Objective To study the ralationship of arrhythmias and heart electrical parameters changes after transcatheter closure of ventricular septal defect (VSD) .Method 50 patients had been successfully finnished the transcatheter closure of ventricular septal defect,and then we observed ralationship of arrhythmias and heart electrical parameters changes. Results (1) Compared with the situation of VSD occluder preoperative and postoperative, during follow-up there were 20 arrhythmia cases, including bundle branch block 16 cases, including the complete left bundle branch block 2 cases,complete right bundle branch block 4 cases,a transient third-degree trioventricular conduction block 1 case, most return to normal in the follow-up. 2 Intracavitary electrogram showed before and after transcatheter closure:A-V conduction parameters A-H,H-V value of (75.10 ± 14.34) ms vs (80.67±23.03) ms and (47.9±12.61) ms vs (50.07±15.23) ms,the difference was not statistically significant ( >0.05) . Conclusions (1) Some patients with new ECG changes after transcatheter closure of VSD, manifested as an increase in bundle branch block in a week, but most return to normal,the prognosis is good. (2) Intraoperative A-H,H-V extension is not related with with postoperative slow arrhythmia;(3) Arrhythmia is a common complication after VSD transcatheler closure, to strictly selecte indications,and to avoid too large diameter are the effective measures to reduce the arrhythmias after transcatheter closure of ventricular septal defect (VSD) .

Objective To evaluate the curative effect and security of mechanical thrombectomy with SolitaireAB stent system in acute superior mesenteric artery embolism(SMAE).Methods The clinical data of 5 cases who had undergone mechanical thrombectomy with SolitaireAB stent system under digital subtraction angiography (DSA) were analyzed retrospectively.Results A successful thrombus removal of superior mesenteric arterial by SolitaireAB stent system was observed in the whole 5 patients.The patients had recovered well after operation and no complications such as arterial dissection,perforation and hemorrhage or intestinal ischemia occurred.Conclusion The arterial mechanical thrombectomy with SolitaireAB stent system are characterized with high rate of recanalization,fine security,minimal invasion and less complications in patients with acute superior mesenteric arterial embolism.

Objective: To create a model to predict nosocomial infections in emergency intensive care units (EICU), so as to provide insights into early identification and interventions among patients with nosocomial infections. Methods: All nosocomial infections were collected from patients hospitalized in the EICU of a large tertiary hospital from 2017 to 2020. The 2017-2019 data were selected as the training set to create a logistic regression model, and the fitting effectiveness of the predictive model was evaluated using Hosmer-Lemeshow test. The 2020 data were selected as the test set to evaluate the external validation of the predictive model. In addition, the value of the model for prediction of nosocomial infections was examined using the receiver operating characteristic (ROC) curve analysis. Results : Totally 1 546 inpatients in EICU were enrolled, and the prevalence of nosocomial infections was 7.18%. Multivariable logistic regression analysis identified hospital stay duration of >7 days (OR=21.845, 95%CI: 7.901-60.398), use of ventilators (OR=3.405, 95%CI: 1.335-8.682), and surgery (OR=1.854, 95%CI: 1.121-3.064) as risk factors of nosocomial infections. The predictive model was p=ey/(1+ey), y=-6.105+(3.084×duration of hospital stay)+(1.225×use of ventilators)+(0.617×surgery). The area under ROC curve was 0.806 (95%CI: 0.774-0.838) for the training set and 0.723 (95%CI: 0.623-0.823) for the test set, and if the 0.065 cut-off of the predictive model created by the training set was included in the test set, the predictive value yield a 0.739 sensitivity and 0.642 specificity for prediction of nosocomial infections among patients hospitalized in EICU. Conclusion The created predictive model for nosocomial infections among patients hospitalized in EICU presents a high accuracy, which shows a satisfactory predictive value for high-risk nosocomial infections.

OBJECTIVETo identify a novel HLA-DRB1 allele in Chinese.

METHODSA novel HLA-DR allele was detected by PCR-SSP and SBT in a patient with leukemia.

RESULTSThe sequence of the novel allele was different from all other known alleles. The novel allele differed from the closet matching allele HLA-DRB1*1404 by one nucleotide substitution in exon 2, at position 33 T>C, this resulted in an amino acid change from Tyr to His at codon 17.

CONCLUSIONThe novel allele is confirmed as a new HLA allele and it was officially named HLA-DRB1*1461 by WHO Nomenclature Committee in May, 2006.

Alleles ; Asian Continental Ancestry Group ; genetics ; HLA-DR Antigens ; genetics ; HLA-DRB1 Chains ; Humans ; Polymerase Chain Reaction ; Sequence Analysis, DNA

OBJECTIVETo study the expressions of tumor necrosis factor alpha-induced protein 3(TNFAIP3) and mammary serine protease inhibitor (Maspin) in the radiotherapy of nasopharyngeal carcinoma and explore the differences in radiosensitivity and radioresistance,the relation with the occurrence and development of radioresistance.

METHODSThe TNFAIP3 and Maspin mRNA expressions were detected by using TNFAIP3 and Maspin multi-point labeled DIG probes in situ hybridization.

RESULTSIn radiosensitivity and radioresistance of nasopharyngeal carcinoma,the moderately and strongly positive TNFAIP3 mRNA expression rates were 27.50% and 48.33% (P=0.037), and the moderately and strongly positive Maspin mRNA expression rates were 67.50% and 46.67% (P=0.040). In the radioresistance of nasopharyngeal carcinoma,TNFAIP3 mRNA moderately and strongly positive expressions were positively correlated with TNM stage (P=0.005). In distant metastasis and no distant metastasis (70.00% and 37.50%, P=0.018), the expression rates had statistical significance. The Maspin mRNA moderately and strongly positive expressions were positively correlated with TNM stage (P=0.039) and T stage (P=0.021). In distant metastasis and no distant metastasis (65.00% and 37.50%, P=0.044), the expression rates had statistical significance.

CONCLUSIONTNFAIP3 may be involved in the development of radioresistant nasopharyngeal carcinoma,and Maspin may be related with the invasion and metastasis of radioresistant nasopharyngeal carcinoma.

Carcinoma ; DNA-Binding Proteins ; Humans ; In Situ Hybridization ; Intracellular Signaling Peptides and Proteins ; Nasopharyngeal Neoplasms ; Nuclear Proteins ; Serine Proteinase Inhibitors ; Tumor Necrosis Factor alpha-Induced Protein 3

Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Blotting, Western ; Bridged Bicyclo Compounds, Heterocyclic ; pharmacology ; Carcinoma, Hepatocellular ; enzymology ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Flow Cytometry ; Humans ; JNK Mitogen-Activated Protein Kinases ; metabolism ; Liver Neoplasms ; enzymology ; pathology ; Signal Transduction ; physiology ; Time Factors

BACKGROUNDAntibodies against type 3 muscarinic acetylcholine receptor (M3R) are involved in the pathogenesis of Sjögren's syndrome (SS), but the clinical value of them in SS patients has been controversial. The aims of this study were to: (1) establish an improved enzyme-linked immunosorbent assay (ELISA) to detect IgA antibodies against M3R; (2) evaluate the value of IgA antibodies against the second extracellular loop of M3R205-220 (c2M3RP) in diagnosis of SS.

METHODSTo increase the ELISA sensitivity, c2M3RP was coupled to bovine serum albumin (BSA) by the glutaraldehyde method and a 96-well microplate was treated by ultraviolet rays before coated. Concentrations of anti-c2M3RP, anti-SSA, and anti-SSB were measured in the sera of 240 individuals: 91 patients with primary SS and 149 controls (16 secondary SS, 27 systemic lupus erythematosus, 40 rheumatoid arthritis and 66 healthy controls). Diagnostic properties of anti-c2M3RP were determined by receiver-operating characteristic curve analysis.

RESULTSThe prevalence of serum IgA anti-c2M3RP antibodies in patients with pSS (46%, 42/91) was significantly higher than that in patients with systemic lupus erythematosus (19%, 5/27), in rheumatoid arthritis (15%, 6/40) and in healthy controls (5%, 3/66). However, there was no significant difference between the two SS groups (P = 0.727). The diagnostic performance of IgA anti-M3RP antibodies was similar to anti-SSA assay, but had 22% higher sensitivity than anti-SSB. By analyzing of IgA anti-c2M3RP antibodies, combination of anti-SSA and anti-SSB resulted in increased sensitivity, whereas their specificity was not significantly changed.

CONCLUSIONSThe improved anti-c2M3RP ELISA is a novel, sensitive, and specific serological test for the diagnosis of SS. The combined application of anti-c2M3RP, anti-SSA and anti-SSB tests can improve the laboratory diagnosis of SS. The IgA anti-c2M3RP antibodies may serve as a novel diagnostic marker for SS.

Adult ; Aged ; Aged, 80 and over ; Animals ; Autoantibodies ; immunology ; Biomarkers ; blood ; Cattle ; Enzyme-Linked Immunosorbent Assay ; methods ; Female ; Humans ; Immunoglobulin A ; blood ; Male ; Middle Aged ; Receptors, Muscarinic ; immunology ; Sjogren's Syndrome ; blood ; Young Adult

OBJECTIVETo explore the optimal treatment selection for treating varicocele (VC) male infertility patients accompanied with oligozoospermia or azoospermia of different Chinese medical syndrome types by comparing the efficacies of integrative medicine.

METHODSOne hundred and twenty male infertility patients with VC accompanied with oligozoospermia or azoospermia were assigned to Chinese medical treatment group (A) and the surgical group (B), each consisting of three Chinese medical syndrome types, i.e., damp-heat stagnation syndrome (DHSS), Shen-deficiency blood stasis syndrome (SDBSS), and blood stasis stagnation syndrome (BSSS), 20 in each group. Corresponding Chinese medical treatment was administered to those in Group A, C, and E, while microscopic ligation of internal vena spermatic was administered to those in Group B, D, and F. The routine analysis of semen, biochemical analysis of seminal plasma, and serum sex hormones (prolactin, testosterone, follicle stimulating hormone, luteinizing hormone, and estradiol) were performed before treatment and by the end of the 24th week after treatment.

RESULTSTotally 18 patients' spouses were pregnant. Of them, 1 in Group A of DHSS (abbreviated as Group A), 3 in Group B of DHSS (abbreviated as Group B), 4 in Group A of SDB-SS (abbreviated as Group C), 5 in Group A of SDBSS (abbreviated as Group D), 1 in Group A of BSSS (abbreviated as Group E), and 4 in Group B of BSSS (abbreviated as Group F). After 24-week treatment, the sperm concentration, class a sperm percentage, class a + b sperm percentage, the motility rate, the seminal plasma of fructose density, and the seminal plasma neutral alpha-glucosidase were more significantly improved in Group B, C, D and F, when compared with the same group before treatment (P <0. 01, P <0. 05). There was no statistical difference in the aforesaid indices between before and after treatment in Group A and Group E (P >0.05). As for the improvement percentage of seminal routine indices, the difference of the seminal plasma of fructose density, and the difference of seminal plasma neutral alpha-glucosidase between before and after treatment in the same Chinese medical syndrome types, better effects were obtained in Group B than in Group A (P <0.01), and better effects were obtained in Group F than in Group E (P <0.01). There was no statistical difference between Group C and D (P >0.05). There was no statistical difference in the 5 items of sex hormones in each group between before and after treatment (P >0.05).

CONCLUSIONSSurgical treatment could effectively improve the semen quality for male infertility VC patients accompanied with oligozoospermia or azoospermia. Of them, Chinese medical treatment could be recommended to those of SDBSS who would not receive surgical treatment.

Adult ; Humans ; Infertility, Male ; diagnosis ; etiology ; therapy ; Integrative Medicine ; Male ; Medicine, Chinese Traditional ; Phytotherapy ; Varicocele ; complications ; diagnosis ; therapy

BACKGROUNDThe down-regulation of constitutive nitric oxide synthase (cNOS) and up-regulation of inducible nitric oxide synthase (iNOS) are associated with the allergen-provocated airway hyperresponsiveness (AHR). This study aimed to determine whether their alteration also plays an important role in the AHR induced by lipopolysaccharide (LPS).

METHODSHartley male guinea pigs, weighing between 250 g and 350 g, were injected with LPS at a dose of 1 mg/kg every 24 hours for three days. A non-selective NOS inhibitor, N(omega)-nitro-L-arginine methyl ester (L-NAME), or a selective inducible NOS inhibitor, aminoguanidine (AG), were used thirty minutes before each injection of LPS. Airway reactions, nitric oxide (NO) production and inflammatory changes were detected 24 hours after the last dose of LPS.

RESULTSAG significantly decreased the NO production in the bronchoalveolar lavage fluid (BALF) and sharply reduced the intensity of bronchoconstriction to histamine challenge. L-NAME also significantly decreased the NO production in the BALF, but had no effect on airway reactions or, perhaps, a tendency to enhance the intensity of AHR.

CONCLUSIONSThe data suggest that inducible NOS contributes to the AHR induced by repetitive intraperitoneal LPS, and constitutive NOS was also involved.

Airway Resistance ; drug effects ; Animals ; Bronchial Hyperreactivity ; chemically induced ; Enzyme Inhibitors ; pharmacology ; Guanidines ; pharmacology ; Guinea Pigs ; Lipopolysaccharides ; toxicity ; Male ; NG-Nitroarginine Methyl Ester ; pharmacology ; Nitric Oxide ; biosynthesis ; Nitric Oxide Synthase ; antagonists & inhibitors ; physiology

Objective To investigate the effects of different bolus and swallow patterns on esophageal manometry in patients with gastroesophageal reflux disease by high resolution manometry .Methods Patients with gastroesophageal reflux disease questionnaire score of more than 8 points and positive 24-hour pH monitoring were included in the study .All the patients were detected by liquid swallow ,solid swallow and continuous swallow .The parameters and comprehensive diagnosis were in accordance with the Chicago Standard .Results A total of 42 patients with gastroesophageal reflux disease were enrolled . Compared with the dynamic parameters of liquid swallow ,the residual pressure of upper esophageal sphincter [(11 .07 ± 3 .97 ,5 .29 ± 3 .36)mmHg] decreased ,the distal latency [(6 .28 ± 1 .87 ,8 .98 ± 2 .25)s] ,and lower esophageal sphincter relaxation time [(7 .79 ± 0 .98 ,10 .69 ± 13 .04)s] prolonged significantly (all P<0 .05) .In the comprehensive diagnosis of esophageal motility ,compared with liquid swallow (38 .1% ) , continuous liquid swallow showed a more sensitive positive diagnostic rate of ineffective esophageal motility (IEM) (63 .2% ) ,with a significant difference (P=0 .008) .Compared with that of liquid swallow ,the diagnostic rate (45 .2% ) of IEM by the solid swallow did not differ significantly (P=0 .581) . Among the ineffective contraction ,the rate of failed contraction (44.3% ) of solid swallow was higher than that of liquid swallow (22 .6% ) .Conclusion Solid swallow is more likely to induce severe esophageal hypomotility disorders than liquid swallow.Continuous swallow has more sensitivity in the diagnosis of IEM.Therefore.it can be used as a supplement to routine manometry in patients with eastroesophageal reflux disease.