Injection of botulinum toxin type A (BTX-A) seems to have a positive therapeutic effect in multiple urological conditions, including detrusor external sphincter dyssynergia, voiding dysfunction, painful pelvic floor, bladder overactivity, frequency-urgency syndrome, interstitial cystitis, benign prostatic hyperplasia, and be thought as a novel and promising treatment for a variety of lower urinary tract dysfunctions within the urological field. However, there is a long way to go to assess the clinical efficacy of this form by randomized, double blinded, placebo-controlled trials.

Objective To investigate the neuronal nitric oxide synthase (nNOS) distribution in intramural striated sphincter of female rats. Methods 4 female Wistar rats were anesthetized with chloral hydrate. The whole bladder and urethra specimen were harvested, fixed in formalin and imbedded in paraffin wax. Longitudinal and transverse sections were developed with 2 urethra respectively. Routine HE staining and Mallory phosphotungstic acid-hematoxylin staining were used for observation of urethral microstructure. nNOS distribution in intramural striated sphincter was determined with immunohistochemical staining. Results The urethras of female Wistar rat were tubular structure about 1.5～2.0 cm long. From outside inward,the structure included circular striated muscle layer,circular smooth muscle layer,longitudinal smooth muscle layer,dense connective tissue and epithelium. The longitudinal sections showed intramural striated muscle predominates the middle and distal third,not the whole urethral length. The transverse sections showed intramural striated muscle is closed ring shape,about 5～10 layers uneven distributed with more layers in the posterior wall than in the front wall. Strong positive expression of nNOS immunoreactivity was found in some intramural striated muscle fiber. Conclusion nNOS expresses in some intramural striated muscle fiber, surggesting nitric oxide may play an important role on intramural striated sphincter.

Objective To study the effects of nitroglycerin on leak point pressure of chronic complete spinal cord injury female rats. Methods Models of chronic complete spinal cord injury in female rats were established. Changes of leak point pressure were investigated following nitroglycerin 3 mg intraperitoneal injection. Results Leak point pressure decreased from (32.27±15.00) cmH2O to (23.29±9.46) cmH2O. Conclusion There was obvious descent of leak point pressure of chronic complete spinal cord injury female rats following nitroglycerin intraperitoneal injection.

Objective To study the effects of nitroglycerin on urethral sphincter of chronic complete spinal cord injury female rats in vitro. Methods 30 SD female rats with 3 months old were transected at T10 spinal cord. After 8 weeks, the 10 rats with BBB scores ≤5 were selected as experimental group, and other 10 normal rats as control group. The difference of tension in both proximal segment (urethral smooth muscle strips) and distal segment (external urethral sphincter muscle strips) were surveyed before and after nitroglycerin 0.5 mg administration in bath. Results The tension of distal segment in control group reduced from (640.50±91.79) mg to (597.50±92.61) mg, and from (485.50±68.94) mg to (459.90±69.51) mg in experimental group. The difference between proximal segment and distal segment were (222.30±12.14) mg and (42.00±7.86) mg before and after administration in control group, and were (223.00±15.78) mg and (25.60±5.17) mg in experimental group. Conclusion The administration of nitroglycerin 0.5 mg in bath can reduce the tension of both urethral smooth muscle and external urethral sphincter in both normal and spinal cord injured rats. The relaxative effect on external urethral sphincter muscle of normal rats exceed that of injured ones, but approximate on urethral smooth muscle.

Objective The aim of this study was to investigate the differences on origin distribution and radiofrequency ablation characteristics between premature ventricular contractions (PVC) from left and right ventricular.Methods A total of 354 frequent PVC patients were enrolled.Two hundred and eighty patients were PVCs with right ventricular origin (group RV) and 74 patients with left ventricular origin (group LV).The age,gender,ablation power,temperature and duration,time of target potential before QRS onset,fluoroscopic time,procedure time and success rate were compared between the two groups.Results Majority PVCs (79.10％) were of right ventricular origin,in which the most common site was at right ventricular outflow tract (RVOT) (55.93％);whereas,only 20.90％ were of left ventricular.There were significantly differences between group RV and group LV in age [(44.7 ± 13.6) yrs vs (49.6 ±15.9) yrs,P =0.017],gender [male:35.4％ (99) vs 55.4％ (41),P =0.002],time of target potential before QRS onset [(37.9 ± 16.2) msvs (31.3 ± 11.7) ms,P=0.008],procedure time [(85.1 ± 36.9) minvs (100.8 ± 45.5) min,P=0.017],fluoroscopic time [(12.3 ± 9.2) min vs (15.9± 10.8) min,P =0.028] and success rate (96.4％ vs 89.2％,P =0.012).Conclusions Radiofrequency ablation of PVCs was a safe and effective method.Subjects with RV PVCs are younger and more females than subjects with LV PVCs.The radiofrequency ablation for RV PVCs was easier,and the success rate was higher than that for LV PVCs.

Objective To develop a promising type of radiation dosimeter based on doped hydroxyapatite,and to study the stability of dosimetric characteristics indepth.Methods The samples prepared by stereotyping techniques were stored under different temperatures,humidity and illumination conditions after 60Co γ-ray irradiation.Electron spin resonance (ESR) technique was used to quantitatively measure the radiation-induced free radical signal.Results The signal change was less than 3% when the dosimeter was preserved at 4℃ or room temperature within 3 months in the experiment.At 40℃,the signal changed by about 13%,but at room temperature with the humidity less than 36%,the signal changed less than 2%.The change rose to about 8% when humidity was 76%.However,no significant decay of signal strength occurred at relatively high temperatures and under high humidity conditions.When the samples were stored under average illumination of 1600 lux or in a light-resistant container,the signal changes were less than 3.8% or 3.4% respectively.Long-term stability inspection at room temperature suggested a signal change within 4.8%.Conclusion The dosimetric properties of the material don't change significantly below room temperature in a natural environment and exhibit good stability over long-term storage.The free radical signal is not influenced drastically by relatively strong light exposure.However,a high temperature or a highly humid environment may have some effect on the measurement process,which should be taken into consideration in further applications.

Objective To investigate the characteristics and treatment effects in patients with spinal fractures associated with dural tears.Methods A retrospective analysis was made on 185 patients with spinal fractures presenting to hospital from February 2013 to February 2015.There were 103 males and 82 females,aged 17-73 years (mean,58 years).Causes of injury were high falls in 72 patients,traffic collisions in 58,hitting by heavy objects in 41,ground-level falls in 12,and collision events in two.Cervical spine fractures were seen in 65 patients,thoracic vertebra fractures in 51,and lumbosacral vertebral fractures 69.Neurologic deficit was assessed using the American Spinal Injury Association (ASIA) score,including grade A in 24 patients,grade B in 22,grade C in 26,grade D in 37 and grade E in 76.Eighty patients were managed by simply anterior surgery,97 by posterior surgery,and eight by anterior-posterior surgery.Twenty-one patients were found with dural tears (group A) and 164 patients without dural tears (group B).Incidence of dural tears in cervical,thoracic and lumbosacral vertebral fractures were recorded and compared.Preoperative neurologic deficit,laminar fracture and spinal canal encroachment rate were compared between groups.Neurological function and complications associated with dural repair were detected.Results In group A,ten patients were rated ASIA grade A,five grade B,three grade C,one grade D and two grade E.In group B,14 patients were rated ASIA grade A,17 grade B,23 grade C,36 grade D and 74 grade E.Group A accounted for 11％ (7/65) of cervical,10％ (5/51) of thoracic,and 13％ (9/69) of lumbosacral spine fractures (P ＞ 0.05).Nineteen patients (91％) in group A were complicated with neurological deficit,compared to ninety patients (54.9％) in group B (P ＜ 0.01).Eighteen patients (86％) in group A had laminar fractures,compared to fifteen patients (9.1％) in group B (P ＜ 0.01).In group A,rate of spinal canal encroachment was (62.3 ± 12.1)％ and 17 patients (81％) showed spinal canal encroachment of greater than 50％.While in group B,rate of spinal canal encroachment was (36.2 ± 15.6)％ and 25 patients (15.2％) showed spinal canal encroachment of greater than 50％ (P ＜ 0.01).For dural tears in group A,11 patients were treated by direct suturing,four by thoracolumbar fascia repair,three by artificial dural coverage and three by fibrin glue sealing.In group A,19 patients were followed up and one of them presented persistent cerebral spinal fluid leak that necessitated an irrigation and debridement to cure.ASIA score was improved from grade A to B in two patients,grade B to C in one,grade C to D in one and grade D to E in one at the final follow-up.Conclusions Majority patients with spinal fractures associated with dural tears exist severe neurologic deficit,spinal canal encroachment and laminar fractures.Incidence of dural tear in cervical,thoracic and lumbosacral vertebral fractures is similar.Incidence of complications related to dural tear repair is low,but the neurological function recovery is poor after operation.

With the continuously exploration,in recent years,further understanding of anatomical characteristics of the cervical pedicle brings great breakthrough in cervical pedicle screw implantation.In addition,pedicle screw implantation in cervical spine is considered as a technique with high safety and reliability,which can be widely used in cervical trauma fracture,cervical instability,degenerative,inflammatory,benign or malignant tumor,deformity and other neck diseases.Because of the tremendous differences between upper cervical spine (C1,C2) and lower cervical spine (C3-7) in anatomical morphology,cervical pedicle screw implantation in C1 and C2 differs from in lower cervical spine.Due to the similar structure of C3-7,pedicle screw implantation methods are based on the same principle and sharing a few points in common.The pedicle screw technique can be classified in two groups according to the practice methods:navigation technology and manual placement of cervical pedicle screw.Navigation nailing is considered as reliable,easy handing,and with clear operative vision,however,with disadvantages as complex procedures,highly cost operation equipment,and risk in navigation draft.Therefore,manual placement of pedicle screw is more reasonable and practical comparing with the former.In this study,it analyzed anatomical characteristics of lower cervical pedicle and the measurement of pedicle structure,discussed technique of manual placement of pedicle screw in lower cervical spine and biomechanical study of pedicle screw,and summed up the comparison of the advantages and disadvantages of current representative manual placement technology.

Objective: To study the hepatitis E virus(HEV) infection in pregnant women and the healthy blood donors in Jinan. Methods: A total of 651 blood samples from pregnant women who came for screening of hemolytic disease of newborn and 600 blood samples from blood donors were collected during June 2015 to October 2016. All the blood samples were tested for anti-HEV IgG and anti-HEV IgM antibodies by using enzyme-linked immunosorbent assay (ELISA). Results: Anti-HEV IgG was positive in 2.61% (17/651) of the blood samples from the pregnant women, and none of the samples were positive for anti-HEV IgM. The serum positive rates for anti-HEV IgG and IgM in blood donors were 16.33% (98/600) and 0.83% (5/600) respectively. The seroprevalence of the two groups was significantly different(χ²=70.43, P<0.0001). Conclusions The HEV infection rate in pregnant women was much lower compared with that in blood donors in Jinan; however, in view of the high mortality of HEV infection in pregnant women, it still cannot be neglected. The infection of HEV in blood donors of Jinan was confirmed, suggesting the potential risk of transfusion-transmitted HEV infection.

OBJECTIVETo identify a rare subtype of the ABO blood group system and explore its molecular basis.

METHODSBased on a standard serological assay, ABO subtype and haplotype were analyzed through PCR amplification of the 7 exons and adjacent introns of the ABO gene and TA clone sequencing.

RESULTSForward typing showed a B type, while reverse typing demonstrated an extremely weak anti-B on routine gel analysis, which indicated a forward and reverse typing discrepancy. Absorption-elution testing confirmed that there was no A antigen on the surface of patient's red blood cells. Sequencing of the ABO gene showed a G>A exchange at position 523 in exon 7, which resulted in a Val to Met substitution at codon 175. Clone sequencing of the amplificons of the ABO gene showed an ABO* Bw14/O01 heterozygote genotype.

CONCLUSIONMolecular method is useful for the identification of ambiguous blood groups. A 523G>A substitution of the ABO gene resulting in a Bw14 subtype probably underlies the weak B phenotype noted in the patient.