Objective:To explore the impact of benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) on the risk of cardiovascular diseases (CVD) recurrence.Methods:This study is a prospective cohort study based on the China Health and Retirement Longitudinal Study (CHARLS) database. The inclusion criteria were participants who underwent the national baseline survey in 2011. The exclusion criteria were as follows: ① female participants; ② participants without BPH/LUTS information at baseline; ③ participants who had not experienced CVD at baseline. The basic characteristics of BPH/LUTS patients and non-BPH/LUTS patients was compared. The Cox proportional hazards model was used to analyze whether BPH/LUTS is a risk factor for CVD recurrence.Results:A total of 903 male patients with stroke or heart disease were finally included, among which there were 324 (36.9%) cases of BPH/LUTS and 579 (64.1%) cases without BPH/LUTS. Patients with BPH/LUTS had a higher proportion of comorbidities such as hypertension [186 cases (57.4%) vs. 165 cases (28.5%), P=0.014], dyslipidemia [100 cases (31.2%) vs. 104 cases (18.2%), P<0.001], diabetes [55 cases (17.2%) vs. 57 cases (9.8%), P=0.002], chronic kidney disease [71 cases (22.2%) vs. 56 cases (9.8%), P<0.001], and chronic lung disease [87 cases (26.9%) vs. 117 cases (20.3%), P=0.029] compared to those without BPH/LUTS. During the 7-year follow-up, there were 341 (37.8%) cases of CVD recurrence, including 319 (35.3%) cases of heart disease recurrence and 38 (4.2%) cases of stroke recurrence. In the multifactorial adjusted Cox regression model, BPH/LUTS was a risk factor for CVD recurrence ( HR=1.41, 95% CI 1.12-1.77, P=0.003) and heart disease recurrence ( HR=1.40, 95% CI 1.10-1.77, P=0.005), while BPH/LUTS was not a risk factor for stroke recurrence ( HR=2.05, 95% CI 0.97-4.32, P=0.058). When stratified by age, in the population aged ≤65 years, BPH/LUTS was a risk factor for CVD ( HR=1.43, 95% CI 1.07-1.91, P=0.002) and heart disease recurrence ( HR=1.40, 95% CI 1.03-1.90, P=0.006), but not for stroke recurrence ( HR=2.16, 95% CI 0.98-6.09, P=0.053). In patients aged >65 years, BPH/LUTS was not a risk factor for CVD ( P=0.110), heart disease ( P=0.096), or stroke recurrence ( P=0.830). Conclusions:BPH/LUTS is closely related to an increased risk of CVD recurrence, especially for CVD patients aged ≤65 years old. Therefore, for elderly male CVD patients aged ≤65 years, preventing and actively treating BPH/LUTS may have significant implications.

Objective:To explore the impact of benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) on the risk of cardiovascular diseases (CVD) recurrence.Methods:This study is a prospective cohort study based on the China Health and Retirement Longitudinal Study (CHARLS) database. The inclusion criteria were participants who underwent the national baseline survey in 2011. The exclusion criteria were as follows: ① female participants; ② participants without BPH/LUTS information at baseline; ③ participants who had not experienced CVD at baseline. The basic characteristics of BPH/LUTS patients and non-BPH/LUTS patients was compared. The Cox proportional hazards model was used to analyze whether BPH/LUTS is a risk factor for CVD recurrence.Results:A total of 903 male patients with stroke or heart disease were finally included, among which there were 324 (36.9%) cases of BPH/LUTS and 579 (64.1%) cases without BPH/LUTS. Patients with BPH/LUTS had a higher proportion of comorbidities such as hypertension [186 cases (57.4%) vs. 165 cases (28.5%), P=0.014], dyslipidemia [100 cases (31.2%) vs. 104 cases (18.2%), P<0.001], diabetes [55 cases (17.2%) vs. 57 cases (9.8%), P=0.002], chronic kidney disease [71 cases (22.2%) vs. 56 cases (9.8%), P<0.001], and chronic lung disease [87 cases (26.9%) vs. 117 cases (20.3%), P=0.029] compared to those without BPH/LUTS. During the 7-year follow-up, there were 341 (37.8%) cases of CVD recurrence, including 319 (35.3%) cases of heart disease recurrence and 38 (4.2%) cases of stroke recurrence. In the multifactorial adjusted Cox regression model, BPH/LUTS was a risk factor for CVD recurrence ( HR=1.41, 95% CI 1.12-1.77, P=0.003) and heart disease recurrence ( HR=1.40, 95% CI 1.10-1.77, P=0.005), while BPH/LUTS was not a risk factor for stroke recurrence ( HR=2.05, 95% CI 0.97-4.32, P=0.058). When stratified by age, in the population aged ≤65 years, BPH/LUTS was a risk factor for CVD ( HR=1.43, 95% CI 1.07-1.91, P=0.002) and heart disease recurrence ( HR=1.40, 95% CI 1.03-1.90, P=0.006), but not for stroke recurrence ( HR=2.16, 95% CI 0.98-6.09, P=0.053). In patients aged >65 years, BPH/LUTS was not a risk factor for CVD ( P=0.110), heart disease ( P=0.096), or stroke recurrence ( P=0.830). Conclusions:BPH/LUTS is closely related to an increased risk of CVD recurrence, especially for CVD patients aged ≤65 years old. Therefore, for elderly male CVD patients aged ≤65 years, preventing and actively treating BPH/LUTS may have significant implications.

Objective : To determine expression profile of VISTA on lymphocyte and the potential regulatory effects on immune response in a murine model of sepsis. Methods : Expression profile of VISTA on T lymphocytes in the spleen and peripheral blood was examined. Mice wereintravenously injected with an agonistic VISTA mAb(MH5A) or isotype control , and then the survival rate , cytokine expression , bacterial burden and lymphocyte apoptosiswere determined. Results : VISTA was substantially expressed on T cell from the spleen and peripheral blood , septic peritonitis did not induce significant changes in the expression profiles at 24h post surgery(P > 0. 05 in each comparison) . Treatment with MH5A improved the survival of septic mice(8/12 vs 2/12 , P = 0. 01) , accompanied by reduced lymphocyte apoptosis [(30 123 ± 6 400) vs (45 482 ± 8 652) , P = 0. 03] , decreased bacterial burden and lessened cytokines expression , such as TNF⁃α , IL⁃6 , IL⁃1β and IFN⁃γ(P < 0. 05 in each comparison) . Conclusion The present study identified VISTA as a novel immune checkpoint in the regulation of T cell apoptosis and inflammatory response during sepsis. VISTA agonism might offer a promising approach in the immunotherapy for sepsis.

Objective:To explore the effect of applying individualized progressive nutrition guide sheet in postoperative enteral nutrition (EN) for patients with oral cancer.Methods:Using convenient sampling method, 40 oral cancer patients admitted to Sichuan Cancer Hospital from November 2017 to October 2018 were selected as the control group, and 46 from November 2018 to October 2019 were selected as the observation group. Both groups received EN support but the observation group were applied with progressive nutrition guide sheet. The pre- and post-operative body weight, nutrition related indicators, gastrointestinal symptoms, proportion of patients achieving daily target energy intake, patient/family satisfaction and other indicators were compared between the two groups.Results:There were significant differences in preoperative potassium, total protein and albumin at 7 days after operation, prealbumin at 3 and 7 days after operation, potassium at 3 days after operation and sodium at 3 days after operation between the two groups( Z=4.963, P<0.01; Z=5.094, P<0.01; Z=-2.022, P<0.05; Z=4.048, P<0.01; Z=2.14, P<0.05, Z=-6.04, P<0.01, Z=-7.13, P<0.01). The dynamic changes of potassium and sodium in the two groups were compared before operation, 3 days after operation and 7 days after operation ( F=30.20, F= 118.51, all P<0.01). There were significant differences in incidence of abdominal pain, abdominal distension and diarrhea between the two groups ( χ2=6.91, P=0.009, χ2=10.36, P=0.001, χ2=4.71, P=0.03). There were also significant differences in the proportion of patients achieving daily target energy intake at 1 day, 2 days, 3 days, 4 days, 5 days, and 6 days after operation between the two groups ( χ2=41.77, χ2=45.09, χ2=45.71, χ2=40.53, χ2=29.97, χ2=6.11, all P<0.01). Conclusion:The application of progressive nutrition guidelines in early postoperative EN support for patients with oral cancer can help to improve postoperative nutritional status, avoid potassium, sodium and electrolyte disturbance, alleviate postoperative gastrointestinal symptoms, improve the achievement of daily target energy intake and patient/family satisfaction, and promote disease recovery.

Adult ; Antibodies, Viral/isolation & purification* ; COVID-19/virology* ; Feces/chemistry* ; Female ; Humans ; Intestines/virology* ; Male ; RNA, Ribosomal, 16S/genetics* ; RNA, Viral/isolation & purification* ; SARS-CoV-2/pathogenicity*

Objective:To explore the consistency of peripheral whole blood and venous serum procalcitonin (PCT) levels, and the value of peripheral whole blood PCT in evaluating pediatric bacterial infection.Methods:This multicenter cross-sectional parallel control study was conducted in 11 children′s hospital. All the 1 898 patients older than 28 days admitted to these hospitals from March 2018 to February 2019 had their peripheral whole blood and venous serum PCT detected simultaneously with unified equipment, reagent and method. According to the venous serum PCT level, the patients were stratified to subgroups. Analysis of variance and chi-square test were used to compare the demographic characteristics among groups. And the correlation between the peripheral blood and venous serum PCT level was investigated by quantitative Pearson correlation analysis.The PCT resultes were also converted into ranked data to further test the consistency between the two sampling methods by Spearman′s rank correlation test. Furthermore, the ranked data were converted into binary data to evaluate the consistency and investigate the best cut-off of peripheral blood PCT level in predicting bacterial infection.Results:A total of 1 898 valid samples were included (1 098 males, 800 females),age 27.4(12.2,56.7) months. There was a good correlation between PCT values of peripheral whole blood and venous serum ( r=0.97 , P<0.01). The linear regression equation was PCT?venous serum=0.135+0.929×PCT peripheral whole blood. However, when stratified to 5 levels, PCT results showed diverse and unsatisfied consistency between the two sampling methods ( r=0.51-0.92, all P<0.01). But after PCT was converted to ordinal categorical variables, the stratified analysis showed that the coincidence rate of the measured values by the two sampling methods in each boundary area was 84.9%-97.1%. The dichotomous variables also showed a good consistency (coincidence rate 96.8%-99.3%, Youden index 0.82-0.89). According to the severity of disease, the serum PCT value was classified into 4 intervals（<0.5、0.5-<2.0、2.0-<10.0、≥10.0 μg/L）, and the peripheral blood PCT value also showed a good predictive value (AUC value was 0.991 2-0.997 9). The optimal cut points of peripheral whole blood PCT value 0.5、1.0、2.0、10.0 μg/L corresponding to venous serum PCT values were 0.395, 0.595, 1.175 and 3.545 μg/L, respectively. Conclusions:There is a good correlation between peripheral whole blood PCT value and the venous serum PCT value, which means that the peripheral whole blood PCT could facilitate the identification of infection and clinical severity. Besides, the sampling of peripheral whole blood is simple and easy to repeat.

Objective To investigate the inhibitory effect of 188 Re-labeled BaGdF5-poly ( ethylene glycol) ( PEG) nanoparticles ( NPs) on hepatoma cells, and explore the application of the radiolabeled NPs for SPECT imaging. Methods BaGdF5-PEG NPs were synthesized by hydrothermal method, and were fur-ther radiolabeled with 188Re using diethylene triamine pentaacetic acid (DTPA) as a coupling agent. The human hepatoma cells SMCC 7721 were treated with different concentrations of BaGdF5-PEG NPs, 188 ReO-4 or 188Re-DTPA-BaGdF5 NPs (14.8, 74.0, 370.0×104 Bq/ml) for 24 h, and then the cell proliferation rates were measured by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay. 188ReO-4 and 188 Re-DTPA-BaGdF5 NPs were administrated into normal rabbits via the ear vein, respectively. For the former, static SPECT/CT imaging were performed at 30, 60 min post-injection, and for the latter, dynamic SPECT images were captured within 10 min, and static SPECT/CT images at 30, 60, 120 min post-injec-tion. The rabbit VX2 tumor model was established, and a microcatheter was inserted into hepatic artery via the rabbit femoral artery, and then the mixture of 188 Re-DTPA-BaGdF5 NPs and lipiodol was injected into the tumor region. SPECT/CT imaging for VX2 tumor was performed at 30 min later. Data were analyzed by two-sample t test. Results The BaGdF5-PEG NPs were nearly square and the particle size was about 10 nm. The labeling yield of 188 Re-DTPA-BaGdF5 was 94.1％ at the optimum conditions. Moreover, it showed high stability in vitro and in vivo. In vitro, BaGdF5-PEG NPs did not exhibit obvious cytotoxicity even at a high concentration. Both 188 ReO-4 and 188 Re-DTPA-BaGdF5 could inhibit the proliferation of SMCC 7721 cells, but 188 Re-DTPA-BaGdF5 showed a significantly stronger inhibitory effect at the doses of 74.0 and 370.0×104 Bq/ml ( t values:4.21,4.09, both P<0.01) . In vivo, 188 ReO-4 was absorbed by maxillary glands and was quickly elimi-nated from blood via the kidneys. The 188 Re-DTPA-BaGdF5 NPs mainly accumulated in the liver and spleen. In addition, retention and accumulation of 188 Re-DTPA-BaGdF5 NPs in the liver tumor could be achieved by using transarterial intervention technique for drug delivery. Conclusion 188Re-DTPA-BaGdF5 NPs have cer-tain killing effects on hepatoma cells in vitro, and with the help of transarterial intervention technique, the NPs can be aggregated within liver tumor, where they not only can be used for SPECT imaging, but also have potential therapeutic effects.

Objective To compare internal fixation with hallow compression screws combined vascularized bone graft(observation group) with only three hallow compression screws(control group) in young patients' Garden III and IV femoral neck fractures. Methods The patients with femoral neck fracture were treated from January, 2004 to December, 2013 were retrospectively reviewed. A total of 417 displaced femoral neck fractures in young and mid-dle-aged patients were long term followed-up. One hundred and thirty-seven patients were underwent open reduction and internal fixation with 3 hallow compression screws combined with a greater trochanter bone graft supported by the profound branch of medial circumflex femoral artery;280 patients were treated by closed reduction with 3 hallow com-pression screws. Results Patients had been followed-up for 5-12 years. At the last follow-up point, the Harris score of flap in observation group(93.68±5.12) were higher than that in control group(92.53±6.12), while it was no sta-tistical difference(P>0.05). It was 0.7％of nonunion incidence rate in the observation group, and incidence of avascular necrosis of femoral head was 6.6％, and incidence of femoral neck shortening was 8.8％. In the control group, inci-dence of avascular necrosis of femoral head was 14.6％, nonunion incidence rate was 4.6％, and incidence of femoral neck shortening was 22.5％. The differences between two groups was statistically significance( P<0.05). Conclusion The open reduction and internal fixation which is hallow compression screws in combination with a greater trochanter bone graft supported by the profound branch of medial circumflex femoral artery is an optimal treatment for young adults with Garden III and IV femoral neck fractures.

Objective: To investigate the value of bedside echocardiography in diagnosis and risk assessment of in-hospital death of patients with Stanford type A aortic dissection. Methods: The clinical data of 229 patients with Stanford type A aortic dissection diagnosed by CT angiography in Zhongshan Hospital affiliated to Fudan University between January 2009 and January 2016 were retrospectively analyzed. The patients were divided into survival group(191 cases)and non-survival group(38 cases)according to presence or absence of in-hospital death. The bedside echocardiography features were analyzed, and influence factors of in-hospital death were determined by multivariate logistic regression analysis. Results: (1) Compared with the survival group, the non-survival group had lower surgery rate (60.52%(23/38) vs. 85.34%(163/191), P<0.01). Age, gender and Debakey classification were similar between survival group and death group (all P>0.05). (2) The bedside echocardiography results showed that prevalence of aortic valve involvement(65.79%(25/38) vs.34.03%(65/191), P<0.01) and severe aortic regurgitation (44.74%(17/38) vs. 14.14%(27/191), P<0.01) were significantly higher in non-survival group than in survival group. The non-survival group had larger aortic root diameter than the survival group ((55.5±6.4)mm vs. (42.3±7.8)mm, P<0.01). There were no significant differences in pericardial effusion, expansion of aortic sinus, and left ventricular ejection fraction between survival group and non-survival group (all P>0.05). (3) The multivariate logistic regression analysis showed that aortic valve involvement(OR=3.275, 95%CI 1.290-8.313, P<0.05), aortic root diameter(OR=1.202, 95%CI 1.134-1.275, P<0.01), and surgery (OR=0.224, 95%CI 0.079-0.629, P<0.01) were independent risk factors for in-hospital death in patients with Stanford type A aortic dissection. Conclusions Bedside echocardiography has significant diagnostic value for Stanford type A aortic dissection. Aortic valve involvement, enlargement of aortic root diameter and without surgery are independent risk factors for patients with Stanford type A aortic dissection.

Objective To provide an anatomical basis for repairing the defect of cervical tracheal wall with vascularized pectoralis major tendon flaps.Methods Thirty-two lateral thoracic necrotomies were studied for the following aspects.Measurement of pectoralis major tendons' length,width and thickness.Anatomy of thoracoacromialartery,pectoral branches:origin,distribution.Measurement of length of pedicle,rotated radius of flaps and length from recipient site.An imitative operation was undergone on a specimen of corpse.One patient was undergone the operation of repairing the 3.0 cm × 1.5 cm defect of anterior cervical trachea wall,accompanying with incision infection,with pectoralis major tendon flap.Results Length of pectoralis major tendon:(22.9 ± 0.9)mm.Width of tendon:(51.0± 2.4)mm.Thickness of tendon:(5.81± 1.35)mm.Length of pedicle:(89.3 ± 5.3) mm.The radius of pedicle pectoralis major myotendinous flap:(121.7± 8.2)mm.The distance from pivot point of flap to central point of recipient:(96.5 ± 8.9)mm.Patient possessed normal pronunciation,good appearance and no emphysema at 5 months' follow-up.Tracheal lumen,measured 2.6 cm in the anteroposterior dimension and 1.8 cm in the lateral dimension,showed no recurrence of obvious stenosis in cervical computed tomography at 3 month postoperatively.Conclusion Pedicle pectoralis major tendon flaps,originated from thoracoacromial artery pectoral branches can repair cervical tracheal wall defects effectively.