【Objective】 To observe the efficacy of blue laser side light in the vaporization and enucleation of non-muscle invasive bladder cancer (NMIBC). 【Methods】 A retrospective analysis was performed on the data of NMIBC patients who received transurethral enucleation of bladder tumor (TURBT) using a 50 W blue laser treatment device. The efficacy and safety of surgery were evaluated by observing the application of blue laser in the treatment of bladder cancer in different locations, operation time, presence of bladder perforation and postoperative urine routine indicators. 【Results】 A total of 16 patients completed the surgery, including 5 cases with multiple bladder tumors, 9 with single bladder tumor, and 2 with lichenoid lesions. The postoperative pathological results showed all of them were NMIBC. The operation time was (10.4±4.7) min, postoperative urinalysis was (689.4±316.7)/μL, and no intraoperative bladder perforation occurred. 【Conclusion】 The lateral infusion mode of 50 W blue laser therapy device can be applied to the surgical treatment of NMIBC. The basal vaporization and enucleation of bladder cancer can be performed under direct vision conditions, and the multi-angle enucleation is suitable for bladder cancer in different positions. The tissue penetration depth of blue laser is shallow, which is conducive to the diagnosis and grading of pathological tissues.

Objective:To study the neurophysiological features of Kennedy disease (KD) and to figure out the function of the nervous system.Methods:Subjects were recruited from the outpatient and the ward of Peking University Third Hospital from November 2010 to November 2022. Sixty patients with KD (29 patients with KD alone, 31 KD cases with the complication of diabetes mellitus) and 60 patients with diabetic polyneuropathy (DPN) were included in this study. Electrophysiological tests were performed in all subjects, including electromyogram, nerve conduction study, somaosensory evoked potential (SEP), contact heat evoked potential (CHEP) and triple stimulation technique (TST). Student′s t-tests were conducted to compare differences intra or inter groups of nerve conduction velocity and action potential of nerve conduction study, latency and interphase of SEP, initial peak latency of CHEP and other parameters. Results:Compared with the normative value, the amplitude of the sensory nerve action potential (SNAP) declined by 30%-80% in KD patients [median nerve (0.7±0.4) μV, ulnar nerve (0.8±0.3) μV, sural nerve (1.8±0.1) μV], the amplitude of the median and ulnar nerves was lower than the sural nerves ( t=2.43, P=0.010; t=2.40, P=0.010). The conduction time of peripheral segments of SEP and CHEP was prolonged by 115%-130%, while that of the central segments was prolonged by 104%-115% in SEP. TST test/TST control declined by 40%-60% in 17 patients with KD. The amplitude of SNAP declined by 30%-50% in patients with DPN [median nerve (2.9±0.5) μV, ulnar nerve (2.6±0.6) μV, sural nerve (1.6±0.2) μV], the amplitude of the sural nerves was lower than the median and ulnar nerves ( t=2.52, P=0.006; t=2.47, P=0.007). The conduction time of peripheral segments of SEP and CHEP was prolonged by 75%-112%, while that of the central segments was normal in both SEP and CHEP in DPN patients. Compared with DPN patients, the upper limb SNAP amplitude was lower in KD patients with the complication of diabetes mellitus [median nerve (0.7±0.3) μV, t=3.18, P=0.001; ulnar nerve (0.8±0.4) μV, t=3.20, P=0.001]. Conclusions:Sensory nerve is involved in patients with KD, including the large fiber and the small one. The central segments was abnormal in the deep sensory pathway, and the pyramid tract may be involved besides the anterior horn cell.

Objective:To investigate the effects of fasting blood glucose levels on the quality of myocardial metabolism imaging via positron emission tomography/X-ray computed tomography(PET/CT)in patients with coronary heart disease.Methods:A total of 78 patients with coronary heart disease from 2019 to 2020 undergone 18-fluorine deoxyglucose( 18F-FDG)PET/CT myocardial imaging in Beijing Anzhen Hospital were retrospectively analyzed, with 64 patients meeting the inclusion criteria eventually enrolled in this study.All patients fasted over 8 hours and were injected with insulin and 18F-FDG following an oral glucose load.Then myocardial imaging evaluations were performed.Depending on whether the myocardial image quality(IQ)offered a match with clinical diagnosis, a score between 0-2 from the semiquantitative scoring system was defined as good IQ, while a score between 3-4 defined as poor IQ.Differences in sex, age, rate of diabetes, body mass index, fasting blood glucose(FBG), glycosylated hemoglobin, glycosylated serum albumin, triglycerides and free fatty acids, lipid-regulating drugs, and oral antidiabetic medications were analyzed between the good( n=55)and poor( n=19)image groups, and risk factors were examined. Results:The diabetes mellitus rate was higher in the poor group than in the good group(63.2% vs.33.3%, χ2=4.872, P=0.027). FBG, glycosylated hemoglobin and glycosylated serum albumin levels in the poor group were increased compared with the good group[7.67(6.02, 11.64)mmol/L vs.5.52(4.97, 6.37)mmol/L, 7.30(6.43, 8.70)% vs.6.20(5.60, 6.87)%, 19.8(15.1, 24.1)% vs.14.8(13.9, 16.8)%, U=-3.909, -2.419 and -3.042, P<0.001, P=0.016 and 0.002, respectively]. Multivariate Logistic regression analysis showed that FBG was an independent risk factor for poor imaging( OR=1.62, 95% CI: 1.19-2.20, P=0.002). The area under the receiver operator characteristic(ROC)curve for FBG was 0.811(95% CI: 0.69-0.93, P<0.001), and the cut-off value for FBG was 6.66 mmol/L. Conclusions:FBG is an independent risk factor for myocardial image quality.Patients with diabetes mellitus should rigorously control their blood glucose levels.

Objective:To explore effects of impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) on the 5-year prognosis after percutaneous coronary intervention (PCI) for coronary heart disease.Methods:A total of 165 patients receiving PCI from December 2011 to September 2013 were selected by the convenient sampling method. According to the results of oral glucose tolerance test, they were divided into T2DM group (54 cases) , IGT group (52 cases) , and non-diabetes mellitus (NDM) group (59 cases) . The patients were followed up in the outpatient clinic after discharge and recorded the occurrence of major adverse cardiovascular events (MACE) of patients within 5 years after PCI, including cardiogenic death, non-fatal reinfarction, non-fatal stroke and re-hospitalization for heart failure.Results:The 5-year follow-up results showed that 72 patients had MACE, of which 15 died of cardiogenic death, 11 were admitted to the hospital due to heart failure, 5 had non-fatal stroke and 41 had non-fatal reinfarction. Among the 72 patients with MACE, there were 17 cases in the NDM group, 30 cases in the IGT group and 25 cases in the T2DM group. The IGT group was higher than the NDM group, and the difference was statistically significant ( P<0.05) , but there was no statistically significant difference between the IGT group and the T2DM group ( P>0.05) . Among the 41 non-fatal reinfarction patients, there were 10 cases in the NDM group, 19 cases in the IGT group and 12 cases in the T2DM group. The IGT group was higher than the NDM group and the T2DM group, and the differences were statistically significant ( P<0.05) . Conclusions:IGT increases the risk of myocardial infarction in patients after PCI, which is a risk factor for MACE events.

Dissolving pulp consists of high purity cellulose and is widely used to as raw materials for the production of regenerated cellulose fiber, cellulose ester and cellulose ether. The characteristic of dissolving pulp affects greatly the production and processing performance of subsequent products. The α-cellulose content, hemicellulose content, pulp viscosity, ash, transition metal ion content, fiber morphology, molecular weight distribution of cellulose and the reactivity are the important properties. Because of its green, mild and high efficiency, the application of enzymes in improving the properties of dissolving pulp has a promising application prospect and has been researched significantly. In this review, the main properties of dissolving pulp are presented first, followed by a recommendation of the enzymes to improve these properties. The application and current research of cellulase and xylanase in improving the properties of dissolving pulp are emphasized. The main problems and the future research areas in improving the properties of dissolving pulp by enzymes are revealed. Finally, the technology prospects in this field are proposed.
Cellulase ; Molecular Weight ; Viscosity ; Wood

Objective:To evaluate the image quality (IQ) of 18F-fluorodeoxyglucose (FDG) PET/CT imaging and identify its influenfial factors in diabetes mellitus (DM) and non-DM patients with coronary artery disease (CAD). Methods:A total of 196 consecutive CAD patients (174 males, 22 females, 68 DM; age: (57±10) years) in Beijing Anzhen Hospital between June 2016 and February 2018 were retrospectively analyzed. All patients underwent 18F-FDG myocardial PET/CT imaging. The standardized fasting+ oral glucose loading (OGL) and intravenously injection of insulin protocol was performed. According to the FDG uptake by myocardium, background activity in blood and other visceral organ nearby the heart, the IQ was visually evaluated and scored by 0-4. Zero-two was considered as good IQ, 3-4 was regarded as poor IQ. Patients were divided into three groups: group 1 (non-DM+ good IQ), group 2 (DM+ good IQ), group 3 (DM+ poor IQ). Factors which may affect IQ were analyzed, which including OGL, the injection dose of insulin, fasting blood glucose (FBG), peak blood glucose (PBG), blood glucose (BG) level at 18F-FDG injection (BG injnection), BG increasing rate ((PBG-FBG)/FBG, %), and BG decreasing rate ((PBG-BG injection)/PBG, %). One-way analysis of variance, Spearman correlation analysis and logistic regression analysis were used for data analysis. Results:There were significant differences ( F values: 13.074-38.371, all P<0.05) of FBG, PBG, OGL, BG decreasing rate and the injection dose of insulin among group 1 ( n=132, 67.3%), group 2 ( n=53, 27.1%), group 3 ( n=11, 5.6%). All those parameters, except for OGL, were positively correlated with FDG PET/CT IQ ( r s values: 0.142-0.262, all P<0.05). OGL was negatively correlated with IQ ( r s=-0.324, P<0.05). Logistic regression analysis showed that FBG (odds ratio ( OR)=0.687, 95% CI: 0.633-0.746), PBG( OR=0.786, 95% CI: 0.746~0.829), BG injection( OR=0.631, 95% CI: 0.595-0.716), OGL( OR=0.897, 95% CI: 0.873-0.922), the injection dose of insulin( OR=0.680, 95% CI: 0.618-0.748) were predictive factors (all P<0.01) for good IQ in all patients. For DM patients, OGL was the only predictive factor for good IQ( OR =0.940, 95% CI: 0.904-0.960; P<0.01). Conclusions:FBG, PBG, BG injection, OGL, the injection dose of insulin can predict IQ for all patients with CAD. For DM patients with CAD, OGL is the only predictive factor for good IQ. A good IQ of 18F-FDG PET/CT could be obtained in majority of CAD patients, with the standardized fasting + OGL and intravenously injection of insulin protocol and adjust according to the personal status, and prevent the hypoglycemia from happening.

Objective:To investigate the effect of intensive blood glucose monitoring and nursing program on blood glucose variability of patients transferred to general wards after coronary artery bypass grafting (CABG) .Methods:A convenient sampling method was used to select 106 patients with coronary heart disease and hyperglycemia who were transferred from the ICU within 72 hours after CABG from Beijing Anzhen Hospital from June to December 2018. They were divided into control group (54 cases) and research group (52 cases) according to the random number table method. The control group was given routine nursing care, and the research group adopted a comprehensive nursing strategy including intensive blood glucose monitoring based on the control group. The average daily blood glucose level (MGL) , standard blood glucose standard deviation ( SD) , daily average blood glucose fluctuation range (MAGE) , and blood glucose variation coefficient ( CV) of the two groups were compared within 3 days after CABG patients were transferred to the general ward. Results:After the patients were transferred from the ICU to the general ward, there were time effects, inter-group effects, and time-group interaction effects in SD; inter-group effects in SD; time- and inter-group effects in MAGE; and inter-group effects and time and group in CV interaction effect. Conclusions:Within 1 to 3 days after the patient is transferred from the ICU to the general ward, compared with the conventional nursing group, continued intensive blood glucose monitoring and nursing can reduce the degree of blood glucose variation.

Objective To investigate cervical spinal upper motor neuron (UMN) dysfunction in patients with frail arm syndrome (FAS) by physical examination,triple stimulation technique (TST) and pectoralis tendon reflex tests.Methods Sixty-seven FAS patients,coming from Peking University Third Hospital from June 2013 to June 2016,underwent physical examination and routine electrophysiological tests.The pyramid signs,the results of pectoralis tendon reflex and TST were collected to estimate the function of cervical spinal UMN.Results On the time of diagnosis,weakness of bilateral proximal upper limbs was found in 61 patients,while weakness of unilateral proximal upper limb was found in six patients.There were 25 patients with tendon hyperreflexia,20 patients with tendon hyporeflexia and 22 patients with tendon areflexia.All the patients were pectoral muscle tendon hyperreflexia except one.UMN score of cervical region was 2.0 ± 0.5.Lower motor neuron score of cervical region was 2.0 ± O.2.The amplitude ratio of TSTtest/TSTcontrol was 78.31％ ± 6.52％.The latency and amplitude of quantitative detection of pectoralis tendon reflex was (7.80 ± 1.22) ms and (1.23 ± 0.14) mV,respectively.In the follow-up study,the tendon reflexes and the UMN score declined,the amplitude ratio of TSTtest/TSTcontrol decreased,while the lower motor neuron score increased and the latency of quantitative detection of pectoralis tendon reflex remained almost unchanged.Conclusion The results showed that there was cervical spinal UMN dysfunction in patients with FAS,and the pyramid signs were often concealed by muscle atrophy with progression of the disease.

Objective To investigate the risk factors of chylous leakage after pancreatioduodenectomy so as to find effective measures to prevent this complication.Methods A retrospective analysis was conducted on 230 patients who underwent pancreatioduodenectomy at the First Affiliated Hospital of Zhejiang University from Jun.2012 to Jun.2014.Patients with chylous leakage were identified and a 1 ∶ 2 patients in the study and the control groups were selected.The parameters for matching included tumor volume,vascular invasion,and extent of lymph node dissection.A logistic analysis was performed to identify independent risk factors of chylous leakage.Results 15 (6.5％) patients developed chylous leakage after pancreatioduodenectomy.The average hospital stay after surgery of the study group was 20.8 days,compared to 13.5 days in the control-group (P =0.004).In the study group,chylous leakage rate increased in patients with 14th and 16th group of lymph nodes dissection (80％ vs 36.7％,P =0.006).Logistic analysis showed that 14th and 16th lymph nodes dissection was an independent risk factor of chylous leakage after pancreatioduodenectomy (P ＜ 0.05,OR =6.909,95％ CI 1.593 ～ 29.958).Conclusions Chylous leakage prolonged hospitalization after pancreatioduodenectomy.Dissection of the 14th and 16th lymph node groups was an independent risk factor of chylous leakage after pancreatioduodenectomy.Careful ligation of the gastrocolic vein near the lymphatic trunk and dissection of 14th and 16th group of lymph nodes were effective interventions to reduce postoperative chylous leakage.

Objective To investigate the role of imaging characteristics of cerebral infarction in different regions in predicting the progressive cerebral infarction (PCI). Methods Patients with cerebral infarction were selected in the De?partment of Neurology of Hefei third People’s Hospital from January 2010 to June 2014. Brain MRI were examined the location of cerebral infarction. Patients were then classified into four groups accordingly:cortical infarction, basal gangli?on infarction, coronaradiata infarction and posterior infarction. Patients were further divided into PCI group and non-PCI group according to their clinical manifestations. MRI imaging features and risk factors were analyzed and compared be?tween PCI group and non-PCI group. Results A total of 150 patients with cerebral infarction were enrolled, including 99 cases of non-PCI and 51 cases of PCI. According to the Brain imaging classification, there were 46 cases of cortical in?farction, 25 cases of coronaradiata infarction, 47 cases of basal ganglion infarction and 32 cases of posterior infarction. There were significant differences in subtype cerebral infarction between PCI group and non-PCI group(χ2=19.239,P=
0.001). The percent of cortical infarction were significantly higher in PCI group compared to the non-PCI group. Cortical infarction was correlated to PCI and the value of R and P was 0.170 and 0.026, respectively. Logistic regression revealed that Imaging of subtypes of cerebral infarction was correlative with PCI (P=0.002). The frequency of progression was sig?nificantly increased in cortical infarction than in other subtypes of cerebral infarction (P=0.002). The trend was still sig?nificant even after adjustment for age and blood glucose, (P=0.014). Conclusion The location of cerebral infarction is closely correlated to PCI in which cortical infarction is more likely to develop PCI.