Objective: To evaluate the therapeutic effect of cystic de compression (CD) operation autosomal dominant polycystic kidney disease(APKD) based on clinical material, experience and related theory. Methods: Thirty-nine APKD received CD operation(unilateral 31 cases, bilateral 8 cas e s) in our hospital from 1985 to 1995. Four main parameters, cystic renal enlargi ng rate(CRER)，lumbar pain recurring rate(LPRR)，blood pressure elevating rate(B PER) and renal function abnormal rate(RFAR), were observed 3, 6, 12, 36 and 60 months after CD operation. And the changes were analyzed based on related theory . Results: The changes of 4 main parameters on 5 different time points post operation in unilateral 31 cases were:（1）CRER 19.4%,38.7%,61.3%,1 0 0% and 100%; （2）LPRR 12.9%,48.4%,71.0%,100% and 100%; （3）BPER 6.5%,22.6%,4 1.9%,71.0% and 96.8%;（4） RFAR 3.2%, 12.9%,22.6%,74.2% and 96.8% respectively. Conclusion: During a short period, CD operation can relieve th e lumbar pain, but it is not certain for improving CRER,BPER and RFAR. in the lo ng run, the therapeutic effect is not sure.

Objective: To probe into the etiology of the sever e post-renal transplantation infection and its diagnosis and t reatment. Methods: A retrospective analysis was made on the seve re infected cases among 1 504 renal transplantation cases. Results: (1)The infected rate in the whole group was 23.74%,and 14.01% of the infecti on cases was severely involved. (2) About 86% of the severe infection occurred within 6 months after operation and as high as 82% of the patients were successf ully rescued by various etiological treatment. (3) The main etiological causes according to their frequency and type were: Bacteria(Mycobacterium tub erculosis, Pseudomonas, Aureus staphylococcus, Bacillus cloacae, etc.); Fungus (Candida albians, Candida tropicals, Penicillum patulum). Cytomegalo virus also often appeared. Conclusion: (1) Infection is one of t h e common complications after renal transplantation and severe infection is an im portant cause of death. (2) Correct diagnosis and combined therapy in time may improve its success rate. (3) Characterized germ spectrum exists in severe post -renal transplantation infection and its role is of great importance to clinica l management.

High-risk human papillomavirus (HR-HPV) infection is the main cause of cervical cancer. Current research shows that other factors work together with HPV to affect the occurrence and development of cervical cancer. Under normal circumstances, the vaginal microbiota can play a fundamental role in maintaining the balance of the vaginal microenvironment and anti-inflammatory and anti-tumor together with the host immune system. Once the body is infected with HPV in synergy with other factors, it will accelerate the progression of cervical cancer. This article reviews the changes in the vaginal microenvironment and local immune response of cervical cancer.

Objective To study the therapeutic window of rapamycin(RPM) concentration in primary recipients of renal transplantation. Methods An open label, multi center study was performed. One hundred primary renal allograft recipients with cadaveric donors were enrolled from 4 transplantation centers in China. The immunosuppressive regimen was triple therapy,i.e.RPM combined with CsA and steroid. A loading dose of RPM 6 mg/d was administered within 48 hours after transplantation, then a maintaining dose of 2 mg/d was administered. The whole blood concentration of RPM was measured by HPLC method. Results The whole blood concentration of RPM in this group was (6.65?2.75)ng/ml, the 10th and 90th percentile for RPM concentration was 3 2 ng/ml and 10 26 ng/ml,respectively.9 5%(8/84)patients suffered from acute rejection during the 6 month period after transplantation in this study, and the concentration of RPM in these was lower than that in non rejection patients(P=0.001). Hyperlipidemia and liver dysfunction were the most frequently adverse events, and RPM concentration was significantly associated with the concentration of triglyceride. Conclusions 4～8 ng/ml is a suitable level for RPM concentration. Regular drug monitoring and reasonable dose modulation may increase the validity and security of RPM.

Objective To investigate the expression of the connective tissue growth factor (CTGF) and integrin β1 in vaginal anterior wall of the model rats with stress urinary incontinence. Methods Twenty-four healthy female SD rats were randomly divided into three groups, group A rats as control group without any treatment;group B rats only with vaginal expansion;group C rats with vaginal expansion and bilateral ovaries removed. At postoperative four weeks to determine the maximum bladder capacity (MBC)and abdominal pressure leakage point pressure (ALPP), to establish detection model for stress urinary incontinence. Modeling successfully executed in rats after four weeks after vaginal anterior wall tissue,immunohistochemical staining method and real-time fluorescent quantitative RT-PCR technique to detect the expression of CTGF and integrinβ1. Results The urine flow dynamic detection(MBC,ALPP)B and C group was significantly lower than group A, there were statistically significant differences (P<0.05);CTGF mRNA and protein expression in group C was significantly lower than group A(P<0.05),there were no statistical significance between group A and group B (P>0 . 05);integrin β1 mRNA and protein in group C expression was low er than that in group A and B(P<0.05), and differences between A and B were statistically significant(P<0.05). Conclusion The anterior wall vaginal CTGF in rats in SUI and low expression of integrin β1 may be related to stress urinary incontinence and other pelvic floor support structure there is a close relationship of the occurrence of degenerative diseases of the pelvic floor support degenerative diseases.

OBJECTIVE: To investigate the CT virtual endoscopy (CTVE) shows the display method of the normal structure of the middle ear, and evaluation of middle ear disease, particularly in the value and significance of the connection status of the ossicular chain, established display ossicular chain and middle ear structure methods. METHOD: Volume scanning with a spiral CT unit was performed in forty normal cases and thirty patients with suspected lesions of middle ear. Respectively, with Germany's Siemens (Siemens SOMATOM Sensation 16) spiral CT the Inner Ear scanner patients with axial scanning, reconstruction of the original image, the software selected Fly-through A, B, C the point approach CTVE imaging studies. Focus ossicular chain connection status, and chronic otitis media shown the results of surgery in exploratory image control. RESULT: Normal group CTVE in the hammer bone, incus promontory, facial nerve, the lateral semicircular canal display rate was 100%; stapes, the two arch of the display rate in three display levels, respectively, to 57.5%, 70.0%, 97.5%; round window, oval window was 90.0%, 93.0%, 97.5%. Ossicular injury, displacement, interruption, deletion, deformity in cases of otitis media, trauma, temporal bone malformations. CONCLUSION CTVE link relations between the three ossicles (such as interrupt, etc.) have a certain advantage. By choosing the appropriate approach, CTVE has a considerable advantage in the ossicles and their connections, relations as well as pathological state. By comparing CTVE in three different display levels,the technique of CTVE is considered to be an advantageous supplement of tomography.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Ear Ossicles ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Temporal Bone ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

Objective To investigate the effects of global registry of acute coronary events (GRACE) and Can Rapid risk stratification of unstable angina patients suppress adverse outcomes with early implementation of the ACC/AHA guidelines(CRUSADE) score in the nursing care for patients with acute coronary syndrome (ACS).Methods A total of 128 patients with ACS undergoing percutaneous coronary intervention (PCI) who were admitted from March 2015 to May 2016 were enrolled in this study and divided into usual care group (63 cases) and optimized care group (65 cases). Patients in the usual care group received usual care according to the guidelines, while patients in the optimized care group received optimized care according to GRACE and CRUSADE score. The major adverse cardiac events, the incidence of bleeding complications, average hospitalization and hospitalization costs were recorded and compared between the two groups. Results The characteristics of angiography (multiple vessel rate and target vessel distribution) and procedures of PCI (position, number, length and diameter of stents, coronary blood flow classification after the implantation of stents) were similar (all P>0.05). There were tendencies of reduction in the incidence of MACE, bleeding complications and average hospitalization time in patients of optimized care group compared to the usual care group, with no statistically significant differences between the two groups (P>0.05). The hospitalization costs in the optimized care group (33491±1982)RMB were significantly less than those in the usual care group (36562±2395)RMB. The difference was statistically significant (t=-7.914,P<0.001).Conclusions Optimized care according to GRACE and CRUSADE can improve the treatment effects of ACS patients undergoing PCI and decrease the cost.

OBJECTIVETo review kidney transplantation in the center and analyze the risk factors affecting long-term allograft survival.

METHODSThirty-two relative variables were analyzed with SAS statistical software. Using Log-rank method, we investigated influence of these variables on short-and long-term survival of grafts. Kaplan-Meier analysis was used to estimate the 1-, 3-, 5-, 10-years graft survival rates and half-life. Proportional hazards regression analysis (Cox model) was used to assess and rank the relative risk of potential variables.

RESULTSThe 1-, 3-, 5-, 10-years graft survival rates were 83%, 75%, 66% and 48%. After excluding the patients died with functioning grafts, the 1-, 3-, 5-, 10 years grafts survival rate increased to 89%, 82%, 75% and 69%, respectively. The mean half-life was 8.78 +/- 0.14 and 14.09 +/- 0.20 years, respectively. By Log-rank analysis, factors affecting short- and long-term graft survival were identified as: renal function, duration of graft function became normal, cold-ischemia time, presence of acute rejection, delayed graft function, immunosuppressive regimen, complication, infection, anti-rejection therapy. Cox model multivariate analysis showed that there were 18 factors affecting graft survival.

CONCLUSIONSNew immunosuppressive agents not only significantly increase short-term graft survival, but also have the better long-term outcome tendency. Making assurance to get high quality donor organ and minimizing the death with graft function may be the most feasible way to prolong graft survival at present.

Adult ; Cadaver ; Female ; Graft Survival ; drug effects ; Humans ; Immunosuppressive Agents ; pharmacology ; Kidney Transplantation ; Male ; Multivariate Analysis ; Transplantation, Homologous

Objective:To perform trans-peritoneal laparoscopic adrenalectomy via a single incision in treatment of adrenal tumors,and to discuss its clinical outcome and safety.Methods:Single incision trans-peritoneal laparoscopic adrenalectomy was used in treatment of three patients with adrenal tumors.The incision was made 3 cm below the costal margin of anterior axillary line; three Tocars were placed in the cut.The instruments used included single port access,CUSA,Hem-o-lok,etc..Results:The three operations were all successful,and there were no conversion to open procedure or a need for extra Ttrocars.The operating time periods were 75,116,and 135 min,with a mean of (108.7?30.7)min.The perioperative blood losses were 10,20,and 30 ml,with a mean of (20?10)ml.The gastric canal and ureteral catheter were withdrew one day after operation,and the drainage tube was withdrew 3 d after operation.The mean postoperative hospital stay was 4 d.Conclusion:Single incision trans-peritoneal laparoscopic adrenalectomy has the advantage of little trauma,less blood loss,satisfactory safety,and prompt postoperative recovery,but is difficult to manage.

OBJECTIVETo detect structural changes in the brain in fetuses with agenesis of the corpus callosum (ACC) and holoprosencephaly (HPE) in the first trimester.

METHODSThe ultrasound data were analyzed retrospectively in 620 normal singleton fetuses between 11 and 13(+6) gestational weeks, 5 fetuses diagnosed to have ACC, and 13 fetuses with HPE. The midbrain diameter (MD) and falx diameter (FD) were measured and their ratio (MD/FD) was calculated for comparative analysis.

RESULTSNo significant difference was found in the MD, FD, and MD/FD ratio between fetuses with ACC and HPE (P>0.05). Compared to the normal fetuses, all the fetuses with ACC and HPE showed significantly increased mean MD and MD/FD ratio (P<0.05); 4 (80%) fetuses with ACC and 11 (84.6%) with HPE had a reduced FD. All the fetuses with ACC and HPE had MD/FD ratios greater than 1, which were below 1 in all the normal fetuses.

CONCLUSIONIn the first trimester, fetuses with ACC and HPE have measurable abnormalities in the midbrain and falx area of the brain, and these changes, represented by abnormal midsagittal MD, FD and their ratio, can be of value in detecting ACC or HPE in fetuses in the first trimester.

Agenesis of Corpus Callosum ; diagnosis ; Corpus Callosum ; diagnostic imaging ; Female ; Fetus ; Gestational Age ; Humans ; Pregnancy ; Pregnancy Trimester, First ; Retrospective Studies ; Ultrasonography, Prenatal