In order to investigate the influence of bleeding tendency on emergent treatment of postrenal renal failure patients, we retrospectively studied the methods and complications of emergent treatment in 86 renal failure patients induced by postrenal obstruction hospitalized from March 1988 to December 2000. Fourteen patients were treated by emergent open operation, in whom one died after operation because of severe bleeding,and 3 with total bleeding volume more than 1000ml. Thirty nine patients were treated with percutaneous nephrostomy, in whom 2 died after operation and 3 had to undergo mephrectomy.32 patients were treated with retrograde indwelling ureteral stent and one with transureteroscopic lithotomy (TUL),without the occurrence of complications. Emergent open operation and percutaneous nephrostomy for renal failure patients induced by postrenal obstruction may induce uncontrolled renal bleeding,resulting in patient death or kidney loss because of bleeding tendency.The retrograde ureteral catheterization for drainge is recommended as the first option for emergent treatment of renal failure patient induced by postrenal obstruction.

Objective To investigate the galectin-3 expression in squamous carcinioma of esophagus and analyze its relationship with clinicopathological characteristics.Methods S-P immunohistochemistry was used to detect the expression of galectin-3 in 80 paraffin-embedded specimens of esophageal carcinoma and 22 specimens of normal tissues adjacent to the benigh lesions of esophagus.RT-PCR was performed to detect galectin-3 mRNA expression in 36 pairs of fresh squamous carcinoma tissues and corresponding adjacent normal mucosa.Results Out of 80 specimens of squamous carcinoma of esophagus,62 specimens had positive expression of galectin-3,with the positive rate of 77.5%(62/80)that was significantly higher than 27.27% in normal esophageal tissues(6/22,P

Objective To study the distribution characteristics of intraperitoneal free gas and the location value of the site of gastrointestinal perforation using multi-slice CT (MSCT).Methods 60 cases of gastrointestinal perforation were retrospectively collected.The distribution of the intraperitoneal free gas in CT image was analyzed and observed.The digestive tract were divided to the upper digestive tract and the lower digestive tract by Treitz ligament.The distribution of the intraperitoneal free gas was analyzed using χ2 test.The distribution of the intraperitoneal free gas between each different perforational site was analyzed.Results 38 cases of the site of gastrointestinal perforation located in upper gastrointestinal tract and 22 cases located in lower gastrointestinal tract,there was statistically significant difference between the upper digestive tract and the lower digestive tract about the distribution of the intraperitoneal free gas(χ2=22.33,P<0.001).In the cases of upper gastrointestinal tract perforation,13 cases of the site located in stomach and 25 cases located in doudenum,there was no statistically significant difference between stomach and duodenum(χ2=1.97,P>0.05).In the cases of lower gastrointestinal tract perforation,11 cases of the site located in bowel and 11 cases located in colon,there was statistically significant difference between bowel and colon(χ2=8.98,P<0.05).Conclusion The MSCT distribution of the intraperitoneal free gas has important value in localization diagnosis of gastrointestinal perforation.

Objective To assess the application value of disposable syringe of low resistance (SLR) in epidural puncture.Methods One hundred and thirty-two patients scheduled to undergoing selective operation under epidural or combined epidural-spinal anesthesia were divided into glass syringe (GS) group and SLR group with 66 cases each by random digits table method.GS was applied in local anesthesia and epidural puncture with loss of resistance in GS group.While SLR was used in SLR group.The defect of the syringes' appearance was evaluated.The fastness between each sub-unit during the procedure was observed.The rupture,dropping,leakage,air leakage and blockage were also estimated.The heart rate,blood pressure,oxygen saturation and other adverse events were also observed.Results In SLR group,syringe excepted 1 case of slight resistance but did not affect the use,the rest of the components connected firmly,surface without defects,clear scale uniform color,not observed rupture,air leakage,leakage and blockage phenomenon,pump liquid and air resistance was small.In GS group,syringe surface without defects,clear scale uniform color,3 cases had loose connection,1 case with rupture when using,5 cases with air leakage and leakage,3 cases of pumping liquid or dry air resistance to 0.9％ sodium chloride and moist after use.There was significant difference in appearance and usage between two groups (x2 =10.324 5,P =0.001 3).There was no significant difference in a puncture success,first three puncture success and inject air negative pressure sensitivity between two groups (P ＞ 0.05).Conclusion SLR is worth to be applied in epidural puncture.

To investigate the incidence and treatment of benign prostatic hyperplasia (BPH) with prostatitis. Methods:2 152 cases of patients withBPH were investigated about their illness history, and the rou tine examination of prostatic fluid, the ultrasonography of prostate, the prostatic special antigen in serum and the urine routine had been done. Results:Among them , 385 patients suffered prostatitis, 87 patients have the obvious symptom of prostatitis, of which only 35 patients were treated discontinuously as prostatitis. Conclusions: The di agnosis and treatment of BPH with prostatitis should be paid special attention to

Purpose:To present the experiences and lessons of emergency management for the obstructive renal failure induced by urinary calculi.Methods:Clinical data of 81 cases of patients with obstructive renal failure from January 1988 to May 2000 was reviewed retrospectively.Results:14 cases were treated by emergent open operation (one died of bleeding ceaselessly), 36 cases by dwelling ureteral stent retrogradely(28 cases succeeded and no severe complications observed, the other 8 cases received nephrostomy of TUL),38 cases treated with percutaneous nephrostomy drainage(3 cases had to undergo nephrectomy, and the other 2 patients died after the primary treatment because of bleeding continually). The serum creatinine level decreased significantly after treatments(P＜0.01).Conclusions:It is noteworthy that the surgical interventions were affected severely by the bleeding tendency caused by uremia, and the complicated surgical intervention could not be carried out before the bleeding tendency be corrected. The indwelling ureteral stent retrogradely is recommended as the first choice of emergent treatment for patients with obstructive renal failure.

Objective To investigate the prevalence rates of diabetes and pre-diabetes among migrating population in Inner Mongolia.Methods Using stratified cluster sampling on different industries.Each industry would have the same sample size.Questionnaire survey was performed together with anthropometric data gathered and laboratory tests completed.Results The prevalence rates of diabetes and impaired glucose regulation (IGR) among the migrating population in Inner Mongolia were 12.5％ and 12.8％ with the age-standardized rate as 9.9％ and 9.9％.The prevalence of diabetes increased significantly along with the increase of age among both males and females (x2=11.162,P=0.001),but was significantly higher in males.The prevalence of IGR in females was significantly higher than in males.The prevalence of diabetes among the construction industry workers was 19.2％,which was the highest among all the industries.The prevalence of diabetes was higher in the inter-province pre-migrating group,while the prevalence of IGR was increasing along with the duration of migration in the intra-province migration group with the trend as x2=9.989,P=0.002.Conclusion The prevalence of diabetes among the migrating population in Inner Mongolia seemed to be high,close to the level of urban residents.The prevalence rates of diabetes in the population of middle-aged and aged population as well as workers at the construction industry were higher than that in the other populations.The prevalence of diabetes and IGR among the migration population were related to the area where the migration population the in-coming areas Inter-provincial migration had a higher contribution to the prevalence of diabetes.

Objective To investigate the CT imaging features of basal cell adenoma in the parotid gland and thus to improve the preoperative diagnostic accuracy.Methods The clinical materials and image findings of 8 cases with parotid basal cell tumor,which were proved by pathology,were retrospectively studied.Results All 8 patients had solitary BCA lesion,which involved both the superficial and deep lobe(n =1) and located at the superficial lobe of parotid gland(n =7).All the 6 tumors were clear boundary and round shape without lobular appearance.The diameters of the max lesions ranged from 10.3-27.6 mm.CT scan showed that all lesions were solid nodules with uniform or uneven density.Cystic degeneration was displayed in 5 lesions,among them,cystic area was ≥90％ in 1 lesion.At enhanced scanning phase,most tumors showed a strong enhancement at the arterial phase and a pattern of persistent strong enhancement or slow decline at the venous phase.Conclusion The multi-slice CT imaging features of BCA in parotid gland are characteristic,which is helpful to make qualitative diagnosis in combination with clinical materials.

OBJECTIVETo investigate the effects of several vasoactive peptides on the development of arterial restenosis after balloon angioplasty.

METHODSIn rat aortic artery restenosis model produced by denudation of aortic endothelia, we observed changes of endothelin (ET), angiotensin II (AII), calcitonin gene-related peptide (CGRP) and adrenomedullin (Adm) in plasma and aorta with radioimmunoassay and expression of hypertension-related gene (HRG-1) with semi-quantitative RT-PCR, and studied the effects of these peptides on intimal hyperplasia, intima/media ratio and MAPK activities of aortic artery after angioplasty respectively. Furthermore, in cultured cells, we studied the effects of these peptides on vascular smooth muscle cell (VSMC) proliferation and expression of HRG-1 of VSMC from spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats with 3H-TdR incorporation and RT-PCR respectively.

RESULTSAfter angioplasty, the levels of ET and AII in plasma and aorta significantly increased, accompanied with VSMC proliferation and neointima hyperplasia. On day 10 after angioplasty, the levels of ET in plasma and aorta increased by 69% and 124% respectively, compared with sham group (P < 0.01); and the level of aortic AII increased by 80% (P < 0.01). Antiserum against ET or inhibitors of angiotensin converting enzyme (ACE) could significantly inhibit the proliferation of VSMC and neointima formation. Compared with the sham group, on day 3 after angioplasty, the CGRP levels in plasma and aorta increased by 64% and 89% respectively (P < 0.01) and the Adm levels in plasma and tissue increased by 129% and 102% respectively (P < 0.01). On day 10, intravenous administration of CGRP significantly inhibited the proliferation of VSMC and neointima formation induced by balloon aortic injury (by 66% and 79% respectively, P < 0.01). In addition, ET and AII attenuated the expression of HRG-1 in aorta and stimulated mitogen-activated protein kinase (MAPK) activity, while CGRP and Adm potentiated the expression of HRG-1 and inhibited MAPK.

CONCLUSIONSET and AII can stimulate the proliferation of injured intima while CGRP and Adm have an anti-hyperplasia effect after angioplasty. These 4 peptides are involved in the regulation of VSMC proliferation and affect the development of vascular restenosis by regulating the expression of HRG-1 and MAPK activity.

Adrenomedullin ; Angioplasty, Balloon ; adverse effects ; Angiotensin II ; pharmacology ; therapeutic use ; Animals ; Aorta, Thoracic ; cytology ; metabolism ; Calcitonin Gene-Related Peptide ; pharmacology ; therapeutic use ; Cell Division ; drug effects ; Cells, Cultured ; Coronary Restenosis ; etiology ; metabolism ; Endothelin-1 ; pharmacology ; therapeutic use ; Male ; Mitogen-Activated Protein Kinases ; metabolism ; Muscle, Smooth, Vascular ; cytology ; Peptides ; pharmacology ; therapeutic use ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY ; Rats, Wistar ; Vasodilator Agents ; pharmacology ; therapeutic use

Objective:To investigate the predictive value of thrombus enhancement (TE) and thrombus permeability in cardioembolic thrombus with acute middle cerebral artery occlusion based on CT.Methods:The clinical and image data of 93 patients with acute middle cerebral artery occlusion who were admitted to the First Affiliated Hospital of Soochow University within 12 hours after onset from January 2020 to July 2022 were retrospectively analyzed. According to the TOAST criteria, the patients were divided into the cardioembolism (CE) group (43 cases) and the large artery atherosclerosis (LAA) group (50 cases). All patients received noncontrast CT and CT angiography, and then thrombus permeability [thrombus attenuation increase (TAI), void fraction (ε)] and TE were assessed. Independent sample t-test, Mann-Whitney U test and χ2 test were used in univariable analysis between two groups. Multivariable logistic regression analysis was used to explore the independent influencing factors for cardioembolic stroke and establish a logistic model. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to evaluate the predictive value of TAI, ε, TE and the logistic model in cardioembolic thrombus with acute middle cerebral artery occlusion. Results:There were statistically significant differences in sex, atrial fibrillation, hypertension, diabetes mellitus, smoking, baseline National Institutes of health stroke scale (NIHSS), TAI, ε and TE between the CE group and the LAA group ( P<0.05). Binary logistics regression analysis showed that TAI (OR=1.300, 95%CI 1.147-1.473, P<0.001), hypertension (OR=0.116, 95%CI 0.025-0.535, P=0.006) and baseline NIHSS (OR=1.165, 95%CI 1.040-1.304, P=0.008) were independent influencing factors for cardioembolic thrombus. The ROC curve indicated that the logistic model predicted cardioembolic thrombus with the highest AUC of 0.907 (95%CI 0.848-0.966). TE predicted cardioembolic thrombus with the highest sensitivity of 90.7%. Conclusion:TE and thrombus permeability have application value for predicting cardioembolic thrombus with acute middle cerebral artery occlusion based on CT.