Bladder malignancy as a cause of spontaneous bladder rupture: A systematic review.

Objectives: To characterise cases of spontaneous rupture of the urinary bladder in the context of bladder cancer. Methods: A systematic review was performed to characterise cases of spontaneous bladder rupture in patients with bladder cancer. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) system was utilised, with databases being searched for relevant cases. Patient characteristics were extracted, including age, sex, presenting signs and symptoms, management modalities, tumour histology and mortality. Results: Thirty cases were included. Seventeen (57%) were male, and the median age of presentation was 59. Abdominal pain and peritonism were the most common presenting symptoms, in 80% and 60% of patients, respectively. Most patients (n = 16, 53%) had urothelial cell carcinoma. Nine patients (30%) died during their initial hospitalisation. Conclusion: Spontaneous bladder perforation in the context of bladder cancer is a rare cause of acute abdomen. The diagnosis is associated with high mortality, highlighting the aggressive nature of the malignancies that cause spontaneous bladder rupture. This raises important questions about the role of emergency cystectomy, the timing of systemic therapy and the appropriate involvement of palliative care.

Systematic evaluation of narrow-sense validity of polygenic risk score for prostate cancer in a Chinese prostate biopsy cohort.

The aim of this study was to assess the narrow-sense validity of polygenic risk score (PRS) for prostate cancer (PCa) in a Chinese prostate biopsy cohort. We performed an observational prospective study with 2640 men who underwent prostate biopsy. Germline DNA samples were genotyped and PRS was calculated for each subject using 17 PCa risk-associated genetic variants. Additional GWAS data of the ChinaPCa dataset was also used to compliment the evaluation process. The mean PRS was 1.02 in patients with negative biopsy results, which met the baseline benchmark. The mean PRS was significantly higher in the PCa cases (1.32 vs. 1.02, p = 5.56 × 10-17 ). Significant dose-response associations between PRS values and odds ratios for PCa were observed. However, the raw calibration slope was 0.524 and the average bias score between the observed risk and uncorrected PRS value was 0.307 in the entire biopsy cohort. After applying a correction factor derived from a training set, the corrected calibration slope improved to 1.002 in a testing set. Similar and satisfied results were also seen in the ChinaPCa dataset and two datasets combined, while the calibration results were inaccurate when the calibration process were performed mutually between two different study populations. In conclusion, assessing the narrow-sense validity of PRS is necessary prior to its clinical implementation for accurate individual risk assessment.

Outcomes of radical prostatectomy in a 20-year localized prostate cancer single institution series in China / 亚洲男科学杂志(英文版)

The long-term survival outcomes of radical prostatectomy (RP) in Chinese prostate cancer (PCa) patients are poorly understood. We conducted a single-center, retrospective analysis of patients undergoing RP to study the prognostic value of pathological and surgical information. From April 1998 to February 2022, 782 patients undergoing RP at Queen Mary Hospital of The University of Hong Kong (Hong Kong, China) were included in our study. Multivariable Cox regression analysis and Kaplan-Meier analysis with stratification were performed. The 5-year, 10-year, and 15-year overall survival (OS) rates were 96.6%, 86.8%, and 70.6%, respectively, while the 5-year, 10-year, and 15-year PCa-specific survival (PSS) rates were 99.7%, 98.6%, and 97.8%, respectively. Surgical International Society of Urological Pathology PCa grades (ISUP Grade Group) ≥4 was significantly associated with poorer PSS (hazard ratio [HR] = 8.52, 95% confidence interval [CI]: 1.42-51.25, P = 0.02). Pathological T3 stage was not significantly associated with PSS or OS in our cohort. Lymph node invasion and extracapsular extension might be associated with worse PSS (HR = 20.30, 95% CI: 1.22-336.38, P = 0.04; and HR = 7.29, 95% CI: 1.22-43.64, P = 0.03, respectively). Different surgical approaches (open, laparoscopic, or robotic-assisted) had similar outcomes in terms of PSS and OS. In conclusion, we report the longest timespan follow-up of Chinese PCa patients after RP with different approaches.

Harnessing recombinase polymerase amplification for rapid detection of SARS-CoV-2 in resource-limited settings

The COVID-19 pandemic has challenged testing capacity worldwide. The mass testing needed to stop the spread of the virus requires new molecular diagnostic tests that are faster and with reduced equipment requirement, but as sensitive as the current gold standard protocols based on polymerase chain reaction. We developed a fast (25-35 minutes) molecular test using reverse transcription recombinase polymerase amplification for simultaneous detection of two conserved regions of the virus, targeting the E and RdRP genes. The diagnostic platform offers two complementary detection methods: real-time fluorescence or visual dipstick. The analytical sensitivity of the test by real-time fluorescence was 9.5 (95% CI: 7.0-18) RNA copies per reaction for the E gene and 17 (95% CI: 11-93) RNA copies per reaction for the RdRP gene. The analytical sensitivity for the dipstick readout was 130 (95% CI: 82-500) RNA copies per reaction. The assay showed high specificity with both detection methods when tested against common seasonal coronaviruses, SARS-CoV and MERS-CoV model samples. The dipstick readout demonstrated potential for point-of-care testing, with simple or equipment-free incubation methods and a user-friendly prototype smartphone application was proposed with data capture and connectivity. This ultrasensitive molecular test offers valuable advantages with a swift time-to-result and it requires minimal laboratory equipment compared to current gold standard assays. These features render this diagnostic platform more suitable for decentralised molecular testing.

Clinical and immunologic features in severe and moderate forms of Coronavirus Disease 2019

BackgroundSince late December, 2019, an outbreak of pneumonia cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, and continued to spread throughout China and across the globe. To date, few data on immunologic features of Coronavirus Disease 2019 (COVID-19) have been reported. MethodsIn this single-centre retrospective study, a total of 21 patients with pneumonia who were laboratory-confirmed to be infected with SARS-CoV-2 in Wuhan Tongji hospital were included from Dec 19, 2019 to Jan 27, 2020. The immunologic characteristics as well as their clinical, laboratory, radiological features were compared between 11 severe cases and 10 moderate cases. ResultsOf the 21 patients with COVID-19, only 4 (19%) had a history of exposure to the Huanan seafood market. 7 (33.3%) patients had underlying conditions. The average age of severe and moderate cases was 63.9 and 51.4 years, 10 (90.9%) severe cases and 7 (70.0%) moderate cases were male. Common clinical manifestations including fever (100%, 100%), cough (70%, 90%), fatigue (100%, 70%) and myalgia (50%, 30%) in severe cases and moderate cases. PaO2/FiO2 ratio was significantly lower in severe cases (122.9) than moderate cases (366.2). Lymphocyte counts were significantly lower in severe cases (0.7 x 10{square}/L) than moderate cases (1.1 x 10{square}/L). Alanine aminotransferase, lactate dehydrogenase levels, high-sensitivity C-reactive protein and ferritin were significantly higher in severe cases (41.4 U/L, 567.2 U/L, 135.2 mg/L and 1734.4 ug/L) than moderate cases (17.6 U/L, 234.4 U/L, 51.4 mg/L and 880.2 ug /L). IL-2R, TNF- and IL-10 concentrations on admission were significantly higher in severe cases (1202.4 pg/mL, 10.9 pg/mL and 10.9 pg/mL) than moderate cases (441.7 pg/mL, 7.5 pg/mL and 6.6 pg/mL). Absolute number of total T lymphocytes, CD4+T cells and CD8+T cells decreased in nearly all the patients, and were significantly lower in severe cases (332.5, 185.6 and 124.3 x 106/L) than moderate cases (676.5, 359.2 and 272.0 x 106/L). The expressions of IFN-{gamma} by CD4+T cells tended to be lower in severe cases (14.6%) than moderate cases (23.6%). ConclusionThe SARS-CoV-2 infection may affect primarily T lymphocytes, particularly CD4+T cells, resulting in significant decrease in number as well as IFN-{gamma} production, which may be associated with disease severity. Together with clinical characteristics, early immunologic indicators including diminished T lymphocytes and elevated cytokines may serve as potential markers for prognosis in COVID-19.

Respiratory pathogen spectrum in adult patients with acute exacerbation of bronchiectasis and its correlation with severity of disease / 中国医师进修杂志

Objective:To analyze the characteristics of respiratory pathogen spectrum in adult patients with acute exacerbation of bronchiectasis and its correlation with the severity of disease.Methods:A total of 108 patients with stable bronchiectasis from January 2014 to May 2018 in the Third People′s Hospital of Haikou City were enrolled. Sputum bacteria were cultured and common respiratory viruses in sputum and nasal swabs were detected by fluorescence quantitative polymerase chain reaction(PCR). All bronchiectasis patients were followed up for 1 year. Sputum bacteria culture and PCR virus detection were performed again in patients with acute exacerbation, and the differences of respiratory pathogen spectrum in patients with different severity of acute exacerbation were compared.Results:During the follow-up period, there were 53 cases of acute exacerbation events and a total of 91 case-times (up to 5 times per patient). The positive rates of sputum virus and nasal swab virus in patients with acute exacerbation were significantly higher than those in patients with stable period [39.6% (36/91) vs. 15.1% (8/53) , 45.1% (41/91) vs. 9.4% (5/53) ], and there were significant differences ( χ2=8.460, 13.621, P<0.05). However, the total positive rate of sputum bacterial culture in acute exacerbation and stable period had no significant difference ( P>0.05). The positive rate of Pseudomonas aeruginosa [0, 34.6% (9/26) ,52.4% (22/42) ] and rhinovirus [8.7% (2/23) ,3.8% (1/26) ,23.8% (10/42) ] in sputum among mild patients (16 cases, 23 case-times), moderate patients (16 cases, 26 case-times) and severe patients (21 cases, 42 case-times) in acute exacerbation stage were significant differences ( P<0.05). The levels of C-reactive protein (CRP) and interleukin (IL)-8 in patients in mixed infection of bacteria and viruses group in acute exacerbation stage were significantly higher than those in negative group, bacteria group and viruses group [CRP: (45.6 ± 23.0) mg/L vs. (11.2 ± 2.7) , (32.3 ± 10.2) , (21.3 ± 8.0) mg/L; IL-8: (9.0 ± 2.5) ng/L vs. (1.5 ± 0.9) , (1.8 ± 1.1) , (2.0 ± 1.3) ng/L], and there were significant differences ( F=23.012, 9.926, P<0.05). The hospitalization rate of patients in mixed infection of bacteria and viruses group was significantly higher than that in negative group, bacteria group and viruses group [29.6% (8/27) vs. 0, 16.7% (4/24) , 1/18] , and there were significant differences ( χ2=7.691, P<0.05). Conclusions:The positive rate of respiratory viruses in acute exacerbation of bronchiectasis in adults is significantly higher than that in stable stage. Pseudomonas aeruginosa and rhinovirus are the main infections in moderate and severe patients, Haemophilus parainfluenzae and influenza A virus are the main infections in mild patients, and the patients with mixed infection of bacteria and viruses have severe systemic inflammatory reaction and high hospitalization rate.

Study on contrast visual acuity and the influence factors of eyes care habits in Air Force pilot cadets at the Aviation University / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To examine and investigate the contrast visual acuity and eyes care habits in Air Force pilot cadets, and analyze the change of contrast visual acuity and the related influencing factors.<p>METHODS: The contrast visual acuity of the students in Grade One and Grade Two at an aviation university was recorded and analyzed, and the visual habits were recorded and analyzed by questionnaire.<p>RESULTS: A total of 117 students in Grade One and 210 students in Grade Two were enrolled. The contrast visual acuity of both eyes over 1.0 were 83 students(70.9%)in Grade One and 174 students(82.9%)in Grade Two respectively(<i>P</i><0.05). Questionnaire survey on the eye care habits by students, showing the second grade students of daily reading time, outdoor sports, sports category, use at night time, with a focus on electronic product knowledge and the degree of attention and when flying cadets were significantly different(<i>P</i><0.05). There were 87.2% students of Grade One and 93.3% students of Grade Two taking less than or equal to 6h to get daily reading and learning time, 34.2% students of Grade One and 13.8% students of Grade Two taking outdoor sports less than or equal to 2h, 57.3% students of Grade One and 90.0% students of Grade Two taking more than One category of exercise,38.5% students of Grade One and 43.3% students of Grade Two using electronic production less than or equal to 2h, 85.5% students of Grade One and 75.7% students of Grade Two using electronic production at night, and 61.5% students of Grade One and 81.0% students of Grade Two paying high attention to the use of scientific knowledge(<i>P</i><0.05). <p>CONCLUSION: The contrast visual acuity of Air Force pilot cadets keeps improving at theoretical study stage, mainly including the following reasons such as the decreasing of reading time, the increasing of outdoor sports, the improving of exercise methods, the reduce using of electronic production and the enhancing of eyes-using knowledge.

Prostate volume does not provide additional predictive value to prostate health index for prostate cancer or clinically significant prostate cancer: Results from a multicenter study in China / 亚洲男科学杂志(英文版)

To evaluate whether prostate volume (PV) would provide additional predictive utility to the prostate health index (phi) for predicting prostate cancer (PCa) or clinically significant prostate cancer, we designed a prospective, observational multicenter study in two prostate biopsy cohorts. Cohort 1 included 595 patients from three medical centers from 2012 to 2013, and Cohort 2 included 1025 patients from four medical centers from 2013 to 2014. Area under the receiver operating characteristic curves (AUC) and logistic regression models were used to evaluate the predictive performance of PV-based derivatives and models. Linear regression analysis showed that both total prostate-specific antigen (tPSA) and free PSA (fPSA) were significantly correlated with PV (all P 0.05). In conclusion, PV-based derivatives (both PHIV and PHID) and models incorporating PV did not improve the predictive abilities of phi for either PCa or clinically significant PCa.

Nomogram for predicting Gleason grouping upgrading(GGU)in a cohort receiving radical prostatectomy based on 2014 ISUP grouping system: development and internal validation / 中华泌尿外科杂志

Objective:To analyze the predictive factors of GGU between biopsy and radical prostatectomy pathology based on 2014 ISUP grouping system, then establish and evaluate nomogram.Methods:Patients undergoing radical prostatectomy in Shanghai Ruijin Hospital from March 2012 to March 2019 were reviewed, and the clinical and pathological information were collected. Age(68.1±7.2), body mass indes(BMI) (24.2±3.2)kg/m 2, prostate specific antigen(PSA) 11.5(6.7-20.4)ng/ml, prostate specific antigen destiny(PSAD) 0.35(0.20-0.66). Before March 2017, the number of biopsy cores were 6 to 8; After then, all patients toke 12 cores systemic biopsy. Based on 2014 ISUP grouping system, the differences between biopsy and radical prostatectomy grades were counted. The independent predictors of GGU were analyzed by univariate and multivariate logistic regression analysis, then the nomogram for predicting GGU were established and evaluated. Results:429 patients were enrolled. There were 161 (37.5%) patients in GGU group and 268 (62.5%) patients in non-GGU group. After multivariate logistic regression analysis, body mass index (BMI)>28 kg/m 2( OR=2.54, P=0.021), prostate specific antigen density (PSAD)( OR=1.65, P=0.018)and 2014 ISUP grouping sysyem ( OR=0.53, P<0.001) of biopsy specimen were independent impact factors of GGU. The predicting model was established according to BMI, PSAD and 2014 ISUP grouping system. The area under the ROC cure of the model was 0.735 (95% CI 0.681-0.789). The nomogram model was well calibrated, with the mean absolute error of 6.7%, which means the prediction of GGU is fairly consistent with the actual situation. Conclusions:Based on the 2014 ISUP grouping system, BMI>28 kg/m 2, PSAD and 2014 ISUP grouping of biopsy specimen were independent predictors of GGU. The nomogram model for predicting GGU has a good statistical significance.

γδ T Cells Contribute to the Outcome of Murine Fulminant Viral Hepatitis via Effector Cytokines TNF-α and IFN-γ / 华中科技大学学报（医学）（英德文版）

The mechanisms involved in virus-induced severe hepatitis have not been fully elucidated.In this study,we investigated the role of gamma delta T cell receptors (γδ) T cells in the pathogenesis of fulminant viral hepatitis (FVH) induced by murine hepatitis virus strain 3 (MHV-3).The model of FVH was established by intraperitoneal injection of MHV-3 into Balb/cJ mice.The survival days of mice,and the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were examined.The proportions ofγδ T cells in blood,spleen and liver,and cytokines secreted by hepatic γδ T cells were analyzed by flow cytometry.The function of hepatic γδ T cells was examined by cytotoxicity assay.Balb/cJ mice died in 3 to 6 days post MHV-3 infection,with severe hepatic necrosis and significant augmentation of serum ALT and AST levels.The proportions of γδ T ceils in blood,spleen and liver were significantly increased post MHV-3 infection,while those of the early activating molecule CD69-expressing γδ T cells and productions of cytokines tumor necrosis factor-alpha (TNF-α) and interferon-γ (IFN-γ) increased remarkably in the liver.These highly activated liver γδ T cells were cytotoxic to MHV-3-infected hepatocytes in vitro and this effect of liver γδ T cells against hepatocytes might involve the TNF-α and IFN-γ pathway.These results demonstrated that γδ T cells might contribute to the pathogenesis ofMHV-3-induced FVH through the effector cytokines TNF-α and IFN-γ.

γδ T Cells Contribute to the Outcome of Murine Fulminant Viral Hepatitis via Effector Cytokines TNF-α and IFN-γ / 华中科技大学学报（医学）（英德文版）

The mechanisms involved in virus-induced severe hepatitis have not been fully elucidated.In this study,we investigated the role of gamma delta T cell receptors (γδ) T cells in the pathogenesis of fulminant viral hepatitis (FVH) induced by murine hepatitis virus strain 3 (MHV-3).The model of FVH was established by intraperitoneal injection of MHV-3 into Balb/cJ mice.The survival days of mice,and the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were examined.The proportions ofγδ T cells in blood,spleen and liver,and cytokines secreted by hepatic γδ T cells were analyzed by flow cytometry.The function of hepatic γδ T cells was examined by cytotoxicity assay.Balb/cJ mice died in 3 to 6 days post MHV-3 infection,with severe hepatic necrosis and significant augmentation of serum ALT and AST levels.The proportions of γδ T ceils in blood,spleen and liver were significantly increased post MHV-3 infection,while those of the early activating molecule CD69-expressing γδ T cells and productions of cytokines tumor necrosis factor-alpha (TNF-α) and interferon-γ (IFN-γ) increased remarkably in the liver.These highly activated liver γδ T cells were cytotoxic to MHV-3-infected hepatocytes in vitro and this effect of liver γδ T cells against hepatocytes might involve the TNF-α and IFN-γ pathway.These results demonstrated that γδ T cells might contribute to the pathogenesis ofMHV-3-induced FVH through the effector cytokines TNF-α and IFN-γ.

New strategies for clinical cure and Institute of hepatitis B: viral suppression combined with immune modulation and its road map / 临床肝胆病杂志

Chronic hepatitis B virus (HBV) infection remains a major global health issue.At present,nucleos(t) ide analogues (NAs) and interferon (IFN) or pegylated interferon (PEG-IFN) are used as the antiviral therapy.NA therapy is generally safe and well tolerated,but it has a high virological recurrence rate after drug withdrawal and a long course of treatment which may require lifelong medication.PEG-IFN therapy has the advantages of relatively shorter course of treatment,longer response,and lower rate of resistance;however,only some patients can achieve sustained response to IFN,and IFN has a high rate of adverse events,which limits the wide application of IFN in clinical practice.Since HBV covalently closed circular DNA and the integrated HBV genome stably exist in the nuclei of infected hepatocytes,it is difficult to achieve the elimination (complete cure) of HBV.The ideal endpoint of antiviral therapy for chronic hepatitis B recommended by most guidelines is the sustained disappearance of HBsAg,with or without HBsAb seroconversion (functional cure).Theoretically,a combination of antiviral agents with different anti-HBV mechanisms,including the drugs for viral suppression and immune modulation,is a promising strategy for the treatment of chronic hepatitis B.Latest studies have demonstrated that compared with NA alone,NA given concurrently or sequentially with PEG-IFN has certain advantages in virologic and serological response.Our articles published in Journal of Hepatology in 2015 and Journal of Infectious Diseases in December 2017 introduce the research advances in treatment strategies for chronic hepatitis B and put forward our thoughts on clinical cure of chronic hepatitis B and related clinical routes,with reference to research findings in China and foreign countries.This article provides some updated information.

CT-guided radiofrequency thermocoagulation of trigeminal nerve via foramen rotundum route: analysis of the three - dimensional puncture pathway and the influence factors / 介入放射学杂志

Objective Based on CT imaging measurements to investigate the relevant parameters of 3D positioning that are used for the puncturing of trigeminal nerve via foramen rotundum route, and to discuss the influences of gender, age, and BMI on the measurements of these parameters in order to improve the success rate of puncturing. Methods A total of 64 patients with trigeminal neuralgia (second branch), who were successfully treated with CT - guided radiofrequency thermocoagulation of trigeminal nerve via foramen rotundum route during the period from August 2015 to March 2017, were included in this study. Their CT images were retrospectively analyzed. The line from the opening of the external auditory canal to the root of the nose (ear-nose line) was used as the base line on sagittal plane, and the angle between the ear-nose line and the puncture needle (angle α) was measured. On transverse section drawing a line between the midpoint of nose bridge and the midpoint of the posterior edge of the ethmoid sinus (M line), the angle between M line and the puncture needle (angle β) was determined. The vertical distance from the midpoint of the foramen rotundum to M line(D1), the vertical distance from needle puncture point to M line(D2), and the puncture depth (D3) were respectively measured. Results The angle α varied from 44. 10° to 63. 50° with a mean of (55. 05°±5. 48°). The angle β ranged from 26. 42° to 68. 37° with an average of (38. 19°±8. 58°). The distance of D1 was (19. 55±2. 67) mm, the distance of D2 was (58. 50±5. 41) mm, and the depth of D3 was (64. 89+8. 21) mm. The gender, age and BMI value showed a close correlation with the puncture angle and the puncture depth (P＜0. 05), and no statistically significant differences in these indexes existed between the left side and the right side (P＞0. 05). Conclusion The angle a and the other puncture parameters can roughly determine the three dimensional spatial orientation of foramen rotundum, which can be further adjusted according to patient's gender, age and BMI value. (J Intervent Radiol, 2018, 27: 234-237)

Role of SUMO-specific proteases in tumor biological behavior / 上海交通大学学报（医学版）

SUMOylation is a dynamically reversible process that needs to be modified by a specific ligase, while its inverse reaction deSUMOylation is catalyzed by a group of SUMO-specific proteases (SENPs). SUMO-modified target protein molecules are closely related to development and disease, especially tumor, metabolism, inflammation and immunity. SENPs play an important role in SUMO protein maturation and deSUMOylation. This review discussed the functions of SENPs in the development and progression of tumors and related mechanisms.

Correlation analysis between clinical features and renal dysfunction in patients of acute lacunar infarction with progressive cerebral microbleeds / 中国医师进修杂志

Objective To analyze the correlation between clinical features and renal dysfunction in patients of acute lacunar infarction with progressive cerebral microbleeds (CMBs). Methods Two hundred and sixty-five patients with first-episode acute lacunar infarction were selected. The serum creatinine was measured within 24 h of admission and the estimated glomerular filtration rate (eGFR) was calculated. The brain MRI (including gradient-echo images) was examined within 2 d of admission and after 1 years of follow-up, respectively. The progressive CMBs was assessed with microbleeds anatomical rating scale (MARS), and the patients were divided into progressive CMBs group (progressive group, 42 cases) and non progressive CMBs group (non progressive group, 223 cases). The clinical features of 2 groups were compared and the correlation between progressive CMBs and renal dysfunction was analyzed. Results The age, 24 h pulse pressure, incidences of renal dysfunction and CMBs in progressive group were significantly higher than those in non progressive group: (69.8 ± 5.8) years vs. (61.5 ± 4.9) years, (63.3 ± 3.1) mmHg (1 mmHg=0.133 kPa) vs. (51.8 ± 4.2) mmHg, 69.0％(29/42) vs. 39.9％(89/223) and 57.1％(24/42) vs. 25.1％(56/223), and the platelet was significantly lower than that in non-progression group:(168 ± 35) ×109/L vs. (189 ± 40) ×109/L, and there were statistical differences (P<0.05 or<0.01). The Logistic regression analysis result showed that renal dysfunction and CMBs were Independent risk factors of progressive CMBs (OR = 1.571 and 1.054, 95％ CI 1.042 - 2.493 and 1.010 - 1.142, P<0.05). Conclusions The rate of renal dysfunction is higher in patients of acute lacunar infarction with progressive CMBs, and progressive CMBs are associated with renal dysfunction.

Relationship between Plasma FA, ET-1, Hcy and VEGF Levels and Pregnancy Induced Hypertension / 现代生物医学进展

Objective:To investigate the relationship between FA,ET-1,Hcy and VEGF in patients with pregnancy induced hypertension.Methods:Selected 80 cases of patients with pregnancy induced hypertension who were treated in our hospital from January 2013 to September 2016,divided into A group (40 cases),and preeclampsia and preeclampsia B group (40 cases),60 cases of normal late pregnant women as C group,60 cases of normal non pregnant women as D group.The plasma levels of FA,ET-1,Hcy and VEGF in each group were detected,and the correlation analysis was performed.Results:The plasma levels of FA and VEGF of group B were lowest in the four groups (P＜0.05),the plasma ET-1 and Hcy levels of group B were highest (P＜0.05).The plasma FA and VEGF levels of women with pregnancy induce hypertension were lower than those of the healthy late pregnant women.The plasma ET-1 and Hcy levels were higher (P＜0.05).The multivariate logistic regression analysis showed that FA,ET-1,Hcy and VEGF levels were risk factors for pregnancy induce hypertension.Conclusion:The elevation of plasma Hcy level caused by FA deficiency in pregnancy might be related to the development of the disease and the incidence of pregnancy induced hypertension syndrome,VEGF might be an important factor in the occurrence and development of pregnancy induced hypertension syndrome.

Mental health of senile dementia caregivers in nursing homes in Shenyang and its influencing factors / 中国实用护理杂志

Objective To investigate the mental health and its correlated factors for senile dementia caregivers in nursing homes in Shenyang. Methods Questionnaire survey was conducted among 174 senile dementia caregivers recruited from the Nursing Home of Shenyang and Shenyang Social Welfare Institute by using Symptom Check-List-90 (SCL-90), Social Support Rating Scale (SSRS) and self-designed general information questionnaire and to analyze the scores of self rating scale of nursing staff, the total score of social support scale, and the factors affecting the mental health status of nursing staff. Results The SCL-90 scores of senile dementia caregivers with education levels from illiteracy, primary school or junior high school, high school or secondary school, college or above were 130.50 ± 10.11, 132.70±12.55, 135.06±9.15, 129.24±8.83, the difference was statistically significant (F=15.05, P<0.01). The SCL-90 scores of senile dementia caregivers with poor, general and good perceived health status were 133.40±10.52, 132.60±11.32, 128.00 ±10.02, the differences were statistically significant (F=9.07, P<0.01). The SCL-90 scores of family monthly income of 1001 to 3000 yuan, 3001 to 5000 yuan and more than 5001 yuan were 132.90 ± 10.39, 132.80 ± 11.52, 131.50 ± 8.20, the difference was statistically significant (F=12.11, P<0.01). The multivariate linear regression analysis showed that the regression coefficient of perceived health status was-0.168 (t=2.880, P<0.01), monthly family income was-0.145 (t=-2.512, P<0.05), SSRS was 0.121 (t=2.112, P<0.05). Conclusions Mental health status of senile dementia caregivers in Shenyang is poor. The health sector should take some measures to improve the degree of social support, nursing staff wages and to ensure their health in order to promote physical and mental health of nursing staff and the nursing level so as to improve the quality of life of the senile dementia elderly.

Relationship between different topographic location and neurological deterioration in acute new isolated pontine infarction / 中国医师杂志

Objective To investigate the relationship between different topographic locations and neurological deteriorations (ND) in patients with acute new isolated pontine infarction.Methods One hundred sixty-eight patients with acute new isolated pontine infarction during arch 2012 to March 2016 were identified by diffusion weighted imaging (DWI) for retrospective review.Patients were divided into two groups according to their clinical symptoms:patients with ND and patients without ND.According to neuroimaging of DWI,the topographic location of pontine infarction was divided into three types:The upper,middle,and lower ones,and the correlations of ND with risk factors,laboratory examination results,clinical manifestations and different topographic locations were explored by statistical tests.Results Of 168 patients,26.8％ (45/168) were diagnosed with ND,and 73.2％ (123/168) were diagnosed without ND.Univariate analysis showed that there were differences in female ratio [62.2％ (28/45) vs 41.5％ (51/ 123)],smoking ratio [13.3％ (6/45) vs 26.0％ (32/123)],mean length of hospital stay [(22.83 ± 7.12)d vs (19.31 ± 7.65)d],ratio of worse short-term clinical outcomes [77.8％ (35/45) vs 33.3％ (41/123)],and ratio of lower pontine infarction [55.6％ (25/45) vs 26.0％ (32/123)] between two groups (P ＜ 0.05).Logistic regression analysis showed that lower pontine infarction was the independent risk factor of ND (OR =1.953,95％ CI:1.092-3.535,P =0.029).Conclusions Topographic location of lower pons lesions may be reliable predictor of ND in acute new isolated pontine infarction.

Correlation between uncoupling protein 2 expression and myocardial mitochondrial injury in rats with sepsis induced by lipopolysaccharide / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the correlation between uncoupling protein 2 (UCP2) expression and myocardial mitochondria injury in rats with sepsis induced by lipopolysaccharide (LPS).</p><p><b>METHODS</b>The rat model of sepsis was established through an intraperitoneal injection of LPS. Forty male Sprague-Dawley rats were randomly and equally divided into control group (an intraperitoneal injection of normal saline), sepsis 6 h group (LPS-6 h group), sepsis 12 h group (LPS-12 h group), sepsis 24 h group (LPS-24 h group), and sepsis 48 h group (LPS-48 h group). The serum and heart tissues were harvested at corresponding time points and myocardial mitochondria was extracted. The microplate reader was applied to measure creatine kinase (CK), creatine kinase-MB (CK-MB), and reactive oxygen species (ROS). Flow cytometry was applied to measure the degree of mitochondrial swelling and mitochondrial membrane potential (MMP). Western blot was used to measure the expression level of UCP2. Electron microscopy was applied to observe the morphological changes in heart tissues and myocardial mitochondria.</p><p><b>RESULTS</b>Compared with the control group, the LPS groups had significantly increased serum levels of CK, CK-MB, and myocardial ROS, as well as a significantly increased degree of mitochondrial swelling (P<0.05), and these values reached their peaks at 24 hours after LPS injection. The LPS groups had a significant decrease in MMP (P<0.05), which reached the lowest level at 24 hours after LPS injection. Western blot showed that the LPS groups had a significant increase in the expression level of myocardial UCP2 compared with the control group (P<0.05), which reached its peak at 24 hours after LPS injection. The results of electron microscopy showed mitochondrial swelling, partial rupture of the mitochondrial membrane, and cavity formation in rats in the LPS groups. The most severe lesions occurred in the LPS-24 h group. In rats with LPS, the ROS level in the myocardial mitochondria and the degree of mitochondrial swelling were positively correlated with the expression level of UCP2 (r=0.796 and 0.893, respectively; P<0.05), while MMP was negatively correlated with the expression level of UCP2 (r=-0.903, P<0.05).</p><p><b>CONCLUSIONS</b>In the rat model of sepsis, the myocardium and myocardial mitochondria have obvious injuries, and the expression level of UCP2 is closely correlated with mitochondrial injury. Therefore, UCP2 might play an important role in myocardial mitochondrial injury in sepsis.</p>

Effect of body temperature for favorable neurological outcome in patients of cardiac arrest / 临床麻醉学杂志

Objective To identify the association between body temperature and neurological outcome in post-arrest patients.Methods This was a multicenter,retrospective cohort study.In the period 1990-2011,a total of 184 patients resuscitated from IHCA with ROSC for more than 20 min were included.Data were collected according to Utstein style.The primary endpoint was hospital dis-charge with good neurological function (Cerebral Performance Category,CPC,1-2).Multivariate Lo-gistic regression was performed to determine the association between body temperature and neurologi-cal outcome.Results Among the 184 enrolled patients,37.0% (68/184)survived to hospital dis-charge,19.6% (36/184)survived to discharge with favorable neurological outcome(CPC,1-2).Mul-tivariate Logistic regression revealed that maximal body temperature between 35.5℃ and 38.4℃ was associated with favorable neurological outcomes (OR=8.986,95% CI 1.156-69.882;P =0.036). Conclusion For IHCA patients achieving spontaneous circulation, maximal body temperature between 35.5℃ and 38.4℃ in the initial 24 h following admission to ICU was associated with favora-ble neurological outcome.