Objective To studythe preventive effects of modified Dihuang decoction on the relapse of urinary calculus after caiculus removed or destroyed.Methods 306 cases were randomly divided into a trealment group (with 149 cases)and a control group(with 157 cases).The trealment group was interfered with modified Dihuang decoction for 6 years,and the control group was not interfered with any medicine.Observe the relapse number in the two groups.Results There were 8 cases relapsed in the treatment group(5.4%)comparing with 46 cases relapsed in the control group(29.3%),showing a significant difference (P＜0.01).Conclusion Medified Dihuang decoction has apparent effects in preventing relapse of urinary calculus.

Objective To investigate the ultrasonic characteristics of invasive micropapillary carcinoma(IMPC) of breast and the metastatic lymph nodes,and to evaluate the value of ultrasonography for preoperative TNM staging.Methods The ultrasonic characteristics of 16 IMPC and 81 invasive ductal carcinoma (IDC) confirmed by pathology,as well as the metastatic lymph nodes were analyzed retrospectively.The TNM-staging for IMPC by preoperative ultrasonography was evaluated according to pathology.Results Compared with IDC group,the masses showed higher A/T ratio (＜ 0.7),larger maximum diameter,more calcification,unclear border and lymph node metastasis rate,while less acoustic halo in IMPC group.Meanwhile,similar ultrasonic characteristics,such as irregular shape,uneven internal echo,spiculate margin,posterior acoustic attenuation and internal blood flow were seen in IMPC and IDC groups (P ＞0.05).According to pathology,the ultrasonic coincidence rate for T staging was 56.3 ％,and T2-staging was 85.7％.The sensitivity,specificity,positive predictive value and negative predictive value of ultrasonic diagnosis on lymph node metastases was 70.0％,83.3％,87.5％ and 62.5％,respectively.Conclusions Ultrasonography displayed more typical malignant signs,higher lymph node metastasis rate and diagnosis accuracy for IMPC,which possessed certain value for preoperative TNM staging.

Objective:To compare the detection rate of genital Chlamydia trachomatis (CT) DNA between urine and urethral/cervical swab samples. Methods:From December 2018 to December 2019, a total of 1 475 outpatients were collected from sexually transmitted disease clinics in 7 medical institutions, such as Department of Venereology, Guangzhou Institute of Dermatology, including 1 118 males and 357 females. One urethral/cervical swab sample and one urine sample were collected successively from each patient. Real-time fluorescence-based PCR was performed to detect CT DNA in urine and urethral/cervical swab samples, and paired chi-square test was used to compare the positive rate of CT DNA between the 2 kinds of samples. Random- or fixed-effect meta-analysis was conducted for the test of heterogeneity and merging of positive rates of CT DNA in the urine and urethral/cervical swabs among 7 medical institutions.Results:The positive rate of CT DNA in the urine samples was significantly higher than that in the swab samples from 4 medical institutions (all P < 0.05) , while there was no significant difference in the positive rate of CT DNA between the 2 kinds of samples from 3 medical institutions (all P > 0.05) . The heterogeneity ( I2) estimates of the CT-DNA positive rate in urine and swab samples among different medical institutions were 78.6% (95% CI: 55.9% - 89.6%) and 73.7% (95% CI: 43.7% - 87.7%) , respectively; meta-analysis showed that the total merged positive rate of CT DNA in the urine samples was 10.8% (95% CI: 7.2% - 15.9%) , which was significantly higher than that in the swab samples (7.8%, 95% CI: 4.9% - 12.1%; χ2 = 39.2, P < 0.05) . Compared with the swab sample-based CT-DNA detection method, the sensitivity, specificity, positive predictive value, negative predictive value and consistency rate of the urine sample-based CT-DNA detection method were 97.0% (128/132) , 96.3% (1 293/1 343) , 71.9% (128/178) , 99.7% (1 293/1 297) , and 96.3% (1 421/1 475) , respectively. The positive rate of CT DNA in the urine samples from 1 118 male patients was 11.0% (95% CI: 7.2% - 16.5%) , which was significantly higher than that in the swab samples (7.6%, 95% CI: 4.9% - 11.8%; χ2 = 34.3, P < 0.05) . There was no significant difference in the positive rate of CT DNA between the urine (11.9%, 95% CI: 7.7% - 17.9%) and cervical swab samples from 357 female patients (10.4%, 95% CI: 7.6% - 14.0%; χ2 = 3.2, P > 0.05) . Conclusions:The positive rate of CT DNA in urine samples is higher than or similar to that in urethral/cervical swab samples. The urine sample-based CT-DNA detection method has characteristics of convenience, non-invasiveness, painlessness and low cost, and is worthy of clinical promotion.

Objective To analyze the prevalence and risk factors of sleep apnea syndrome (SAS) in patients with Alzheimer's disease (AD), and to provide theoretical basis for the prevention of SAS in AD patients. Methods A total of 130 AD patients admitted to the Department of Neurology of Guang'an People's Hospital of Sichuan Province from January 2019 to September 2022 were selected and divided into control group (without SAS) and observation group (with SAS) according to whether the patients were complicated with SAS{AHI ≥5 times/h}. Snoring, waking at night, dry mouth in the morning, AHI and SaO2 values were compared between the two groups. Clinical data of AD patients, including age, gender, body mass index (BMI), AD course, tobacco and alcohol history, and neurodegenerative diseases, were collected by self-made questionnaire and consulting the patient's electronic medical record bed. Univariate analysis and logistic regression were used to analyze the independent risk factors for SAS in AD patients. Results Among 130 AD patients, 43 cases (33.08%) of SAS occurred. The proportion of snoring, awakening at night, dry mouth in the morning and AHI value in the observation group were significantly lower than those in the control group (P<0.05). SaO2 value in observation group was significantly lower than that in control group (P<0.05). There were significant differences in age, duration of AD, BMI, smoking history, combined hypertension, neurodegenerative disease, PSQI score and PSQI score between the two groups (P<0.05). Multivariate logistic regression analysis showed that BMI≥28 kg/m², PSQI score >16 points and CDR score ≥2 points were independent risk factors for SAS in AD patients (P<0.05). Conclusion The incidence of SAS associated with AD is higher, and the main risk factors are BMI≥28 kg/m², PSQI score >16 and CDR score. Polysomnosis monitoring should be performed regularly to prevent SAS.

OBJECTIVE： To observe improvement effects of fingolimod on middle cerebral artery occlusion/reperfusion （MCAO/R） injury model rats. METHODS： Male SD rats were randomly divided into sham operation group， model group and fingolimod low-dose， medium-dose and high-dose groups （0.5， 1， 2 mg/kg）， with 8 rats in each group. Except for sham operation group， MCAO/R injury model was induced by suture-occluded method in other groups. Administration groups were given relevant medicine intragastrically after reperfusion [1 h after reperfusion （1st day）， 22.5 h after reperfusion （2nd day）， and then every 24 h until 142.5 h of reperfusion （7th day）]. Sham operation group and model group were given constant volume of normal saline intragastrically， once a day， for consecutive 7 d. The scores of neurological deficit and balance beam test， the times of memory error [work memory error （WME）， reference memory error （RME） and total error] were recorded in each group. The contents of serum inflammatory cytokines （IL-6， IL-8， IL-10， TNF-α） were determined by ELISA， and triphenyl tetrazolium chloride staining method was used to detect the rate of cerebral infarction. RESULTS： Compared with sham operation group， neurological deficit scores （at different time points of 1st-7th day after administration）， balance beam test scores （2nd， 4th， 7th day after administration）， times of memory error （2nd， 4th， 7th day after administration）， the contents of serum inflammatory cytokines and the rate of cerebral infarction were increased significantly in model group （P＜0.05 or P＜0.01）. Compared with model group， neurological deficit scores （low-dose group at different time points of 3rd-7th day， medium-dose and high-dose groups at different time points of 2nd-7th day after administration）， balance beam test scores （low-dose group at 7th day， medium-dose group at 4th and 7th day， high-dose group at 2nd， 4th， 7th day）， RME times and total error times （low-dose group at 4th and 7th day， medium-dose group and high-dose group at 2nd， 4th， 7th day after administration）， WME times （administrations groups at 7th day after administration）， serum contents of IL-6， IL-8 and IL-10 （administrations groups）， serum contents of TNF-α （medium-dose and high-does groups） and cerebral infarction rate （medium-dose and high-dose groups） were all decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS： Intragastric administration of fingolimod can significantly reduce neurological deficit score， balance beam test score and the times of memory error in MCAO/R injury model rats， and has a protective effect on cerebral tissue and memory function. These effects may be related to the down-regulation of inflammatory cytokines such as IL-6 and TNF-α by fingolimod.