Objective To assess the advantages and disadvantages of urine drainage by double-J ureteral stent or by percutaneous indwelling stent for pyeloplasty. Methods A total of 62 patients who had undergone pyeloplasty (6 patients had undergone operation on both sides) were reviewed.These patients had 68 sides of drainage during operation.The therapeutic effects,relevant complications and recoveries of 31 sides with internal stent and 37 with external stent for pyeloplasty were analyzed retrospectively. Results The rate of total postoperative complications such as hematuria,urinary tract infection,anastomotic leakage of urine or stenosis and urinary salt deposit in the internal drainage group (7/31,22.6%) was remarkably lower than that of the external drainage group (17/37,45.9%), P

Objective To study the relationship of bladder residual urine volume and renal function and urinary tract infection in patients with benign prostatic hyperplasia(BPH). Methods Eighty-one BPH eases from September 2005 to September 2008 were studied retrospectively. All the cases were divided into group A (53 cases, the residual urine volume <60 ml), group B (18 cases, the residual urine volume 60-200 ml),and group C (10 cases, the residual urine volume 200 ml). Blood urea nitrogen(BUN), serum ereatinine (Cr) and urine bacterial culture were observed. Results The BUN and serum Cr in group A, B and C were (5.90 ± 3.01) mmol/L, (90.13 ± 25.08)μmol/L, (7.85±3.53) mmol/L, (128.36 ±30.25) μmol/L and (10.57 ± 4.01)mmol/L, (152.11 ± 36.68) μmol/L, respectively. The BUN and serum Cr in group C were higher than those in group A and B (P < 0.01 or < 0.05). And there was significant difference between group A and group B (P< 0.05). The incidence of urinary tract infection in group A ,B and C was 28.3%(15/53), 44.4%(8/18), 50.0%(5/10), respectively. There was significant difference between group A and group B, C (P < 0.05). But there was no significant difference between group B and group C (P 0.05). Eacherichia was the main bacteria in urinary tract infection. Conclusion The increase of bladder residual urine volume in patients with BPH enhances renal failure and urinary tract infection.

Objective To investigate the biocompatilility of human acellular amniotic membrane(HAM) with vascular smooth muscle cells(VSMCs) and to explore the possibility to construct tissue engineering bladder with HAM as the scaffold and VSMCs as the seed cells. Methods After physical and 1% trypsogen preparation,the HAM was mixed with VSMCs taken from rats for culture in vitro.Histological obserbation was done under inverted microscope and scanning electron microscope respectively.20 rats were divided into two groups.Hemicystectomies were performed in 20 rats,and 10 of them were repaired with HAM grafts with VSMCs on the half bladder,the other 10 were repaired with HAM grafts without VSMCs as the control group.The rats underwent postoperative assessment of bladder volume at the 2nd,4th and 8th weeks,and the grafts were observed by light microscope at the 2nd,4th and 8th weeks after surgery. Results The physical and 1% trypsogen treated HAM was pure with hollows and undamaged collagen fibers.The VSMCs could grow,adhere to and differentiate on the surface of HAM and into the hollows.At the 2nd,4th and 8th weeks after surgery, the bladder volumes of the experimental group were not different significantly compared with those of the control group.Epithelialization and smooth muscle cells regeneration occurred with the infiltration of inflammatory cells in the 2nd week after grafting,and the HAM were absorbed.In the 4th and 8th weeks,it was difficult to delineate the junction between the host bladder and grafts by histology.Conclusion HAM can be used as the scaffold to construct tissue engineering bladder as it has good biocompatibility with VSMCs without disturbing the cell form and the graft can be absorbed quickly.

Objective To investigate whether maternal antibody to hepatitis B surface antigen (anti-HBs)in infants may interfere with the antibody response to hepatitis B vaccine. Methods Infants from singleton pregnant mothers,who delivered at full term at the Affiliated Drum Tower Hospital of Nanjing University Medical School from October 2006 to January 2007,were divided into two groups based on their mothers'status of anti-HBs(43 positive and 29 negative).All infants were vaccinated with hepatitis B vaccine at birth and one month thereafter.Serum anti-HBs were quantitatively determined for the mothers before delivery and for infants in cord blood at delivery and in serum at the age of 1 and 3.5 months. Results Anti-HBs of all 43 newborns in the positive group were positive in cord blood with the coefficiency of 0.98 to the maternal serum anti-HBs level(t=39.05,P<0.01).Forty-two out of the 43 infants remained anti-HBs positive at the age of 1 month.Anti-HBs was negative both at birth and 1 month old in infants of the negative group.However,all infants in both groups were anti-HBs positive at 3.5 months of age,while the average concentration of anti-HBs in infants of the negative group was significantly higher than that of the positive group [(466.9±86.7)mIU/ml vs(151.2±23.1)mIU/ml,t=2.72,P=0.011].Among the 5 infants whose maternal anti-HBs level>1000 mIU/ml,3 did not produce active antibodies against two doses of hepatitis B vaccination. Conclusions Passively acquired maternal anti-HBs in infants can inhibit the active antibody response to hepatitis B vaccine,and the extent of this effect is associated with maternal anti-HBs level.

Objective To observe the difference among the patients with chronic fatigue syndrome (CFS), mild-to-moderate depression or anxiety disorders in symptoms of fatigue, depression and anxiety. Methods Fatigue Scale-14 (FS-14), Hamilton Rating Scale for Depression (HAMD) and Hamilton Rating Scale for Anxiety (HAMA) were used to evaluate 182 cases with CFS, mild-to-moderate depression or anxiety disorders. Results There was no significant difference in physical fatigue, mental fatigue and comprehensive fatigue among 3 groups (P>0.05). There were 39 (62.9%) CFS patients perhaps with depression symptoms and 23 (37.1%) patients with mild-to-moderate depression symptoms. There were 46 (74.2%) CFS patients perhaps with anxiety symptoms and 16 (25.8%) patients with mild-to-moderate anxiety symptoms. The score of HAMD was significant lower in the CFS group than in the mild-to-moderate depression disorder group (P<0.001). There were significant differences in the anxiety/somatization and hysteresis (P<0.01), as well as in cognitive disturbance, diurnal variation and hopelessness (P<0.05) between the CFS group and mild-to-moderate depression disorder group. The scores of HAMA was significant lower in the CFS group than in the mild-to- moderate anxiety disorder group (P<0.001). There was significant difference in mental-anxiety (P<0.01), as well as in body-anxiety (P<0.05) between the CFS group and the mild-to-moderate anxiety disorder group. Conclusion The symptoms of emotion disorders and fatigue symptoms were both presented in patients with CFS, mild-to-moderate depression and anxiety disorders. They share common clinical features.

Objectives To evaluate accurately hepatocyte injury degree of severe hepatitis patients by quantifying plasma DNA of severe hepatitis patients and study its clinical application in diagnosis of severe hepatitis comparing with ALT.Methods Six milliliters of peripheral blood samples were collected from 185 patients with hepatitis B which are divided into four groups, severe hepatitis with 30 cases, acute hepatitis with 20 cases, chronic B hepatitis with 90 cases, and liver cirrhosis with 45 cases. 100 healthy controls were enrolled. Circulating DNA was extracted from plasma by the BILATEST virus DNA/RNA extraction kit and quantified with a novel duplex real-time PCR assay, respectively.Results Plasma DNA levels of hepatitis B patients were significantly higher than those of healthy controls (104.2 ng/ml vs. 23.4 ng/ml (median),P=0.0000).A significant difference of plasma DNA concentration was found between severe hepatitis and acute hepatitis (P=0.0018), and chronic B hepatitis (P=0.0000), and liver cirrhosis (P=0.0000).The median value of serum ALT of hepatitis B patients was 107.5 U/L, much higher than that of the healthy controls (24.1 U/L,P=0.0000).The levels of serum ALT were significantly different between severe hepatitis and acute hepatitis (P=0.0024), while there was no remarkable difference between severe hepatitis and chronic B hepatitis (P=0.0600), liver cirrhosis (P=1.0000). Moreover, for distinguishing severe hepatitis from liver cirrhosis and chronic B hepatitis, the plasma DNA assay was notably superior to ALT by the analysis of receive operating characteristic (ROC) curves (AUC, 0.95 vs. 0.51,P=0.0000; 0.86 vs. 0.34,P=0.0000).Conclusion The results by measuring plasma DNA of hepatitis B patients with the novel duplex real-time quantitative PCR showed that plasma DNA may be considered as a robust predictive marker for accurately evaluating hepatocyte injury degree of severe hepatitis patients.

Objective To explore the value of cMRI and MRS in diagnosis and differential diagnosis of single brain metastases and localized high grade gliomas.Methods The cMRI (T1WI,T2WI and contrast-enhanced MRI)and MRS data of 23 cases with single brain metastases and in 28 cases with high grade gliomas confirmed by pathology were collected and analyzed retrospectively.Results cMRI:①There were no significant differences of T1WI,T2WI and constrast-enhanced MRI between single brain metastases and high-grade gliomas.②Enhanced images of single brain metastases and localized high-grade gliomas showed that there was a significant difference in the peritumoral edema area:the nodular or ring enhancement were found in single brain metastases,the outer outline of ring enhancement was smooth,and there was no enhancement at the peripheral edema area;Irregular patchy or ring enhancement were found in localized high-grade glioma tumor,both of the outer and inner edges of the ring enhancement rough,a little patchy enhancement at the peripheral edema area were found in 1 6 patients,and there was no enhancement of the edema area in the other 1 2 patients.MRS:①There were no significant differences of the tumor parenchyma in the peaks of NAA,Cr,Cho and central Lac between single brain metastases and localized high grade gliomas.②A significant difference of the peripheral edema area were observed between them.The peaks of NAA,Cr,Cho at the edema area in all single brain metastases patients were normal.But in all high-grade glioma patients,the NAA and Cr peaks were decreased,while the Cho peaks were increased.Conclusion The morphological manifestations of single brain metastases are similar to localized high grade gliomas.An obvious difference of cMRI and MRS lines exists in the peritumoral edema area between them,which could be used for differential diagnosis.

Objective:To determine whether there is a correlation between the cross-sectional area (CSA) and the parameters as measured on nerve conduction studies.Methods:Twenty-one patients with neuromuscular diseases in Beijing Tiantan Hospital from March 3, 2022 to May 4, 2023 underwent ultrasound measurement of the CSA of the median nerves and ulnar nerves at the wrist, elbow and the upper arm, followed by nerve conduction studies (NCS). A linear regression model was performed to compare NCS and CSA.Results:A total of 180 sets of motor nerve conduction velocity (MCV) and CSA at the different sites including 102 sets of median nerve and 78 sets of ulnar nerve, 220 sets of compound muscle action potential (CMAP) amplitude and CSA at the different sites including 104 sets of median nerve and 116 sets of ulnar nerve, 60 sets of sensory nerve conduction velocity (SCV) and CSA and sensory nerve action potential (SNAP) amplitude and CSA at the wrist including 32 sets of median nerve and 28 sets of ulnar nerve were recorded. The linear correlation between MCV and CSA was statistically significant both in median nerve ( r2=0.10,adjusted r2=0.09, P=0.001) and in ulnar nerve ( r2=0.18,adjusted r2=0.17, P<0.001).When CSA>10 mm 2, the linear correlation between CMAP amplitude and CSA was statistically significant both in median nerve ( r2=0.09,adjusted r2=0.08, P=0.024) and ulnar nerve ( r2=0.19,adjusted r2=0.17, P=0.004). The correlation between CMAP and CSA was not statistically significant when CSA≤10 mm 2. And the correlations between SCV and CSA and between SNAP and CSA were not statistically significant. Conclusions:CSA can better show the characteristics of changes in motor nerve conduction especially in motor conduction velocity. It is suggested that its application prospect in demyelinating peripheral neuropathy with motor nerve damage may be more extensive.

Objective:To measure the mesio-distal interradicular space of posterior teeth at different height by CBCT.Methods:60 subjects with skeletal Class Ⅰ,Ⅱ and Ⅲ patterns were included(n =20).From the distal of first premolar to the mesial of second molar,the mesiodistal width at the height of 2,4,6,8 and 10 mm from the alveolar crest were measured and analysed.Results:The interradicular distance was larger than 3 mm within 4-10 mm height in maxilla and in mandible.The maxillary mesiodistal width values measured between the first premolar and second premolar in skeletal Class Ⅰ and Class Ⅱ pattern was greater than that in Class Ⅲ(P ＜0.05) and there was no significant difference in other zones.In the mandible,the values of skeletal Class Ⅲ pattern were greater than those of skeletal Class Ⅰ and Class Ⅱ pattern(P ＜0.05).Conclusion:The suitable interradicular zone is within 4-8 mm to the alveolar crest between the second premolar and first molar for miniscrew implant placement in maxilla,and over 4 mm between the first molar and second molar in mandible.The difference of interradicular spaces in sagittal skeletal features is existed.

The geometric bone model of patients is an important basis for individualized biomechanical modeling and analysis, formulation of surgical planning, design of surgical guide plate, and customization of artificial joint. In this study, a rapid three-dimensional (3D) reconstruction method based on statistical shape model was proposed for femur. Combined with the patient plain X-ray film data, rapid 3D modeling of individualized patient femur geometry was realized. The average error of 3D reconstruction was 1.597-1.842 mm, and the root mean square error was 1.453-2.341 mm. The average errors of femoral head diameter, cervical shaft angle, offset distance and anteversion angle of the reconstructed model were 0.597 mm, 1.163°, 1.389 mm and 1.354°, respectively. Compared with traditional modeling methods, the new method could achieve rapid 3D reconstruction of femur more accurately in a shorter time. This paper provides a new technology for rapid 3D modeling of bone geometry, which is helpful to promote rapid biomechanical analysis for patients, and provides a new idea for the selection of orthopedic implants and the rapid research and development of customized implants.
Humans ; Imaging, Three-Dimensional/methods* ; Tomography, X-Ray Computed/methods* ; Femur/surgery* ; Femur Head ; Lower Extremity