.55% and 72.41%, respectively. Multivariate Cox regression analysis results showed that N-acetyl-β-D-glucosidase (NAG) enzyme level>17.6 U/g·cr ( HR=15.729, 95% CI 1.045-15.977, P=0.042) and IgM deposition in renal tissue ( HR=7.523, 95% CI 1.142-9.541, P=0.033) were independent risk factors for developing ESRD in AIN children. Conclusions:AKI is the main clinical manifestation of AIN in children. The characteritic of renal pathology in AIN is tubulointerstitial lesions. After active treatment, most of the patients have a good prognosis. Prevention of infection and rational use of drugs are the key to reduce the incidence rate of AIN in children. The N-acetyl-β-D-glucosidase enzyme level>17.6 U/g·cr and IgM deposition in renal tissue are independent risk factors for developing ESRD in AIN children.

Objective To investigate the state of endemic fluorosis, running status of water improvement project to reduce fluoride in Jiangsu province, and to provide a scientific basis for prevention and control of endemic fluorosis. Methods In 2008, in the ten key counties of endemic fluorosis (zone), in Xuzhou,Lianyungang and Suqian, a stratified sampling method was employed to select 40 diseased villages according to their past water fluoride survey data. All children aged 8 to 12 were examined dental fluorosis, and all adults over 16 years were examined clinical skeletal fluorosis. Thirty per cent of the 40 diseased villages were selected, and 20 adults over the age of 16 in each selected village were examined by X-ray, respectively;50% of the 40 diseased villages were selected, and 30 any time urine samples of children aged 8 to 12 in each diseased village were tested urine fluoride. In each city, select a county, the status of water improvement project to reduce fluoride, water supply capacity and coverage in the county were investigated. Results A total of 3560 children aged 8 to 12 were examined, the detection rate of dental fluorosis was 38.51% (1371/3560), tooth defect rate was 5.34% (190/3560), and dental fluorosis index was 0.8. Seven hundred and eight urine samples were tested, the median urinary fluoride was 1.47 mg/L and the range was 0.08 ~ 10.08 mg/L. Clinical detection of skeletal fluorosis was 21.3% among adults over the age of 16, and X-ray detection rate of skeletal fluorosis was 39.2% (123/314).Investigated a total of 248 facilities of centralized water improvement projects, no funds to run or damaged 49, the water fluoride > 1.0 mg/L was 18. Conclusions Endemic fluorosis in Northern Jiangsu province has not been controlled completely, but has a rising trend, we should further strengthen the supervision of water fluoride reduction.

Objective To investigate the supply of iodized salt in non-excessive iodine counties and iodine-free salt in excessive iodine counties at household level in Jiangsu Province so as to provide a basis for the prevention and control of iodine deficiency disorders(IDD).Methods According to the National Iodine Deficiency Disorders Monitoring Program(Trial),county(city,district) was taken as a elementary sampling unit in Jiangsu Province.Townships(towns) and administrative villages were selected by systematic sampling and random sampling in every county and households were chosen by random sampling to collect their edible salt samples.The salt iodine content in non-and excessive iodine regions was detected by direct titration method and semi-quantitative method,respectively.Results All 30 840 salt samples were collected from 106 non-excessive iodine counties,and qualified iodized salt was 30 303 copies,iodine-free salt 199 copies.Weighted by the population of counties,the rate of iodine-free salt was 0.71％,the coverage rate of iodized salt accounted for 99.29％,out of which,98.93％ was qualified and the consuming rate of qualified iodized salt was 98.23％.All 1296 salt samples were collected in 5 counties with excessive water iodine content and the coverage rate of iodine-free salt was 98.99％ (1283/1295).Conclusions The national targets for preliminary elimination of IDD have been achieved in regions of nonexcessive and excessive iodine of Jiangsu Province.But it still should be strengthen the management work of iodinefree salt in excessive iodine counties and iodine saft in non-excessive iodine counties.

Objective To observe the effect of low arsenic sub-chronic exposure on blood routine test index in rabbits to pave a way for screening early injury of the low arsenic exposure. Methods Twelve healthy male rabbits were randomly divided into four groups. They were administrated with As at the concentration of 0(control), 10, 50 and 250 μg/L in the drinking water. Blood samples were collected from the vein of the ear edge in 8 weeks, and blood test routine including leukocyte (WBC), lymphocyte (LYM), lymphocyte percentage (LYM%), neutrophil (GRA), neutrophil percentage (GRA%), monocyte (MON), monocyte percentage (MON%), red blood cell (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin content (MCH), mean corpuscular hemoglobin concentration(MCHC), RDW, platelets(PLT), mean platelet volume(MPV), platelet hematocrit(PCT) and platelet distribution width (PDW), were detected by the ABX-60 hemocyte analyzer. Results Compared with the control group, the WBC, GRA and GRA% increased in 0, 50 and 250 μg/L groups, but there was no significance(P > 0.05). PLT and MPV had a statistical significance in 4 groups(F = 4.07,4.20, all P < 0.05). Compared with the control group[(292.00±16.97)×109/L, (7.10±0.99)fL], PLT decreased in the 250 μg/L group [(221.33±22.50)×109/L] and MPV decreased in the 50μg/L group [(5.57±0.46)fL] significantly (P < 0.05). The other index didn't change obviously. Conclusions Sub-chronic low level arsenic exposure may lead to the change in the blood system. The blood routine test may be considered for early injury of the arsenic poisoning.

Adult ; Aged ; Asthma ; epidemiology ; etiology ; Bronchiolitis Obliterans ; epidemiology ; etiology ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Smoking ; adverse effects

Adult ; Aged ; Aged, 80 and over ; Carcinoma ; metabolism ; pathology ; Female ; Gallbladder Neoplasms ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Kangai-1 Protein ; metabolism ; Male ; Middle Aged ; NM23 Nucleoside Diphosphate Kinases ; metabolism ; Tomography, Spiral Computed

OBJECTIVETo compare the efficacy difference in diarrhea-predominant irritable bowel syndrome between acupuncture in terms of soothing liver and strengthening spleen and western medication.

METHODSSeventy cases were randomized into an acupuncture group and a western medication group, 35 cases in each one. In the acupuncture group, the conventional acupuncture was applied to Tianshu (ST 25), Zusanli (ST 36), Shangjuxu (ST 37), Sanyinjiao (SP 6), Taichong (LR 3), etc. The electric stimulation was added at bilateral Tianshu (ST 25). The treatment was given once a day, 3 to 4 treatments required a week. In the western medication group, Pinaverium (Dicetel) was prescribed for oral administration, 50 mg each time, 3 times a day. The treatment of 4 weeks was taken as one session. Separately, before treatment and after one session of treatment, the clinical symptom score and Irritable Bowel Syndrome Quality of Life (IBS-QOL) score were observed for the patients in two groups. The efficacy and the recurrence rate were assessed in two groups.

RESULTSThe symptom score and IBS-QOL score were all improved significantly after treatment in two groups (all P < 0.01). The improvements in the acupuncture group were superior to those in the western medication group (all P < 0.01). The effective rate was 94.3% (33/35) in the acupuncture group, which was better than 77.1% (27/35) in the western medication group (P < 0.01). In 3 months, the recurrence rate was 36.4% (12/33) in the acupuncture group, which was remarkably lower than 72.0% (18/25) in the western medication group (P < 0.01).

CONCLUSIONAcupuncture in terms of soothing liver and strengthening spleen achieves the superior efficacy on diarrhea-predominant irritable bowel syndrome as compared with western medicine Pinaverium. It remarkably improves the quality of life for the patients and reduces the recurrence rate of the disease.

Acupuncture Points ; Adult ; Diarrhea ; drug therapy ; therapy ; Electroacupuncture ; Female ; Humans ; Irritable Bowel Syndrome ; drug therapy ; physiopathology ; therapy ; Liver ; physiopathology ; Male ; Middle Aged ; Morpholines ; therapeutic use ; Quality of Life ; Spleen ; physiopathology ; Treatment Outcome