As a key aspect of quality of life in patients w ith stroke, the clinical research of sexual function and sexual satisfaction is stil rare. The rehabilitation goals in patients w ith stroke usualy include recovering functional activities and improving quality of life, how ever, it is not yet know n about the recovery of sexual function. This article review s the epidemiology, etiology, risk factors, clinical manifestations, treatment and rehabilitation of sexual dysfunction in male patients w ith stroke.

Objective To investigate the surgical treatment of coronary malperfusion due to acute type A aortic dissection.Methods The clinical data of 305 consecutive patients with type A aortic dissection, who were hospitalized and underwent operation between 2004 and 2015, were analyzed retrospectively.Among that, there were 37 cases with coronary malperfusion due to aortic dissection.Results The right coronary artery was involved in 33 cases, the left in 2 cases, and both coronary arteries in 2 cases.There were 22 coronary bypass grafting using saphenous vein in 21 patients, including 20 patients with the right coronary bypass grafting and 1 patient with the left.Six patients died postoperatively, with the mortality of 16.22％.Conclusion Acute type A aortic dissection with coronary involvement is associated with high mortality rate, which is necessary to restore the coronary revascularization as soon as we can.The methods to reconstruct the involved coronary is depend on the patients' condition and experience of surgeon.

ObjectiveTo explore the relationship between anastomotic leakage of patients undergoing colonic surgery and the collagen metabolism of colonic wall.Method We measured the overall collagen content of colonic tissue by biochemistry and detected the collagen I, III, MMP-1,MMP-13 by immunohistochemistry in 16 patients with anastomotic leakage compared with 16 control cases. Resultthe overall collagen content and collagen I,III of colonic wall in the leakage group were lower than those in the control group (t=3.417,t=2.841, t=2.261,P

Humans ; Pulmonary Embolism ; diagnosis ; therapy ; Venous Thromboembolism ; diagnosis ; therapy

Objective To study drug resistance of carbapenem-resistant Klebsiella pneumonia ( CRKP) in neonates hospitalized in the neonatal unit , and to identify the risk factors for CRKP colonization in neonates .Methods Totally 108 neonates with Klebsiella pneumonia colonization admitted in Department of Neonates , the Second Hospital of Tianjin Medical University during January 2012 and June 2014 were enrolled in the study , including 23 cases with CRKP colonization ( case group ) and 85 cases with carbapenem-sensitive Klebsiella pneumonia (CSKP) colonization (control group).Chi-square test and fisher exact test were used to compare the differences in resistance to 21 antibiotics between CRKP and CSKP . Univariate analysis and Logistic regression analysis were performed to identify the risk factors for CRKP colonization in neonates .Results All of the CRKP strains were resistant to penicillins , cephalosporins and SMZco, and 95.7% and 87.0% of the CRKP strains were resistant to meropenem and imipenem , respectively.All of the CRKP strains were susceptible to amikacin , gentamicin, ciprofloxacin and tetracycline, but were highly resistant to the rest 16 antibiotics compared with CSKP strains (all P<0.05). Univariate analysis showed that 14 factors were associated with CRKP colonization: exposure to cefoxitin (χ2 =20.053, P<0.01), sputum suction (χ2 =15.817, P<0.01), gastrointestinal decompression (χ2 =10.731, P<0.01), nasogastric feeding (χ2 =15.146, P<0.01), invasive procedure (χ2 =22.572, P<0.01), birth weight (χ2 =6.026, P<0.05), frequency of sampling for CRKP/CSKP (χ2 =18.577, P<0.01), hypertension of pregnancy (χ2 =8.698, P<0.01), premature birth (χ2 =4.904, P<0.05), prenatal hospitalization experience (χ2 =8.396, P<0.01), adequacy for gestational age (χ2 =7.295, P<0.05), gestational age (χ2 =7.294, P<0.05), rupture of membranes (χ2 =9.397, P<0.01), length of hospitalization (χ2 =14.649, P<0.01) and admission to the neonatal intensive care unit (NICU) (OR=11.050, P<0.01).Multivariate Logistic regression analysis showed that hypertension of pregnancy (OR=9.718, P<0.01), rupture of membranes ( <24 h) (OR=6.640, P<0.01) and admission to NICU ( OR=4.119, P<0.05) were independent risk factors for CRKP colonization .Conclusions CRKP strains are highly resistant to most antibiotics .Preventing hypertension of pregnancy and rupture of membranes , and monitoring bacterial resistance in NICU may help to reduce the occurrence of CRKP colonization and dissemination .

Objective To investigate the alternation of left ventricular systolic function in patients underwent transcatheter aortic valve implantation operation(TAVI) by three-dimensional speckle tracking technology (3D-STI).Methods Totally 20 patients with severe aortic stenosis were enrolled.All the subjects underwent successful TAVI operation.The real-time 3D full volume datasets on apical four-chamber view were acquired on before,7 days and 1 month after TAVI.Left ventricular global longitudinal strain(GLS),regional peak systolic longitudinal strain(LS),regional peak systolic circumferential strain(CS) and regional peak systolic radial strain(RS),were analysed using off-line TomTec software,the differences among the three groups were compared.Results Compared with the preoperation,aortic valve blood flow velocity (AV),mean aortic valve pressure gradient(mPAG) of 7 days after operation decreased significantly.Threedimensional left ventricular ejecation fraction(3D-LVEF) among the patients whose 3D-LVEF under 50％had a remarkable increase and whose 3D-LVEF exceed 50％ before operation had no significant change,while 1 month after operation the 3D-LVEF had a significant improvement compared with the preoperational data regardless of 3D-LVEF under 50％ or not.The GLS and LS of all segments of 7 days after TAVI were higher than pre-operation(all P ＜0.05),and it had a further improvement 1 month after TAVI.Conclusions LV systolic function had improvement early after TAVI.3D-STI is a new,convenient way to detect the global and regional left ventricular systolic function of TAVI patients.

Objective To investigate the micminnammatory state and its relationship with atherosclerosis and cardiac function in patients on continuous ambulatory peritoneal dialysis(CAPD). Methods Sixty-seven CAPD patients,27 non-dialytic stage 5 chronic kidney disease(CKD 5)patients and 27 gender and age matched healthy controls wore enrolled in this cross-sectional study.Clinical data and biochemical parameters were collected.Serum interleukin-6(IL-6)and IL-10 levels were measured by enzyme-linked immunosorbent assay(ELISA).High-sensitivity C-reactive protein(hs-CRP)was measured by immunoturbidimetry.Prevalence of atherosclerosis was detected by carotid uhrasonography while cardiac function was detected by echocardiography. Results Serum levels of inflammatory biomarkers were elevated significantly in CAPI)and CKD 5 patients as compared with healthy controls[IL-6(ng/L):2.400,1.515 vs 0.698;IL-10(ng/L):1.988,1.958 vs 0.277;hs-CRP(mg/L):1.090,1.345 vs 0].Left ventricular mass index(LVMI),myocardial performance index(Tei index 0.75±0.31,0.66±O.27 vs 0.52±0.23)in CAPD and CKD 5 patients increased significantly.The prevalence of carotid artery atherosclerosis and left ventricular hypertrophy(LVH)in CAPD and CKD 5 patients was significantly higher than that in healthy controls.No significant difference of the ultrasonic parameters was found between CAPD and CKD 5 patients.In CAPD patients,IL-6 was positively correlated with Tei index,whereas IL-10 was negatively correlated with INMI and was positively correlaled with ejection fraction(EF).In a multiple regression model,IL-6,self-rating depressive scale(SDS)score and pulse pressure were independent predictors of carotid artery atherosclerosis.Similarly,IL-6 and primary hypertension were independent correlates of Tei index in CAPD patients. Conclusions Microinflammatory state exists in either non-dialytic CKD 5 patients or CAPD patients and it is associated with atherosclerosis and cardiac distunetion.IL-6 is an independent risk factor of atherosclerosis and increased Tei index in CAPD patients.

Objective To investigate the effect of endoscopic management of upper tract urothelial carcinoma (UTUC),and evaluate the indication and clinical value of postoperative prophylactic pelviureteric instillation chemotherapy.Methods Patients who met the inclusion criteria included elderly patients,patients who could not tolerate radical surgery,patients with renal insufficiency or needed dialysis after removal of the kidney,patients with bilateral UTUC,patients with tumor≥3 cm in diameter but could be completely resectted under ureteroscopy who required to preserve renal function.Surgical procedure was successful.The ureteral stents were placed,and prophylactic ureteral infusion chemotherapy via the retrograde transvesical ureteric catheterisation was conducted 1-2 times one week at 2 days after surgery.40 milligram of pirarubicin hydrochloride or epirubicin hydrochloride was dissolved in 40 milliliter sterile water for the prophylactic infusion chemotherapy.These instillations were completed within 40 minutes.Results Totally,9 patients (3 males and 6 females) aged 60-86 years,mean age of (69.7±6.4) years,were enrolled in this study.The carcinoma of the renal pelvis was found in 2 cases and ureteral tumors in 7 cases.In pathological results,ureteral polyps was found in 1 case,papillary ureteral neoplasm with low malignant potential in 2 cases,urinary tract epithelial carcinoma in 4 cases (1 case with poorlydifferentiation,1 case with well-differentiation,2 cases with urinary tract epithelial cancer),and 2 cases were lack of pathological reports because of too few pathologic specimens.4 patients received adjuvant chemotherapy by instillation successfully,and lumbago,fever or other complications were not found.Patients were followed up for a mean period of 15 moths (4-31 months).Only 1 patient had recurrence of bilateral ureteral tumor 15 months after surgery,and no tumor recurrence was found in other patients.Conclusions Endoscopic management is a safe and effective in treating UTUC,which can preserve renal function by avoiding nephrorectomy in some patients.The instillation chemotherapy after endoscopic management is safe,which has a satisfactory effect,but further validation in a large clinical sample is needed.Patients with tumor resection under ureteroscopy who cannot obtain the pathology results need to be closely followed up.

Objective To explore the function and significance of caudal type homeobox transcription factor-2 (CDX)-2,heparin-binding epidermal growth factor-like growth factor (HB-EGF) and bone morphogenetic protein 4 (BMP-4) of esophageal stromal tissues in the pathogenesis of Barrett's esophagus (BE).Methods A total of 116 patients were divided into groups according to gastroscopic finds and hematoxylin-eosin (H &E) staining of biopsy samples.They were divided into control group (n=29),RE group (n=32),BE group (n=35),RE treatment group (n=10) and BE treatment group (n=10).The expression of CDX 2,HB-EGF and BMP-4 in different esophageal mucosal lesions was detected by immunohistochemical staining and the changes of positive expression levels of CDX-2,HBEGF and BMP 4 were compared among groups.Variance analysis and chi-square analysis were performed to analyze the correlation among the three factors.Results The CDX-2 positive cell number of control group ((0.0±0.0)/high power field(HPF)),RE group ((43.1±10.6)/HPF),and BE group ((67.8±11.3)/HPF) increased in turn,and the differences among three groups were statistically significant (F=67.664,P＜0.01).The HBEGF positive ((6.4±1.4)/HPF,(39.4±13.5)/HPF,(55.8±13.9)/HPF) and BMP 4 positive ((0.0±0.0)/HPF,(22.6±6.4)/HPF and ((25.1± 10.3)/HPF) cell number of three groups had the same trend and the differences among three groups were statistically significant (F HB-EGF =22.925,FBMP-4 =10.463,both P＜0.01).Except the expression of BMP-4 between RE group and BE group,there were significant differences between every other two groups (LSD test,all P＜ 0.01).The expression of CDX 2,HB EGF,BMP-4 in RE treatment group ((21.7±1.7)/HPF,(16.6±5.0)/HPF and (9.2±1.0)/HPF) and BE treatment group ((51.4±8.7)/HPF,(31.0± 10.4)/HPF and (12.7±3.9)/HPF) were lower than those in RE group and BE group respectively,the differences were also statistically significant (LSD test,all P＜0.05).In RE group,the positive rate of CDX-2 (31.2％ (10/32)) was significantly lower than that of HBEGF and BMP4 (62.5％ (20/32) and 56.2％(18/32)),and the differences were statistically significant (x2=6.275 and 4.063,both P＜0.05).However in BE group,there was no statistically significant difference in the positive rate among CDX-2(85.7％(30/35)),HB-EGF (88.6％(31/35)) and BMP-4 (74.3％(26/35),all P＞0.05).Conclusions CDX-2,HB-EGF and BMP-4 may play an important role in the pathogenesis of RE and BE.HB-EGF and BMP-4 may be involved in the early episodes of BE genesis and have promotion effects on CDX-2 expression.HB-EGF and BMP-4 may be the new target in the research and treatment of BE.

We aimed to make comprehensive cancer care guidelines of China according to American guidelines of National Comprehensive Cancer Network,Ametican Society of Clinical Oncology and Oncology Nursing Society,and to guide clinical nurses to study and draw lessons from foreign latest guidelines,and combined with the actual situation in our country.The results of study and application were advantageous to the nursing profession,the security and interests of the patients.We should develop comprehensive cancer care guidelines of our country,eventually make nursing practice guide system of China constantly improve and perfect.