The diagnosis and clinical features of HFpEF in women / 中国医师杂志

Recently,it has become increasingly recognized that important sexual dimorphisms exist in cardiovascular disease,heart failure with preserved left ventricular ejection fraction (HFpEF) is more common in women.In this review,we will provide an overview of the epidemiology,clinical Features,and diagnosis in women with HFpEF.

Expert consensus on the diagnosis and treatment of cryptococcal meningitis / 中华内科杂志

Cryptococcal meningitis is a common and refractory central nervous system infection,with high rates of mortality and disability.The experts of the Society of Infectious Diseases of Chinese Medical Association have reached this consensus after a thorough discussion.Based on the current situation of cryptococcal meningitis in China,the management of cryptococcal meningitis includes 6 aspects:introduction,microorganism identification,clinical manifestations and diagnosis,principles of antifungal therapy,treatment of refractory and recurrent meningitis,treatment of intracranial hypertension.There is not a separate consensus on human immunodeficiency virus (HIV) infection in patients with cryptococcal meningitis.This article focuses on different antifungal regimens and reducing intracranial pressure by reference to Infectious Disease Society of America (IDSA) guidelines.The importance of early diagnosis,combined long-term antifungal therapy,control of intracranial hypertension are emphasized.

Ultrasound volume navigation technology in transforaminal puncture of minimally invasive lumbar surgery with full-en-doscopic techniques / 中华骨科杂志

Objective To evaluate the effectiveness of ultrasound (US) volume navigation technology in guiding the lum?bar transforaminal puncture with full?endoscopic technique through posterolateral approach. Methods From June 2011 to June 2013, 60 patients (37 males and 23 females;mean age:32.9 years) with single?level lumbar disc herniation who had undergone lumbar transforaminal puncture with full?endoscopic technique through posterolateral approach were enrolled in this retrospective study, and they were randomly divided into 2 groups according to whether the assistance of ultrasound volume navigation technolo?gy was used. They received the minimally invasive surgery on L4, 5 (47 cases) and L5S1 (13 cases). In the US?guidance group (29 cas?es), ultrasound volume navigation was used to guide puncture process, and in the C?arm guided group (31 cases), C?arm was ap?plied to guide the puncture process The total puncture time and C?arm fluoroscopy times were recorded. Parameters including Os?westry disability index (ODI) and visual analogue scale (VAS) were selected to evaluate the clinical efficacy. Results Patients had no obvious discomfort during the puncture procedure and no postoperative complications. In US?guidance group, the preopera?tive time was 13.7 ± 2.1 min (range, 11-16 min), and the whole process took 20.6 ± 3.1 min (range, 16-28 min), while the average time of C?arm exposure were 4.9 ± 0.8 times (range, 4-7 times). In C?arm guided group, the average time for puncture procedure was 27.9±1.7 min (range, 25-32 min), and the average times of C?arm exposure were 14.3±1.2 times (range, 13-17 times). There were significant differences between two groups. Compared with C?arm guided group, US?guidance group had the same accuracy rate of puncture (the puncture needles all reached the target area), but the fluoroscopy times and puncture timewere decreased sig?nificantly. There’s no significant difference among the pre and postoperative ODI and VAS indexes. Patients were followed?up at 3 months and 1 year postoperation. The mean follow?up period was 16.4 months (range, 12-26 months). The ODI score of the US?guidance group were 72.9%±5.9%, 17.1%±3.6%and 15.9%±3.3%before operation, 3 months postoperation and 1 year postopera?tion respectively. The ODI score of the C?arm guided group were 73.2%±4.9%, 17.3%±3.3%and 16.1%±2.9%respectively. The VAS were 7.4±0.9, 2.2±0.7 and 1.9±0.8 in US?guidance group, and were 7.2±0.9, 2.1±0.7, 1.8±0.8 in C?arm guided group. Con?clusion The ultrasound volume navigation can guide the lumbar transforaminal puncture with full?endoscopic technique through posterolateral approach accurately, reducing the puncture time and the amount of X?ray radiation significantly. Its puncture accura?cy and efficacy have no significant differences, which could be broadly used in clinical application.

The effect of catalase on smoking related laryngeal squamous cell carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Investigate the effect of oxidative stress on the occurrence and development of laryngeal squamous cell carcinoma associated with smoking, and the clinical diagnostic value of catalase on smoking related laryngeal squamous cell carcinoma.@*METHOD@#Collecting 119 smokers(including the smoking related laryngeal cancer group 68 cases, the control group 51 cases), the indexes of catalase (CAT), malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH), nitric oxide (NO) in blood plasma and cancerous tissue in two groups were compared. The association between these oxidative stress indicators and the occurrence and severity of smoking related laryngeal squamous cell carcinoma was analysised by SPSS 17.0.@*RESULT@#(1) Compared with control group, the smoke frequency and amount, CAT, MDA, GSH increased significantly in the smoking related laryngeal cancer group (P = 0.000; 0.000; 0.000; 0.000; 0.000); whereas SOD, NO decreased (P = 0.000; 0.000). (2) The lower the differentiation degree, the higher the serum CAT (P = 0.000) and the higher CAT, MDA, GSH of larynx tissue (P = 0.000; 0.000; 0.000), but the lower the serum NO (P = 0.000) and the lower SOD, NO of larynx tissue (P = 0.000; 0.000); The higher the clinical stage, the higher CAT of serum and larynx tissue and the higher GSH of larynx tissue (P = 0.000; 0.001), the lower NO of larynx tissue (P = 0.009). (3) The serum CAT, MDA were independent risk factors of smoking related laryngeal squamous cell carcinoma (OR = 1.060, 2.475; P < 0.01, P < 0.05).@*CONCLUSION@#Oxidative stress is the key factor of the occurrence of smoking related laryngeal squamous cell carcinoma, and the CAT can be used as the indicator of clinical diagnosis of smoking related laryngeal squamous cell carcinoma.

Posterior Isobar non-fusion internal fixation system in repair of lumbar disc herniation:more advantages in restoring range of motion of lumbar spine / 中国组织工程研究

BACKGROUND:The patients with lumbar intervertebral disc protrusion can be treated with internal fixation of posterior surgery way. We can choose the conventional posterior intervertebral fusion nail stick system internal fixation. Isobar non-fusion internal fixation system was used in recent years. As a kind of a strong internal fixation of lumbar posterior dynamic screw rod fixation system, it has been gradual y applied in clinic, and has been one of patient’s treatment options. OBJECTIVE:To compare and analyze the clinical efficacy of Isobar non-fusion internal fixation system and traditional intervertebral fusion nail rod system internal fixation operation method in treatment of lumbar disc herniation. METHODS:From September 2011 to September 2012, 40 patients with lumbar disc herniation who were treated in the Department of Orthopedic, Changhai Hospital, the Second Military Medial University of Chinese PLA were enrol ed in this study. They were equal y assigned to the Isobar non-fusion internal fixation system group (Isobar group) and the traditional intervertebral fusion nail rod system internal fixation group (rigid internal fixation group) and subjected to corresponding treatments. RESULTS AND CONCLUSION:Surgery was successful y completed in patients of the two groups. These patients received at least 2 years of fol ow-up, no drop out. Compared with pre-fixation, low back pain Visual Analog Scale and Oswestry Disability Index were improved significantly after fixation in both groups. Compared with the rigid internal fixation group, range of motion of lumbar spine was larger in the Isobar group. Low back pain Visual Analog Scale and Oswestry Disability Index were similar between the two groups. These results indicated that posterior Isolbar non-fusion internal fixation obtained identical outcomes as traditional treatment, and showed more advantages in range of motion of lumbar spine.

Spinal cord-derived neural stem cells cultured by serum-free suspension method：separation, cultivation and identification / 中国组织工程研究

BACKGROUND:Until now, there is yet no complete recovery from spinal cord injury in terms of structure and functional recoveries. Neurotrophic factors have limited effects on nerve regeneration. Currently, stem cel transplantation may be an effective way to repair spinal cord injury. OBJECTIVE:To separate, cultivate and purify mouse spinal cord-derived neural stem cels using serum-free suspension method folowed by morphological observation, immunofluorescence technology and multi-lineage differentiation experiments. METHODS:By using the suspension culture method, mouse spinal cord-derived neural stem cels at embryonic day 13.5 were cultured and purified. Cel morphology changes were observed under inverted microscope. Cel proliferation ability was detected using cel counting kit-8. Nestin and Sox2 expression was detected by immunofluorescence technology. Multilineage differentiation of spinal cord-derived neural stem cels at passage 4 was detected by natural differentiation method in order to prove the differentiation ability. RESULTS AND CONCLUSION: Serum-free medium suspension culture method was successfuly applied to separate spinal cord-derived neural stem cels. Cultured cels had good proliferative ability and highly expressed Nestin and Sox2 that was in accordance with the results of DAPI nucleus staining, suggesting the high purity of cels. After induction, the cels could express both Tuj1 and GFAP, indicating the cels had good differentiation potential. This experiment has successfuly established the isolation, culture, identification system of spinal cord-derived neural stem cels, providing experimental basis for subsequent studies of neural stem cels.

Vascular complications of transplant renal artery:a report of 29 cases and literature review / 器官移植

Objective To summarize the clinical characteristics and treatment experience on vascular complications of transplant renal artery.Methods Of 322 patients undergoing renal transplantation in the 281st Hospital of People's Liberation Army from June 2007 to June 2014,29 patients developed vascular complications of transplant renal artery after transplantation. Clinical data of such 29 patients were retrospectively studied to summarize the clinical characteristics and treatment experience.Results Two patients developed anastomotic haemorrhage of transplant renal artery,23 patients developed transplant intrarenal artery spasm,2 patients developed transplant renal artery thrombosis and 2 patients developed transplant renal artery stenosis.The anastomotic haemorrhage from transplant renal artery was postoperative haemorrhage,and surgical exploration and hemostasis were conducted in time. Patients with transplant intrarenal artery spasm were given antispasmodic treatment during operation.And the dark red and soft renal graft became full and ruddy.Patients with transplant renal artery thrombosis underwent surgical exploration once confirmed.The renal grafts were dark red and did not recover to normal after blood supply recovery,thus the renal grafts were removed.For patients with developed transplant renal artery stenosis,balloon dilatation and stent implantation were adopted.The blood pressure of patients returned to normal and the renal function was normal.Conclusions Vascular complications of transplant renal artery are characterized by quick progression, fast condition changes and serious consequences.In order to reduce the incidence and increase the recovery rate,active prevention and decisive treatment are very important.

Observation on safety of renal transplantation in patients with idiopathic thrombocytopenic purpura / 器官移植

Objective To investigate the safety of renal transplantation in patients with idiopathic thrombocytopenic purpura (ITP).Methods Clinical data of two ITP patients undergoing renal transplantation were retrospectively analyzed and pertinent literatures were reviewed.Results Prior to renal transplantation, the platelet count of these two patients was 41 ×109 /L and 34 ×109 /L,respectively.The coagulation function was normal and no active bleeding was observed.They underwent renal transplantation successfully without obvious bleeding intra-or post-operatively.The platelet count of one patient who received hydrocortisone impulse therapy for three days and maintenance treatment with immunosuppressant based on ciclosporin recovered to normal range and kept stable at 7 days after renal transplantation.Though receiving platelet-promoting drugs and platelet infusion,the platelet count of the other patient treated with methylprednisolone impulse therapy for 3 days and maintenance therapy with immunosuppressant based on tacrolimus did not recover to normal range but fluctuated between 10 ×109 /L and 30 ×109 /L after renal transplantation.Renal function was well maintained in both recipients.Conclusions The risk of renal transplantation related bleeding in ITP patients is correlated with whether the preoperative active bleeding or not.Renal transplantation is relatively safe for uremia patients without active bleeding pre-operation.

Relationship between selenium intake and hypertension of residents in rural areas of Jilin province / 吉林大学学报(医学版)

Objective To understand the prevalence of hypertension and selenium intake of the residents in rural areas of Jilin province,and to discuss the relationship between selenium intake and the prevalence of hypertension, and to provide reference for prevention and therapy of hypertension.Methods A total of 1 380 inhabitants in rural areas of Jilin province were selected by way of cluster sampling to conduct dietary investigation,physical and blood examination.The selenium intake was categorized into three groups according to tritiles after adjusted by energy, and the relative risk for incidence of hypertension in each group was estimate by using the Logistic regression model with the first group as the reference.Results The prevalence of hypertension in the study area was 37.4%.The average for selenium intake was 35.908μg·d-1 and was lower than the standard level of selenium recommended by RNI.After adjustment for other risk factors,the relative risk for incidence of hypertension for different selenium intakes in the men was 1.00,0.471(95%CI 0.290-0.765),and 0.596(95%CI 0.373-0.951),the P values were 0.002 and 0.030. There was no significant relationship between selenium intake and the incidence of hypertension in the women,and there was also no significant relationship between Han people and Korean people in China.Conclusion The selenium intake is the influencing factor affecting the incidence of hypertension of the male rural residents in Jilin province,which reminds that the increasing selenium intake is helpful for the prevention of male hypertension.

Effect of Trimetazidine on T-peak to T-end Interval in Patients With Unstable Angina Pectoris After Percutaneous Coronary Intervention / 中国循环杂志

Objective: To explore the effect of trimetazidine (TMZ) on T-peak (Tp) to T-end (Te) interval of resting ECG in patients with unstable angina pectoris (UAP) after percutaneous coronary intervention (PCI). Methods: We investigated 94 UAP patients with PCI and 76 of them ifnished the study as 2 groups. Control group,n=42, the patients received conventional treatment, and TMZ group,n=34, in addition to conventional treatment, the patients received TMZ 60 mg at 0.5 to 1 hour before PCI. The changes of Tp to Te interval before and after PCI were calculated, serum levels of creatine kinase (CK), creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) at before and at 6, 24 hours after PCI were compared between 2 groups. Ventricular arrhythmia was recorded during PCI. Results: Both groups had shortened Tp to Te intervals after PCI, and TMZ group had more shortened Tp to Te interval, bothP0.05. The occurrence rate of ventricular arrhythmia in Control group was higher than that in TMZ group (12.52% vs 5.16%) during PCI,P<0.05. Compared with Control group, TMZ group had lower levels of CK, CK-MB and cTnI at 6, 24 hours after PCI, allP<0.05. Conclusion: TMZ could decrease Tp to Te interval of resting ECG, prevent ventricular arrhythmia and reduce the relevant myocardial injury in UAP patients after PCI.

Protective Effect of Nicorandil on Myocardial Injury and Recurrent Angina after Percutaneous Coronary Intervention / 天津医药

Objective To explore the protective effect of pre-operation administration of nicorandil on myocardial injury and recurrent angina in patients with unstable angina pectoris who underwent percutaneous coronary intervention (PCI). Methods A total of 91 patients with unstable angina pectoris were admitted for PCI and randomly divided into 2 groups who either received nicorandil(5 mg tid)or not for 7 days prior to the procedure and routine dose of nicorandil (5mg tid) after it. The concentrations of creatine kinase MB (CK-MB) and cardiac troponin I(cTnI) were compared between two groups before PCI and 6 hours, 18 hours and 24 hours after PCI;Recurent angina and major adverse cardiac events,includ-ing death,re-infarction and stroke at 6 months after the procedure were also chased and compared. Results In total, 75 pa-tients who were successfully undergone elective PC1 were finally enrolled,among whom 37 cases were in nicorandil group and 38 cases were in routine group. Post-procedural levels of CK-MB and cTnI significantly reduced in the nicorandil group between 6~24 h (P<0.05) compared those in routine group.At 6 months follow-up,symptoms of recurrent angina after PCI were significantly relieved in the nicorandil group compared with that in routine group (P < 0.05).Conclusion nicorandil can limit the PCI-induced myocardial injury and relieve the symptoms of recurrent angina after PCI in patients with unstable angina.

Clinical significance of heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction / 中国医师进修杂志

ObjectiveTo explore the clinical significance of heart-type fatty acid-binding protein (H-FABP) in acute myocardial infarction(AMI) patients. MethodsThe level of H-FABP was assayed within 30 min, 1 h, 2 h, 4 h,6 h and 12 h by enzyme linked immunosorbent assay (ELISA) in 46 AMI patients, and cardiac troponin Ⅰ(cTnⅠ) and creatinine kinase(CK-MB) also was assayed by routine method.The diagnostic accuracy was compared among different methods. ResultsThe diagnostic accuracy of H-FABP[95.7％ (44/46)] was significantly higher than cTnⅠ[65.2％(30/46)] and CK-MB[41.3％ (19/46)](P ＜0.05). The levels of H-FABP, cTnⅠ and CK-MB significantly increased after AMI onset 4,6,12 hrespectively. ConclusionThe diagnosticaccuracy of H-FABP is higher and can be used as a parameter for the early diagnosis of AMI.

A study of association between the interleukin-1 single nucleotide polymorphism and risk of chronic periodontitis among the Hui and Dongxiang minorities in Gansu province / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To examine and analyze the interleukin (IL)-1B gene single nucleotide polymorphism (SNP) at positions +3954, and explore the association between SNP and risk of chronic periodontitis (CP) among the Hui and Dongxiang minorities in Gansu province.</p><p><b>METHODS</b>CP group consisted of 215 patients from Hui and Dongxiang and healthy control group consisted of 219 subjects. Anti-coagulated peripheral blood sample was obtained from each subject and genomic DNA was extracted from each sample. SNP at IL-1B+3954 were analyzed by standard polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay.</p><p><b>RESULTS</b>Statistically significant differences were found in genotype and allele frequencies between CP group and healthy control group. The exist of position alleles C increased the incidence of CP. The trend of frequency distribution of gene polymorphism above in Dongxiang was the same as that of Hui.</p><p><b>CONCLUSION</b>The present study reveals that IL-1B+3954C/T genotypes are significantly associated with the risk of CP. These results indicate that genetic polymorphism is significantly associated with the risk of CP among the Hui and Dongxiang minorities in Gansu province.</p>

Human leishmaniasis: a retrospective clinical analysis of 86 patients / 中国感染与化疗杂志

Objective To improve the diagnosis and treatment based on the retrospective clinical analysis of 86 patients with leishmaniasis, an endemic disease caused by various species of Leishmania. Methods The data of 86 consecutive patients with visceral leishmaniasis and lymph node leishmaniasis were retrospectively reviewed, including epidemiological data, clinical manifestations, laboratory features, diagnosis, therapeutic procedures and prognosis. Results There were specific endemic zones of leishmaniasis in Sichuan province. The main clinical symptoms and signs in the initial evaluation were: fever (100%), splenomegaly (100%), enlarged lymph nodes with hepatosplenomegaly (58.1%). All patients were treated with sodium pentavalent antimony gluconate (SPAG). About 95.3% (82/86) of the patients were cured, 3.5% (3/86) improved, and 1.2% (1/86) relapsed. Splenotomy was carried out for 2.3% (2/86) of the patients. The misdiagnosis rate was 30.2%.Conclusions Visceral leishmaniasis has no specific manifestations and is easily misdiagnosed. If leishmaniasis is suspected, bone marrow biopsy and smear examination, lymph node biopsy, rk-39 strip test for visceral leishmaniasis pathogen should be done to improve the outcome. SPAG is the first choice for leishmaniasis chemotherapy.