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【Objective】 To investigate the efficacy of negative pressure suction and topical testosterone cream in the treatment of simple micropenis in school-aged obese children and the effects on blood lipids and serum sex hormones. 【Methods】 A total of 79 children aged 7 to 14 (10.50±1.62) years treated and followed up during Nov.2020 and Jul.2022 were involved. The patients were randomly enrolled in the negative pressure suction group (n=39) and the topical testosterone cream group (n=40). The negative pressure suction group was treated with negative pressure suction for 30 min/time, 1 time/day, for 30 d. The topical testosterone cream group was treated with topical testosterone cream applied to the scrotum of the penis 2 times/day for 30d. The transverse and longitudinal diameter of the glans, penile flaccidity, retraction length, serum sex hormones and blood lipids were measured before and after treatment. 【Results】 In both groups, penile flaccidity, retracted length and transverse and longitudinal diameter of the glans were significantly greater at 30 days of treatment and 2 months of follow-up than those before treatment (P0.025). In the topical testosterone cream group, at 30 days of treatment, there were significant differences in serum total cholesterol (CHOL), apolipoprotein B (Apo B), apolipoprotein A1 (Apo A1), high-density lipoprotein (HDL), low-density lipoprotein (LDL), sex hormone binding protein (SBG), estradiol (E2) and testosterone (TES) compared to those before treatment; at 2 months of follow-up, the differences in Apo A1, HDL, TES and DHS were still significant (P<0.025). 【Conclusion】 Both topical testosterone cream and negative pressure suction have significant efficacy in the treatment of micropenis in school-aged obese children, while topical testosterone cream has some side effects and retraction may occur after treatment. Negative pressure suction is safe and easy to operate, without side effects and retraction, and can be promoted for the treatment of micropenis in obese children.
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Objective:To investigate the effect of ethephon exposure on sperm quality of adolescent male SD rats and the influence mechanism.Methods:A total of 40 45-day-old male SD rats were divided into control group and low, middle and high experimental groups according to the random number table method, 10 rats in each group.The said 4 groups were given 9 g/L normal saline, 100 mg/kg, 200 mg/kg, and 400 mg/kg ethephon aqueous solution for 28 days, respectively.One epididymal tail was taken to prepare sperm suspension, the sperm concentration and motility were detected.The testis and epididymis tissues were stained with HE, and their pathological changes were observed under light microscope.The activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and the malondialdehyde (MDA) content in the testis were detected.Enzyme linked immunosorbent assay kit was used to mea-sure the epididymal α-glucosidase activity, L-carnitine (LC) content, nuclear factor erythroid 2-related factor 2 (Nrf2) and organic cation transporter 2 (OCTN2) expression levels.Then the oxidative damage caused by ethephon to epididymis was evaluated.SPSS 26.0 software was used for data analysis.Data were compared by One- way ANOVA among groups and LSD method between 2 groups. Results:The sperm concentration of the control group, low, medium and high dose groups were (40.21±1.94)×10 9/L, (35.23±2.53)×10 9/L, (23.61±2.62)×10 9 /L, and (18.86±2.16)×10 9 /L, respectively.The sperm activity rate were (70.98±3.01)%, (57.96±3.75)%, (45.71±2.41)%, and (31.23±2.26)%, respectively.The concentration and vitality of epididymal sperms in the experimental group were significantly lower than those in the control group (all P<0.01). In the control group, low, medium and high dose groups, the SOD activity were (46.48±2.21) U/mg prot, (38.49±2.56)U/mg prot, (33.80±1.73) U/mg prot, and (27.65±2.05) U/mg prot, respectively.The GSH-Px activity in said 4 groups were (21.41±1.95) U/mg prot, (17.32±1.28) U/mg prot, (15.09±0.94) U/mg prot, and (14.08±1.23) U/mg prot, respectively.The MDA content in said 4 groups were (1.41±0.09) nmol/mg prot, (1.59±0.09) nmol/mg prot, (1.81±0.09) nmol/mg prot, and (2.16±0.14) nmol/mg prot, respectively.Compared to the control group, the experimental groups had significantly lower SOD and GSH-Px activities and significantly higher MDA content (all P<0.05). α-glucosidase levels in the control group, low, middle and high experimental groups were (15.46±0.71) U/mL prot, (12.95±0.72) U/mL prot, (11.34±0.65) U/mL prot, and (8.76±0.60) U/mL prot, respectively.LC levels in the control group, low, middle and high dose groups were(6.21±0.31) μg/L, (5.89±0.13) μg/L, (5.02±0.12) μg/L, (4.38±0.07) μg/L, respectively, compared with those of the control group, the concentration of α-glucosidase and LC in experimental groups decreased significantly (all P<0.01). The expression levels of Nrf2 in epididymis of the control group, low, middle and high dose groups were (1.34±0.05) ng/L, (1.25±0.04) ng/L, (1.08±0.06) ng/L, (0.92±0.04) ng/L, respectively; the expression levels of OCTN2 in epididymis of the control group, low, middle and high dose groups were (4.55±0.12) ng/L, (4.23±0.11) ng/L, (3.20±0.24) ng/L, (2.59±0.05) ng/L, respectively, compared with those of the control group, the expression levels of Nrf2 and OCTN2 in experimental groups decreased significantly (all P<0.01). Conclusions:Ethephon exposure leads to excessive generation of reactive oxygen and oxidative stress in reproductive organs.Ethephon exposure may activate the Keap1-Nrf2/ARE signal pathway, resulting in a decrease in the number, vitality and quality of sperms, and impaired fertility.
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Objective:Clinical and genetic analysis were conducted in 2 patients with hypophosphatasia(HPP) and their families to explore the pathogenic mechanism of HPP.Methods:The genomic DNA was extracted from peripheral blood of two patients with HPP and their family members. Sanger sequencing and pedigree verification were performed on the pathogenic variants identified using whole-exome sequencing. Then the function of the mutation sites was analyzed with bioinformatics software.Results:Proband 1 presented with developmental retardation, pectus funnel and premature loss of deciduous tooth, of which the serum alkaline phosphatase level was slightly lower than the bound of the normal range. Two complex heterozygous missense variants c. 1120G>A and c. 1334C>G of ALPL gene were detected in the proband 1 which were inherited from his parents respectively, showing an autosomal recessive inheritance. Both the variants were predicted to inflict deleterious effects on ALPL gene function by multiple bioinformatics program, and were classified as likely pathogenetic variants according to American College of Medical Genetics and Genomics(ACMG) guidelines. Proband 2 showed three missing permanent teeth and the significantly lower level of serum alkaline phosphatase than normal range. A heterozygous variant c. 1190-3C>G of ALPL gene was detected in proband 2 whose pattern of inheritance was unknown. The clinical significance of this variant was unknown according to ACMG standards and guidelines. All of these variants were considered as novel since none of them has been reported. Along with the above combined results, proband 1 and 2 were diagnosed as childhood HPP and Odontohypophosphatasia, respectively.Conclusion:This study reinforced the relationship between HPP and variants in ALPL gene. Two variants, c. 1120G>A and c. 1334C>G, were located in the homodimer interface and crown domain of tissue-nonspecific alkaline phosphatase(TNSALP), respectively, while c. 1190-3C>G were located in the splice sites, which might result in low TNSALP activity.
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Objective:To explore the therapeutic effect of electrical stimulation biofeedback in children with different types of urinary incontinence.Methods:A total of 20 children with stress urinary incontinence admitted to the Department of Pediatric Surgery, the First Affiliated Hospital of Xinxiang Medical University from October 2010 and June 2019 were enrolled in this study and treated by electrical stimulation biofeedback twice a week, with 5 weeks as a course of treatment.There were 12 males and 8 females aged 2.5-7.0.Nine cases developed urinary incontinence after spina bifida operation, 6 cases developed urinary incontinence after high anal atresia operation and 5 cases were non-neurogenic urinary incontinence.The frequency of involuntary urination, urinary volume and the voltage of pelvic floor muscles were compared before and after treatment.Results:After 1 course of treatment, 10 cases (50.00%) of urinary incontinence were cured, 4 cases (20.00%) were effective, and 6 cases (30.00%) were ineffective.Among the 6 patients developing urinary incontinence after high anal atresia operation, 5 cases (83.33%) were cured and 1 case (16.67%) was effective.Of 9 cases developing urinary incontinence after spina bifida operation, 3 cases (33.33%) were effective.All 5 cases with non-neurogenic urinary incontinence (100.00%) were cured.The voltage of pelvic floor muscles was increased from (20.36±3.92) μV before electrical stimulation biofeedback therapy to (36.44±7.57) μV after treatment, and the difference was statistical significance ( t=10.68, P<0.05). Conclusions:Electrical stimulation biofeedback therapy is effective for children with urinary incontinence.
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Objective:To explore the effects of different doses of Ethephon on testes of male pups.Methods:Thirty-two 45-day-old healthy female Sprague-Dawley (SD) rats were randomly divided into the control group and the low dose, middle dose and high dose Ethephon groups by the random figure table.The female rats in the low dose, middle dose and high dose Ethephon groups were given 200, 400, and 800 mg/kg Ethephon solution, respectively.The control group was treated with 9 g/L saline.After the birth of the offspring, the mother rats were not administrated with any medications, and the male offspring rats were given Ethephon solution instead.Twelve offspring male rats were randomly selected from each group and killed at the age of 0, 14 and 28 days after birth.Fresh testicular tissues were stained with hematoxylin eosin (HE), and the morphological changes of testicular tissues were observed under light microscope.The apoptotic cells were labeled by terminal dexynucleotidyl transferase (TdT) mediated dUTP nick end labeling (TUNEL) method and the apoptosis index (AI) of spermatogenic cells was detected by fluorescence microscope.Results:(1) Compared with the newborn rats in the middle dose group, low dose group and control group, se-miniferous tubules in the newborn rats of the high dose group were slightly thicker, and seminiferous cells were arranged slightly in disorder.The AI of the newborn rats in high dose group was significantly higher than that in the control group (1.00±0.06 vs.0.41±0.03, P<0.01). The AI of the newborn rats in the middle dose group was not significantly different from that in the control group and the low dose group ( P>0.05). (2) The seminiferous tubules of the 14-day-old rats in the low dose, middle dose and high dose Ethephon groups were significantly thicker and arranged more loosely than those in the control group.Compared with the control group, there were very few seminiferous cells, which were arranged disorderly in the low dose, middle dose and high dose Ethephon groups.The AI of the 14-day-old rats in the low dose, middle dose and high dose Ethephon groups was (2.13±0.10), (2.18±0.10) and (3.90±0.23), respectively, which were significantly higher than that in the control group (1.00±0.02) ( F=2 508.36, P<0.01). There was no significant difference in the AI between the middle dose and low dose groups ( P>0.05). (3) Compared with the control group, the seminiferous tubules of the 28-day-old rats in the low dose, middle dose and high dose groups were significantly thicker and arranged much more loosely, and spermatogenic cells were even less and arranged in a severely disordered way.The AI of 28-day-old rats in the low dose group (5.52±0.13), the middle dose group (9.44±0.07) and the high dose group (14.56±0.27) was significantly higher than that in the control group (3.11±0.13) ( F=10 784.69, P<0.01). Conclusions:Ethephon can thicken the seminiferous tubules of newborn and young rats, cause the germ cells to arrange disorderly, promote the apoptosis of spermatogenic cells and reduce the ability of spermatogenesis.Moreover, a longer exposure of the rats to a higher concentration of Ethephon will result in more serious damage to testicular tissues.
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Objective:To explore the effective method for treatment of small and short penis after hypospadias surgery.Method:s From November 2017 to November 2018, 57 children aged 4 to 14[mean age(7.91±2.89)years] with hypospadias who met the diagnostic criteria of small penis were reexamined at the First Affiliated Hospital of Xin-xiang Medical University.They were randomly divided into the physical treatment group and the drug treatment group according to the order of visits, and the untreated patients were included in the control group.Among them, 21 patients in the physical treatment group were treated with penile rehabilitation therapy apparatus, supplemented by Salvia mil-tiorrhiza bath (30 minutes/time, once/day, 10 days), and 20 patients in the drug treatment group were treated with Testosterone cream topically (3 times/day, 10 days). Penile relaxation length, stretch length, transverse and longitudinal diameters of glans in 2 groups before and after the treatment were measured.The relevant indexes of 16 patients in the control group measured before and after 10 days and compared with those in the treatment group.Result:s (1)The penile relaxation length in the physical treatment group increased from (25.48±6.13) mm to (30.72±6.49) mm, the length of stretch increased from (34.90±7.71) mm to (41.08±8.43) mm, the transverse diameter of glans increased from (14.81±3.40) mm to (16.57±3.42) mm, and the longitudinal diameter increased from (13.94±3.15) mm to (15.82±3.52) mm, and the differences were statistically significant (all P<0.05). (2)The penile relaxation length in the drug treatment group increased from (21.07±4.26) mm to (31.32±4.72) mm, the length of stretch increased from (31.94±7.96) mm to (45.39±7.24) mm, the transverse diameter of glans increased from (13.38±1.77) mm to (16.64±2.10) mm, and the longitudinal diameter increased from (13.09±1.77) mm to (16.62±1.86) mm, and the differences were statistically significant (all P<0.05). (3)There was no significant difference in penile relaxation length, the length of stretch, transverse diameter and longitudinal diameters of glans before and after 10 days in the control group (all P>0.05). (4) Compared with the control group, the penile relaxation length, the length of stretch, transverse diameter and longitudinal diameters of glans in the physical treatment group increased significantly, and the differences of growth values between the two groups were statistically significant (all P<0.05). (5) Compared with the control group, the penile relaxation length, the length of stretch, transverse diameter and longitudinal diameters of glans in the drug treatment group also increased significantly, and the difference of growth values between the two groups were statistically significant (all P<0.05). (6) The growth of penile relaxation length, the length of stretch and transverse and longitudinal diameters in the drug treatment group were higher than those in the physical treatment group, and the difference of growth values were statistically significant (all P<0.05). Conclusions:Both the negative pressure suction method and topical application of Testosterone cream are effective in the treatment of small and short penis after hypospadias surgery.However, Testosterone cream is difficult to obtain, and the treatment of negative pressure suction is simple, noninvasive, painless and free of adverse reactions.
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Objective@#To investigate the effect of Ethephon on the testis pathological structure and apoptosis of spermatogenic cell in offspring male rats.@*Methods@#Twenty-four healthy female SD rats of 45 days old were randomly divided into control group, low-dose Ethephon group, medium-dose Ethephon group and high-dose Ethephon group according to body weight.The male rats of the same age were selected to mate with female rats.The rats were fed with Ethephon solution of different concentrations or 9 g/L saline every day, and they were continued to be fed with Ethephon during pregnancy and lactation.At the age of 7 days and 14 days, 10 offspring male rats were randomly selec-ted from each group and were put to death.The testicular tissue was stained with HE, and the morphological changes in the testis were observed with light microscope; the apoptotic cells were labeled with terminal deoxynucleotidyl transfe-rase dUTP nick-end labeling (TUNEL method) and the apoptosis index(AI) of testis spermatogenic cells was detected with fluorescence microscope.@*Results@#At the age of 7 days, the testis internal structure of the control group developed well, and the spermatic tubules were neatly and compactly arranged.In the low-dose Ethephon group, the seminiferous tubules of the testis were slightly smaller and the spermatogenic cells were loosely arranged compared with the control group.In the medium-dose Ethephon group, the testis seminiferous tubules were slightly disordered and the cell gap increased.In the high-dose Ethephon group, the testis development was poor, the diameter of seminiferous tubules decreased significantly, and the spermatogenic cells arrangement was in disorder.There was no statistically significant difference in spermatogenic cell AI between the low-dose group [(0.54±0.10)%] and the control group[(0.53±0.09)%] (P>0.05), while the spermatogenic cell AI in the medium-dose Ethephon group [(0.63±0.11)%] and the high-dose Ethephon group [(0.81±0.06)%] were higher than that in the control group, thus there exists a statistically significant difference (all P<0.01). The spermatogenic cell AI in the low-dose Ethephon group [(0.54±0.10)%] was lower than that in the medium-dose Ethephon group [(0.63±0.11)%], and the difference was statistically significant (P<0.05). The spermatogenic cell AI in the medium-dose Ethephon group was higher than that in the high-dose Ethephon group, and the difference was statistically significant (P<0.01). At the age of 14 days, the spermatogenic cells AI in control group, low-dose Ethephon group, medium-dose Ethephon group and high-dose Ethephon group were (0.54±0.08)%, (0.65±0.11)%, (0.77±0.11)%, and (0.88±0.10)% respectively, and the spermatogenic cells AI in all groups increased gradually, in which the differences were statistically significant (all P<0.01).@*Conclusions@#Excessive dose of Ethephon can induce pathological changes in testicular tissue and increase the apoptosis of spermatogenic cells, resulting in low fertility of offspring rats.
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Objective To investigate the effect of Ethephon on the testis pathological structure and apoptosis of spermatogenic cell in offspring male rats.Methods Twenty-four healthy female SD rats of 45 days old were randomly divided into control group,low-dose Ethephon group,medium-dose Ethephon group and high-dose Ethephon group according to body weight.The male rats of the same age were selected to mate with female rats.The rats were fed with Ethephon solution of different concentrations or 9 g/L saline every day,and they were continued to be fed with Ethephon during pregnancy and lactation.At the age of 7 days and 14 days,10 offspring male rats were randomly selected from each group and were put to death.The testicular tissue was stained with HE,and the morphological changes in the testis were observed with light microscope;the apoptotic cells were labeled with terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL method) and the apoptosis index(AI) of testis spermatogenic cells was detected with fluorescence microscope.Results At the age of 7 days,the testis internal structure of the control group developed well,and the spermatic tubules were neatly and compactly arranged.In the low-dose Ethephon group,the seminiferous tubules of the testis were slightly smaller and the spermatogenic cells were loosely arranged compared with the control group.In the medium-dose Ethephon group,the testis seminiferous tubules were slightly disordered and the cell gap increased.In the high-dose Ethephon group,the testis development was poor,the diameter of seminiferous tubules decreased significantly,and the spermatogenic cells arrangement was in disorder.There was no statistically significant difference in spermatogenic cell AI between the low-dose group [(0.54 ± 0.10)％] and the control group[(0.53 ±0.09) ％] (P ＞ 0.05),while the spermatogenic cell AI in the medium-dose Ethephon group [(0.63 ± 0.11) ％]and the high-dose Ethephon group [(0.81 ± 0.06) ％] were higher than that in the control group,thus there exists a statistically significant difference (all P ＜0.01).The spermatogenic cell AI in the low-dose Ethephon group [(0.54 ±0.10) ％] was lower than that in the medium-dose Ethephon group [(0.63 ± 0.11)％],and the difference was statistically significant (P ＜ 0.05).The spermatogenic cell AI in the medium-dose Ethephon group was higher than that in the high-dose Ethephon group,and the difference was statistically significant (P ＜0.01).At the age of 14 days,the spermatogenic cells AI in control group,low-dose Ethephon group,medium-dose Ethephon group and high-dose Ethephon group were (0.54 ± 0.08) ％,(0.65 ± 0.11) ％,(0.77 ± 0.11) ％,and (0.88 ± 0.10) ％respectively,and the spermatogenic cells AI in all groups increased gradually,in which the differences were statistically significant (all P ＜ 0.01).Conclusions Excessive dose of Ethephon can induce pathological changes in testicular tissue and increase the apoptosis of spermatogenic cells,resulting in low fertility of offspring rats.
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OBJECTIVE@#To analyze the current status of diagnosis and management of acute appendicitis (AA) in China.@*METHODS@#Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary.@*RESULTS@#A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001).@*CONCLUSIONS@#The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Acute Disease , Anti-Bacterial Agents , Therapeutic Uses , Appendectomy , Appendicitis , Diagnosis , Therapeutics , China , Health Care Surveys , Laparoscopy , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To explore the clinical effect of negative pressure suction combined with washing by Chinese herbal bath to treat small penis in obese children at school age.Methods The data of 60 obese cases with small penis at the First Affiliated Hospital of Xinxiang Medical University from June 2016 to September 2017 were retrospectively analyzed,the age ranged from 7 to 15 years old,and the average age was (11.1 ± 2.0) years old,the body mass index(BMI) was 19.2-30.5,and the average BMI was 24.5 ± 2.6.Treatment group received the penis treatment with negative pressure instrument suction supplemented by traditional Chinese medicine bath treatment,once a day,20 minutes each times,10 days asa course,a totally of 2 treatment courses.Other 46 cases of male children who came to our hospital in the same period for physical exam were selected as healthy control group,aged 8-14 years old [(11.2 ± 2.1) years],BMI:14.6-21.0,mean 18.1 ± 1.6,and the relaxation length and elongation of 20 days before and after the normal growth state of the penis in the control group were measured.The length and elongation of the penis in the treatment group were compared with those of the healthy control group before and after treatment.Results The length of penile relaxation in the treatment group increased to (3.76 ±0.61) cm in comparison with that before treatment (2.94 ± 0.52) cm,and the difference was statistically significant (t =-7.82,P ＜ 0.05);the penis elongation increased compared with that before treatment (4.29 ± 0.67) cm to (5.37 ± 0.82) cm,and the difference was statistically significant (t =-7.91,P ＜ 0.05).The initial relaxation length of the control group was (3.96 ± 0.65) cm,(4.07 ± 0.65) cm 20 days after natural growth,the difference was not statistically significant (t =-0.82,P ＞ 0.05),the initial stretch length was (5.96 ± 0.92) cm,(6.03 ± 0.90) cm natural growth after 20 days,and the difference was not statistically significant (t =-0.37,P ＞ 0.05).Before and after treatment,the length of penis relaxation and elongation were significantly increased,but they didn't reach the normal level at the same age.Conclusions Negative pressure suction supplemented with Chinese herbal medicine bath has a significant effect on treating obese children with small penis.
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Objective To evaluate pelvic peritoneum reconstruction with barbed suture and irrigation and negative pressure drainage in laparoscopy rectal anterior resection for locally advanced rectal cancer.Methods From 2014 to 2018 159 locally advanced rectal cancer patients treated by laparoscopy were derided into study group (n =76),and those received gravity drainage without pelvic peritoneum reconstruction (n =83).Results There were not significant difference in the operation time between the two groups [(165 ± 18) min vs.(160 ± 17) min,t =0.098,P =0.069].There were significant differences in postoperative drainage tube indwelling duration [(5.7 ± 2.4) d vs.(7.4 ± 3.7) d,t =3.309,P =0.001],intraabdominal infection (7％ vs.17％,x2 =3.991,P =0.046) and anastomotic leakage (4％ vs.13％,x/2 =4.280,P =0.039).There was no significant difference in anastomotic stenosis (5％ vs.10％,x2 =1.088,P =0.297) and intestinal obstruction (9％ vs.11％,x2 =0.117,P =0.732) between the two groups.Conclusion It is simple,safe and reliable to perform pelvic peritoneal reconstruction using barbed suture,combined with irrigation and negative pressure drainage,it can decrease drainage tube indwelling duration,reduce the incidence of intraabdominal infection and anastomotic leakage.
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OBJECTIVE@#To determine the incidence of surgical site infection (SSI) after abdominal surgery and to further evaluate the related risk factors of SSI in China.@*METHODS@#The multicenter cross-sectional study collected clinical data of all adult patients who underwent abdominal surgery from May 1, 2018 to May 31, 2018 in 30 domestic hospitals, including basic information, perioperative parameters, and incisional microbial culture results. The primary outcome was the incidence of SSI within postoperative 30 days. SSI was classified into superficial incision infection, deep incision infection, and organ/gap infection according to the US Centers for Disease Control and Prevention (CDC) criteria. The secondary outcome variables were ICU stay, postoperative hospital stay, total hospital stay, 30-day mortality and treatment costs. Multivariate logistic regression was used to analyze the risk factors of SSI.@*RESULTS@#A total of 1666 patients were enrolled in the study, including 263 cases of East War Zone Hospital of PLA, 140 cases of Affiliated Hospital of Qingdao University, 108 cases of The First Affiliated Hospital of Nanchang University, 87 cases of Central War Zone Hospital of PLA, 77 cases of West China Hospital, 74 cases of Guangdong General Hospital, 71 cases of Chenzhou First People's Hospital, 71 cases of Zigong First People's Hospital, 64 cases of Zhangjiagang First People's Hospital, 56 cases of Nanyang City Central Hospital, 56 cases of Lanzhou General Hospital of Lanzhou Military Command, 56 cases of Shandong Provincial Hospital, 52 cases of Shangqiu First People's Hospital, 52 cases of People's Hospital of Xinjiang Uygur Autonomous Region, 48 cases of The Second Xiangya Hospital of Central South University, 48 cases of Chinese PLA General Hospital, 44 cases of Affiliated Hospital of Xuzhou Medical University, 38 cases of Hunan Province People's Hospital, 36 cases of Dongguan Kanghua Hospital, 30 cases of Shaoxing Central Hospital, 30 cases of Northern Jiangsu People's Hospital, 29 vases of The First Affiliated Hospital of Zhengzhou University, 27 cases of General Hospital of Tianjin Medical University, 22 cases of Zigong Fourth People's Hospital, 21 cases of The Second Hospital of University of South China, 18 cases of Tongji Hospital, 15 cases of Nanchong Central Hospital, 12 cases of The 901th Hospital of PLA, 11 cases of Hunan Cancer Hospital, 10 cases of Lanzhou University Second Hospital. There were 1019 males and 647 females with mean age of (56.5±15.3) years old. SSI occurred in 80 patients (4.8%) after operation, including 39 cases of superficial incision infection, 16 cases of deep incision infection, and 25 cases of organ/interstitial infection. Escherichia coli was the main pathogen of SSI, and the positive rate was 32.5% (26/80). Compared with patients without SSI, those with SSI had significantly higher ICU occupancy rate [38.8%(31/80) vs. 13.9%(220/1586), P<0.001], postoperative hospital stay (median 17 days vs. 7 days, P<0.001) and total hospital stay (median 22 days vs. 13 days, P<0.001), and significantly higher cost of treatment (median 75 000 yuan vs. 44 000 yuan, P<0.001). Multivariate analysis showed that male rise(OR=2.110, 95%CI:1.175-3.791, P=0.012), preoperative blood glucose level rise(OR=1.100, 95%CI: 1.012-1.197, P=0.026), operative time (OR=1.006, 95%CI:1.003-1.009, P<0.001) and surgical incision grade (clean-contaminated incision:OR=10.207, 95%CI:1.369-76.120, P=0.023; contaminated incision: OR=10.617, 95%CI:1.298-86.865, P=0.028; infection incision: OR=20.173, 95%CI:1.768-230.121, P=0.016) were risk factors for SSI; and laparoscopic surgery (OR=0.348, 95%CI:0.192-0.631, P=0.001) and mechanical bowel preparation(OR=0.441,95%CI:0.221-0.879, P=0.020) were protective factors for SSI.@*CONCLUSIONS@#The incidence of postoperative SSI in patients with abdominal surgery in China is 4.8%. SSI can significantly increase the medical burden of patients. Preoperative control of blood glucose and mechanical bowel preparation are important measures to prevent SSI.
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Adult , Aged , Female , Humans , Male , Middle Aged , Abdomen , General Surgery , China , Cross-Sectional Studies , General Surgery , Operative Time , Postoperative Complications , Preoperative Period , Retrospective Studies , Risk Factors , Surgical Wound InfectionABSTRACT
This paper aims to understand the blood pressure control status for hypertension patients, and discuss the relationship between social support, medication compliance and blood pressure for hypertensive patients. The survey objective was the hypertensive patients in chronic disease management system in Xinxiang city. The survey was conducted as the questionnaire survey filled by objectives. Social support rating scale and medication therapy compliance questionnaire was utilized to evaluate the patients' social support and medication therapy compliance. 1095 patients in medication were investigated, the blood pressure of 66.6% investigated objectives was controlled at target levels [<140/90 mmHg], 70.0% investigated objectives have good medication therapy compliance; the overall social support score for hypertensive patients in medication was [40.01+/- 6.54] points, the subjective support score, objective support score and support utilization degree score were respectively [24.43+/- 4.61] points, [8.59+/- 2.59] points and [7.00+/- 2.06] points; Rank correlation coefficient of Spearman illustrated that the support utilization rating evaluation was apparently correlated to medication therapy compliance [rs=0.88, P<0.01]; multivariate analysis proved that the protective factors for medication therapy compliance were the high support utilization rate [OR 1.62; 95%CI 1.19tildE[2].05], long hypertensive duration [5tilde10 years: OR 2.01, 95%CI 1.42tildE[2].73; more than 10 years: OR 1.46, 95%CI 1.01tilde1.99] and high average monthly household income [OR 2.03, 95%CI 1.45tildE[2].69]; Risk factor for blood pressure control were male [OR 0.61, 95% CI 0.47tilde0.79] and high hypertensive grade [OR 0.31, 95%CI 0.19tilde0.44]; The protective factors for blood pressure control was good medication therapy compliance [OR 1.54, 95%CI 1.22 tilde 1.89], [average P<0.05]. It required to build effective social support system, increase patients' social support utilization degree, emphasized the intervention on low average monthly household incomes, male higher rate, higher hypertensive degree, and further improve the medication therapy compliance and hypertensive control rate of hypertensive patients
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Objective To investigate the influence of single agent and combined medication chemotherapy on elderly patients with gastric cancer. Methods One hundred and twenty elderly inpatients with gastric cancer in the general surgery department of the Nanyang Municipal Central Hospital from January 2009 to October 2014 were divided into the single agent chemotherapy group (n=60) and combined medication chemotherapy group(n=60). The adverse reactions and survival time were compared between the two groups. Results The occurrence rates of nausea, vomiting, diarrhea, constipation, leukopenia, oral mucositis and peripheral neuropathy in the single agent group were lower than those in the combined chemotherapy group, the difference between the two groups was statistically significant (P<0.05) ; the occurrence rates of Hb decrease, thrombocytopenia and transaminase elevation in the single agent group were lower than those in the combined chemotherapy group,but the difference was not statistically significant(P>0. 05);the survival time in the combined chemotherapy group was longer than that in the single agent chemotherapy group,but the difference between them was not statistically significant(P>0.05). Conclusion Single agent chemotherapy may be considered as the first-line chemotherapy scheme for elderly patients with gastric cancer.
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Objective To investigate the efficacy and safety of preoperative regional intra-arterial chemoembolization combined with systemic vein chemotherapy in the treatment of locally advanced gastric cancer.Methods The clinical data of 78 locally advanced gastric cancer patients treated by radical D2 gastretomy from January 2010 to December 2012 were retrospectively analyzed.Patients were devided into treatment group receiving regional intra-arterial chemoembolization combined with systemic vein chemotherapy (n =36),and those with preoperative systemic vein chemotherapy (n =42) 3 to 4 weeks before surgery.Systemic chemotherapy with mFOLFOX6 was started after 5 weeks of surgery in the two groups.Results The incidence of toxicity reaction and postoperative anastomotic leakage were lower in treatment group than in control group,all P ＜ 0.05.The 1-year recurrence and overall survival rate were similar between the two groups (all P ＞ 0.05).The 3-year liver metastasis rate was higher in treatment group than in control group (x2 =4.063,P ＜ 0.05).The 3-year survival rate was higher than that of the control group(x2 =4.396,P ＜ 0.05).Conclusions Preoperative systemic vein chemotherapy combined with regional intra-arterial chemoembolization decreases toxicity reaction,anastomotic leakage and liver metastasis,while prolonging 3-year overall survival.
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Objective:To discuss the diagnostic value of miR-26a/b and relationship of this microRNA with clinicopathological features in patients with gastric cancer. Methods:The expression of serum miR-26a/b was detected in 121 patients with gastric cancer and 116 healthy controls using real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). The relationship of miR-26a/b and clinicopathological parameters of patients were analyzed. The receiver operating curve (ROC) was constructed to in vestigate the value of miR-26a/b in the diagnosis of gastric cancer. Results:The relative expression levels of serum miR-26a and miR-26b in patients with gastric cancer were lower than those in the control group (1.60±1.02 vs. 5.35±0.44;1.44±0.71 vs. 5.35±0.71;P<0.05). The relative expression level of miR-26a/b correlated with TNM stage, and the relative expression level of miR-26a also correlated with invasion depth and lymph node metastasis (P<0.05), but not with sex, age, tumor size, or histological type (P>0.05). The area under the ROC curve of miR-26a was 0.828 (95％CI:0.776～0.881), with sensitivity of 73.3％and specificity of 81.0％, while the area under the ROC curve of miR-26b was 0.853 (95％CI:0. 801～0.906), with sensitivity of 68.1％and specificity of 99.2％. Conclusion:The expression of miR-26a/b significantly reduced in patients with gastric cancer, and its expression level correlated with the clinical stage, invasion depth, and lymph node metastasis. MiR-26a/b has potential diagnostic value for gastric cancer.
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Objective:To explore the influence of psychological factors on temporomandibular disorders(TMD) in school students.Methods:52 school students aged 14-26 years with TMD classified as muscular dysfunction (MD,n =26),temporomandibular displacement(TD,n =14) and MD with TD(MD +TD,n =12),and 53 healthy adolescents as the controls were investigated.All the participants accepted TMD examination and their psychological status were tested by symptom checklist-90 (SCL-90).The patients were divided into acute(case history ≤6 months,n =32) and chronic(case history ＞6 months,n =20) groups.The psychological differences among the related groups were analyzed by SPSS 17.0 statistical software package.Results:The total and the factor scores of the TMD group were higher than those of control(P ＜ 0.05).There was no significant statistically difference between the MD group and the TD group(P ＞ 0.05).MD + TD group got higher SCL-90 total score and factor scores (except depression,phobic anxiety and Psychoticism score) than the other 2 groups (P ＜ 0.05).The acute and chronic group got similar SCL-90 total scores and factor scores (P ＞ 0.05),except somatization score (P ＜ 0.05).There was a positive correlation between the TMD pain level and total score of SCL-90.Conclusion:The psychological status have remarkable influence on the students with TMD.The pain degree of TMD is affected by psychological factors.Therefore,psychological therapy should be applied during the diagnosis and treatment of students with TMD.
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Objective To investigate the effects of Ethephon on spermatogenic cells and sex hormones levels of adolescent male rats.Methods The male SD rats of 25-day old were randomly (from the random number table) divided into high dose group (2 000 mg/kg),middle dose group (1 000 mg/kg),low dose group (500 mg/kg) and control group (the same amount of physiological saline).They were given Ethephon through stomach for 14 d.The pathological changes in testis tissues were observed by HE staining.The apoptosis of germ cells were detected by terminal transferase labeling (TUNEL).The automatic chemical luminescence immunoassay analyzer was used to test the serum sex hormone levels.Results After ethephon and saline lavage for 14 days in the dose of 2 000 mg/kg,1 000mg/kg,500 mg/kg concentrations respectively,body weight growth was significantly decreased (F =3.58,P =0.03).Testis mass growth [(0.91 ± 0.17) g,(1.13 ± 0.15) g,(1.21 ± 0.11) g,(1.29 ± 0.28) g] was significantly decreased (F =4.31,P =0.02).Experimental group spermatogenic cell apoptosis,the apoptosis index increased (F =156.00,P =0.00),high dose group[(2.40 ±0.18)％] and middle dose group[(1.72 ±0.14)％] was significandy increased (P ＜ 0.01).The levels of testosterone and estrogen in serum showed a decreasing trend along with the increase of the doses,and there was a statistical significance (F =11.85,38.93,all P =0.00).Compared with the control group [(0.86 ± 0.10) μg/L],the testosterone levels in high dose group [(0.31 ± 0.08) μg/L],middle dose group [(0.36± 0.05) μg/L] decreased significantly (P ＜ 0.01).Compared with the control group,low dose group,middle dose group [(36.43 ± 3.57) ng/L,(38.62 ± 2.24) ng/L,(31.87 ± 5.78) ng/L],the estrogen level in high dose group[(27.39 ± 2.11) ng/L] was significantly reduced (P ＜ 0.01).Conclusion Ethephon has reproductive toxicity,and can cause the serum level of testosterone and estradiol decreased,resulting in spermatogenic cell apoptosis index increased and the spermatogenic capability decreased.
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Objective To investigate the impact of neoadjuvant chemotherapy on surgery and prognosis in patients with stage Ⅲ gastric cancer.Methods The 90 cases staging Ⅲ gastric cancer were randomly divided into neoadjuvant chemotherapy group and surgery group.Both surgical complications and prognosis were compared.Results The overall effective rate of neoadjuvant chemotherapy was 53％ (24/45),disease control rate of neoadjuvant chemotherapy was 91％ (41/45).Blood loss (t =4.102,P =0.037),local adhesions surgery (x2 =19.756,P =0.000),local tissue necrosis (x2 =13.512,P =0.000),tissue fragility (x2 =12.870,P =0.000) number of cases found in neoadjuvant chemotherapy group were higher than surgery group,and the data were statistically significant.There were no statistically significance between two groups about operation time (t =2.391,P =0.129),tissue congestion (x2 =0.865,P =0.352),postoperative bleeding(x2 =0.720,P =0.396),postoperative fistula (x2 =1.047,P =0.306).The survival time of neoadjuvant chemotherapy group was longer than surgery group,but it was not statistically significant(t =1.086,P =0.372).Conclusions Neoadjuvant chemotherapy could reduce the stage of the gastric cancer and increase the complexity of surgery.Thus preoperative evaluation should be prepared before the surgery.
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Objective:To investigate the role and mechanism of miR-143 in the proliferation and migration of gastric cancer (GC) cells. Methods:Western blot was performed to detect the expression level of avian erythroblastosis oncogene B-3 (ERBB3) in GC tissues, paired non-cancerous tissues, and SGC7901 GC cells. RT-qPCR was conducted to determine the mRNA and miR-143 of ERBB3 quantita-tively. Bioinformatics tools were used to predict the target gene of miR-143. Luciferase reporter assay was carried out to confirm the predicted target gene. Transwell and EdU assays were applied to observe the migration and proliferation of SGC7901 GC cells transfect-ed with miR-143 mimics/inhibitor/NC mimics/inhibitor. Results:Compared with the expression levels of ERBB3 and miR-143 in the paired non-cancerous tissues, the expression level of ERBB3 was upregulated and the expression level of miR-143 was downregulated in GC tissues. In the prediction of the potential target gene, miR-143 could bind to a specific sequence of the 3′-untranslated regions (UTR) of the mRNA of ERBB3. This finding was supported by luciferase reporter assay results. In vitro, ERBB3 protein expression and cell migration and proliferation were suppressed significantly in the SGC7901 cells transfected with miR-143 mimics. By contrast, these processes were remarkably enhanced when the cells were transfected with miR-143 inhibitor. Conclusion:miR-143 can suppress the migration and proliferation of GC cells by downregulating the expression of ERBB3.