OBJECTIVESTo investigate the correlation between corpus cavernosum disruption and high-flow priapism for the understanding of high-flow priapism and its treatment.

METHODSTo report the clinical data of a case of spontaneous idiopathic high-flow priapism.

RESULTSThe diagnosis was made as right cavernosal artery disruption after angiography. The result of cavernosal blood gas analysis was normal. The penis became detumescent after the gelatin embolization treatment was performed.

CONCLUSIONSSpontaneous high-flow priapism of old people(non-ischemic) is rare in clinic. Blood gas analysis and angiography are needed to find the hemorrhage site when conservative treatment fails. Gelatin embolization or cavernosal artery ligation are usually effective in the subsequent treatment.

Angiography ; Blood Gas Analysis ; Embolization, Therapeutic ; Humans ; Male ; Middle Aged ; Penis ; blood supply ; Priapism ; diagnosis ; therapy ; Regional Blood Flow

OBJECTIVETo understand the use of lipidemia related assistant examinations and lipid-lowering agents, the clinical ability among physicians in district and community hospitals in Beijing, and to evaluate the capability of dislipidemia diagnosis and treatment in these hospitals.

METHODSA survey was carried out in 42 hospitals in Chaoyang and Haidian district, including 9 district level hospitals, and the rest were at the community level. Questionnaire survey and in-depth interview were used to collect information from the leaders of related departments in those hospitals. A total number of 632 physicians in those hospitals were investigated, using a close book examination.

RESULTS100% of the hospitals could perform TC and TG tests; 87.5% and 72.5% of the hospitals had medications as statins and bile acid, respectively; 100% of the hospitals could test ALT and 40.0% of the hospitals could test CK. The correct rates of selecting treatment strategy and determining the appropriate treatment goals were 53.7% and 17.6%, respectively.

CONCLUSIONThe hardware condition of community hospitals seem to have satisfied the implicit requirements of dyslipidemia evaluation and treatment but it was essential to improve the knowledge and ability among physicians in community hospitals.

China ; Data Collection ; Dyslipidemias ; diagnosis ; therapy ; Hospitals, Community ; statistics & numerical data ; Humans ; Practice Patterns, Physicians'

OBJECTIVETo analyze the influence of knowledge about hypertension and clinical competence among physicians in district and community hospitals on management of hypertensives.

METHODSQuestionnaire investigation was used in 9 district and community hospitals in Chaoyang and Haidian district, including 181 physicians and 204 patients with hypertension.

RESULTS(1) The hospitals involved were divided into two groups according to our evaluation on the knowledge of hypertension and clinical competence of physicians. Four hospitals were graded as high-score group and 5 hospitals as low-score group. (2) There was no significant difference on physicians' evaluation between district and community hospitals. There was higher proportion of hypertensives with instructed physical exercises, reducing salt ingestion, psychological balance and weight reduction in district hospitals than those in community ones. (3) The proportion of hypertensives who were examined with funduscopy, ambulatory pressure and instructed with physical exercises, reducing salt ingestion and weight reduction in high-score group was obviously higher than that in low-score group. The control rates of blood pressure, on the days of examination during lastest check-up or the past three months, were significantly higher in high-score group than in low-score group (P < 0.05).

CONCLUSIONKnowledge of hypertension and clinical management competence among physicians in district and community hospitals did influence the management of hypertension and education of physicians and thus should be increased.

Clinical Competence ; standards ; Delivery of Health Care ; standards ; Directive Counseling ; standards ; Education, Medical ; standards ; Hospitals, Community ; classification ; standards ; Humans ; Hypertension ; diagnosis ; therapy ; Patient Care ; standards ; Physicians ; standards

The role of atrial natriuretic peptide (ANP) in the central regulation of the circulation is known to be a neurotransmitter or a neuromodulator, but its actions on baroreceptor reflex function are not fully resolved. The present study examined the role of ANP (6, 60 ng/0.2 microl) by direct microinjection into the hypothalamic paraventricular nucleus (PVN) in conscious rats. OPC-21268 (0.45 microg/3 microl), an antagonist of the V(1) receptor, was microinjected into the lateral ventricle to examine whether the effect of ANP on baroreflex sensitivity is mediated by vasopressin (VP). ANP significantly increased the baroreflex sensitivity, and OPC-21268 attenuated the increase of baroreflex sensitivity induced by ANP. Intravenous injections of ANP (60 ng/0.04 ml) did not affect baroreflex sensitivity. These results suggest that ANP in the PVN may produce a facilitative effect on baroreflex, and the effect may be via, at least in part, the central vasopressin.
Animals ; Atrial Natriuretic Factor ; pharmacology ; physiology ; Baroreflex ; drug effects ; physiology ; Male ; Microinjections ; Paraventricular Hypothalamic Nucleus ; physiology ; Random Allocation ; Rats ; Rats, Wistar

OBJECTIVETo estimate the knowledge level and clinical ability of hypertension treatment among physicians in district and community hospitals in big and moderate cities.

METHODS43 district and community hospitals were selected by non-random sampling in Beijing and Baotou inner-Mongolia municipality. A total of 754 physicians in those hospitals were investigated, through an examination.

RESULTSThe correct rates on blood pressure stages, risk stratification and treatment strategy were 64%, 28% and 54%, respectively. The knowledge level on non-pharmacologic treatments was insufficient among physicians. The knowledge level of special indications on the common antihypertensive drugs (such as diuretics, beta-blockers, ACE inhibitors) was even worse.

CONCLUSIONPhysicians in district and community hospitals did not have enough knowledge and ability to fulfill the task of hypertension treatment and management.

Adult ; Antihypertensive Agents ; therapeutic use ; Clinical Competence ; standards ; Cross-Sectional Studies ; Education, Medical ; standards ; Female ; Hospitals, Community ; classification ; standards ; Humans ; Hypertension ; diagnosis ; therapy ; Male ; Patient Care ; standards ; Physicians ; standards

OBJECTIVETo study the use of hypertension related physical examinations, laboratory tests and anti-hypertension drugs among district and community based hospitals in Beijing and to analyze the possible hardware (examination, test, drug) problems under the application of the "China Hypertension Guide" in those hospitals.

METHODSThe survey was carried out in 40 hospitals in Chaoyang and Haidian districts, including 9 district level hospitals, and the rest at community level. Questionnaire survey and in-depth interview were used to collect information from the leaders of related departments in those hospitals.

RESULTS(1) The hardware condition of district hospital satisfied the implicit requirements of hypertension evaluation and treatment in "China hypertension Guide". (2) 64.5% of the community level hospitals had the basic equipments and routine laboratory tests for diagnosis and treatment on hypertension, but 35.5% of them lack of tests on blood chemistry (potassium, sodium, creatinine) and urine protein. (3) 71.0% of community level hospitals could not judge the patient's "target organ damage" independently. (4) Both district and community level hospitals had all major types of anti-hypertension drugs in there pharmacy except ARB.

CONCLUSIONWhen necessary laboratory tests for both district and community level hospitals were provided, they could accomplish the tasks of hypertension treatment and management. However, the community level hospitals should cooperate with hospitals at higher level to have a comprehensive clinical understanding of patients with high blood pressure.

China ; Clinical Laboratory Techniques ; statistics & numerical data ; Cross-Sectional Studies ; Diagnostic Services ; statistics & numerical data ; Hospitals, Community ; statistics & numerical data ; Humans ; Hypertension ; diagnosis ; drug therapy ; Pharmaceutical Services ; statistics & numerical data ; Surveys and Questionnaires

Taking 3'-Me-Ado (3'-methyladenosine) and Cladribine as the leading compounds, seventeen 3'-C-methyl-furanonucleosides were designed and synthesized. All the structures were confirmed by 1H NMR and MS. The target compounds were tested in vitro against human pulmonary carcinoma A549, human colon carcinoma LOVO and human leukemia CEM by MTT assay. The results showed that these compounds possessed moderate cytotoxicities.
Adenosine ; analogs & derivatives ; chemical synthesis ; pharmacology ; Antineoplastic Agents ; chemical synthesis ; pharmacology ; Cell Line, Tumor ; Cladribine ; chemical synthesis ; pharmacology ; Drug Screening Assays, Antitumor ; Humans ; Molecular Structure

OBJECTIVETo compare the impact of two different continuing education models: traditional model and a new model entitled "problem-oriented and case-based" mutual pattern and "train the trainer" course, on improving hypertension diagnosis and treatment competence of community physicians.

METHODSA total of 632 physicians from 22 district and community hospitals in Haidian district (new model) and 20 district and community hospitals in Chaoyang district (traditional model) in Beijing were trained during July to October 2002. The survey was carried out before and 2 years after training with examination questionnaire.

RESULTSThe competence evaluated as a score (maximal 100) for hypertension diagnosis and treatment of physicians was similar in physicians before training from the two districts. Post training, the score significantly increased from 40.0 to 47.4 (P < 0.01) in physicians from Chaoyang district and from 40.5 to 70.5 (P < 0.01) in physicians from Haidian district and the final score for physicians from Haidian district is significantly higher than that for physicians from increased from Chaoyang district (P < 0.01).

CONCLUSIONThe new model is more efficient for improving community physician's competence for diagnosing and treating hypertension.

Adult ; Clinical Competence ; Education, Medical, Continuing ; methods ; Female ; Hospitals, Community ; Humans ; Hypertension ; diagnosis ; therapy ; Male ; Physicians ; Practice Patterns, Physicians' ; Surveys and Questionnaires

BACKGROUNDRenal biopsy is necessary for diagnosing the pathological changes of primary nephrotic syndrome (NS). However, it is invasive, time-consuming and can not be performed frequent on the same patient. Thus, development of a non-invasive and rapid diagnostic method may improve clinical patient management.

METHODSProteomic tool magnetic bead-based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MB-based MALDI TOF MS) was applied to serum to determine peptidome patterns that are characteristic of different pathological changes.

RESULTSSerum specimen from 114 patients with NS (62 were minimal change disease (MCD), 30 were membranous nephropathy (MN), and 22 were focal segmental glomerulosclerosis (FSGS)) and 60 normal individuals were analyzed using MB-based MALDI TOF MS. The peptidome pattern was generated by genetic algorithms using a training set of 31 MCD, 15 MN, 11 FSGS and 30 normal individuals and was validated by an independent testing set of the remaining samples. The serum peptidome pattern, based on a panel of 14 peaks, accurately recognized samples from MCD, MN, FSGS and healthy control with sensitivities of 93.5%, 86.7%, 63.6% and 90.0%, and specificities of 98.2%, 94.4%, 100% and 89.5%, respectively. Moreover, one peptide from peptidome pattern was identified by liquid chromatography tandem mass spectrometry (LC MS/MS) as fibrinogen A.

CONCLUSIONDetection of the serum peptidome pattern is a rapid, non-invasive, high-throughout, and reproducible method for identifying the pathological patterns of patients with nephrotic syndrome.

Adult ; Female ; Humans ; Male ; Middle Aged ; Nephrotic Syndrome ; blood ; Peptides ; blood ; Proteomics ; methods ; Reproducibility of Results ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; methods ; Young Adult

OBJECTIVETo evaluate the efficacy and safety of zoledronic acid in the treatment of bone pain in patients with bone metastasis from solid tumor or multiple myeloma.

METHODSA randomized, double-blind, double-simulated and multi-center phase III clinical trail with pamidronate as control was conducted. Patients with moderate to severe bone pain (VAS > 50 mm) induced by solid tumor or multiple myeloma were randomized to receive intravenous zoledronic acid 4 mg or pamidronate 90 mg. Then the change of VAS and urinary NTX/Cr and CTX/Cr were observed in two groups.

RESULTSFrom July 2005 to September 2006, 228 patients with bone pain induced by bone metastasis from 15 cancer centers were randomize into two groups: 116 patients in zoledronic acid group and 112 patients in pamidronate group. The VAS value was decreased gradually after treatment in these two groups. Significant improvement in bone pain after treatment were observed both in zoledronic acid group and the control group when compared with baseline VAS on D8 (-11.77% vs. -10.87%), D15 (-24.60% vs. -21.06%) and D28 (-32.37% vs. -31.26%) (P< or =0.0001), but no significant difference existed between two groups (P =0.6587). Compared with baseline, urine NTX/Cr and CTX/Cr level were decreased rapidly after treatment in both groups, the nadir was on D8, the median decreased on D28, which was -36.9% vs. -32.1% for NTX/Cr (P = 0.7922) and -63.2% vs. -47.9% for CTX/Cr (P =0.834). The frequently observed adverse events were pyrexia (19.0% vs. 31.3%), vomiting (6.0% vs. 8.9%), nausea (4.3% vs. 4.5%), fatigue (3.4% vs. 2.7%) and constipation (2.6% vs. 1.8%) in the two groups. Compared with baseline, the serum creatinine level was not significantly increased throughout the study.

CONCLUSIONIntravenous injection of 4 mg zoledronic acid can significantly reduce bone pain and bone resorption marker in urine in the Chinese patients with bone metastasis from solid tumor or multiple myeloma, which is tolerable and also comparable to pamidronate in the efficacy and safety.

Adult ; Aged ; Analgesics ; adverse effects ; therapeutic use ; Bone Density Conservation Agents ; adverse effects ; therapeutic use ; Bone Neoplasms ; complications ; secondary ; Breast Neoplasms ; pathology ; Collagen Type I ; urine ; Colorectal Neoplasms ; pathology ; Creatinine ; urine ; Diphosphonates ; adverse effects ; therapeutic use ; Double-Blind Method ; Female ; Fever ; chemically induced ; Humans ; Imidazoles ; adverse effects ; therapeutic use ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Multiple Myeloma ; complications ; Pain Measurement ; Pain, Intractable ; drug therapy ; etiology ; urine ; Peptides ; urine ; Prospective Studies ; Vomiting ; chemically induced