Prevalence of late-onset hypogonadism among middle-aged and elderly males in China: results from a national survey / 亚洲男科学杂志(英文版)

This study aimed to propose an operational definition of late-onset hypogonadism (LOH) that incorporates both clinical symptoms and serum testosterone measurements to evaluate the prevalence of LOH in aging males in China. A population-based sample of 6296 men aged 40 years-79 years old was enrolled from six representative provinces in China. Serum total testosterone (TT), sex hormone-binding globulin (SHBG), and luteinizing hormone (LH) were measured and free testosterone (cFT) was calculated. The Aging Males' Symptoms (AMS) scale was used to evaluate the LOH symptoms. Finally, 5078 men were included in this analysis. The TT levels did not decrease with age (P = 0.59), and had no relationship with AMS symptoms (P = 0.87 for AMS total score, P = 0.74 for ≥ 3 sexual symptoms). The cFT levels decreased significantly with age (P < 0.01) and showed a negative association with the presence of ≥ 3 sexual symptoms (P = 0.03). The overall estimated prevalence of LOH was 7.8% (395/5078) if a cFT level <210 pmol l

Correlation of serum androgen levels with lipid metabolism in middle-aged and elderly men in Zunyi, Guizhou / 中华男科学杂志

<p><b>Objective</b>To investigate the relationship of the levels of serum androgens with lipid metabolism in middle-aged and elderly men in Zunyi, Guizhou.</p><p><b>METHODS</b>Using the stratified cluster sampling method, we conducted a questionnaire investigation and physical examinations among 437 men in Zunyi City. We divided the subjects into a middle-aged (40－64 ［53.20 ± 7.41］ years, n = 269) and an elderly group (=≥65 ［70.63 ± 4.66］ years, n = 168) and collected fasting elbow venous blood samples from them for measuring the levels of total testosterone (TT), sex hormone-binding globulin (SHBG), luteinizing hormone (LH), total cholesterol (TCH), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), calculated free testosterone (cFT), free testosterone index (FTI), and testosterone secretion index (TSI).</p><p><b>RESULTS</b>Compared with the elderly group, the middle-aged males showed significantly lower SHBG, LH, HDL and LDL, and higher cFT, FTI, TSI, TG and TCH (all P < 0.05). TT and SHBG were negatively correlated with TG, TCH, HDL and LDL, while cFT was positively correlated with TCH, and so was FTI with TG, TCH with LDL, and TSI with TCH, HDL and LDL (all P < 0.05), but LH was negatively correlated with TG, TCH and LDL (all P < 0.05). Multivariate linear regression analysis showed that TT and SHBG were negatively correlated with TG, TCH, HDL and LDL, and so was LH with TCH, HDL and LDL (all P < 0.05).</p><p><b>CONCLUSIONS</b>In the middle-aged and elderly men in Zunyi, low concentrations of TT, SHBG and LH were associated with the increased risk of high-TCH and -LDL dyslipidemia, low concentrations of TT and SHBG with that of high-TG dyslipidemia, while high concentrations of TT, SHBG and LH with that of low-HDL dyslipidemia.</p>

High level of Mn in brain is a risk for Alzheimer disease / 生理学报

Alzheimer disease (AD) is a neurodegenerative disease. Manganese (Mn) is an essential trace element in the human body. It can enter the brain through the blood-brain barrier and blood-cerebrospinal fluid barrier. Excessive accumulation of Mn in the brain may disturb the homeostasis of the central nervous system (CNS) microenvironment and cause severe neuronal damage. The most recent data suggest that excessive Mn is associated with impaired learning and memory in animal models, and may lead to irreversible and progressive mild cognitive impairment and AD. However, the mechanism for the involvement of Mn in AD pathogenesis remains controversial. This paper reviews the effects of Mn on CNS, mitochondrial function, p53 expression, and amyloid precursor protein/β-amyloid metabolism, and analyzes the relationship between these effects and AD pathogenesis.

Logistic regression analysis on risk factors for surgical site infection after colorectal surgery / 中国感染控制杂志

Objective To explore risk factors for surgical site infection(SSI) in colorectal surgery,and provide evidence for formulating measures for preventing SSI.Methods Patients who underwent colorectal surgery in the department of gastrointestinal surgery of a hospital from June 2013 to June 2016 were surveyed retrospectively,the related risk factors for SSI were analyzed by unconditional logistic regression analysis.Results Among 397 patients who underwent colorectal surgery,67 (16.88％) had SSI.Logistic regression analysis showed that smoking,low albumin,seniority of surgeons less than 5 years,irrational use of antimicrobial agents during perioperative period,and high National Nosocomial Infection Surveillance (NNIS) score were independent risk factors for SSI after colorectal surgery (all P＜0.05).Conclusion There are multiple risk factors for SSI after colorectal surgery,it is necessary to pay attention to it and formulate preventive measures,so as to reduce the occurrence of SSI effectively.

Vasectomy has no obvious longterm influence on the levels of serum androgens in aging males / 中华男科学杂志

Objective@#To explore the longterm influence of vasectomy on the levels of serum androgens in aging males.@*METHODS@#Using stratified random sampling, we conducted a questionnaire survey and physical examinations among 437 adult males aged ≥40 years, 232 with and 205 without the history of vasectomy. In addition, we measured the levels of serum total testosterone (TT), sexhormone binding globulin (SHBG), calculated free testosterone (cFT), testosterone secreting index (TSI), free testosterone index (FTI), and luteinizing hormone (LH).@*RESULTS@#Compared with the nonvasectomy group, the vasectomy group showed significantly increased levels of serum TT (［16.01±5.41］ vs ［17.39±6.57］ nmol/L), SHBG (［58.91±36.89］ vs ［70.28±40.90］ nmol/L), and LH (［8.86±6.49］ vs ［10.85±11.73］ IU/L) (all P0.05), nor after adjustment for relevant factors in TT (β: 1.015, 95% CI: －0.180－2.210), SHBG (β: 5.118, 95% CI: －2.069－12.305), cFT (β: 0.003, 95% CI: －0.011－0.018), FTI (β: －0.012, 95% CI: －0.035－0.011), TSI (β: 0.138, 95% CI: －0.131－0.407), and LH (β: 1.011, 95% CI: －0.811－2.834) (all P>0.05).@*CONCLUSIONS@#Vasectomy has no obvious longterm influence on the levels of serum androgens in aging males.

The comparation on living quality of the empty nest elderly and the non-empty-nest old people in rural area of Guizhou Province / 预防医学

Objective To survey the living quality of the rural empty nest elderly in Guizhou Province,and to provide basic information for further study of how to improve the living conditions of empty nest elderly.Method Using Multi -stage stratified cluster sampling method to extract the 30 villages,which respectively surveyed 10 to 15 people of the elderly subjects who aged over 60,A self-designed questionnaire was used to investigate and collected the relevant's information, the living condition of the empty nest elderly and the non-empty-nest old people was compared,and the related factors which might affect the living quality of the empty nest elderly was analysed.Results Finally 341 rural elderly were recruited,of which empty nest elderly accounted for 63. 05%,In the survey of empty nest elderly,only 22. 33%consider themselves healthy,Lower than the non -empty -nest old people's proportion of 38. 89% (P <0. 05 ).The ratio of children visitation,comfortably fixed for money,and children given pocket money were 85. 58% and 66. 98% and 39. 53%,lower than the non-empty-nest old people 96. 03%and 75. 40%and 55. 56%(P<0. 05);the ratio of timely medical treatment and loneliness among empty-nest old people were 58. 14%and 47. 91%,higher than the non-empty-nest old people were 44. 44% and 35. 71%(P<0. 05).Conclusion The perceived health status among the empty nest elderly in rural area of Guizhou Province was generally poor.The empty nest elderly needed more life care,medical security and emotional assistance.

Adjuvant Efficacy of Nutrition Support During Pulmonary Tuberculosis Treating Course: Systematic Review and Meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Malnutrition and tuberculosis (TB) tend to interact with each other. TB may lead to nutrition deficiencies that will conversely delay recovery by depressing immune functions. Nutrition support can promote recovery in the subject being treated for TB. The aim of this study was to evaluate the effectiveness of nutrition support on promoting the recovery of adult pulmonary TB patients with anti-TB drug therapy.</p><p><b>METHODS</b>English database of the Cochrane Controlled Trials Register, PubMed, EMBASE, and Chinese database of CBM, CNKI, VIP, and WANFANG were searched. Randomized controlled trials comparing nutrition support (given for more than 2 weeks) with no nutrition intervention, nutrition advice only, or placebo-control for TB patients being anti-TB treated were included. Two reviewers conducted data extraction, assessed the quality of the studies independently, and any discrepancies were solved by the third reviewer. Data were entered and analyzed by RevMan 5.2 software, and meta-analysis was done using risk ratios (RR s) for dichotomous variables and mean differences (MDs) for continuous variables with 95% confidence intervals (CI s).</p><p><b>RESULTS</b>A total of 19 studies (3681 participants) were included. In nutritional support for TB patients, pooled RR and its 95% CI of sputum smears- or culture-negative conversion rate and chest X-ray (CXR) absorption rate were 1.10 (1.04, 1.17) and 1.22 (1.08, 1.39), respectively, the pooled MD and its 95% CI of body mass index (BMI) and time of sputum smears or culture negativity were 0.59 (0.16, 1.2) and - 5.42 (-7.93, -2.92), respectively, compared with the control group. The differences in outcomes of CXR zone affected, TB score, serum albumin, and hemoglobin were not statistically significant (P = 0.76, 0.24, 0.28, and 0.20, respectively) between the intervention group and the control group. No systemic adverse events were recorded.</p><p><b>CONCLUSIONS</b>During anti-TB course, nutrition support may be helpful in treatment of TB patients by improving both sputum smears- or culture-negative conversion rate and BMI, shortening the time of sputum conversion negative. Whether it can improve the final clinical effect, there still needs high-level quality studies to confirm in the future.</p>

Effect and safety of L-carnitine in the treatment of idiopathic oligoasthenozoospermia: a systemic review / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the effect and safety of L-carnitine in the treatment of idiopathic oligoasthenozoospermia based on current clinical evidence.</p><p><b>METHODS</b>We searched the Cochrane Library, PubMed, MEDLINE, EMBASE, CNKI, VIP, CBM and Wanfang Database from the establishment to April 2014 for the published literature on the treatment of idiopathic oligoasthenozoospermia with L-carnitine. We conducted literature screening, data extraction, and assessment of the methodological quality of the included trials according to the inclusion and exclusion criteria, followed by statistical analysis with the RevMan 5. 2 software.</p><p><b>RESULTS</b>Seven randomized controlled trials involving 751 patients with idiopathic oligoasthenozoospermia met the inclusion criteria, and 678 of them were included in the meta-analysis. L-carnitine treatment achieved a significantly increased rate of spontaneous pregnancy as compared with the control group (RR = 3.2, 95% CI 1.74 to 5.87, P = 0.0002). After 12-16 and 24-26 weeks of medication, total sperm motility (WMD = 5.21, 95% CI 2.78 to 7.64, P < 0.0001 and WMD = 9.29, 95% CI 1.28 to 17.29, P = 0.02) and the percentage of progressively motile sperm (WMD = 12.44, 95% CI 4.58 to 20.31, P = 0.002 and WMD = 9.76, 95% CI 3.56 to 15.97, P = 0.002) were remarkably higher than those in the control group, but no statistically significant differences were observed in sperm concentration between the two groups (WMD = 4.91, 95% CI -2.63 to 12.45, P = 0.2 and WMD = 0.93, 95% CI -3.48 to 5.34, P = 0.68). After 12-16 weeks of treatment, the percentage of morphologically abnormal sperm was markedly decreased in the L-carnitine group as compared with the control (WMD = -2.48, 95% CI -4.35 to -0.61, P = 0.009), but showed no significant difference from the latter group after 24-26 weeks (WMD = -4.38, 95% CI -9.66 to 0.89, P = 0.1). No statistically significant difference was found in the semen volume between the two groups after 12-16 or 24-26 weeks of medication (WMD = -0.13, 95% CI -0.43 to 0.18, P = 0.42 and WMD = 0.28, 95% CI -0.02 to 0.58, P = 0.07). No serious L-carnitine-related adverse events were reported in 4 of the randomniized controlled trials.</p><p><b>CONCLUSION</b>The current evidence indicates that L-carnitine can improve spontaneous pregnancy and semen parameters in the treatment of idiopathic oligoasthenozoospermia, with no serious adverse reactions.</p>

Effect and safety of testosterone undecanoate in the treatment of late-onset hypogonadism: a meta-analysis / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of testosterone undecanoate (TU) in the treatment of late-onset hypogonadism (LOH) by meta-analysis.</p><p><b>METHODS</b>We searched Pubmed (until April 1, 2014), Embase (until March 28, 2014), Cochrane Library (until April 17, 2014), CBM (from January 1, 2001 to February 2, 2014), CNKI (from January 1, 2001 to February 2, 2014), Wanfang Database (from January 1, 2000 to February 2, 2014), and VIP Database (from January 1, 2000 to Febru ary 2, 2014) for randomized controlled trials of TU for the treatment of LOH. We evaluated the quality of the identified literature and performed meta-analysis on the included studies using the Rveman5. 2 software.</p><p><b>RESULTS</b>Totally, 14 studies were included after screening, which involved 1 686 cases. Compared with the placebo and blank control groups, TU treatment significantly increased the levels of serum total testosterone (SMD = 6.22, 95% CI 3.99 to 8.45, P < 0.05) and serum free testosterone (SMD = 4.35, 95% CI 1.86 to 6. 85, P < 0.05) but decreased the contents of luteinizing hormone (WMD = -2.23, 95% CI -4.03 to -0.42, P < 0.05), sex hormone binding globulin (WMD = 2.00, 95% CI 1.38 to 2.63, P < 0.05). TU also remarkably reduced the scores of Partial Androgen Deficiency of the Aging Males (WMD = -9.49, 95% CI -12.96 to -6.03, P < 0.05) and Aging Males Symptoms rating scale (WMD = -2.76, 95% CI -4.85 to -0.66, P <0.05) but increased the hemoglobin level (SMD = 2.35, 95% CI 0.29 to 4.41, P < 0.05) and packed-cell volume (SMD = 4.35, 95% CI 1.36 to 7.33, P < 0.05). However, no significant changes were shown in aspertate aminotransferase, alanine transaminase, prostate-specific antigen, or prostate volume after TU treatment (P > 0.05).</p><p><b>CONCLUSION</b>TU could significantly increase the serum testosterone level and improve the clinical symptoms of LOH patients without inducing serious adverse reactions. However, due to the limited number and relatively low quality of the included studies, the above conclusion could be cautiously applied to clinical practice.</p>

Early biological markers of manganese exposure / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the biomarker of manganese exposure by analyzing the relationship between manganese exposure and concentration in some biomaterials.</p><p><b>METHODS</b>The air samples were collected through the individual air sample. According to the manganese levels in the air, workers were assigned to control group, low concentration group and high concentration group, and manganese in the hair, urine, serum, blood cell and saliva from different group were measured respectively. The correlations between concentration of external manganese exposure and manganese concentrations in biomaterials, and years of employment and concentrations in biomaterials were analyzed.</p><p><b>RESULTS</b>In the high concentration group, saliva manganese was 32.17 µg/L, hair manganese was 37.39 mg/kg, urine manganese was 2.50 µg/L, plasma manganese was 29.61 µg/L, blood manganese was 14.49 µg/L, were higher than those in the control group (10.40 µg/L, 1.60 mg/kg, 0.77 µg/L, 10.30 µg/L, 4.56 µg/L respectively) (P < 0.01). The manganese concentration in the saliva was significantly correlated with airborne manganese concentration (r = 0.649, P < 0.01), with the years of employment (r = 0.404, P < 0.01), with the total exposure of manganese (r = 0.342, P < 0.01), with the manganese concentration of plasma (r = 0.303, P < 0.01) and with the manganese concentration in blood cells (r = 0.359, P < 0.01), respectively.</p><p><b>CONCLUSIONS</b>The concentration of manganese in saliva could work as a biomarker of manganese internal exposure.</p>

Survey an knowledge, attitude, practice related to contraception among college students in Beijing / 中华流行病学杂志

Objective To understand the current status and relative factors on knowledge, attitude, practice to contraception among college students in Beijing and to provide evidence for developing aimed contraceptive service and education in colleges. Methods Quantitative surveys were employed, questionnaire was conducted anonymously among 12 450 unmarried college students under informed consent. Results Among 12 129 students, acknowledgement of contraceptive knowledge among females was superior to males in college(P=0.000). Rates on the favor for unmarried sexual practice and 'sexual liberation' were 81.9% and 60.2% for males, comparing to 74.8% and 54.3% for females respectively. The prevalence rates for masturbation were 74.3% for males and 24.9% for females respectively. 18.4% of the male and 10.5% of the female students had ever experienced unmarried sexual intercourse. Among those students who had sexual experiences, 29.4% of the males had made their sex partners pregnant and 23.1% of the female students had experienced unexpected pregnancy. Statistical significance was found between males and females (P=0.000) in terms of attitudes and behaviors. 51.3% of the male and female students took contraceptive measures during the episode of first sexual intercourse. The excuses for not taking any measures would include: sexual intercourse happened incidentally, not interested in using condom, only one sexual experience would not cause pregnancy, etc. Conclusion The prevalence of unmarried sexual intercourse among college students had been rising. Among those who had experienced unmarried sexual intercourse, the rate of taking contraceptive measures was low and the incidence of unexpected pregnancy was high. It is urgent to strengthen the education and service programs on contraception among college students.