Objective:To investigate whether the risk of intravesical recurrence increases in patients with upper urinary tract urothelial carcinoma (UUT-UC) and diabetes mellitus (DM) after radical nephroureterectomy (RNU) with bladder cuff excision. Methods:We ret-rospectively analyzed the clinicopathological data of 282 UUT-UC patients with no history of bladder neoplasm and who underwent RNU with bladder cuff excision in the Second Hospital of Tianjin Medical University from January 2005 to December 2013. The recurrence-free survival (RFS) and cancer-specific survival (CSS) were compared between the non-diabetic (233 patients) and diabetic (49 patients) patients. The factors influencing intravesical recurrence in patients with UUT-UC after RNU were analyzed. These factors included age, DM, pathologic grade, and stage. Results:Among the 282 patients included in the study, 80 (28.4%) patients developed intravesical recurrence during the median fol ow up of 41 months, and the median time to recurrence was 11 months. Non-diabetic patients had a significantly longer duration of bladder neoplasm RFS than diabetic patients (P=0.013). Multivariate analysis using Cox's regression model indicated that DM (P=0.014), renal pelvis and ureter tumor (P=0.001), and postoperative chemotherapy (P=0.024) were independent influential factors for intravesical recurrence in patients with UUT-UC after RNU with bladder cuff excision. Conclusion:DM posed an increased risk for intravesical recurrence after RNU with bladder cuff excision in patients with UUT-UC. Therefore, these patients need to be closely monitored, and their blood glucose must be controlled.

Objective To study the expression of hypoxia inducible factor-1 (HIF-1 ) and Notch signaling pathway downstream gene HES 1 in the hippocampus of pubertal rats with status epilepsy (SE), and to explore the regulation site of HIF-1αin Notch signaling pathway. Methods One hundred and seventy-six 21-day-old SD rats were randomly divided into control group (NS group), pentetrazole (PTZ)-induced SE group (PTZ group), and Notch signaling pathway speciifc inhibitor (DAPT) intervention group (DAPT group). In PTZ group PTZ was intraperitoneally injected to build SE model and in NS group normal saline was injected as control. The intraperitoneal injection of diazepam was used to terminate SE seizures. After successful modeling, the bilateral hippocampuses were isolated after the rats were sacriifced at 0.5, 1, 2, 4 and 8 h, respectively, and RT-PCR was performed to detect the mRNA expression of HES 1 and HIF-1α. The Western Blot was performed to detect protein expression in hippocampuses which were collected at 2 , 4 , 8 , 12 , and 24 h after successful modeling. DAPT group received intraperitoneal injection of DAPT 30 min before the start of molding, then the hippocampuses were isolated at 2 and 8 h after successful modeling. RT-PCR was performed to detect the mRNA expression of HES 1 and HIF-1αat 2 h, and Western blot was performed to detect protein expression at 8 h. Results At each time point after SE, the expression of mRNA of HES 1 and HIF-1αand the expression of protein were higher than the same time point of NS group (P

Objective To probe the biological effect of multiple intraepithelial injections of recombinant adenovirus-p53(rAd-p53)on inducing the apoptosis in patients with dysplastic oral leukoplakia.Methods 18 patients clinically and histopathologically diagnosed as dysplastic oral leukoplakia were recruited for this study.Intraepithelial injections of rAd-p53 were administered.Immunohistochemistry was used to examine the protein expression of p53 and bcl-2.TUNEL was performed to detect apoptotic cells.Results In the post-treatment patients,p53 protein expression were significantly enhanced(100 ％,18/18),yet bcl-2 protein presented low expression(17 ％,3/18).Statistical analysis revealed the expression of p53 protein had a negative correlation with that of bcl-2 protein(r =-0.837,P ＜ 0.01).15 post-treatment samples (83 ％)were detected obvious apoptotic cells,especially in the samples that were strong p53-positive(r =0.684,P ＜ 0.01).Conclusion Intraepithelial injections of rAd-p53 can induce apoptosis for patients with dysplastic oral leukoplakia.It may be a promising treatment for oral leukoplakia.

The biotransformation, CYP reaction phenotyping, the impact of CYP inhibitors and enzyme kinetics of 3-cyanomethyl-4-methyl-DCK (CMDCK), a new anti-HIV preclinical candidate belonging to DCK analogs, were investigated in human intestinal microsomes and recombinant cytochrome P450 (CYP) enzymes. CMDCK (4 micromol L(-1)) was incubated with a panel of rCYP enzymes (CYP1A2, 2C9, 2C19, 2D6 and 3A4) in vitro. The remaining parent drug in incubates was quantitatively analyzed by a LC-MS method. CYP3A4 was identified as the principal CYP isoenzyme responsible for its metabolism in intestinal microsomes. The major metabolic pathway of CMDCK was oxidation and a number of oxidative metabolites were screened with LC-MS. The Km, Vmax, CLint and T1/2 of CMDCK obtained from human intestinal microsome were 45.6 micromol L(-1), 0.33 micromol L(-1) min(-1), 12.1 mL min(-1) kg(-1) and 25.7 min, respectively. Intestinal clearance of CMDCK was estimated from in vitro data to be 3.3 mL min(-1) kg(-1), and was almost equal to the intestinal blood flow rate (4.6 mL min(-1) kg(-1)). The selective CYP3A4 inhibitors, ketoconazole, troleandomycin and ritonavir demonstrated significant inhibitory effects on CMDCK intestinal metabolism, which suggested that co-administration of CMDCK with potent CYP3A inhibitors, such as ritonavir, might decrease its intestinal metabolic clearance and subsequently improve its bioavailability in body.

This paper was aimed to understand the clinical features of traditional Chinese medicine (TCM) through the analysis of relevant information among fracture patients treated by the Cervus and Cucumis Polypeptide Injection (CCPI).The study was conducted among fracture patients treated by CCPI in the hospital information systems (HIS) among 26 national triple-A hospitals from 2003 to 2014.The general information,TCM syndrome and solar term of morbidity were analyzed.The results showed that the number of patients from 45-64 years old were the most,accounting for 39.84％.Among them,the number of male patients from 18-44 years old was the most,accounting for 43.38％;the number of female patients from 45-64 year old was the most,accounting for 44.33％.The main TCM syndrome of admission and discharge was qi stagnation and blood stasis,which accounted for 60.53％ and 53.08％,respectively.Beginning of Summer (7th solar term) and Rain Water (2nd solar term) were solar terms with the most patients,which accounted for 5.26％ and 5.24％,respectively.It was concluded that the majority of fractures patients treated with CCPI were the elderly.The syndrome of qi stagnation and blood stasis was the most.The hospital admission of most patients was at the Beginning of Summer and Rain Water.It provided theoretical basis to pay attention on TCM syndrome differentiation in the treatment of clinical fractures.The treatment should be adapted to the characteristics of the disease itself,the change of solar terms,and dialectical medication.

Objective: To explore the change of bone mass density(BMD) and micronutrients in middle-aged and old patients with iron overload and the effect on levels of micronutrients.Methods: BMD was measured by dual energy X-ray absorptiometry(DXA) in 19 middle-aged and old patients with iron overload and 41 age-and gender-matched healthy subjects.Serum selenium(Se)was measured by fluorospectrophotometry.Serum zinc(Zn) was measured by inductively coupled plasma atomic emission spectrometry(ICP-AES).Plasma vitamin A,D and E were measured by HPLC.The levels of blood lipid and plasma homocysteine were measured by automatic biochemical analyzer.Results: Plasma vitamin E of 19 iron overload patients was significantly lower than control group,and the levels of triglyceride and homocysteine increased significantly(P

Objective To investigate the relationship between the right-to-left shunt(RLS)detected with contrast-enhanced transcranial Doppler (c-TCD) and recurrent stroke in patients with cryptogenic stroke.Methods The consecutive patients w ith ischemic stroke w ere enrol ed. The patients w ith cryptogenic stroke w ere screened according to the TOAST criteria. They w ere divided into either a RLS positive group or a RLS negative group according to the c-TCD findings, and then they w ere fol ow ed up for a period of one year. They w ere also divided into a recurrent group and a non-recurrent group according to w hether they had recurrence or not. Results A total of 118 patients w ith cryptogenic ischemic stroke w ere enrol ed, including 46 in the RLS positive group, 72 in the RLS negative group, 10 in the recurrent group, and 108 in the non-recurrent group. There w ere no significant differences in demographic and baseline data betw een the RLS negative group and the RLS positive group. There w ere significant differences in RLS positive rate (7/10 vs.39/108; P=0.046) and proportion of patients with server RLS (2/10 vs.1/108; P=0.019) betw een the recurrent group and the non-recurrent group. Multivariate logistic regression analysis show ed that the positive RLS w as an independent predictor of recurrent stroke (odds ratio 4.896, 95% confidence interval 1.135-21.120;P=0.033). Conclusions The positive RLS may be an independent risk factor for the recurrence in patients w ith cryptogenic ischemic stroke.

Objective To assess the effect of safflowerGualou-Gancao decoction combined with pulsed radio frequency for the patients with herpes zoster.Methods A total of 60 patients with herpes zoster were randomly divided into 2 groups, 30 in each. Both groups were treated with safflowerGualou-Gancao decoction, and the treatment group added Pulsed radio frequency at 3rd day. Both groups were treated 13 days. the VAS scale was used to evaluate the outcome of pain.Results The recovery rate of the treatment group was 83.3%(25/30), and the control group was 43.3%(13/30). The difference between two groups was sifnificant (χ2=8.648,P=0.003). The VAS scores at 9th day (4.4 ± 0.2vs .6.4 ± 0.1,t=48.990) 13th day (1.9 ± 0.2vs. 3.6 ± 0.1,t=41.641) in the treatment group were significantly lower than the control group (P<0.01),Conclusions The safflowerGualou-Gancao decoction combined with Pulsed radio frequency could relieve the pain and improve the clinical effect on the patients with herpes zoster.

Objective: Based on the MSM college students in Tianjin, this study aims to explore the demographic and behavioral characteristics of MSM with different sexual partners, and to provide evidence and information for intervention in combination with social networks. Methods: According to the source and access of seeking sexual partners, 546 MSM of Tianjin college students aged 18-24 in 2018 Jan. and 2019 Dec. were divided into internet-based MSM (396) and traditional MSM (150). Chi-square test and rank-sum test were used to compare the demographic information, sexual behavior characteristics, HIV prevention and testing awareness, and psychoactive substance use of the two MSMs, and Logistic regression was used to explore factors affecting college students use of the Internet for sexual partners. Results: Internet-based MSM has advantages in receiving HIV testing and safety consulting services, AIDS knowledge level, and peer education in the past year (P<0.05). The psychoactive substance use of the survey population reached more than 40%, and the awareness rates of pre-exposure prophylaxis and post-exposure prophylaxis were 32.98% and 55.32%, respectively. After multivariate Logistic regression analysis, MSM students who had received condom distribution, AIDS counseling and peer education (OR=2.16, 1.98, P<0.01) were more inclined to use the Internet for sexual partners. Conclusion Relevant departments can use the Internet to intervene in the prevention and control of MSM in colleges and universities in terms of AIDS-related knowledge, HIV testing, and mental substances.

Objective:To investigate the effects of early Comfort using Analgesics, minimal Sedatives and maximum Humane care (eCASH) patterns on the risk of negative mood and continuous renal replacement therapy (CRRT)-related adverse events in patients with severe CRRT.Methods:A total of 90 patients with severe CRRT in Shenzhen Integrated Traditional Chinese and Western Medicine Hospital from October 2018 to October 2020 were selected as the study subjects, and they were divided into observation group and control group according to random number table method, with 45 patients in each group. The control group was given routine nursing program, and the observation group was given eCASH mode on the basis of the control group.Nursing satisfaction, CRRT-related adverse events and negative mood scores before and after nursing were compared between 2 groups.Results:The nursing satisfaction degree of the observation group was 86.67% (39/45), significantly higher than that of the control group (66.67%, 30/45), and the difference was statistically significant ( χ2=5.03, P<0.05). After nursing, the Hospital Anxiety and Depression Scale-Anxiety(HADS-A) and Hospital Anxiety and Depression Scale-Depression(HADS-D) scores of the observation group were 5.18 ± 0.67 and 5.27 ± 0.61, respectively, lower than 8.14 ± 1.18, 7.94 ± 1.07 before intervention, and 6.33 ± 0.72, 5.94 ± 0.49 of the control group. Barthel Index(BI) (65.17 ± 8.67) was significantly higher than that before nursing 41.56 ± 6.46 and control group 60.48 ± 6.47, the difference was statistically significant ( t values were 5.74-20.76, all P<0.05). The scores of Visual Analogue Scale(VAS), Present Pain Intensity(PPI), sensory total score and emotional total score of observation group after nursing were 3.24 ± 0.56, 1.18 ± 0.25, 6.38 ± 0.89, 2.68 ± 0.59 significantly lower than those before nursing 6.24 ± 0.87, 3.24 ± 0.56, 11.24 ± 1.81, 6.37 ± 1.04 and 4.36 ± 0.67, 1.31 ± 0.31, 7.26 ± 0.96, 2.98 ± 0.62 of the control group. The difference was statistically significant ( t values were 2.19-20.70, P<0.05). Conclusions:eCASH model can significantly improve the negative emotions of patients with severe CRRT, improve their comfort and reduce the risk of related adverse events, which is worthy of clinical promotion.