[Objective] To evaluate the efficacy and safety of sacral neuromodulation (SNM) in the treatment of patients with benign prostatic hyperplasia (BPH) complicated with underactive bladder (UAB) who respond poorly to transurethral resection of the prostate (TURP). [Methods] A retrospective analysis was performed on 10 patients with BPH and UAB treated with TURP by the same surgeon in Zhongda Hospital Southeast University during Jan.2018 and Jan.2023.The residual urine volume was not significantly relieved after operation, and the maximum urine flow rate and urine volume per discharge were not significantly improved.All patients underwent phase I SNM, and urinary diaries were recorded before and after surgery to observe the average daily frequency of urination, volume per urination, maximum urine flow rate, and residual urine volume. [Results] The operation time was (97.6±11.2) min.During the postoperative test of 2-4 weeks, if the residual urine volume reduction by more than 50% was deemed as effective, SNM was effective in 6 patients (60.0%). Compared with preoperative results, the daily frequency of urination [(20.2±3.8) times vs. (13.2±3.2) times], volume per urination [(119.2±56.7) mL vs. (246.5±59.2) mL], maximum urine flow rate [(8.7±1.5) mL/s vs. (16.5±2.6) mL/s], and residual urine volume [(222.5±55.0) mL vs. (80.8±16.0) mL] were significantly improved, with statistical significance (P<0.05). There were no complications such as bleeding, infection, fever or pain.The 6 patients who had effective outcomes successfully completed phase II surgery, and the fistula was removed.During the follow-up of 1 year, the curative effect was stable, and there were no complications such as electrode displacement, incision infection, or pain in the irritation sites.The residual urine volume of the other 4 unsuccessful patients did not improve significantly, and the electrodes were removed and the vesicostomy tube was retained. [Conclusion] SNM is safe and effective in the treatment of BPH with UAB patients with poor curative effects after TURP.

According to the general goal of long term development of basic science from 2021 to 2035 and the "14th Five-Year Plan" in China, starting from the reasearch characteristics and the basic situation of endemiology, this study discusses the strategic position, development law, development trend, development status and layout, development goals and realization ways of endemiology, combined with the strategic needs of the discipline, the important interdisciplinary research areas of endemiology are put forward. The purpose of this study is to promote the rapid development of basic research on endemic diseases, to provide reference for the scientific and technological layout and policy formulation of the endemiology, to provide reference for the "14th Five-Year Plan" in China, and to provide guarantee for the people in the sick area to seek health.

Based on the general goal of the medium and long term development of basic science from 2021 to 2035 and the "14th Five-Year Plan" in China, combined with the national strategic needs, this paper discusses the five priority development areas of endemiology according to the development trends and characteristics of endemiology in the next 5 - 15 years. The five areas are study on the pathogenesis and prevention measures of endemic fluorosis; study on risk assessment, pathogenic mechanism and control strategy of environmental arsenic exposure; research on the basis and application transformation of the pathogenesis of iodine nutrition-related diseases; molecular mechanism and targeted intervention of cartilage injury in Kashin-Beck disease; precise prevention and treatment, preservation of biological samples and etiology study of Keshan disease. Combined with the scientific significance and national strategic needs of various field, the authors analyze its main study directions and core scientific issues.

Objective To observe the intervention effect of vitamin C (Vit C) and adenosine triphosphate (ATP) on myocardial fibrosis in rats.Methods Forty male SD rats were selected,body weight were 125-140 g,and they were divided into 8 groups according to body weight using a random number table method.Four rats for control group,3 rats for model group,6 rats for Vit C early group,6 rats for ATP early group,6 rats for Vit C + ATP early group,5 rats for Vit C late group,5 rats for ATP late group,and 5 rats for Vit C + ATP late group.Rats in model group and these intervention groups were induced with doxorubicin (2 mg/kg each week) for 6 weeks,and control group was given the same amount of normal saline.All early groups were intragastrically administered with Vit C (200 mg·kg-1·d-1),ATP (45 mg·kg-1·d-1) and Vit C + ATP (200 mg·kg-1·d-1 + 45 mg·kg-1 ·d-1) in the fourth week;these late groups were intragastrically administered with the same dose in the sixth week;each group was continuously administered for 21 days.Three days after the last intervention,cardiac ultrasonography was performed in all surviving rats,and left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter (LVESD),left ventricular ejection fraction (LVEF),and left ventricular fractional shortening (LVFS) were recorded.The rats were sacrificed and the hearts were taken.HE staining and Masson staining were used to observe the pathological changes of myocardial tissue and the collagen volume fraction (CVF) was calculate.Serum cardiac troponin Ⅰ (CTn-Ⅰ) and type Ⅰ procollagen amino terminal peptide (PINP) levels were determined by enzyme-linked immunosorbent assay (ELISA).Results Compared with control group [(3.65 ± 0.25) mm,(80.63 ± 3.03)％,(43.57 ± 2.54)％],LVESD [(5.07 ± 0.58),(4.06 ± 0.68),(4.71 ± 0.43),(4.87 ± 0.44),(4.79 ± 0.59),(5.07 ± 0.62),(4.97 ± 0.29) mm] of model group and each intervention groups were increased,LVEF [(62.17 ± 4.92)％,(71.28 ± 3.54)％,(65.03 ± 3.35)％,(59.81 ± 2.45)％,(60.42 ± 9.22)％,(60.15 ± 3.06)％,(60.65 ± 2.05)％],and LVFS [(30.05 ± 2.95)％,(36.44 ± 2.90)％,(31.63 ± 2.15)％,(26.95 ± 1.05)％,(28.35 ± 6.84)％,(27.79 ± 2.41)％,(28.38 ± 1.42)％] were decreased (P ＜ 0.05);compared with model group,LVESD was decreased,LVEF and LVFS were increased in Vit C early group (P ＜ 0.05).HE staining showed that the myocardial pathology of each early group improved to different degrees,such as cardiomyocyte degeneration,necrosis and fibrosis,inflammatory cell infiltration,moderate degree of interstitial edema,Vit C early group and Vit C + ATP early group were more pronounced.Masson staining showed significant improvement in fibrosis in the Vit C early group and Vit C + ATP early group,and collagen fibers were significantly reduced.Compared with the control group [(0.52 ± 0.14)％],the CVF [(27.11 ± 5.05)％,(9.80 ± 1.84)％,(16.55 ± 2.21)％,(5.06 ± 1.45)％,(12.11 ± 2.12)％,(15.71 ± 1.56)％,(16.93 ± 2.76)％] of myocardial tissue in model group and each intervention groups were significantly increased (P ＜ 0.05).There were no significant differences in CTn-Ⅰ and PINP levels between the eight groups (P ＞ 0.05).Conclusions Vit C can reduce myocardial fibrosis and improve cardiac function in the early stage.The effect of ATP alone to improve fibrosis is not obvious.

Objective To explore expression level of circulating microRNA (miR)-133a and Galectin-3 and their potential clinical application in differential diagnosis between patients with chronic Keshan disease and dilated cardiomyopathy.Methods Twenty-eight patients with chronic Keshan disease and 28 cases of age-and sex-matched healthy people as control from the same severe historical endemic areas of Keshan disease in Heilongjiang Province,and another 28 patients with dilated cardiomyopathy from non-affected areas were chosen for the study.All the subjects were asked for disease history and did physical examination,examined by Doppler echocardiography for left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD),and collected fasting venous blood specimen (elbow vein).The plasma miR-133a and the serum Galectin-3 were determined by Real-time PCR and enzyme-linked immunosorbent method,respectively.Meanwhile,the correlation was analyzed between miR-133a,galectin-3,LVEF and LVEDD.Results The miR-133a and Galectin-3 levels in different groups were statistically different (F =48.789,9.485,P ＜ 0.01).The plasma miR-133a level in chronic Keshan disease group and dilated cardiomyopathy group [median (quartile):0.394 (0.271,0.770),1.665 (0.943,2.713)] were both significantly lower than those in control group [2.382 (1.502,3.302],P ＜ 0.01 or ＜ 0.05],and the plasma miR-133a level in chronic Keshan disease group was lower than that in dilated cardiomyopathy group (P ＜ 0.01).There was no significant difference of serum Galectin-3 level between chronic Keshan disease group and dilated cardiomyopathy group [17.710 (9.624,27.799),12.692 (9.376,26.290) μg/L,P ＞ 0.05],but both were significantly higher than those in control group [8.070 (7.135,9.308) μg/L,P ＜ 0.01].The miR-133a was positively correlated with LVEF (rs =0.297,P ＜ 0.01),while negatively correlated with LVEDD,and Galectin-3 (rs =-0.271,-0.318,P ＜ 0.05 or ＜ 0.01);the serum Galectin-3 was negatively correlated with LVEF (rs =-0.392,P ＜ 0.01),and positively correlated with LVEDD (rs =0.385,P ＜ 0.01).Conclusion The combined application of miR-133a,Galectin-3,LVEF and LVEDD may provide assistance in clinical differential diagnosis of chronic Keshan disease and dilated cardiomyopathy.

Endemic diseases include iodine deficiency disorders,fluorosis,arsenicosis,Keshan disease and Kaschin-Beck disease,which have been well under controlled or basically eliminated so far in China thanks to the great efforts made by our governments and medical staffs over the past decades.We are entering into a new era for consolidation of the achievements.Meanwhile,unprecedented social changes are happening in the diseases affected rural areas of China,which features:first of all,younger generation left and permanent population aging;second,severely polluted natural environment and better housing conditions;third,social transformation from self-sufficient natural economy to commodity economy with improved living standard,but still leaving a certain number of poor farmers and;lastly,backward social security system.However,there are some preferential policies issued in recent years for agriculture,alleviating grass-root social conflicts.All these changes may exert positive or negative influences on combating endemic disease,at least through disease incidence,control measures and surveillance,and further investigations are needed.

Objective To explore the relationship between self-management behaviors and family function among elderly pa-tients with diabetes in community in order to provide evidence for community nursing of diabetes.Methods A total of 670 elderly patients with diabetes were selected with convenience sampling household survey method and investigated with the family Adapta-tion,Partnership,Growth,Affection,and Resolve(APGAR)and the Summary of Diabetes Self-Care Activities(SDSCA).Results The family functions total score of the elderly patients with diabetes in community was (6.95±2.91),the self-management behav-iors total score was (20.06±5.80),among the self-management behaviors the score for exercise was the highest and blood glucose monitoring was the lowest;family function had remarkable positive relation with the total score of self-management behaviors a-mong elderly patients with diabetes in community(r=0.156,P <0.05).Conclusion There is a correlation between the self-man-agement behaviors and family function,good family function is conducive to the improvement of self-management behaviors for the elderly patients with diabetes.

BACKGROUND: Varicocele (VC) can induce the infertility in males, so the investigation on its mechanism is important for the treatment of male infertility. OBJECTIVE: To analyze the effects of VC induced by surgical operation on the contents of mitochondria calcium, cytochrome C and cell apoptosis as well as the changes of microstructure and ultrastructure in epididymis. DESIGN: Randomized control experiment. MATERIALS: The experiment was conducted in Jiamusi University between June 2003 and May 2004. Forty male adolescent Wistar rats with the average body mass of (220±20) g were selected, which were provided by the Animal Laboratory of Jiamusi University. Rats were randomly divided into sham-operation group and deligation group with 20 rats in each group at one week after feeding at room temperature. METHODS: Rats in the sham-operation group were made into sham-op eration models by exposing the left renal vein. Rats in the deligation group were deligated of partial left renal veins so as to establish VC models. Bilateral epididymides were removed at ten weeks after operation. The levels of mitochondria calcium in head and body of epididymis as well as the contents of cytochrome C and cytoplasm cytochrome C were detected. The cell apoptosis was detected by in situ terminal deoxynucleotityl transferase mediated dTUP nick end labeling (TUNEL) technique. The specimens of corpus epididymis were routinely made for observation under optimal microscope and electron microscope. The changes of microstructure and ultrastructure of epididymis were studied.MAIN OUTCOME MEASURES: The contents of mitochondria calcium, cytochrome C and cytoplasm cytochrome C. Cell apoptosis. Changes of cellular morphous in epididymis. RESULTS: A total of 40 rats were involved in the analysis of results.① The contents of mitochondria calcium in bilateral epididymis were obviously decreased in the deligation group than the sham-operation group [(4.72±1.45), (5.90±1.97), (10.13±2.34) mg/g, (P ＜ 0.01)].②The content of mitochondria cytochrome C in right epididymis obviously increased more in the deligation group than the sham-operation group [(0.36±0.20), (0.19±0.14), (0.15±0.07) μmol/L (P ＜ 0.05)]. ③The contents of cytoplasm cytochrome C in bilateral epididymis greatly increased more in the deligation group than the sham-operation group [(8.17±1.49), (7.48 ± 1.60), (5.93±1.60) mol/L, (P ＜ 0.05)].④The apoptotic rate of bilateral cells in the deligation group was significantly increased than the sham-op eration group [( 13.3±1.9)%, ( 12.6±1.5)%, (6.2±0.3)%,(P ＜ 0.01 )]. However, there were no significant differences in mitochondria calcium, cytochrome C, cytoplasm cytochrome C and apoptotic rate between the left and right mitochondria of the deligation group (P ＞ 0.05).⑤Main changes under light microscope: cuctus epididymis shrinked, the blebbing appeared in epithelial cells, and the light cells as well as halo cells in epithelia were significantly increased. ⑥Main representation under electron microscope: the cytolysosome inside the chief cells were increased and enlarged with increased residual bodies, and the endoplasmic reticulum expanded, the mitochondria cristae was dim, the Golgi complex was vacuolated. Besides, nuclear chromatin were dense and in lump at different size, which located mainly in the nuclear membrane. The microvilli of columnar epithelial cells were sparse and local defects could be seen. CONCLUSION: The cytochrome C is released to kytoplasm via mitochondrial outer membrane, which activates the caspase 3 and leads to the apoptosis, and accordingly causes excessive apoptosis of epididymal tissues and as well as the changes of microstructure and ultrastructure. All these changes may be one of the important reasons of infertility resulting from VC.

OBJECTIVETo assess the telomerase activity inhibitory effect of ham merhead ribozyme targeting the 5'-end of human telomerase reverse transcriptase mRNA (hTERT-5'RZ), to compare it with the effect of another ribozyme teloRZ, and the combine the applications of the two ribozymes.

METHODShTERT-5'RZ gene was synthesized and cloned into pcDNA3.1(+); the ribozyme was produced by in vitro transcription. The teloRZ ribozyme was produced in the same way by in vitro transcription of p(SPT19-teloRZ) which had been constructed by the present authors. The ribozymes were transiently transfected into HeLa cells by liposome every 24 hours. After 72 hours, the cells were collected and their telomerase activities were assayed.

RESULTSThe ribozyme targeting the 5'-end of hTERT mRNA exhibited a very strong telomerase-inhibitory activity, the combined use of hTERT-5'RZ and teloRZ also showed clear inhibitory activity, but the inhibitory effect of teloRZ used alone was not so strong.

CONCLUSIONThese observations suggest that the use of hTERT-5'RZ and the combined use of hTERT-5'RZ and teloRZ are more effective in telomerase inhibition as compare with the use of teloRZ alone. They may find applications in cancer therapy.

5' Untranslated Regions ; Cloning, Molecular ; DNA-Binding Proteins ; HeLa Cells ; Humans ; RNA, Catalytic ; metabolism ; RNA, Messenger ; Telomerase ; antagonists & inhibitors ; genetics ; Transcription, Genetic

AIM: To observe the relationship between aortic atherosclerosis plaque formation and telomerase activation in vascular smooth muscle cells (VSMC). METHODS:Iliac artery atherosclerosis plaque from 20 renal failure patients and five cases of normal iliac arteries were obtained and confirmed by histological examination. The endothelial cells and the connective tissue on surface were lightly scraped and removed. Telomerase activity of the residual tissue was detected by telomeric repeat sequence amplification protocol. RESULTS:Five cases of normal iliac arteries showed negative telomerase activity. Eight of 20 cases athorosclerosis plaque showed positive telomerase activity, the other 12 cases showed negative telomerase activity. CONCLUSION: Telomerase activation may play a certain role in VSMC proliferation and atherosclerosis formation.