Objective To explore the causes of short P R interval syndrome.Methods 15 patients of short P R interval syndrome were tested with transesophageal atrial pacing (TEAP),and then the results and the parameters of TEAP were analyzed.Results The detection rates of dual atrioventricular nodal pathways(DAVNP),L G L syndrome and latent preexcitation syndrome were 66.67%(10/15),26.67%(4/15)and 6.67%(1/15)respectively.Conclusion The most common causes of short P R interval syndrome are DAVNP and the L G L syndrome

Objective To study the clinical characteristics of epidemic Japanese encephalitis in 4 adult patients and to improve the level of diagnosis.Methods The clinical characteristics, laboratory results and MRI features of 4 adult patients with epidemic Japanese encephalitis hospitalized in our hospital between 2007 and 2008 was retrospectively reviewed and analyzed.Results All patients were sporadic.Two were female and others were male with the age from 34 to 68 years old and onset in summer and autumn.One patient had diarrhea at onset while others had fever and headache at onset.All patients had high fever and psychiatric symptoms.Two patients had respiratory failure.Obvious elevation of white cells in cerebrospinal fluid was seen in all patients and Japanese viral antibody of IgM was all positive whereas the image of MRI was abnormal only in one patient.Two patients had neurological sequelae.Conclusions The clinical manifestations of epidemic Japanese encephalitis in adults are severe and untypical and the respiratory failure is likely to occur.

Objective To investigate urinary iodine and dietary iodine intake in adults, and to ana-lyze the relationship of urinary iodine and daily dietary iodine intakes with thyroid nodules.Methods To-tally 30 participants with nutritional background were enrolled prospectively from January to March 2015 in Shanghai.The 3-day survey of 24-hour's diet record was made using weighting method to evaluate the daily nutrient intakes.On the second and third days of dietary records, urine samples in fasting status and 2 hours after meals were collected from all the participants (n=240).The levels of urine iodine were meas-ured, and dietary iodine intake calculated.3-month food frequency questionnaire was completed and thy-roid ultrasonography performed.Results The median urinary iodine ( MUI) of fasting and 2 h postprandi-al urine samples was 137.56 μg/L ( 91.4-211.5 μg/L) .The portions of participants with iodine insuf-ficiency, iodine adequate, and iodine above requirements or excess were 20.2%, 56.7%, and 23.3%, respectively.Inter-individual MUI varied from 36.31 μg/L to 359.20 μg/L.No significant difference was found between the fasting urinary iodine and 2 h postprandial urinary iodine ( P=0.389 ) .The average di-etary iodine intake was (197.2 ±74.2) μg/d, and the proportions from iodine salt and drinking water were 70.2% and 5.4%, respectively.There was a significant positive correlation between dietary iodine intake and urinary iodine value of the same day (r=0.426, P=0.019).Participants with thyroid nod-ules had higher urinary iodine than participants without thyroid nodules [ ( 194.0 ±101.5 ) μg/L vs. (135.7 ±72.9) μg/L, P<0.001].Conclusions Inter-individual iodine nutritional status are signifi-cantly different under natural living status.Increased urinary iodine may be related with thyroid nodules. Repeat random urine iodine test combined dietary assessment may reduce the error in evaluating individual iodine nutritional status.

Objective To evalute the accuracy of stroke volume variation (SVV) in monitoring blood volume in patients undergoing off-pump coronary artery bypass grafting.Methods Twenty-one ASA Ⅱ or Ⅲ patients of both sexes aged 44-77 yr undergoing off-pump coronary artery bypass grafting were enrolled in this study.Anesthesia was induced with midazolam,etomidate,fentanyl,rocuronium and dolicaine and maintained with target-controlled infusion of propofol,infusion of remifentanil,intermittent iv injetion of atracurium and inhalation of sevoflurane.The patients were mechanically ventilated (VT 8 ml/kg,RR 12 bpm,I:E 1:2,PEEP 0,FiO2 80％ ).PEr CO2 was maintained at 35-44 mm Hg.Radial artery was cannulated and connected to FloTrac pressure transducer and Vigileo monitor.6％ hydroxyethyl starch 130/0.4 sodium chloride solution 7 ml/kg was infused at a rate of 0.25 ml· kg- 1 1· min- 1 at 5 min of haemodynamics stabilization after pericardiotomy (T1).HR,MAP,CVP,systemic vascular resistance (SVR),systemic vascular nesistance index (SVRI),SVV,stroke volume index (SVI)and CI were recorded at T1 and at 10 min after loading dose (T2).The change rate of HR(△HR),MAP(△MAP),CVP(△CVP),SVR(△SVR),SVV(△SVV),SVI(△SVI) and CI(△CI) were calculated.△SVI≥25％ was considered effective volume expansion.The ROC curves for HR,MAP,CVP,SVR and SVV in determining the volume expansion efficacy were plotted.The area under the curves and 95 ％ confidence interval were calculated.Results Compared with T1,CVP,SVI,CO and CI were significantly increased,SVRI and SVV decreased at T2 (P ＜ 0.01).There was no significant difference in MAP and HR between T1 and T2(P ＞0.05).△SVI was negatively correlated with △HR and △SVR ( r =- 0.737,r =- 0.480,P ＜ 0.05).△SVI was not correlated with △CVP,△MAP and( P ＞ 0.05).The change in SVI was determined by SVV 8.8％ (sensitivity =52.6％,specificity =100.0％ ).The area under the curve for SVV and 95％ confidence interval were 0.579(0.346-0.812).Conclusion SVV can not be used to accuratelymonitor the changes in blood volume in patients undergoing off-pump coronary artery bypass grafting.

Objective To study the effects of transcranial magnetic stimulation (TMS) on learning and memory, and angiogenesis and the dendritic structure of hippocampal CA3 pyramidal neurons after cerebral infarction. Methods Forty-eight male Sprague-Dawley rats were divided into a sham operated group, a model group and a TMS group (n = 16). Rat models of focal cerebral infarction were established with unilateral middle cerebral artery (MCA) suture occlusion in the model and TMS groups. The rats of the TMS group were given 4 weeks of TMS treatment beginning 1 day after the infarction (2 times per day, 30 pulses per time). Their learning and memory abilities were tested with a Y-maze. Angiogenesis and the dendritic structure of their hippocampal CA3 pyramidal neurons were detected after 4 weeks. Results Compared with the model group, learning and memory improved significantly in the TMS group. The average microvessel density of the hippocampus in the TMS group was significantly more than in the model group. The total length of apical dendrites of hippocampal CA3 pyramidal neurons in TMS group was significantly longer than in the model group. Conclusions The improved learning and memory observed following TMS treatment are likely to be related to changes in angiogenesis, the dendritic.structure of the hippocampal CA3 pyramidal neurons, and enhanced synaptic plasticity.

Penile verrucous carcinoma is a rare, well-differentiated and low-grade tumor. The surgeons are deficiently aware about the biological behavior and the clinicopathological characteristic of this disease, which raises difficulties during the treatment. In our present study, the clinical and pathological data of 11 patients with penile verrucous carcinoma, aged between 49 to 85 years was retrospectively analyzed. The tumors exhibited exophytic, papillary, caulifower-like or verrucose lesions of great dimensions measuring between 2 to 10 cm on the penises. The tumors were located at glans in 6 cases, invaded the coronoid sulcus in 4 cases and invaded the shaft of the penis in 1 case. Eight cases underwent partial penectomy, while the other 3 were treated with local excision. The diagnosis of penile verrucous carcinoma was confirmed by histopathologic examination of the specimens with the negative surgical margins in all the cases. Within the period of 12 to 60 months of follow-up, all the patients were disease-free with no case of recurrence and metastasis. The novel knowledge and experience of the treatment of penile verrucous carcinoma will be a useful clinical guide for surgeons in the future.
Aged ; Carcinoma, Verrucous ; Follow-Up Studies ; Humans ; Male ; Neoplasm Metastasis ; Penis ; Recurrence ; Retrospective Studies

Objective To observe the value of three-dimensional constructive interference in steady state (3D-CISS) sequence for displaying anterolateral ligament (ALL) of knee joint.Methods MR scans of right knee joint were performed on 30 healthy volunteers,and the protocol included axial and coronal fat saturation proton density weighted imaging (FS-PDWI) and 3D-CISS sequence.MRP and CPR (reconstructive angles including 0°,30°,60°,90°,120°,150° and 180°) images were generated from of 3D-CISS sequence.The visibility rates of the femoral part,meniscal part,tibial part,meniscal insertion,femoral footprint and tibial footprint of ALL were compared among different protocols.Results The visibility rates of tibial footprint and femoral footprint of ALL on 3D-CISS CPR images were both 96.67％ (29/30),and on 3D-CISS MPR images were both 93.33％ (28/30),all of them were higher than those on FS-PDWI images (all P＜0.017).The visibility rates of tibial part,meniscal part and meniscal insertion of ALL on 3D-CISS CPR images were 96.67％ (29/30),83.33％ (25/30) and 83.33％ (25/30),respectively,and all of them were higher than those on FS-PDWI images (all P＜0.05).There was no statistical difference of visibility rate of femoral part between 3D-CISS CPR images and FS-PDWI images (P=0.095).Conclusion 3D-CISS sequence with CPR can significantly enhance the ability to identify ALL.

Objective: The primary aim was to evaluate the influence of depressive and anxiety symptoms on the 1-year recurrence rate of non-muscle invasive bladder cancer (NMIBC) patients. The secondary aim was to examine the risk factors leading to psychological distress. Methods: A total of 104 NMIBC patients were enrolled for interviews, and the Hospital Anxiety and Depression Scale (HADS) questionnaire survey was administered 1 month after their operation. Their cystoscopy results were followed up. The risk factors affecting their 1-year recurrence rate were evaluated through univariate analysis, Cox regression and Kaplan-Meier analysis. The risk factors causing depressive and anxiety symptoms were evaluated through univariate analysis and logistic regression. Results: In addition to American Urological Association risk stratification, depressive symptoms were another independent risk factor for recurrence in NMIBC patients (HR: 2.493, 95% CI: 1.048–5.930, p=0.039), and the increase in the recurrence rate was highly significant in intermediate-risk patients (HR: 8.496, 95% CI: 2.178–33.138, p=0.019). Anxiety symptoms were not an independent risk factor for recurrence (HR: 1.655, 95% CI: 0.714–3.837, p=0.240). We also observed that the burden of medical expenses of NMIBC on the family was an independent risk factor for depressive symptoms (p=0.029) and anxiety symptoms (p=0.048); chronic pain was an independent risk factor for anxiety symptoms (OR: 3.447, 95% CI: 1.182–10.052, p=0.023). Conclusion Depression symptoms are an independent risk factor for recurrence in NMIBC patients. Moreover, the burden of medical expenses on the family is an independent risk factor for depressive and anxiety symptoms in NMIBC patients. Additionally, chronic pain is a risk factor for anxiety symptoms in NMIBC patients. This study provided a theoretical foundation for clinical oncologists to pay more attention to the mental health of NMIBC patients.

Objective: The primary aim was to evaluate the influence of depressive and anxiety symptoms on the 1-year recurrence rate of non-muscle invasive bladder cancer (NMIBC) patients. The secondary aim was to examine the risk factors leading to psychological distress. Methods: A total of 104 NMIBC patients were enrolled for interviews, and the Hospital Anxiety and Depression Scale (HADS) questionnaire survey was administered 1 month after their operation. Their cystoscopy results were followed up. The risk factors affecting their 1-year recurrence rate were evaluated through univariate analysis, Cox regression and Kaplan-Meier analysis. The risk factors causing depressive and anxiety symptoms were evaluated through univariate analysis and logistic regression. Results: In addition to American Urological Association risk stratification, depressive symptoms were another independent risk factor for recurrence in NMIBC patients (HR: 2.493, 95% CI: 1.048–5.930, p=0.039), and the increase in the recurrence rate was highly significant in intermediate-risk patients (HR: 8.496, 95% CI: 2.178–33.138, p=0.019). Anxiety symptoms were not an independent risk factor for recurrence (HR: 1.655, 95% CI: 0.714–3.837, p=0.240). We also observed that the burden of medical expenses of NMIBC on the family was an independent risk factor for depressive symptoms (p=0.029) and anxiety symptoms (p=0.048); chronic pain was an independent risk factor for anxiety symptoms (OR: 3.447, 95% CI: 1.182–10.052, p=0.023). Conclusion Depression symptoms are an independent risk factor for recurrence in NMIBC patients. Moreover, the burden of medical expenses on the family is an independent risk factor for depressive and anxiety symptoms in NMIBC patients. Additionally, chronic pain is a risk factor for anxiety symptoms in NMIBC patients. This study provided a theoretical foundation for clinical oncologists to pay more attention to the mental health of NMIBC patients.

Rabbit bone marrow-derived mesenchymal stem cells(MSCs) are multipotent. We studied the adipogenic and osteogenic differentiation potent using adipogenic supplement (AS) or osteogenic supplement (OS) in vitro. Specific markers of this induced adipogenic and osteogenic lineage were identified. The findings showed that the rabbit MSCs are capable of differentiating into adipogenic and osteogenic lineages spontaneously. On the 21st day, approximately 75% rabbit MSCs were induced to adipogenic or osteogenic cells in medium containing AS or OS, respectively. These results demonstrated that the differentiation of MSCs could be regulated in vitro. The underlying molecular mechanisms of adipogenic or osteogenic differentiation await elucidation.
Adipose Tissue ; cytology ; Animals ; Bone and Bones ; cytology ; Cell Differentiation ; Cell Lineage ; In Vitro Techniques ; Mesoderm ; cytology ; Rabbits ; Stem Cells ; cytology