Brain Diseases ; complications ; microbiology ; mortality ; Fatal Outcome ; Female ; Humans ; Middle Aged ; Otitis Externa ; complications ; microbiology ; mortality ; Pseudomonas Infections ; complications ; mortality

Objective To evaluate the value of gated ~(99)Tc~m-methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging in detection of myocardial ischemia in hypertrophic cardiomyopathy.Methods Sixty-nine patients with clinically proven hypertrophic cardiomyopathy were divided into 2 groups using coronary angiogram as "gold standard":positive group(n=19,narrowing≥50%) and negative group (n=50,narrowing＜50%).Gated ~(99)Tc~m-MIBI myocardial perfusion imaging was performed and positive in all 69 patients (41 males,28 females,aged 35-75 years).Comparative analysis between the two groups was carried out using t-test.Results In the positive group,reversible and irreversible perfusion defects were detected in 9 and 10 patients,respectively.Left ventricular ejection fraction (LVEF) increased to (69.1±2.8)% in 8 patients and decreased to(42.8±2.1)% in 11 patients.In the negative group,reversible and irreversible perfusion defects were found in 37 and 13 patients,respectively.LVEF increased to(70.8±4.0)% in 38 patients and decreased to(48.9±2.7)% in 12 patients.The values of ischemic area,severity and extent of perfusion defect,and LVEF were significantly different between the two groups(t=9.28,16.51,2.65;P＜0.001,＜0.001,＜0.01,respectively).Conclusions Gated ~(99)Tc~m-MIBI myocardial perfusion imaging is valuable in assessing patients with hypertrophic cardiomyopathy.Detection for the presence or absence of coexisting coronary artery disease and myocardial ischemia has an important prognostic indication and management indication for these patients.

Objective To observe the extracellular content of dopamine (DA)and expression of D1 receptors in hippocampal dentage gyrus (DG)in the model rats with vascular dementia (VD),and to investigate the relationship between them.Methods 12 male SD rats were randomly divided VD group and sham-operation group,and the VD model was prepared by permanent bilateral carotid occlusion.The extracellular content of DA in the DG was determined by in vivo microdialysis and HPLC,and the expression of D1 receptors was measured by immunehisto-chemistry.Results The DA content in the DG of the rats in VD group was lower than that in sham-operation group (P <0.05).The number of D1 receptor-positive cells in the DG hilus in VD group was increased compared with sham-operation group (P < 0.05),whereas the expression of D1 receptor in DG granule cell layer did not change (P > 0.05).Conclusion The DA content in the hippocampal DG is decreased in the VD rats,and its function may be compensated by the up-regulation of D1 receptors in the DG hilus.

Objective To investigate the correlation between knee joint line and anterior knee pain after total knee arthroplasty (TKA).Methods From January 2008 to December 2010,76 patients with osteoarthritis underwent primary TKA in our hospital,including 11 males and 65 females,aged from 47 to 83 years (average,68.88±7.61 years).Fixed-bearing posterior stabilized TKA (PFC) was used in all patients.All patients were followed up every 12 months after TKA.According to the Figgie's method,pre-and post-operative knee joint line was measured,and the changes of pre-and post-operative knee joint line were calculated.If the knee joint line was elevated,it was defined as positive; on the contrary,it was defined as negative.The Feller's patellar score was used to assess pre-and post-operative patellar function.The correlation between joint line level and Feller's patellar score was analyzed 24 months after operation.Results The joint line level ranged from-6.8 to 10.44 mm (average,2.69±3.31 mm).With the rise of the joint line,the patient's patella score decreased.There is a negative correlation between the elevated joint line level and Feller's patellar score (r=-0.763,P=0.000).The Feller's patellar score decreased with the fall of joint line level,and there is a positive correlation between them (r=0.914,P=0.000).The Feller's patellar score was higher in patients whose joint line change was less than 4 mm than that in patients whose joint line change was greater than 4 mm (t=12.648,P=0.000; t=l 1.775,P=0.000).Conclusion The joint line change was correlated to anterior knee pain after TKA with fixedbearing posterior stabilized prosthesis.The joint line change less than 4 mm can result in a better knee joint function.

Objective To investigate the clinical features of multiple primary malignancies ( MPM) in patients with kidney malignancy .Methods The clinical data of 111 patients suffered from MPM associated with kidney malignant tumor in Yantai Yuhuangding Hospital and Affiliated Yantai Hospital of Binzhou Medical College from April 1984 to December 2014 were retrospectively analyzed .Results Among the 111 cases,there were 100 cases with two primary malignancies ,9 with three cancers and 2 cases with four or five cancers.Synchronous MPM were 37 cases,and metachronous 74 cases.The interval between the first and the second primary malignancy was between 0 and 348 months,with average of 46 months and median of 16 months.One hundred and seventy-two cases were treated by operation , and 64 cases by conservative therapy.The proportion of operation from the first to the fifth cancers were 89.2%(99/111),59.5%(66/111),54.5%(6/11),50.0%(1/2),0%(0/1),respectively,with the trend of declining.Finally 95 cases (85.6%) were followed up ,with 53 cases survived and 42 cases died.From the diagnostic date of the first primary cancer,overall survival in 1 year,3 years,5 years,10 years were 97.2%,77.2%,67.8%,48.4%, respectively.Median survival time was 120 months.From the diagnostic date of the last primary cancer , overall survival in 1 year,3 years,5 years were 81.4%,53.4%,48.2%,respectively.Median survival was only 48 months.Univariate analysis showed that the cumulative survival rate was higher in patients with operation than conservative therapy ( P =0.000 ) , in metachronous group than synchronous group ( P =0.009).COX proportional hazard model showed metachronous MPM (OR=3.870,95%CI 1.702-8.801,P=0.001),aggressive operation of the first primary cancer (OR=0.107,95%CI 0.018-0.647,P=0.015) and the second cancer (OR=0.313,95%CI 0.131 -0.750, P=0.009) were independent prognostic factors. Conclusions The main treatment of MPM associated with kidney malignancy is aggressive operation, radiotherapy, chemotherapy and biological therapy are adjuvant .Early detection and early operation for MPM are beneficial for increasing the survival of the patients .

Objective To observe the ultrastructure changes of hippocampal dentage gyrus (DG) and spatial learning and memory ability changes in rats models of vascular dementia (VD), and investigate the relationship between them.Methods Twelve adult male SD rats were randomly divided into sham-operated group and VD model group (n=6);the VD rat models were prepared by improved permanent bilateral carotid occlusion.The spatial learning and memory abilities of rats were assessed by Morris water maze (MWM), and the ultrastructures of DG were detected by transmission electron microscope.Results (1) In the place navigation trial of MWM, the mean escape latency in VD group was significantly longer than that in sham-operated group (P＜0.05);in the spatial probe trial, the number of platform crossings in VD group was markedly smaller as compared with that in sham-operated group (P＜0.05).(2) The changes in ultrastructures of hippocampal DG in VD rats were as follows: the number of synaptic vesicles was reduced;the rough endoplasmic reticulum was reduced and arranged in disorder,and free ribosome was increased;the membrane and cristae of mitochondria in the synaptosoma were blurred, and the cristae was fractured;the synaptic cleft was blurred.Conclusion The spatial learning and memory disabilities in VD rats may be associated with injury of ultrastructures in hippocampal DG.

Objective:Objectives The aim of the study is to evaluate the mechanical performance, safety and efficacy of the novel robotic-assistant flexible ureteroscopy system (Ra-fURS) under in vitro and in vivo environments.Methods:Combing with commercial flexible ureteroscopes, the novel Ra-fURS was used for the in vitro test and animal model operation in October 2020. The study included three sections. ①Basic mechanical performance assessment: including endoscope motion control (dual deflection, axial rotation and forward/backward distance), reaction time and fiber regulation. ②Simulated surgery in ex-vivo 3D-printing renal collecting system model: including completion rate and time of calyxes exploration, directional movement and laser fragmentation [gypsum models (0.5×0.5×0.5 cm) were used to stimulate kidney stones]. ③Intrarenal surgeries in animal models (two 5-month female Yorkshire white pigs). In total, 32 surgeries was performed (8 surgeons × 2 pigs × 2 kidneys/pig). In vivo assessments were carried out including: ①consuming time for Ra-fURS installation and offloading; ②completion rate and time of calyxes exploration; ③comfort score (ranging from 0-10) as compared to the manual f-URS, which was corresponding to each Ra-fURS surgery. In simulated surgery and animal surgery sections, 8 surgeons were enrolled in the study (group A 4 without flexible ureteroscopy experience; group B: 4 highly experienced), and results were compared between two groups.Results:Under the Ra-fURS control, the flexible ureteroscope movement in three degrees of freedom (forward / backward: + 11 to -11 cm, axial rotation + 225°to -225°; active duel-flection: + 270°to -270°, as well as the laser fiber regulation + 2.5 to -2.5 cm). In simulated surgery tests, both groups achieved 100% completion rate of calyxes exploration, and there were no statistical differences in the time of the calyxes exploration between group A and group B (116.0±8.0)s vs.(110.3±15.4)s( P>0.05). Time-consumption for laser fragmentation of group B was shorter than that of group A (525.8±58.5)s vs. (780.5±141.2)s( P<0.01). In animal surgery, the installation time of Ra-fURS gradually shortened within the first 7 cases was(234.0±43.0)s, and became comparable in the later 8-32 cases was(149.3±8.0)s. The average uninstall time was (43.9 ±5.9)s and was relatively stable. There were 51 renal calyxes in two pigs. It was higher for the completion rate of calyxes exploration in group B than in group A [(95.5±9.1)% vs. (59.1±9.1)%, P<0.05], and the exploration time was also statistically variant between the two groups group A and group B[(274.8±34.6)s vs.(127.3±18.2)s, P<0.05]. For all the operators, the comfort scores were favorable to the Ra-fURS as compared to the manual f-URS (8.9±0.3 vs. 5.9±1.1, P<0.05). Conclusions:This preliminary study demonstrated that the novel Ra-fURS was capable of controlling flexible ureteroscope to perform retrograde intrarenal surgery and fragmenting stones with laser. Besides, other features, including easy installation, stable performance and comfortable manipulating environment, made it easy to use in clinical application.

OBJECTIVETo explore the relationship between genetic polymorphisms of CYP-1A1 and CYP2D6 and risks of chronic benzene poisoning (BP).

METHODSA case control study was conducted. 152 BP patients and 152 workers occupationally exposed to benzene without poisoning manifestations were involved. Polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP) technology was used for detecting the single nucleotide polymorphisms (SNPs) of MspI in the non-coding region of CYP-1A1 gene and c.188, g.212 position in the first extron of CYP2D6 gene.

RESULTSThe individuals with CYP1A1 MspI T/T genotype had a 1.32 times (95% CI: 1.05 approximately 1.65, P = 0.02) increased risk of BP compared with those carrying T/C and C/C genotypes. In no-smoking population, there was a 1.56 times (95% CI: 1.15 approximately 2.12, P = 0.003) increased risk of BP for subjects carrying CYP1A1 MspIT/T genotype compared with those carrying T/C and C/C genotypes. The individuals carrying CYP2D6 c.188 C/C or C/T genotype had a 1.23 times (95% CI: 1.05 approximately 1.42, P = 0.01) increased risk compared with those carrying T/T genotypes. In no-smoking population, there was a 1.23 times (95% CI: 1.04 approximately 1.47, P = 0.01) increased risk of BP for subjects carrying CYP2D6 c.188 C/C or C/T genotypes compared with those carrying T/T genotype. The single nucleotide polymorphism of g.212 position in the first extron of CYP2D6 gene had not been validated.

CONCLUSIONThe individuals with CYP2D6 c.188 C/C, CYP2D6 c.188 C/T and CYP1A1 MspIT/T genotypes tend to be more susceptible to benzene toxicity.

Adolescent ; Adult ; Benzene ; poisoning ; Case-Control Studies ; Chronic Disease ; Cytochrome P-450 CYP1A1 ; genetics ; Cytochrome P-450 CYP2D6 ; genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Middle Aged ; Occupational Diseases ; genetics ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length

OBJECTIVETo evaluate the effect of daily low-dose tadalafil on erectile dysfunction (ED) induced by pelvic fracture urethral disruption (PFUD).

METHODSThis study included 46 cases of PFUD-induced ED treated from Jan 2008 to Dec 2011. The patients were aged 33.9 +/- 7.2 years (range 25 -51 yr), and the interval between injury and treatment was 19.6 +/- 12.7 months (range 3 - 72 mo), all with normal erectile function before PFUD. Based on the nocturnal penile tumescence and rigidity (NPTR) recorded by erectometry without medication of phosphodiesterase type 5 inhibitor (PDE-5I), the patients were divided into an abnormal nocturnal erection group and a non-nocturnal erection group, and treated with tadalafil 10 mg once daily for 3 months. The therapeutic effect was evaluated by IIEF-5 scores and the rate of yes responses to questions 2 and 3 of the Sexual Encounter Profile (SEP).

RESULTSTotally 38 (82.6%) of the patients accomplished the treatment and follow-up, 26 (68.4%) in the abnormal nocturnal erection group and 12 (31.6%) in the non-nocturnal erection group. After 3 months of daily tadalafil treatment at 10 mg, the IIEF-5 scores were significantly improved in the abnormal nocturnal erection group than in the non-nocturnal erection group (P < 0.05), and the rate of yes responses to SEP2 and SEP3 was remarkably higher in the former than in the latter (76.9% vs 41.7% and 65.4% vs 25.0%, P < 0.05).

CONCLUSIONSDaily low-dose tadalafil can effectively improve the erectile function of PFUD-induced ED patients, particularly in those with nocturnal erection.

Adult ; Carbolines ; administration & dosage ; therapeutic use ; Dose-Response Relationship, Drug ; Erectile Dysfunction ; drug therapy ; etiology ; physiopathology ; Fractures, Bone ; complications ; Humans ; Male ; Middle Aged ; Pelvis ; injuries ; Penile Erection ; Tadalafil ; Treatment Outcome ; Urethra ; injuries

Objectives: To explore the feasibility and safety of "2-staged" hybrid coronary revascularization using bilateral internal thoracic artery (BITA) for the treatment of multivessel coronary artery disease. Methods: Data of 65 patients who underwent "2-staged" hybrid technique (HCR) using BITA (BITA-HCR group) in our heart center because of multivessel coronary artery lesions during 2014.05-2017.05 were retrospectively analyzed. Results were compared with 96 patients who underwent "2-staged" HCR with single ITA (SITA-HCR group) by the same surgeon over the same time period. Results: There was no significant difference of preoperative characteristics between two groups. Operation time was significantly longer [(204.6±28.7) min vs (147.9±31.6) min, P<0.05], number of distal anastomoses was significantly higher [(2.2±0.5) vs (1.0±0.0), P<0.05], number of stents was significantly lower [(1.90±0.67) vs (2.40±0.49), P<0.05] in BITA-HCR group than in SITA-HCR group. Bleeding volume [(520.1±120.3) ml vs (532.2±350.3)ml, P>0.05], mechanical ventilation time [(7.7±3.2) h vs (6.9±2.3) h, P>0.05] and blood transfusion required [5(7.7%)vs 8(8.3%), P>0.05] were similar between the two groups. Conclusions: The "2-staged" hybrid procedure using BITA is safe and feasible for the revascularization of multiple coronary artery lesions.