To study the clinical symptoms, copper metabolism and imaging characteristics of Wilson disease (WD) carriers and to explore the treatment strategy of WD carriers. Forty WD carriers, 40 WD patients and 20 normal controls from the First Affiliated Hospital of Sun Yat-sen University from July 2007 to May 2018 were included. The modified Young scale was used for neural symptom scoring, and Child grading of liver function, mental symptoms rating scale, magnetic resonance imaging (MRI) scan, susceptibility weighted imaging (SWI) inspection, metal metabolism tests were also applied to all the included subjects. Corrected phase (CP) was measured by SWI. WD carriers were divided into symptomatic group and asymptomatic group. Symptomatic WD carriers were treated with penicillamine for 2 weeks and zinc gluconate for 3 months, then their neurological symptoms, liver function grade, metal metabolism index were rechecked. Six WD carriers presented with some clinical symptoms, including 5 with neurological symptoms and 4 with liver dysfunction. The score of Hamilton anxiety (HAMA) scale of symptomatic WD carriers was higher than that of normal control group ( =0.021). 85% of carriers had ceruloplasmin level less than 0.26 g/L. 80% of carriers had serum copper between normal controls and WD patients. The free copper level of WD carriers was lower than that of WD patients ( =0.012, 0.019). Urinary copper in symptomatic WD carriers was higher than normal controls ( =0.047). The CP values of thalamus, globus pallidus and putamen in symptomatic WD carriers were lower than those in normal control group. After treatment with penicillamine in symptomatic WD carriers, urinary copper was higher than that before treatment ( =0.036). After treatment, the liver enzymes of symptomatic WD carriers returned to normal, and the score of modified Young scale was lower than before treatment ( =0.031). Mild copper metabolism abnormality is seen in WD carriers. A few carriers have neurological symptoms such as limb tremors, or liver symptoms such as abnormal liver enzymes. Abnormal copper metabolism is more serious in symptomatic WD carriers than in asymptomatic WD carriers. Symptomatic WD carriers can be treated with zinc gluconate.
To investigate the protective effect of liraglutide on kidney of diabetic mice induced by high-fat diet and its possible mechanisms. C57BL/6J male mice were randomly divided into normal chow diet (NC) group and high-fat diet (HFD) group, which were fed with normal chow diet and HFD for 12 weeks respectively. After diet challenge, the mice were randomly divided into normal control group, normal chow diet with liraglutide treatment (NC+Lira) group, HFD group and high-fat diet with liraglutide treatment (HFD+Lira) group. The mice in NC+Lira and HFD+Lira groups were given intraperitoneal injection of liraglutide (400 μg·kg(-1)·d(-1)) for 8 weeks, while mice in NC and HFD groups were given intraperitoneal injection of same amount of normal saline. Urinary albumin and creatinine levels were measured by enzyme-linked immunosorbent assay (ELISA). Renal morphology was observed by HE staining. The expression levels of silent mating type information regulation 2 homolog 1 (SIRT1) and thioredoxin-interacting protein (TXNIP) were determined by Western blot. Compared with HFD group, liraglutide significantly lowered the body weight [(30.98±1.29) g vs (39.43±2.58) g], fasting blood glucose (FBG) [(7.21±0.15) mmol/L vs (9.55±0.29) mmol/L] and urinary albumin/creatinine ratio (ACR) [(205.48±17.14) μg/mg vs (319.86±34.14) μg/mg] in HFD+Lira group (all 0.05). HE staining showed that glomerular hypertrophy of HFD group alleviated after liraglutide treatment. The expression level of TXNIP in the kidney of HFD mice significantly decreased after liraglutide treatment (0.41±0.10 vs 3.50±0.70), while expression level of SIRT1 significantly increased (0.75±0.15 vs 0.32±0.04) (both 0.05). Liraglutide could improve diabetic nephropathy by up-regulation of SIRT1 expression and down-regulation of TXNIP expression in diabetic mice induced by HFD.
To explore the mechanism of androgen in improving erectile dysfunction in castrated rats. Forty 8-week-old male Sprague-Dawley (SD) rats were randomly divided into 4 groups:normal control group (Group A); castration group (Group B, in which rats were castrated); intervention groups (group C and D), in which rats were treated with different concentrations of testosterone undecanoate orally every day at 10 mg/kg (low dose) and 20 mg/kg (high dose), respectively after being castrated. Animals in group A and B were given 0.9% NS instead. After 8-week treatment, the level of serum testosterone, intra cavernous pressure (ICP) and mean arterial pressure (MAP) were detected, and the expression of androgen receptor (AR)and vascular endothelial growth factor (VEGF) were detected in the penis by Immunohistochemistry and Western blot. The level of serum testosterone was significantly lower in group B [(1.3±0.6) nmol/L] than in group A [(17.1±1.5) nmol/L] ( 0.05).After testosterone supplementation, serum testosterone levels in group C [(8.7±1.2) nmol/L] and group D [(15.5±1.6) nmol/L] were higher than that in group B (all 0.05). Max ICP/MAP of group C and D were higher than that in group B (all 0.05). Immunohistochemistry and Western blot showed that the expression levels of AR and VEGF in group B were significantly lower than those in group A, C and D, and group D > group C (all 0.05). Androgen replacement therapy with testosterone undecanoate can improve the erectile function of castrated rats by protecting the integrity of endothelial cells through AR/VEGF pathway.
To evaluate the efficacy and safety of cortical screw fixation in posterior lumbar spine fixation with cortical bone trajectory (CBT) fixation or pedicle screw (PS) fixation in posterior lumbar fusion. It was a prospective study and CBT or PS for the treatment of lumbar disease from August 2015 to August 2017 in Beijing Chaoyang Hospital were analyzed. There were 53 males and 51 females, aged 56-78 years (mean age, (67±5) years). The patient's gender, age, operative time, intraoperative blood loss, postoperative bleeding, postoperative hospital stay, and postoperative patient satisfaction were collected. The Oswestry disability index (ODI) and visual analogue scale (VAS) of back pain were used to evaluate preoperative and half-year, one-year and two-year postoperative function and quality of life. Complications such as wound infection, cage displacement, screw extraction and fixation fracture were compared between the two groups. The data of normal distribution were compared with Student test between the two groups. There was no significant difference in the operation time between the CBT group ( 50) and the PS group ( 54) ((223±17) min vs (221±16) min, 0.74, 0.46). The intraoperative blood loss and wound drainage volume were significantly lower in the CBT group than those in the PS screw group ( 24.20, -57.62, both 0.05). The average length of hospital stay in the CBT group was significantly shorter than that in the PS group ( 7.65, 0.00). Patients with CBT screws had better postoperative satisfaction than patients in PS group (91±6 vs 86±7, 3.89, 0.00). The ODI score in the CBT group was significantly lower than that in the PD screw group half a year after the operation (3.9±1.9 vs 5.8±3.1, 3.66, 0.00). The VAS and ODI scores in the CBT group were significantly lower than those in the PS group 1 year after the surgery ( 3.03, -4.09, both 0.05). There was no significant differences in wound infection, cage displacement, screw extraction and fixation fracture between the two groups. CBT screw technique is minimally invasive, with short operation time, less intraoperative blood loss, rapid postoperative recovery and low complications. It can be effectively used in posterior lumbar cone fusion.
To investigate the impact of different methods of fluid resuscitation on hemorheology during burn shock stage. Twenty four miniature swines were randomly divided into four groups with 6 in each group (succinylated gelatin group, hydroxyethyl starch group, Parkland group and allogeneic plasma group). Severe burn shock model was established by burning miniature swine with napalm. Two hours after injury, succinylated gelatin, hydroxyethyl starch (130/0.4) and swine allogenic plasma were used as colloid (alternative colloid) in fluid resuscitation according to the burn shock fluid resuscitation formula which is commonly accepted in the field of Burns Surgery. In Parkland group, miniature swines received liquid recovery according to Parkland Formula. The vital signs before and within 48 h after burn were observed by Solar 8000i electrocardiomonitor during the process of transfusion. The infusion speed was adjusted based on the heart rate, blood pressure, urine volume and central venous pressure. The level of hematocrit (HCT), viscosity of plasma (ηp), index of rigidity (IR), red cell assembling index (RCA) and erythrocyte electrophoresis time (EFT) were measured at the time of pre-injury as well as 4, 8, 24 and 48 h post-injury and statistical analysis was performed. HCT in hydroxyethyl starch group and Parkland group at 8 h post-injury were significantly higher than pre-injury [(0.395±0.047) vs (0.333±0.042), (0.379±0.026) vs (0.352±0.019)] (both 0.05). And compared with pre-injury, HCT in hydroxyethyl starch (130/0.4) group at 48 h decreased significantly (0.232±0.021) vs (0.333±0.042) ( 0.05). HCT in Parkland group at 24, 48 h post-injury were lower than pre-injury [(0.277±0.021), (0.241±0.029) vs (0.352±0.019)] (both 0.05). Compared with pre-injury, the levels of ηp in Parkland group decreased substantially at 4, 8 and 24 h post-injury [(1.61±0.07), (1.55±0.07) and (1.63±0.07) vs (1.73±0.04) mPa·s] (all 0.05). Compared with allogeneic plasma group, IR decreased in succinylated gelatin group at 24, 48 h post-injury [(1.10±0.05 vs 1.26±0.07), (1.11±0.05 vs 1.32±0.05)](both 0.05). RCA in succinylated gelatin group was significantly higher (both 0.05) at 4 h (6.80±0.87) than pre-injury (5.92±0.43). RCA in hydroxyethyl starch group at 8 h post-injury (6.73±0.56) was significantly higher (both 0.05) than pre-injury (6.03±0.53). Compared with pre-injury (17.3±1.3 s, 16.4±1.5 s), the levels of EFT in hydroxyethyl starch group (15.5±1.4 s) and Parkland group (13.4±1.2 s) decreased substantially at 48 h post-injury (both 0.05). Compared with allogeneic plasma group, the level of EFT in succinylated gelatin group at 4 h post-injury (19.5±2.3 s) increased and decreased at 24 h post-injury (12.0±5.7 s) (both 0.05). During swine burn shock stage, the hemorheological parameters of shock resuscitation with artificial colloid are more stable than those with Parkland formula resuscitation.
To study the clinical and imaging characteristics of cerebral amyloid angiopathy characterized by cortical superficial siderosis and improve clinicians' understanding of the disease. Retrospective analysis was performed on 16 patients with cerebral amyloid angiopathy characterized by cortical superficial siderosis from June 2013 to August 2016 in Beijing Hospital, and the information including epidemiological data, clinical features, cranial MRI and electroencephalogram (EEG) results were analyzed. The ratio of male to female in 16 patients was 1.67∶1, and the average age of onset was 73 (69-79) years. The most common clinical symptoms were transient focal neurological episodes (TFNEs)(12/16). Cranial MRI showed localized (9/16) and diffuse type cortical superficial siderosis (7/16); few of them were associated with different degrees of cerebral microbleeds. Most of the EEG findings were normal (6/9) and a few showed focal slow waves (3/9). During a mean follow-up of 17 (17±11) months, 5 patients developed repeated TFNE, of which 1 had cerebral hemorrhage. Cerebral amyloid angiopathy characterized by cortical superficial siderosis occurs predominantly in the elderly. TFNE is the most common clinical manifestation. Cranial MRI is the most important diagnostic method, and antithrombotic therapy should be avoided as much as possible.
To investigate the factors of first misdiagnosis, treatment and prognosis of acute pregnancy complicating with Guillain-Barré syndrome (GBS) in order to improve the first diagnosed rate. A total of 45 acute pregnancy complicating with GBS patients were retrospectively analyzed recruited from January 2009 to October 2017 at the Tianjin Fourth Central Hospital.Patients were divided into the first diagnosis group and the first misdiagnosis group, and GBS clinical types were classified into classic and variant types to analyze the misdiagnosis factors of the first diagnosis. All patients received intravenous immunoglobulin (IVIG) treatment, and the therapeutic effect and prognosis were compared and analyzed. There were 20 cases in the first diagnosis group, 25 cases in the first misdiagnosis group, 35 cases in the typical GBS group, and 10 cases in the variant GBS group.There was no statistically significant difference in the baseline data of the patients( 0.05).The misdiagnosis factors are divided into four categories: physician factors, patient factors, disease itself factors and laboratory factors. Variant GBS is more likely to lead to misdiagnosis in the first diagnosis than typical GBS. The therapeutic effect of the first diagnosis group was better than that of the first misdiagnosis group( 0.05).Three patients died in the first misdiagnosis group, and the rest of the pregnant patients gave birth normally, and the babies were born without congenital malformation. Pregnancy is one of the inducing factors of GBS. Early diagnosis and correct treatment can improve maternal and infant clinical outcomes.
To compare the outcome of either flexor hallucis longus transfer or turn-down of proximal Achilles tendon tissue repair in treating chronic Achilles tendon rupture. The clinical data of 21 patients who underwent repair of Myerson type Ⅲ chronic Achilles tendon rupture at Peking University Sports Medicine Research Institute from May 2012 to March 2015 were retrospectively analyzed. Among them, 11 cases were treated with flexor hallucis longus (FHL) transfer, and 10 cases were treated with gastrocnemius turn-down flaps repair. The American Orthopedic Foot & Ankle Society (AOFOS) hindfoot score and Tegner motor function score before and after surgery were recorded and compared between the two groups. Data comparison between groups was performed with test. The patients in the both group were followed up for an average of (21±7) months. The postoperative AOFOS hindfoot score in the long flexor and gastrocnemius groups were both significantly higher than those before surgery, and the differences were statistically significant (97.7±2.6 vs 72.0±8.1 and 96.0±5.5 vs 78.5±6.4, 10.70, 6.42, both 0.05).The postoperative Tegner scores of the two groups were also significantly higher than those before surgery (4.2±1.4 vs 0.7±0.4 and 4.1±0.8 vs 0.6±0.5, 7.29, 9.35, both 0.05). There were no significant differences in postoperative AOFOS hindfoot scores and Tegner motor function scores between the two groups (both 0.05). The flexor hallucis longus transfer and turn-down of proximal Achilles tendon tissue repair can both get satisfactory results in treating chronic Achilles tendon rupture.
To investigate the effect of the derepression of chemokine receptor-7 (CXCR7) in prostatic tissues from patients with Castration Resistant Prostate Cancer (CRPC) on the resistance to enzalutamide (Enza). During the period of January 2015 to December 2017 all CRPC cases who underwent radical radiotherapy or androgen deprivation therapy (ADT) were evaluated. After prostatic puncture biopsy, the tissues were treated for immunostaining with CXCR7. Cox proportional hazard modeling and Kaplan-Meier analysis were used to determine PSA Progression-Free Survival (PSAP-FS) and Clinical or Radiographic Progression-Free Survival (CRP-FS) in the cohort. At last, PSA response rates and progression outcomes in CXCR7 negative cases and CXCR7 positive cases were analyzed. Total 39 CRPC patients were enrolled in this study. And 23 cases derepress CXCR7, 16 cases negatively express CXCR7. The median follow-up duration was 12 months (range: 6-18) in the cohort. Chi-square analysis confirmed that PSA response rates after Enza treatment were significantly associated with CXCR7 derepression (χ(2)=22.129, 0.000 06). Compared with CXCR7 positive expression group, CXCR7 negative expression group displayed improved median PSAP-FS (4.4 mon vs 11.7 mon, 0.040 8) and CRP-FS (5.2 mon vs 13.1 mon, 0.036 2) after Enza treatment. Derepression of CXCR7 in CRPC patients may be associated with resistance to enzalutamide. This protein may be novel target for treatment of CRPC.
To investigate the effects of rosuvastatin (RSV)on autophagy and apoptosis of myocardial cells in rats with acute myocardial infarction. SD rats were divided into control (Sham group), acute myocardial infarction model rats (AMI group), AMI rats treated by RSV with the dose of 5 mg·kg(-1)·d(-1) (RSV group), AMI rats treated by RSV and AMPK inhibitor Compound C at the same time (RSV+ CC group)( =8) based on simple random sampling methods.Rat myocardial cell line H9c2 was divided into control group, Hypoxia group, Hypoxia+ RSV group, Hypoxia+ RSV+ Compound C group, Hypoxia+ AICAR (AMPK activator)group.After 6 weeks, the rats were examined by hemodynamics, and pathological observation of myocardial tissue by HE staining was also carried out.RT-PCR/Western blot were used to detect the expression of Beclin1, p62, BAX and Bcl-2 mRNA or protein of different groups and .Western blot was used to detect the expression of mTOR and AMPK protein and phosphorylation in cardiac tissue of each group. In this study, the rat model of acute myocardial infarction was successfully prepared.Compared with the AMI group, the myocardium inflammation in the RSV group was alleviated, the LVMI decreased significantly, LVSP increased significantly, LVEDP decreased significantly, HR decreased significantly, the absolute value of dP/dTmax and -dP/dTmax increased significantly.The levels of Beclin1 and Bcl-2 mRNA were significantly up-regulated from 0.43 to 2.01 and 0.30 to 0.72, the expression of p62 and BAX mRNA decreased in half, the phosphorylation level of AMPK was significantly up-regulated, and the level of mTOR phosphorylation significantly reduced( <0.05). These changes were antagonized by AMPK inhibitors in RSV+ CC group. experiments showed that, after RSV intervening, the levels of Beclin1 and Bcl-2 mRNA and protein in the myocardial cells of Hypoxia group significantly increased in triple, while the expressions of p62 and BAX mRNA and protein significantly decreased above a half.The above changes were consistent with those of the AMPK activator group and were antagonized by Compound C. RSV can effectively promote autophagy and decrease apoptosis in rat heart after myocardial infarction through AMPK/mTOR pathway.
With the aid of an acute visceral pain model of uterine cervical distension (UCD), the present study aimed to observe the effects of intrathecal administration of transient receptor potential vanilloid 1 (TRPV1) antagonist SB-366791 on UCD induced-visceral nociception as well as its involved molecular mechanisms. A total of 30 Sprague-Dawley-derived adult virgin female rats were used. UCD model was established under isoflurane inhalation anesthesia. Briefly, a lower abdominal incision at midline was made to expose the uteral cervix, two metal rods were inserted through both sides of the cervix separately, one rod was fixed and the other one was connected to a pulley system with application of manual weighted traction (0, 25, 50, 75 or 100 g) for simulating 1 h of cervical distension. In addition, 12 Sprague-Dawley-derived adult virgin female rats were subjected to intrathecal catheter implantation, and UCD was established 7 days later. The rats were divided randomly into two groups; one group was administrated with intrathecal SB-366791 while the other was administrated with the same volume of saline as control. The 75 g distension force was then applied for an hour and the electromyographic (EMG) of musculus rectus abdominis, heart rate as well as respiratory frequency were measured continuously during the surgery. The spinal cord (T(12)-L(2)) was collected 30 minutes after UCD for the detection of changes of c-FOS and TRPV1 expression. UCD increased EMG activity ( 0.05) and c-FOS expression ( 0.05) in the deep dorsal horn region and central canal of the spinal cord (T(12)-L(2)) in a stimuli-dependent manner, the expression of TRPV1 in the T(12)-L(2) spinal cord also increased in response to UCD stimulation ( 0.05). Compared with the saline group, intrathecal SB-366791 significantly decreased EMG activity ( 0.05) as well as spinal c-FOS ( 0.05) expression induced by UCD. UCD in rats increases EMG activity of musculus rectus abdominis as well as spinal c-FOS and TRPV1 expression. Intrathecal administration of TRPV1 antagonist SB-366791 significantly decreases the visceral nociception induced by UCD.
To investigate the effect of active cytomegalovirus infection post kidney transplant on the expressing of receptor CD226 on NKT cell. Case controlled study. From December 2013 to December 2014, 43 cases of kidney transplant recipient with CMV infection were collected in the Organ Transplantation Research Institute of the former 309th Hospital of PLA. The healthy control group included 15 cases. 15 cases of recipients who were stable after operation and followed up in our hospital at the same time were also collected as control. Peripheral blood specimen with EDTA as anticoagulant were used and analyzed by flow cytometry. The population of NKT in CMV infection recipients were 5.19(1.18, 25.92)%, while in the remission stage the population were 4.89(0.68, 25.33)%, Compared with normal healthy controls and the stable recipients, the percentage of CD3(+)CD56(+) NKT cells in periphery blood mononuclear cells did not vary among these groups( 0.05). The CD226(+) NKT population during the active CMV infection was (70±13)%, which was significantly lower than the health control [(87±10)%] and stable recipients [(80±9)%]( 0.001). Whereas in the CMV infection remission stage, the CD226(+)NKT population was (81±16)%, which was significantly higher than that of CMV active infection group ( 0.05), and showed no difference with the health control group and stable recipients ( 0.05). The CD226 MFI expressed on NKT in CMV infection group was 101±49, which showed no difference with health controls and stable recipients ( 0.05). However, significantly up regulation of CD226 MFI on NKT was observed in the samples obtained from the same recipients in CMV active infection (91±40) and in CMV regression stage(173±73)( 0.001). The CD226(+) NKT cells population was down during the active CMV infection post kidney transplantation, while the expression of CD226 and the population of CD226(+)NKT could regression when the CMV infection regressed, which indicates the involvement of CD226 in the process of NKT cells anti-CMV infection.
To summarize the experience of renal autotransplantation for severe iatrogenic proximal ureteral damage and renal artery aneurysms in eight patients and to explore the clinical application value of renal autotransplantation. Two patients of renal artery aneurysms and six patients of severe iatrogenic proximal ureteral damage between January 2010 and March 2018 in our center were retrospectively reviewed. The procedures of eight cases were successful, with immediate return of renal function in the patients. The warm ischemia time was (3±1) minutes, the total operation time was (340±164) min, and the estimated blood loss was (180±60) ml, respectively. For renal artery anastomosis, six patients of severe iatrogenic proximal ureteral damage received end-to-end anastomosis between the internal iliac artery and renal artery, and two patients of renal artery aneurysms were treated with renal artery and internal iliac artery for reconstruction, then end-to-side anastomosis to recipien external iliac artery. A direct ureterovesical anastomosis was performed in seven patients, one patient was received pyeloureteroplasty. No serious complications of blood vessel and ureter were found during perioperative and long-term follow-up. All cases follow-up hitherto have normal renal function and blood pressure. Renal autotransplantation can be appropriate for patients with proximal ureteral loss and complex hilar renal artery aneurysms. In addition, it is able to protect renal functions to the most extent and provides a surgical alterative for complex renal diseases.
To analyze the influence of different thyroid stimulating hormone (TSH) cut-offs to diagnose subclinical hypothyroidism (SCH) in the first trimester of gestation. A total of 896 pregnant women were enrolled in Peking University International Hospital between October 2016 and March 2018. Among them, 421 pregnant women with single fetus who were conformed to the criteria of National Academy of Clinical Biochemistry (NACB), without adverse pregnancy outcomes and obstetric complications, were selected to establish their self-sequential longitudinal reference ranges of thyroid function. Then, SCH was diagnosed in the first trimester, using different TSH cutoffs, such as the upper limit of the first trimester-specific reference range, 4.0 mU/L recommended by the 2017 Guidelines of American Thyroid Association (ATA), 5.17 mU/L (Roche reagent) recommended by 2012 Guidelines of Chinese Society of Endocrinology and Chinese Society of Perinatal Medicine, and 2.5 mU/L recommended by 2011 Guidelines of ATA, respectively. The TSH reference range was 0.12-4.16 mU/L in the first trimester. Using TSH>4.16, 4.0, 5.17 and 2.5 mU/L to diagnose SCH in the first trimester, the prevalence rates were 4.35% (39/896), 5.92% (53/896), 1.56% (14/896) and 20.87% (187/896), respectively. There was no statistically significant difference between the prevalence rates of SCH using the TSH upper reference limit of 4.0 mU/L and 4.16 mU/L ( =0.134). When TSH was defined as>4.0 mU/L to diagnose SCH, the sensitivity, specificity and Youden index was 97.4%, 98.2%, and 0.956, respectively. The TSH upper reference limit of 4.0 mU/L recommended by 2017 Guidelines of ATA can be used as a cut-off to diagnose SCH in first trimester for the areas without trimester-specific reference ranges for TSH in China.
To investigate pathogenic bacteria and drug resistance in the patients with skin and soft tissue infection in order to provide the scientific evidences for clinical reasonable use of antibiotics. A retrospective analysis was performed on patients with skin and soft tissue infections in Department of Dermatology, Peking University Third Hospital from January 2012 to December 2017. Pus, secretions, skin lesions, urine, throat swabs, and alveolar lavage fluid were collected for bacterial culture, bacterial species were identified by VITEK2 Compact system and BD-Bruker MALDI Biotyper system. Drug resistance was detected by K-B agar diffusion method recommended by CLSI. A total of 392 strains of bacteria were isolated from 327 patients distributed in 21 genus and 56 species, of which 225 were gram-positive cocci (57.40%), 114 were gram-negative rods (29.08%), 46 were gram-positive rods (11.73%), and 7 were gram-negative cocci (1.79%). The top 3 bacteria were 91(23.21%), 42 (10.71%), and 24 (6.12%). had a high rate of resistance to penicillin and erythromycin (>50%). Gram-negative rods were resistant to ampicillin (86.1%), and also had certain resistance to most second-generation and some third-generation cephalosporin (about 50%). There was no significant change in the drug resistance rate of MRSA compared to MSSA. Only the resistance rate to tetracycline was statistically different ( 0.05). The emergence of drug-resistant strains is an important factor leading to refractory infections. There are a wide range of pathogenic bacteria species among the skin and soft tissue infection patients, and antimicrobial drugs should be chosen wisely according to drug sensitivity.
To discuss the correlation between histogram analysis of quantitative mono-exponential, bi-exponential and diffusion kurtosis models in diffusion weighted imaging and the Gleason score of prostate cancer, and evaluate the application value and diagnostic efficiency in identifying low and high grade prostate cancer. A total of 50 patients with histologically confirmed as prostate cancer were examined from May 2015 to May 2016 in the Second Affiliated Hospital of Soochow University using DWI performed at 3.0 T with an extended b-value range from 0 to 2 000 s/mm(2). Data were post-processed by whole tumor histogram analysis,the ROI was manually drown in DWI (b=1 000 s/mm(2)) step by step along the outline of cancer, and quantitative analysis were performed respectively by mono-exponential, bi-exponential and diffusion kurtosis models for quantification of apparent diffusion coefficients (ADCs), diffusivity D, pseudo-diffusivity D(*), perfusion fraction f, diffusion coefficients by non-Gaussian distribution (D(k)) and kurtosis coefficient (K).Then the histogram analysis was performed to get the mean, median, 25th percentile, 75th percentile, skewness and kurtosis. The correlation between histogram analysis results of these quantitative parameters and Gleason score of prostate cancer were evaluated by correlation coefficient. The diagnostic performance of histogram analysis results of each quantitative parameters in identifying low (Gleason score≤6) and high (Gleason score>6) grade prostate cancer was performed by comparing the area under the ROC curve and the curve values. The values of ADC, D and D(k) (mean, median, 25th, 75th) were negatively correlated with Gleason score of prostate cancer ( value was -0.3880.624, 0.05). The values of D (skewness and kurtosis) had a certain correlation with Gleason score of prostate cancer ( value were 0.413 and 0.402, 0.05). The histogram analysis results of D(*) and f had no statistically significant correlation with Gleason score of prostate cancer ( 0.05). The values of K (mean, median, 25th, kurtosis) were positively correlated with Gleason score of prostate cancer ( value was 0.423-0.699, 0.05). The quantitative parameters of three diffusion models (ADC, D, D(k), K) in DWI are all related to the Gleason score of prostate cancer, but in the differential diagnosis of low and high grade prostate cancer, the diagnostic efficacy of mono-exponential model is sufficient. The more complex model such as bi-exponential and diffusion kurtosis may complement it in other ways.
This study aimed to assess the prevalence and factors associated with pelvic organ prolapse (POP) in a representative sample of Chinese urban women. A total of 29613 Chinese urban women were recruited to this cross-sectional study between February 2014 and March 2016. The prevalence of POP, defined as any stage Ⅱ or higher POP resulting in symptoms, was assessed using questionnaires and physical examinations. Multivariable logistic regression was used to assess factors associated with POP. 2 864 of 29 613 women (9.67%) had POP. The prevalence of POP increased with age ranging from 1.23% (82/6 646) of women aged between 20 and 29 years to 26.11% (727/2 784) for those aged 70 years or older ( 0.000 1). Overweight and obese women were more likely to have POP than normal weight women [ 1.56, 95 1.42-1.72 vs 1.74, 95 1.48-2.03]. In the multivariate analysis, the independent risk factors were cough ( 1.70, 95 1.44-2.02), constipation ( 2.05, 95 1.82-2.32), physical disease ( 1.27, 95 1.15-1.41), and gynecological diseases ( =2.08, 95 1.89-2.29). Nulliparous ( 0.12, 95 0.06-0.22) and caesarean section (CS) ( 0.55, 95 0.47-0.64) were protective factors for POP. POP affects nearly 10% of women in Chinese urban region. The prevalence of POP increases significantly with age. The independent risk factors for POP are body mass index, cough, constipation, physical disease and gynecological diseases. Nulliparous and CS are protective factors for POP.
This study aimed to explore the effect of perfluorooctanoate acid (PFOA) on the proliferation, migration and invasion of the human muscle rhabdomyosarcoma RD cell line and its related mechanisms. RD cells were cultured and exposed to PFOA of different concentrations with 6-72 hours. The cell viability was assessed by cell counting kit-8 (CCK-8) assay. Wound healing and transwell filter assay were used to evaluated the migration and invasion ability of the RD cells respectively. The cell cycles were detected by Flow cytometry. Quantitative real-time PCR and Western blot were used to quantify the mRNA and protein expression difference of related genes, respectively. CCK-8 assay showed that, after treated the RD cell with different dose of PFOA for 72 h, low dose PFOA (1,10,50, 100 μmol/L) promotes the proliferation of RD cells while high dose PFOA (250, 500 mol/L) inhibits the proliferation ( 0.001). Flow cytometry showed that compared with the control group, there was no significant difference in G0/G1 phase, while cells in S phase deceased and G2/M phase cells increased after treated with PFOA (50 μmol/L) for 72 h. The relative proportions of S and G2/M were significantly different between the two groups ( 0.01). The results of qPCR showed that the mRNA relative expression of CDK2 of the control group and the PFOA (50 μmol/L) group were 0.97±0.07 and 2.64±0.11 respectively, and there was a significant difference ( 12.60, 0.001); The mRNA relative expression of cyclin E2 of the control group and the PFOA (50 μmol/L) group were 1.33±0.17 and 3.35±0.22 respectively, and there was a significant difference ( 7.42, 0.001); The results of Western blot showed that the protein relative expression of CDK2 of the control group and the PFOA (50 μmol/L) group were 0.35±0.01 and 0.84±0.03 respectively, and there was a significant difference ( 14.60, 0.001); The protein relative expression of cyclin E2 of the control group and the PFOA (50 μmol/L) group were 0.67±0.04 and 0.86±0.01 respectively, and there was a significant difference ( 4.88, 0.01); There was no significant difference in the mRNA and protein expression of p21 and p53 between the PFOA and control group ( 0.05). The wound healing rate of the PFOA (50 μmol/L) group was faster than that of the control group, and the relative migration area of the PFOA group was larger accordingly ( 0.001). After PFOA (50 μmol/L) treated, the number of the cell through the membranes was much more than the control group ( 54.40, 0.001), which means PFOA significantly stimulated the invasion ability of the RD cells. The results of qPCR showed that the mRNA relative expression of vimentin of the control group and the PFOA (50 μmol/L) group were 0.71±0.03 and 2.53±0.16 respectively, and there was a significant difference ( 11.00, 0.001); The mRNA relative expression of MMP2 of the control group and the PFOA (50 μmol/L) group were 1.09±0.04 and 10.73±1.20 respectively, and there was a significant difference ( 8.04, 0.001). The results of Western blot showed that the protein relative expression of vimentin of the control group and the PFOA (50 μmol/L) group were 0.55±0.06 and 0.81±0.01 respectively, and there was a significant difference ( 4.50, 0.05). The protein relative expression of cyclin E2 of the control group and the PFOA (50 μmol/L) group were 0.64±0.04 and 1.03±0.13 respectively, and there was a significant difference ( 2.94, 0.05). Low dose PFOA (50 μmol/L) exposure promotes cell proliferation, migration and invasion in the human muscle rhabdomyosarcoma cell line through inducing the expressions of MMP2, vimentin and cell cycle related genes.