Objective To conduct a single-center retrospective analysis on the distribution characteristics and prevalence of idiopathic membranous nephropathy (IMN) patients diagnosed with pathology for the past 16 years,to investigate diagnostic and differential diagnostic value of serum antiphospholipase A2 receptor antibodies (PLA2R-Ab),and to evaluate the correlation between PLA2R-Ab and clinical disease activity.Methods (1) 6996 biopsy-proven primary glomerular nephropathy (PGN) patients,including 1567 IMN cases,admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January 2000 to December 2015 were involved.Demographics and pathological type were gathered from all patients.(2) 433 cases receiving renal biopsy and testing PLA2R-Ab from June 2015 to December 2015 were involved,with their clinical and laboratorial data being collected.During the period patients' follow-up time,therapeutic schedule and laboratory results were recorded.Results (1) IMN accounted for 22.4％ of primary glomerular disease,and patients above 40 years old accounted for more than 60％ of the IMN.(2) The sensitivity and specificity of serological PLA2R-Ab were 58.1％(95％CI 47.0％-68.5％) and 98.6％(95％CI 95.6％-99.6％) respectively.PLA2R-Ab positive rate was affected by immunosuppression therapy.(3) The PLA2R-Ab titers wasn't correlated with 24-hour urinary protein (r=-0.017,P=0.887),serum albumin (r=-0.072,P=0.549) and urinary red blood cell count (r=-0.030,P=0.802).There was no difference between PLA2R-Ab positive positive and PLA2R-Ab negative on proportion of IMN pathological stage Ⅰ-Ⅱ (P ＞ 0.05).Thirteen cases of patients with PLA2R-Ab positive were all prescribed glucocorticoid combined with immunosuppressant.After (2.21± 1.09) months,the decrease of PLA2R-Ab titers was in accordance with 24-hour urinary protein quantity descending and serum albumin ascending (P ＜ 0.05).Condusions The incidence of IMN increase year by year,especially in the mid-aged and the elderly.Serum PLA2R-Ab correlates not with IMN pathological stage,but with the development of IMN.Monitoring PLA2R-Ab titers individually may access the efficiency of treatment.

Objective To investigate the features of computed tomography (CT) and magnetic resonance imaging (MRI) on pancreatic neuroendocrine tumors (pNENs).Methods The retrospective and descriptive study was adopted.The clinicopathological data of 33 patients with pNENs who were admitted to the Tongji Hospital of Tongji Medical School of Huazhong University of Science and Technology between May 2012 and February 2016 were collected.All the patients underwent plain and enhanced scans of CT and MRI.Observation indicators:(1) overall imaging findings and pathological results of pNENs,(2) imaging findings of functional pNENs,(3) imaging findings of non-functional pNENs.Main analysis indicators included tumor diameter,location,boundary,density,cystic degeneration,enhancement,signal,calcification,with or without pancreaticobiliary duct dilation,with or without surrounding tissues invasion,lymph node and distant organ metastases.Results (1) Overall imaging findings and pathological results of pNENs:of 33 patinets with pNENs,24 underwent CT examination,3 underwent MRI examination and 6 underwent CT and MRI examinations.Tumors of 33 patients were solitary with a diameter of 0.6-16.0 cm.Ten,1,13 and 9 tumors were respectively located at the head of pancreas,uncinate process of pancreas,body of pancreas and tail of pancreas.Thirty-three patients were diagnosed as pNENs by pathological examination,including 20 with functional pNENs (insulinoma) and 13 with non-functional pNENs,and G1,G2 and G3 were respectively detected in 24,7 and 2 patients.The coincidence rate between preoperative CT or MRI examination and pathological examination was 90.9％ (30/33).One,1 and 1 patients were misdiagnosed as pancreatic cancer,enlargement of peripancreatic lymph nodes and duodenal gastrointestinal stromal tumor,respectively.(2) Imaging findings of functional pNENs:tumor diameter of 20 patients with functional pNENs was 0.6-3.0 cm with an average diameter of 1.5 cm.Fòur,10 and 6 tumors were respectively located at the head of pancreas,body of pancreas and tail of pancreas.Of 20 patients with functional pNENs,tumors of 19 patients showed clear boundary and 1 showed unclear boundary,and tumors of 18 patients had uniform density and 2 had uneven density with cystic degeneration,without the occurrence of calcification.Of 20 patients undergoing dynamic enhanced scans,tumors of 19 patients demonstrated obvious enhancement in arterial phase and slightly obvious enhancement or were equal to normal pancreatic tissues in portal vein phase and lag phase,and tumor of 1 patient demonstrated slight enhancement in arterial phase and was equal to or less than normal pancreatic tissues in portal vein phase and lag phase.Tumors in 3 patients undergoing MRI scans were manifested as hypointensity on T1-weighted imaging (T1WI),hyperintensity on T2WI and hyperintensity on DWI (b =1 000 s/m2),with clear imaging.Of 20 patients,1 was accompanied with atrophy of pancreatic tissues at distal tumor,pancreatic duct dilatation,multiple retention cyst and enlargement of lymph nodes around the hepatic artery.(3) Imaging findings of non-functional pNENs:tumor diameter of 13 patients with non-functional pNENs was 1.5-16.0 cm with an average diameter of 5.0 cm.Six,1,3 and 3 tumors were respectively located at the head of pancreas,uncinate process of pancreas,body of pancreas and tail of pancreas.Of 13 patients with non-functional pNENs,tumors of 11 patients showed clear boundary and 2 showed unclear boundary,tumors of 3 patients had uniform density and 10 had uneven density with cystic degeneration,and tumors of 2 patients had calcification.Of 13 patients undergoing dynamic enhanced scans,tumors of 12 patients demonstrated obvious enhancement in arterial phase,continuous enhancement in portal vein phase and lag phase and less obvious enhancement at cystic degeneration area,with marked enlargement of supplying arteries and draining veins in partial tumors.Tumor of 1 patient demonstrated slight enhancement,and its enhancement was slightly less than normal pancreatic tissues in arterial phase,portal vein phase and lag phase,with unclear boundary.Results of MRI scans in 6 patients showed that tumors of 4 patients were manifested as hypointensity on T1WI,slight hyperintensity or mixed signal on T2WI and hyperintensity on DWI (b =1 000 s/m2),and tumors of 2 patients were manifested as hypointensity on T1WI,hypointensity on T2WI and hyperintensity on DWI (b =800 s/m2).Of 13 patients with non-functional pNENs,4 had pancreaticobiliary duct dilation and 7 had local tissues invasion or distant organ metastasis (4 with liver metastasis,1 with peripanereatic lymph node metastasis,1 with liver and peripancreatic lymph node metastases and 1 with liver metastasis combined with splenic venous and arterial invasion),including 1 in G1,4 in G2 and 2 in G3.Of 5 patients with tumor diameter ＞ 5.0 cm,4 were complicated with liver or lymph node metastases.Conclusions CT and MRI features of pNENs have a certain characteristics.For functional pNENs,benign and solid tumor is common,with clear boundary and smaller diameter.For non-functional pNENs,tumor size is bigger and cystic necrosis occurs within the tumor,with various enhancements.

Objective To improve the establishment of rabbit model with VX2 liver tumor and assess sonographical value in monitoring the tumor growth.Methods Fifteen New Zealand white rabbits were implanted with VX2 tumor in two liver lobes under ultrasound guidance percutaneously.Ultrasound examinations were performed at twenty days and thirty-six days after implantation.At the same time exploratory laparotomy was performed.Results Among 30 implanted tumors of 15 rabbits,16(53%) tumors were successfully implanted with few complications.It took 15 to 40 minutes to implant tumors in one rabbit.Implantation rates of left lobe and right lobe were 53% and 50% respectively,and there was no significant difference.Ultrasound examination could monitor tumor growth well.Conclusions After the improvement,the establishment of model was easier,less time-consuming,minimally invasive and caused few complications than other implantation methods.Serial ultrasound examinations should be performed in monitoring the tumor growth.

Objective:To explore the feasibility of mesencephalon progenitor cells as dopamine neuron's graft in treatment of Parkinson disease(PD) in rats. Methods: Animal model of PD were established in SD rats by 6 hydroxydopamine. Mesencephalon progenitor cells were obtained from 13 day old fetal rats. After in vitro proliferation and differentiation, the cells were planted into PD rat striatum. Results: Progenitor cells were expanded in an undifferentiated state with endothelia growth factor and basic fibroblast growth factor as mitogens. IL 1 and striatal culture media further increased the number of TH immunoreactive cells. Transplantation of these neurons relieved the rotation symptom of PD rats. Conclusion: Transplantation of mesencephalon progenitor cells has certain effects on PD rats.

Objective To explore the relationship between fetal heart size and gestational weeks (GW). Methods The size of left atrium (LA), right atrium (RA), left ventricle (LV), right ventricle (RV), aorta (AO), pulmonary artery (PA), foramen ovale (FO), heart area (HA), thoracic area (TA), heart circumference (HC) and thoracic circumference (TC) were measured for 512 fetal hearts at 14-39 GW. The relationship between GW and the measurement was evaluated. Results The size of fetal heart chambers, AO, PA and ventricular septum (IVS) increased with the development of GW. The PA/AO, LA/RA, LV/RV, HC/TC and HA/TA were stable compared with different GW. Conclusion Fetal heart chambers increase with the development of GW. HA is correlated well with GW.

ObjectiveTo investigate the effect and gender differences of experimental moderate pain on attentional bias towards pain-related words.MethodsWith the tourniquet around the left upper limb,32 healthy college students were asked to perform two dot-probe tasks including five kinds of pain-related words,one task with the tourniquet deflating and the other task with the tourniquet inflating to 200 mm Hg pressure.The reaction time (RT) and the error rate of recognition task were recorded.The pain intensity and distress were recorded too.Results ( 1 ) Compared with no pain condition ( RT of affective and social-threat words were (507 ± 78 ) ms,(504 ±89 )ms respectively),the react time was shorter in female in the condition of tourniquet pain,particularly for affective and social-threat words (the RT were (464 ± 79 )ms,(465 ± 72 )ms respectively,F ( 1,4) =19.157,P ＜0.01 ),but not in male.( 2 ) In condition of no pain,the reaction time of male ( (456 ± 59) ms ) was shorter than that of female (504 ± 79ms).However,in the condition of pain,the significant main effect was not found.ConclusionThe reacting time of female was shorter in condition of moderate tourniquet pain,which imply that female showed significant attentional bias towards affective and social-threat words.

Objective:To evaluate the efficacy of combination of toy and cartoon video-assisted admission in preventing agitation during recovery from general anesthesia in preschool children.Methods:Totally 96 children who undergoing elective surgery from July 2018 to October 2019 in Guangzhou Women and Children′s Medical Center were divided into experimental group ( n=48) and control group ( n=48). Two groups were admitted to the general preoperative waiting room for 60 minutes before the operation, and children in the experimental group recieved toy and cartoon video combination intervention, while children in the control group were subjected to routine nursing intervention. The children′s agitation was assessed by using Pediatric Anesthesia Emergence Delirium Scale (PAED) when children entered the post-anesthesia care unit (PACU), 10 minutes after in PACU and leave PACU. In addition, the vital signs such as blood pressure, heart rate, respiratory rate of the two groups were also recorded. Results:The emergence time and duration of PACU stay in the experimental group were (17.19±1.76) minutes and (22.47±2.36) minutes, significantly shortern than in the control group (18.36±2.19) minutes and (23.82±2.62) minutes, the difference was statistically significant ( t values were 2.760, 2.546, P<0.05). 10 minutes after in PACU and out of PACU, the PAED scores, systolic pressure, heart rate, respiratory rate was [7.56±1.86, 4.60±1.19, (108.12±10.19)mmHg, (102.72±8.55) mmHg, (112.91±6.10) times/minute, (106.39±6.75) times/minute, (18.87±1.98) times/minute, (17.49±1.68) times/minute], significantly lower than those in the control group [13.40±1.47, 6.71±2.21, (116.73±14.17)mmHg, (107.62±12.44) mmHg, (121.07±8.07) times/minute, (114.69±5.78) times/minute, (20.96±1.86) times/minute, (18.47±1.63) times/minute], the difference was statistically significant ( t values were 2.162-16.332, P<0.05). Conclusion:Toy and cartoon video combine-assisted admission can reduce the agitation and stable vital signs during recovery from general anesthesia in preschool children.

OBJECTIVE: In order to improve the postoperative effect of modified UPPP, removing the partial pharyngeal muscle in surgery, we investigate the postoperative effect, the characteristics of pharyngeal cavity and the potential complications in OSAHS patients. METHOD: To choose 82 OSAHS patients with obstructive oropharyngeal plane diagnosed by Apneagraphy (AG), Fibre nasopharyngoscope combined with Müller examination and nasopharyngeal 3D-CT, which had completed clinical data inpatients in the anesthesia underwent of the partial pharyngeal muscles in the postoperative, divided into a control group of 26 cases, operating the H-UPPP surgery which did not remove partial pharyngeal muscle; The experimental group of 56 cases did a H-UPPP surgical which removed partial pharyngeal muscle of possible concurrent symptoms such as nasal regurgitation, Eustachian tube dysfunction and other follow-up study in six months after the monthly telephone follow-up or outpatient exams to understand the disease. Patients were evaluated the sleepiness by ESS(Epworth sleepiness scale) in 6 months after the surgery, compared with the preoperative ESS scores, do a t test for statistical analysis. AG can be used to evaluate effects of the UPPP after 6 months. By measuring uvula length (L1), extent from free edge of soft palate to postpharyngeal (L2) and stenosis of nasopharynx width (L3) mean, we investigate the characteristics of pharyngeal cavity using the multiple linear regression to do the hypothesis test and evaluate the association between measuring mean and effect. Using SPSS19.0 software do the preoperative contrast analysis. RESULT: After 6 months in surgery, 56 cases in the experimental group, effect in 50 cases (89.29%), effective in 6 cases (10.71%); ESS score: Preoperative 11.74 +/- 2.48, after the first 6 months 3.84 +/- 2.05. Twenty-six cases in control group,effect in 19 cases (73.08%), effective in 7 cases (26.92%); ESS score: Preoperative 11.91 +/- 2.40, after the first 6 months 6.92 +/- 2.47, t-test P value of less than 0.05 between the experimental group and the control group; There are no ear fullness, hearing loss, increase their own sound which reflect eustachian tube dysfunction and other complications in two groups; The function of pharyngeal cavity could be recovered normal lever after 6 months; After 6 months of the operation, in the experimental group and the control group L1 mean was respectively (5.91 +/- 3.38) mm and (6.20 +/- 3.76) mm (P>0.05); L2 mean was respectively (15.70 +/- 3.29)mm and (15.35 +/- 1.44) mm (P> 0.05); L3 mean was respectively (20.54 +/- 3.33) mm and (16.43 +/- 2.21) mm (P<0.05). Nasal fauces pitch mean was significantly widened. By the multiple linear regression analysis, the postoperative effect has the linear correlation between L2 and 1,3 residual mean with the negative correlation. Due to the standardized coefficient, L3 residual mean has the most influence on the postoperative effect. CONCLUSION Modified UPPP surgery removing the partial pharyngeal muscle is in favor of upgrading the postoperative effect with significantly increasing the width of postoperative nasal pharyngeal isthmus area, then there are not occur the eustachian tube dysfunction, the soft palate function, swallowing and articulation function disabled.
Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Palate, Soft ; surgery ; Pharyngeal Muscles ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery ; Treatment Outcome ; Uvula ; surgery ; Young Adult

OBJECTIVE: Ambulance personnel who witness trauma experienced by patients have been reported to experience positive changes, known as vicarious posttraumatic growth (VPTG). We examined VPTG and its relationship with social support and resilience among ambulance personnel. METHODS: The sample (n=227) was recruited from six emergency centers in China. The measures included the Posttraumatic Growth Inventory (PTGI), the Social Support Rating Scale (SSRS), and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Structure Equation Modeling (SEM) and the bootstrapping procedure were used to examine indirect effects. RESULTS: The participants' mean score for VPTG was 68.96 (SD=15.51). Social support had significant direct effects on resilience (β=0.51, p < 0.001) and VPTG (β=0.25, p=0.001), and resilience (β=0.58, p < 0.001) had a significant direct effect on VPTG. Furthermore, social support had a significant indirect effect (0.51×0.58=0.30, p < 0.001) on VPTG through resilience. CONCLUSION: Although the nature of the work of ambulance personnel is not expected to change, the negative effects of the trauma they encounter can be reduced by providing them with more support resources and interventions to foster their resilience, which in turn, promote VPTG.
Ambulances* ; China* ; Emergencies ; Humans

Objective:To investigate the relationship between adiponectin (ADIPOQ) gene polymorphism and postpartum type 2 diabetes mellitus (T2DM) in pregnant women with gestational diabetes mellitus (GDM).Methods:A retrospective study was conducted on 236 GDM postpartum women admitted to the Affiliated Hospital of Jining Medical College from June 2020 to June 2021 as observation subjects. They were divided into a T2DM group and a non T2DM group based on the occurrence of T2DM after delivery. The clinical data of the two groups were compared. The double deoxygenation end termination method was used to detect the single nucleotide polymorphism (SNP) of the ADIPOQ gene, and the four loci rs17366568, rs822395, rs1501299, and rs2241766 were classified. The relationship between ADIPOQ genotype polymorphism and postpartum T2DM was analyzed using a logistic regression model.Results:The G allele carrying the rs2241766 locus in ADIPOQ gene was negatively correlated with the occurrence of T2DM ( OR=0.71, 0.68, P<0.05). Compared with T2DM patients with TT genotype, the GT+ GG genotype at the rs2241766 locus had a lower risk of occurrence for gestational age ≥2 and HbA 1c>85%. Similarly, T2DM patients with pre pregnancy body mass index (BMI)>25 kg/m 2 were more likely to be carriers of the rs2241766 TT genotype ( P=0.026). The (GT+ TT) genotype carrying the T allele at the rs1501299 locus was a protective factor for gestational age and HbA 1c in T2DM patients. Conclusions:The rs2241766 and rs1501299 polymorphisms of the ADIPOQ gene are associated with susceptibility to postpartum T2DM in GDM women. Individuals with rs2241766 and rs1501299 mutant genotypes belong to the high-risk population for T2DM.