Objective To assess the symptoms of patients due to indwelling double ureteral stent and their impact on quality of life. Methods Sixty patients were assessed by the specific questionnaire. Average time of indwelling stent was 21.4 d. All patients finished the special questionnaire when the stent was removed by cystoscope, including specific urinary symptoms, IPSS (international prostate symptom score), VAS (visual analogic scale) and QOL (quality of life). To assess the pain feeling, the patients were divided into 3 groups by varied methods of anesthesia, including local anesthesia, balance anesthesia and general anesthesia. Results Insertion or removal of ureteral stents with local anesthesia provoked pain in 11 of 12 (91%) patients and 8 of 10 (80%) patients in balance anesthesia group. But 38 patients of general anesthesia group did not feel any pain when inserting stents. In 54 of 60 (90%) patients, the indwelling catheter provoked one or several urinary symptoms: nocturia (70%), frequency (65%), urgency (60%), tenesmus (58%), dysuria (52%), hematuria (35 % ) and incontinence (30 %). 75 % of the patients experienced pain, in the flank and lower abdomen. 29 (48 %) patients were found to be unsatisfied with their quality of life due to the indwelling stent. Among them, 18 (62%) patients demonstrated that the provoked overactive bladder symptoms were the main influence factor of QOL, compared with 5(17 %) patients complaining pain feeling. Conclusions Urinary symptoms and pain associated with indwelling double J ureteral stents could interfere the daily activities and 50 % of patients were found reduced quality of life. Overactive bladder symptoms were the main influence of QOL during the time of indwelling stent.

Objective To observe the effect of magnetic stimulation of sacral roots on detrusor overactivity and urge incontinence after spinal cord disease.Methods 15 cases with detrusor overactivity and urge incontinence after spinal cord disease were treated with magnetic stimulation of sacral roots for 10 d.Voiding diary,quality of life scale and urodynamic investigation were applied to evaluate the effect.Results The mean frequency of voiding in 24 h after treatment decreased,urine volume increased,frequency of incontinence decreased and the quality of life score improved.Urge incontinence improved in 85.7% cases.The results of urodynamic investigation showed bladder capacity at first desire to void and maximum cystometric capacity significantly increased after stimulation,while the detrusor pressure at storage decreased.Conclusion Magnetic stimulation of sacral roots can improve urinary frequency and urge incontinence of patients with detrusor overactivity after spinal cord disease by inhibiting detrusor overactivity,increasing cystometric capacity.Magnetic stimulation of sacral roots may be an alternative promising rehabilitation technique.

OBJECTIVES: Cardiovascular disease (CVD) has a substantial financial impact on healthcare systems in the US. This study aimed to examine the impact of CVD on health insurance coverage and health service use under economic stress as indicated by the Great Recession in the US (December 2007–June 2009). METHODS: Data of 26,483 adults aged ≥ 20 years from the 2003–2012 National Health and Nutrition Examination Survey were analyzed. There were 9,479 adults assigned to the group “before the Great Recession” (2003–2006), 5,674 adults assigned to “during the Great Recession” (2007–2008), and 11,330 adults assigned to “after the Great Recession” (2009–2012). RESULTS: Patients with CVD from low-income families were more likely to have health insurance during the recession (OR:1.57, 95% CI: 1.01,2.45). Those participants without CVD, who were from low-income families or < 65 years, were more likely to use the emergency room rather than primary care facilities to gain access to routine healthcare (p < 0.05). Patients with CVD from high-income families were also more likely to use the emergency room (p < 0.05). Patients with CVD but not those without CVD, who reported a high family income or were ≥ 65 years old, were less likely to use mental health services during the recession than before the recession. CONCLUSION: Effective strategies need to be developed to promote primary care use among the general adult American population. In addition, use of mental health services among patients with CVD needs to be improved when financial stress occurs.
Adult ; Cardiovascular Diseases ; Chronic Disease ; Cost of Illness ; Delivery of Health Care ; Emergency Service, Hospital ; Health Services ; Humans ; Insurance, Health ; Mental Health Services ; Nutrition Surveys ; Primary Health Care

OBJECTIVETo determine mutations of two common potassium channel subunit genes KCNQ1, KCNH2 causing long QT syndrome (LQTS) in the Chinese.

METHODSThirty-one Chinese LQTS pedigrees were characterized for mutations in the two LQTS genes, KCNQ1 and KCNH2, by sequencing.

RESULTSTwo novel KCNQ1 mutations, S277L in the S5 domain and G306V in the channel pore, and two novel KCNH2 mutations, L413P in the transmembrane domain S1 and L559H in the transmembrane domain S5 were identified. The triggering factors for cardiac events developed in these mutation carriers included physical exercise and excitation. Mutation L413P in KCNH2 was associated with the notched T wave on ECGs. Mutation L559H in KCNH2 was associated with the typical bifid T wave on ECGs. Mutation S277L in KCNQ1 was associated with a high-amplitude T wave and G306V was associated with a low-amplitude T wave. Two likely polymorphisms, IVS11 + 18C > T in KCNQ1 and L520V in KCNH2 were also identified in two LQTS patients.

CONCLUSIONSThe mutation rates for both KCNQ1 (6.4%) and KCNH2 (6.4%) are lower in the Chinese population than those from North America or Europe.

Asian Continental Ancestry Group ; Cation Transport Proteins ; China ; DNA-Binding Proteins ; ERG1 Potassium Channel ; Ether-A-Go-Go Potassium Channels ; Female ; Humans ; KCNQ Potassium Channels ; KCNQ1 Potassium Channel ; Long QT Syndrome ; genetics ; Male ; Mutation ; Potassium Channels ; genetics ; Potassium Channels, Voltage-Gated ; Trans-Activators ; Transcriptional Regulator ERG

Objective:To investigate the relationship between double mutations of myosin heavy chain gene (MYH6) p.Gly743Arg and p.Glu1389Lys and the cardiac phenotype.Methods:Patients carrying double mutations in the MYH6 gene p.Gly743Arg and p.Glu1389Lys were screened from 52 unrelated left ventricular hypertrophy (LVH) who were admitted to the Second Hospital of Chongqing Medical University from 2015 to 2020, and the genetic testing of peripheral blood of patients by second-generation whole-exome sequencing assay technology and genomic DNA of their family members Sanger sequencing was performed to validate the genomic DNA of the family members. The cardiac phenotype was evaluated by electrocardiogram, coronary computed tomography angiography (CTA), echocardiography, and cardiac magnetic resonance imaging (MRI) as adjuncts.Results:All whole-exome gene were detected in 52 unrelated patients with LVH, of which 1 patient (1.9%) had double mutations in MYH6 gene p.Gly743Arg and p.Glu1389Lys (proband). Two members of the maternal line of this patient carried p.Glu1389Lys mutation, but there was no obvious clinical phenotype. Two members of the paternal line carried p.Gly743Arg mutation and had obvious clinical phenotype of bradycardia, but there was no LVH. The male proband, aged 21 years old, presented with LVH and sinus bradycardia but no coronary artery stenosis on CTA before treatment, MRI showed that the left ventricular end diastolic diameter was 58 mm. After treatment with angiotensin receptor-enkephalinase inhibitor (ARNI), electrocardiogram showed that the heart rate increased significantly (from 43 bpm to 72 bpm). Echocardiography showed that the left ventricular end diastolic diameter decreased significantly (from 60 mm to 49 mm).Conclusions:The p.Glu1389Lys mutation of the MYH6 gene may not manifest the phenotype of heart disease. MYH6 gene p.Gly743Arg mutation may be manifested asymptomatic sinus bradycardia, but there is no LVH phenotype. The cardiac disease phenotype caused by the double mutations of p.Gly743Arg and p.Glu1389Lys in the MYH6 gene is more obvious. Asymptomatic LVH and sinus bradycardia can appear in adolescence, but the LVH phenotype can be reversed in a short period of time after ARNI treatment.

Factors affecting male fertility include lifestyle,psychology,environment.and so on.Pathogenic microorganisms in the genitourinary system can also lead to decline of male fertility.However,doctors tend to ignore the effects of immune responses and oxidative stress caused by pathogenic microorganisms on fertility,thus delaying the optimal time of treatment.This paper reviews the relationship between bacteria(such as Escherichia coli,Helicobacter pylori),viruses((severe acute respiratory syndrome coronavirus 2,human papilloma virus),and other pathogenic microorganisms(mycoplasma and chlamydia)and male infertility,and summarizes the latest research progress,aiming to provide guidance for the multidimensional treatment and to provide new ideas for the prevention of male infertility.