Objective To study the prevalence and characteristics of gastroesophageal reflux disease (GERD) in patients with idiopathic pulmonary fibrosis(IPF).Methods A total of 48 patients with diffuse parenchymal lung disease(DPLD) including 25 IPF and 23 other DPLD were enrolled from Department of Respiratory Disease in the First Affiliated Hospital of China Medical University.All patients were subjected to 24-hour esophageal pH monitoring.Pulmonary function test and HRCT of lung were performed at the same time.Results The prevalence of GERD in IPF patients was 64.0％,which was significantly higher than that in other DPLD patients.DeMeester scores were significantly higher in IPF patients than those in non-IPF group[(22.8 ± 21.5) score vs (15.7 ± 14.0) score respectively P ＜ 0.05].Numbers of reflux longer than 5 minutes [(3.8 ± 4.1) time vs (2.1 ± 2.1) time respectively) and reflux index (1.8 ± 1.7 vs 1.3 ± 1.2) in IPF group were higher than those in non-IPF group,yet without statistical significance.Patients with IPF had significantly higher values of following parameters than those in non-IPF patients including percentage of total reflux time(pH ＜ 4.0) (9.2 ± 5.1) ％,percentage of upright reflux time (8.5 ± 5.2) ％,percentage of supine reflux time (10.8 ± 10.7) ％,numbers of reflux (54.2 ± 22.7) time,numbers of regurgitation longer than 5 minutes (6.3 ± 4.2) time,thelongest reflux time (14.5 ± 15.3) min,reflux index 2.5 ± 1.7 and DeMeester scores (34.9 ± 20.3) time (P ＜ 0.05).DeMeester score was positively correlated with gastroesophageal reflux diseases questionnaire (GerdQ) score (r =0.667,P ＜ 0.01).The prevalence of typical GERD sympotoms in the IPF-GERD patients was higher (heartburn 7/16,regurgitation 6/16) than that in IPF patients without GERD (heartburn 2/9,regurgitation 1/9).Conclusion Patients with IPF have a high prevalence of GERD,but usually without typical GERD symptoms.In the hospitals 24-hour esophageal pH monitoring not available,GerdQ can be used to identify GERD in IPF patients.

Objective To evaluate the diagnostic value of contrast-enhanced digital subtraction MRI in vertebra]metastatic tumors.Methods Forty-four vertebral metastatic tumors in thirty patients were scanned by routine MRI including SE T_1WI,SE T_2WI,STIR and enhanced T_1WI with an injection of Gd-DTPA(0.1 mmol/kg).Digital subtraction was performed between pre-contrast and enhanced T_1 weighted images.All the images of vertebral malignant tumors were evaluated by means of signal intensity ratio(SIR) and nose ratio(NR).The quality of images was also evaluated by comparing subtraction MRI with routine MRI.Results SIR and NR of subtraction MRI was 2.93,0.98 respectively.SIR of routine MRI (enhanced T_1WI,SE T_1 WI,SE T_2WI,STIR)was as follows:1.15,1.16,1.26,1.69.While NR of those was 5.25,3.44,4.56,23.32 respectively.SIR and NR of subtraction MRI images had significant statistical differences from those of routine MRI images(P

OBJECTIVETo discuss the probable causes of the post-surgery complications with the intra-artcular fracture of calcaneus, the proper steps for prevention and solution.

METHODSSeventy-one patients (76 injured feet) included 49 males and 22 females aged from 19 to 56 years old (mean 35.6 years). According to Sanders' classification, 23 cases (24 injuried feet) belonged to type II, 36 (38 injured feet) were type III, the remain 12 (14 injured feet) met the criteria of type IV. All the patients received the operation of open reduction, autogenous bone grafting and internal fixation with stainless steel plates.

RESULTSThirteen injuried feet developed early complications. Two injuried feet got the superficial layer of the wound disrupted and infected, I had the deep layer of the wound disrupted and infected. Cutaneous necrosis at the pointed end of the wound occurred in 7 cases. Another 1 developed osteomyelitis. Two cases suffered from sural nerve damage. Two injuried feet developed late complications, both of them suffered from arthritis of talocalcaneal joint. All the patients were followed up at least 6 months (ranged from 6 to 42 months, mean 19 months). According to Kerr's post-surgery evaluation criteria, 34 injuried feet were excellent, 32 were fine, 9 were acceptable, only 1 was bad.

CONCLUSIONIf proper measures are taken, the post-surgery complications of intra-articular fracture of calcaneus will be reduced. This requires us to be strict in selecting operation indication, to make a good plan and preparation, to select a right time for operation, to improve surgical skills and pay more attention to peri-surgery nursing. If complications happen, according measures should be taken in order to get a better outcome.

Adult ; Calcaneus ; injuries ; Female ; Follow-Up Studies ; Foot Joints ; injuries ; Fractures, Bone ; pathology ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; prevention & control ; Young Adult

Objective To evaluate the effectiveness and safety of terazosin in the treatment of Chinese benign prostatic hyperplasia (BPH) patients. Methods A multicenter prospective postmarketing observational study was conducted from June 2007 to March 2008 in 32 urologic centers.Patients were given terazosin for 4 weeks according to the routine medical care procedures following instructions. Effectiveness evaluation included the primary endpoint focusing on the changes in IPSS total score at the end of 2nd and 4th week compared with the baseline. The secondary endpoints were the changes in Qmax and QOL at the end of 4th week, diastolic and systolic blood pressures at the end of 2nd and 4th week compared with the baseline and the discontinuation rate of terazosin within the four weeks. Safety was assessed by adverse events. Results There were 1006 patients included in this study (FAS) and 992 patients (PP) completed the study. Among them, there were 344 patients having hypertension. The total IPSS score reduced from 22.32±6. 13 at baseline to 16. 98±5.92 at the end of the 2nd week and to 14.00±5. 52 at the end of the 4th week in FAS population (P＜0. 01).The total IPSS score changed from 22.32±6.15 at baseline to 16. 96±5.93 at the end of the 2nd week and to 13. 95±5.52 at the end of the 4th week in the PP population (P＜0.01). The efficacy rate was 26.54% at the 2-week treatment and 60.64% at the 4-week treatment, which was defined as obtaining improvement by 30% compared with the baseline. Patient's IPSS in different age groups with different prostatic hyperplasia levels and patients combined with or without 5-α reductase inhibitors were all decreased significantly(P＜0.01). With 4-week treatment of terazosin, Qmax and QOL were improved significantly by 32% and 45% (P＜0.01). Terazosin decreased BPH patient blood pressure with untreated or uncontrolled hypertension (P＜0.05), but had little influence on normal blood pressure of those under control. The incidence of adverse reactions was low. The most common adverse event was dizziness (3.68%). At the end of the study, 960 subjects (95%) were taking drug continuously.Conclasions Terazosin can significantly improve the symptoms and quality of life in Chinese BPH patients with good safety and compliance.

Objective To investigate the risk factors of pancreatic pseudocysts(PPC) in patients with acute pancreatitis (AP) in a retrospective cohort study. Methods 460 AP patients with complete follow-up data admitted in Affiliated Hospital of Qingdao University from January 2004 to March 2012 were retrospectively analyzed,who were divided into PPC group and control group. Age,gender,body mass index(BMI),history of diabetes,etiology,the presence of ascites and hydrothorax,the presence of abdominal mass,the presence of acute fluid collection, APACHEⅡ score at 48 h admission, CT severity index (CTSI), serum albumin, amylase,LDH,ALP, BUN, Cr, TG, TB, conjugated bilirubin, CRP, serum calcium and other laboratory markers were recorded. Univariate logistic regression analysis was used to select the factors that were statistically different between two groups, and multivariate logistic regression analysis was performed to determine the independent risk factors for AP complicated with PPC. Results 143(31.1%) of 460 AP patients developed PPC. On univariate analysis, a total of 11 factors including male sex, BMI ≥28 kg/m2, history of diabetes, alcoholic pancreatitis, ascites, pleural effusion, palpable abdominal mass, acute fluid collections,APACHEⅡscore,CTSI≥7 and serum albumin were statistically different between two groups. On multiple logistic regression analysis, it was shown that male sex (OR 3.23, 95% CI 1.560~ 6.301, P=0.03),history of diabetes (OR 2.23,95% CI 1.021~3.920,P=0.04), ascites (OR 1.62,95% CI 0.652~2.432, P=0.01), pleural effusion (OR 2.43, 95% CI 1.201~7.201, P=0.03), a palpable abdominal mass(OR 1.83,95% CI 0.737~4.320,P<0.001) and CTSI≥7(OR 5.12,95% CI 1.890~14.012, P<0.001) were independent risk factors significantly associated with the PPC formation. Conclusions The male sex, diabetic history, ascites, pleural effusion, palpable abdominal mass and high CTSI score were the independent risk factors of PPC formation in AP.

A practical approach to the synthesis of the A, B and C-ring subunit of cyclopamine has been developed. This synthetic tactic highlights the utility of mandelate acetal-mediated resolution of the fused ring ketone (±)-4 and IBX-mediated oxidation cascades from 12 to 9. The availability of advanced intermediates from enantiomerically pure (+)-4 and 2 could provide efficient access to biologically active and structurally diverse C-nor-D-homo-steroidal alkaloids such as cyclopamine.
Chemistry Techniques, Synthetic ; methods ; Molecular Structure ; Organic Chemistry Phenomena ; Stereoisomerism ; Steroids ; chemistry ; Veratrum Alkaloids ; chemical synthesis ; chemistry

Objective To explore the efficacy and the clinical practice value of rehabilitation nursing to hepatolenticular degeneration patients with dysarthria. Methods 136 hepatolenticular degeneration patients with dysarthria in hospital were enrolled in this study, and they were randomly assigned to rehabilitation nursing group and usual nursing group. Both groups were treated formally by sodium dimercaptosulphonate, the 68 patients of usual nursing group were given general nursing, the 68 patients of rehabilitation nursing group were given general nursing and rehabilitation nursing of dysarthria. Frenchay dysarthria measurement, Phonolaryngeal graph,Microspiro, Activity of Daily Living Scale and WHOQOL-BREF were used to evaluate and compare the therapeutic effect after 8 weeks. Results The total effect rate of rehabilitation nursing group was 95.6％, and usual nursing group was 72. 1％, and the difference was significant (X2 = 13.88, P ＜ 0. 01). MPT in rehabilitation nursing group was different before and after treatment [(6. 12 ± 5.36) s vs (8.94 ± 6.43) s, t =2. 78, P ＜0. 01] and FVC was also different (t =2.46, P ＜0.05). The MPT and FVC in the two group were different (P ＜ 0. 01). WHOQOL-BREF results have reach the statistically significance in the two group after treatment (P ＜ 0. 01 or P ＜0. 05). Conclusions Dysarthria is a common language barrier of hepatolenticular degeneration; it seriously affects the physical and mental health of patients. Early speech rehabilitation training,with the treatment of hepatolenticular degeneration patients by sodium dimercaptosulphonate, can greatly promote sound organ function recovery, can obviously improve the speech function of patients and can improve daily life ability and the life quality of them, it has high value of clinical applications.

Objective To explore the effects of psychological intervention on the mental status and life quality of hepatolenticular degeneration patients during the perioperative period of splenectomy.Methods 64 cases hepatolenticular degeneration patients during the perioperative period of splenectomy were randomly divided into two groups,the intervention group and the control group,each with 32 cases.Both groups received conventional comfortable nursing,and the intervention group had psychological intervention for eight weeks in addition.Symptom checklist (SCL-90) was used to assess their changes of mental health,while the World Health Organization Quality of Life Scale (WHOQOL-100) was used to assess their quality of life before and after psychological intervention.Results Before psychological intervention,there was no statistically siguificant difference between two groups' SCL-90 scores (P ＞ 0.05).After eight weeks of psychological intervention,the sores of somatization,force,interpersonal relationship,depression,anxiety,hostility,paranoid and psychotic factors in SCL-90 of the intervention group were respectively (1.26 ± 0.43),(1.72 ± 0.44),(1.74 ± 0.45),(1.59±0.43),(1.58±0.52),(1.66±0.74),(1.44±0.57),(1.61±0.68),(1.51±0.43),all of which were lower than those of the control group [(1.60 ± 0.49),(2.06 ± 0.50),(1.74 ± 0.45),(1.85 ±0.49),(1.90±0.55),(2.07±0.66),(1.71 ±0.57),(1.95 ±0.64),(1.82 ±0.56)],and the differences were statistically significant (t =2.950,2.888,2.466,2.256,2.386,2.339,2.060,2.484,respectively; P ＞ 0.05).Before psychological intervention,there was also no statistically significant difference between two groups' WHOQOL-100 scores (P ＞ 0.05).And after eight weeks of psychological intervention,the score of every dimension was higher in the intervention group than in the control group,and the differences were statistically significant (t =4.401,4.694,3.242,5.410,4.576,4.847,3.834,respectively;P ＜0.01).Conclusions Psychological intervention can effectively improve the mental health and quality of life of hepatolenticular degeneration patients during the perioperative period of splenectomy,and thus should be strengthened.

The present study was aimed to investigate the mechanism of the granulocyte colony-stimulating factor (G-CSF) on the viability of the bone marrow mesenchymal stem cells (MSCs). MSCs were cultured by classical whole bone marrow adhering method, and the MSCs were analyzed for the cell surface differentiation markers CD34, CD133, CD90 and CD105 by flow cytometry (FCM). The ability of the MSCs to differentiate into osteocytes and adipocytes was tested in osteogenic and adipogenic mediums, separately. The effect of G-CSF (20 mug/mL) on the passage 3 MSCs viability was evaluated by MTT method, and the molecular mechanism of the G-CSF mediated effects was assayed through the pretreatment of the signal pathway inhibitors including 50 nmol/L wortmannin (phosphatidylinoesitol 3 kinase inhibitor), 50 mumol/L PD98059 [extracellular signal-regulated-kinase1/2 (ERK1/2) inhibitor], 30 mumol/L SB203580 (p38 mitogen-activated protein kinase inhibitor), 10 mumol/L H89 (protein kinase A inhibitor), 20 mumol/L Y27632 (Rho kinase inhibitor), 1 mumol/L rapamycin [mammalian target of rapamycin (mTOR) inhibitor], 10 mmol/L straurosporine [protein kinase C (PKC) inhibitor], 6 nmol/L G0697 (PKCalpha inhibitor) and 50 mumol/L Pseudo Z (PKCzeta inhibitor). Cultured passage 3 MSCs expressed CD90 and CD105 strongly, and showed the ability of multi-differentiation into osteocytes and adipocytes. G-CSF promoted the viability of MSCs, and the promotion was completely inhibited by PKC inhibitor straurosporine and partially inhibited by wortmannin, rapamycin, PD98059, SB203580 or G0697. However, its effect was not inhibited by H89, Y27632 and Pseudo Z. It is thus suggested that the promoting effect of G-CSF on MSCs viability was closely related to AKT-mTOR-PKC signal pathway, and PKC maybe the central role in the signal pathway.
Animals ; Bone Marrow Cells ; cytology ; Cell Differentiation ; Cell Survival ; Cells, Cultured ; Enzyme Inhibitors ; pharmacology ; Granulocyte Colony-Stimulating Factor ; pharmacology ; Hematopoietic Stem Cells ; Humans ; Mesenchymal Stromal Cells ; cytology ; Signal Transduction

OBJECTIVETo evaluate clinical application of transurethral plasmakinetic enucleation of the prostate (PKEP) to the treatment of benign prostatic hyperplasia (BPH).

METHODSA total of 90 BPH patients, aged 59-83 (mean 71) years and with indication of surgery, underwent transurethral resection of the prostate (the TURP group, n=50) and transurethral plasmakinetic enucleation of the prostate (the PKEP group, n=40), respectively. We recorded and analyzed the preoperative prostate volume, IPSS, QOL and Qmax, operation time, intra- and post-operative bleeding and complications, postoperative continuous bladder irrigation, and IPSS, QOL and Qmax at 2 weeks and 6 months after surgery.

RESULTSThe preoperative prostate volume and operation time were 58.9 g and 58.8 min in the TURP group versus 58.3 g and 93.0 min in the PKEP group. Mild transurethral resection syndrome (TURS) appeared in 2 TURP receivers, while no abnormality was found in electrocardiogram monitoring in those undergoing PKEP. Continuous bladder irrigation was necessitated in 3 and urgent incontinence of urine occurred in 4 cases of TURP, as compared with 1 and 4 cases in the PKEP group. None of the 90 patients needed blood transfusion. At 2 weeks before and after surgery and 6 months postoperatively, IPSS averaged 19.7, 11.6 and 5.1, QOL 4.6, 3.3 and 1.1, and Qmax 6.3, 13.0 and 18.1 ml/s in the TURP group versus 18.6, 8.4 and 4.9 (IPSS), 4.5, 2.7 and 1.1 (QOL) and 6.9, 14.2 and 19.0 ml/s (Qmax) in the PKEP group. There were significant differences in operation time, IPSS and QOL at 2 weeks postoperatively between the two groups, as well as in IPSS, QOL and Qmax at 6 months before and after surgery (P < 0.01). But no remarkable differences were found in preoperative prostate volume, IPSS, QOL and Qmax, 6-month postoperative IPSS and QOL, and Qmax at 2 weeks and 6 months after surgery between the two groups (P > 0.01).

CONCLUSIONTransurethral PKEP is a safe, effective and thorough surgical method to be chosen for the treatment of BPH.

Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; surgery ; Retrospective Studies ; Transurethral Resection of Prostate ; methods ; Treatment Outcome