Research progress on effects of metallic elements on male semen quality / 环境与职业医学

In recent years, the quality of male sperm has shown a downward trend year by year. The male infertility rate in China continues to increase. It has been found that the impacts of environmental factors on male semen quality are mainly negative. Inorganic metallic elements as environmental contaminants have become a class of chemicals that cannot be ignored, and their health impacts on human reproductive systems have been received widespread attention and research. They certainly play a significant role in impairing male reproductive ability and are relative to the lower and lower semen quality. This review focused on the relationship between exposure to environmental metallic elements and semen quality of humans and animals, as well as summarized specific results from epidemiological studies, animal trials, or molecular experiments to provide a theoretical basis for protecting male reproductive capacity.

Based on the analysis of emergency dying patients to explore the demand of emergency palliative care / 中国实用护理杂志

Objective:To explore the demand and mode of palliative care for emergency dying patients by analyzing the case data of emergency death and cardiopulmonary resuscitation.Methods:The data of 776 cases of emergency clinical death and cardiopulmonary resuscitation in the Second Affiliated Hospital of Soochow University from 2017 to 2020 were retrospectively analyzed.Results:A total of 687 patients were included with (70.38 ± 16.57) years old, and 49.8% (342/687) of them were 75 years old and above; among them, 36.0% (247/687) patients or their families chose not to give cardiopulmonary resuscitation (DNR) in the last stage of their lives,and 63.2%(156/247) of DNR patients were 75 years old and above. The top four etiology of DNR were cerebral hemorrhage, respiratory failure, multiple organ dysfunction syndrome and out of hospital cardiac and respiratory arrest.After successful cardiopulmonary resuscitation, 37.5% (45/120) of the patients' family members chose to give up treatment again. The median stay time of DNR patients in the emergency room was 738.7 minutes.Conclusions:The patients who choosed DNR were mainly 75 years old and above, with cerebral hemorrhage, respiratory failure, multiple organ failure and cardiac and respiratory arrest. The detention of these patients in the emergency room increases the congestion of the emergency room, and at the same time, they can not get a peaceful palliative care environment. It is suggested that emergency medical staff should strengthen the awareness and improve the ability of palliative care. A relative independent area and corresponding soothing palliative treatment and nursing should be given to the DNR patients.

The relationship between the changes of hemoglobin and ferritin in different stages of pregnancy and adverse pregnancy outcomes / 中国医师杂志

Objective:To study the relationship between the changes of hemoglobin concentration and serum ferritin concentration during pregnancy and the adverse pregnancy outcome, and to guide iron supplementation during pregnancy.Methods:122 parturient women who delivered in the Aerospace Center Hospital from August 2016 to may 2018 were prospectively selected. Data on hemoglobin concentration in each trimester and first day after delivery, ferritin concentration in first and second trimester, pregnancy outcomes of 122 parturient women was collected. Gestational diabetes mellitus, gestational hypertension (gestational hypertension and preeclampsia-eclampsia), preterm labor, premature rupture of membranes, postpartum hemorrhage, and neonatal weight were collected for statistical analysis.Results:⑴ There were significant differences in hemoglobin concentration among the early, middle, late pregnancy and the first day after delivery in 122 cases of parturient women ( P<0.01). There was significant difference in serum ferritin between early and middle pregnancy ( P<0.01). ⑵ There was a significant difference in hemoglobin between the gestational diabetes group and the non-gestational diabetes group ( P<0.05). Hemoglobin between pregnancy-induced hypertension (PIH) disease group and the normal hypertension group in early pregnancy have significant difference ( P<0.05), while hemoglobin between the preterm and term groups have significant difference ( P<0.05). ⑶ Patients with iron deficiency (ferritin ≥ 20 μg/L) were more likely to have premature rupture of membranes than those with iron deficiency, and those with anemia in late pregnancy were more likely to have premature delivery. ⑷ The risk factors of gestational diabetes mellitus were high body mass index (BMI) before pregnancy ( OR=3.578, 95% CI: 1.604-7.985) and high hemoglobin concentration during middle pregnancy ( OR=1.425, 95% CI: 1.058-1.918). High BMI before pregnancy ( OR=5.313, 95% CI: 1.746-16.169) and early high hemoglobin concentration ( OR=1.975, 95% CI: 1.048-3.720) were risk factors for PIH. The independent risk factor of PROM was serum ferritin ≥15 μg/L ( OR=2.836, 95% CI: 1.05-7.637). The independent risk factor of preterm birth was anemia in late pregnancy ( OR=13.625, 95% CI: 2.470-75.161). Conclusions:It is necessary to master the time and reasonable dose of iron supplement during pregnancy. Individualized iron supplement is the most appropriate method. Close monitoring should be carried out in the process of iron supplement to avoid adverse pregnancy outcomes.

Clinical study of the puncture success rate during ultrasound-guided percutaneous nephrolithotomy / 中华泌尿外科杂志

Objective@#To evaluate the success rate during ultrasound-guided percutaneous nephrolithotomy (PCNL) and analyze the reasons of puncture failure.@*Methods@#A retrospective analysis was performed based on the data of 58 patients who underwent ultrasound-guided PCNL by 4 experienced urologists(10 years' experience of PCNL and more than 80 cases per year)in our center from August 2018 to November 2018. Of all the 58 patients, there were 36 males and 22 females (aged from 22 to 73 years) with the mean age of 51 years. The calculi ranged from 9 mm to 93 mm, with the average of 26.5 mm. The separation of renal collecting system ranged from 5 mm to 30 mm, with the average of 15.1 mm. All of the 58 patients underwent one-stage PCNL and the numbers of punctures, the numbers of percutaneous tubes and the reasons for failure were recorded.@*Results@#All percutaneous tubes and surgeries were established and done successfully. Of all the 118 punctures, 74 punctures succeeded by detecting the urine and 68 surgery tracts were established (6 punctures failed because of the dilation). The total puncture success rate was 62.7%(74/118). Of the total 74 successful punctures, 56.8%(42/74)succeeded at the first puncture, 28.4%(21/74)succeeded at the second puncture and 14.9%(11/74)succeeded at least after three punctures. The success puncture rate of the 4 urologists were 59.2%(29/49), 64.1%(25/39), 66.7%(16/24), 66.7%(4/6)respectively, and there were no statistical differences between the puncture success rates of the urologists (P=0.679). Each channel needed 1.7 punctures on average. Fouty-four punctures failed without detecting the urine, including 20 failed punctures because of the puncture tract deviation, 17 punctures without seeing the urine after the core needle being removed, 7 punctures no display on the ultrasound imagine. There were 33 punctures to be tubeless while other 35 indwelling the nephrostomy tubes. Five nephrostomy tubes' position were different with the preoperationally predicted position which means the discrepancy rate was 14.3%(5/35). One patient had complications and classified as Grade II or above on the modified Clavien Grading System of aerothorax.@*Conclusions@#The puncture success rate during ultrasound-guided PCNL is not satisfied. The main reasons of puncture failure are the deviation of puncture tract, unclear imaging of puncture tract and other unclear reasons( puncture needle went too deep or superficially or tip of the needle embedded into the stone).

Clinical study of the puncture success rate during ultrasound-guided percutaneous nephrolithotomy / 中华泌尿外科杂志

Objective To evaluate the success rate during ultrasound-guided percutaneous nephrolithotomy (PCNL) and analyze the reasons of puncture failure.Methods A retrospective analysis was performed based on the data of 58 patients who underwent ultrasound-guided PCNL by 4 experienced urologists(10 years'experience of PCNL and more than 80 cases per year)in our center from August 2018 to November 2018.Of all the 58 patients,there were 36 males and 22 females (aged from 22 to 73 years) with the mean age of 51 years.The calculi ranged from 9 mm to 93 mm,with the average of 26.5 mm.The separation of renal collecting system ranged from 5 mm to 30 mm,with the average of 15.1 mm.All of the 58 patients underwent one-stage PCNL and the numbers of punctures,the numbers of percutaneous tubes and the reasons for failure were recorded.Results All percutaneous tubes and surgeries were established and done successfully.Of all the 118 punctures,74 punctures succeeded by detecting the urine and 68 surgery tracts were established (6 punctures failed because of the dilation).The total puncture success rate was 62.7％ (74/118).Of the total 74 successful punctures,56.8％ (42/74) succeeded at the first puncture,28.4％ (21/74)succeeded at the second puncture and 14.9％ (11/74)succeeded at least after three punctures.The success puncture rate of the 4 urologists were 59.2％ (29/49),64.1％ (25/39),66.7％ (16/24),66.7％ (4/6)respectively,and there were no statistical differences between the puncture success rates of the urologists (P =0.679).Each channel needed 1.7 punctures on average.Fouty-four punctures failed without detecting the urine,including 20 failed punctures because of the puncture tract deviation,17 punctures without seeing the urine after the core needle being removed,7 punctures no display on the ultrasound imagine.There were 33 punctures to be tubeless while other 35 indwelling the nephrostomy tubes.Five nephrostomy tubes'position were different with the preoperationally predicted position which means the discrepancy rate was 14.3％ (5/35).One patient had complications and classified as Grade Ⅱ or above on the modified Clavien Grading System of aerothorax.Conclusions The puncture success rate during ultrasound-guided PCNL is not satisfied.The main reasons of puncture failure are the deviation of puncture tract,unclear imaging of puncture tract and other unclear reasons (puncture needle went too deep or superficially or tip of the needle embedded into the stone).

Physiological changes of Saccharomyces cerevisiae during serial re-pitching: a review / 生物工程学报

The morphological structure and physiological indexes of Saccharomyces cerevisiae have changed during serial re-pitching due to the stress conditions in serial handlings and the cells become aging. It is of great significance to study the physiological changes of S. cerevisiae during serial re-pitching to understand the anti-aging effect of S. cerevisiae. In this paper, the changes of the physiological indexes during re-pitching of yeast are summarized, and based on the analysis of the previous works further research directions are proposed.

Relation between renal pelvic pressure and ratio of endoscope-sheath diameter during percutaneous nephrolithotomy / 中华泌尿外科杂志

Objective To observe the influence of ratio of endoscope-sheath diameter on renal pelvic pressure during PCNL.Methods The model of 24 isolated adult porcine kidneys were used to imitate percutaneous nephrolithotomy from September 2016 to June 2017.Each tract was established (F12,F14 and F16).Three kinds of endoscopes (F8 all-seeing needle percutaneous nephroscope,F6/7.5 and F8/ 9.8 rigid ureteroscope),input a 200μm laser,were adopted.There were 8 combinations,and 3 kidneys were used for each one.Renal pelvic pressure was measured 3 times repeatedly in every combination with steady irrigation (50,100,150,200,250,300,350,400,450,500 cmH2O).Results The linear equations,ratios of endoscope-sheath diameter and highest renal pelvic pressures for each combination were:F8-F12,Pr =0.026 P0-1.533,0.67,12.2 ± 0.54;F6/7.5-F 12,Pr =0.112 P0-5.001,0.92,51.2 ± 0.93;F8-F 14,Pr =0.010P0 + 1.067,0.58,6.2 ± 0.48;F6/7.5-F14,Pr =0.020P0 + 1.000,0.79,10.8 ± 0.46;F8/9.8-F14,Pr =0.144P0 +20.933,0.87,84.7 ± 1.17;F8-F16,Pr =0.005P0 + 1.067,0.50,2.8 ±0.34;F6/7.5-F16,Pr =0.009P0 + 0.533,0.68,5.1 ± 0.32;F8/9.8-F16,Pr =0.020P0 + 2.200,0.75,12.6 ± 0.56.The combinations of F6/7.5-F12 and F8/9.8-F14 might lead to a high renal pelvic pressure without proper irrigation (＜401.7 cmH2O for F6/7.5-F12;＜ 132.4 cmH2O for F8/9.8-F14).Conclusion In order to keep a safe pressure,a proper ratio of endoscope-sheath diameter (＜ 0.80) and appropriate irrigation must be considered.

Research Progress of Urinary Tract Infections in Patients with Spinal Cord Injury (review) / 中国康复理论与实践

Urinary tract infections remain the most frequent infection in patients with either traumatic or nontraumatic spinal cord inju-ry. The urinary tract infections are closely related to impaired bladder storage, voiding dysfunction, and use of indwelling catheters after spi-nal cord injury. Repeated urinary tract infections can cause upper urinary tract deterioration, and related chronic or repeated exposure to the antibiotics used to treat urinary tract infections increases the risk of multidrug-resistant bacteria colonization. Therefore, it is important to de-termine appropriate urinary tract infections treatment in spinal cord injury patients who are admitted to rehabilitation hospitals. The limita-tions of the usual measures in prevention of urinary tract infections in this population have led the way to explore more innovative modali-ties and approaches. We reviewed the researches of urinary tract infections on spinal cord injury. It is presented to provide reference for clini-cal diagnosis and treatment.

Interventional treatment of coronary artery fistulas by using Guglielmi detachable coils：analysis of feasibility and safety with single center experience / 介入放射学杂志

Objective To summarize the experience in treating coronary artery fistula (CAF) by using Guglielmi detachable coils. Methods During the period from July 2009 to November 2014 at the Affiliated Changhai Hospital of Second Military Medical University, interventional treatment of CAF by using Guglielmi detachable coils was performed in 40 patients. The clinical data were retrospectively analyzed. The feasibility, safety and effectiveness of this technique were evaluated. Results Successful transcatheter closure of CAF with Guglielmi detachable coils was achieved in all 40 patients; the average Guglielmi detachable coils used in each patient was(2.33±1.38) coils. No procedure-related complications occurred. Intra-operative angiography showed that residual shunt completely disappeared in 12 patients (30%) and blood flow was significantly decreased in 28 patients (70%). All the patients were followed up for 1-65 months, neither complications such as recurrent bleeding and ischemia nor stenosis and occlusion of related arteries, or fistula cavity rupture occurred. Conclusion The use of Guglielmi detachable coil in interventional treatment of CAF is safe and effective, although its long-term effect needs to be further verified.

Application of teaching-picture archiving and communication system to improve the medical image reading ability of eight-year-program medical students / 中华医学教育探索杂志

Objective To evaluate the application effect of teaching-picture archiving and communication system (T-PACS) in training image reading ability of eight-year-program students. Methods Sixty students were divided into two groups: control group (applying traditional teaching method) and experimental group (applying traditional teaching method and T-PACS) when doing clinical medical image reading ability training. Making multimedia teaching movie, clinical image reading teaching and establishing image database by T-PACS were used in experiment group. Mean-while, reading room was set up and classroom teaching and problem-oriented assignments were in-creased. Finally objective evaluation of image recognition ability and questionnaire were used to compare the teaching effect. Measurement data were expressed as x±s. Total scores of image reading were am-alyzed by t test. Full score rates were analyzed by X2 test. Results The results showed that the score of medical image reading ability was higher in experimental group (90.08±4.52) than in control group (86.92±4.68) (P=0.010). There were differences in respiratory and orthopedic full score rate (P=0.006;P=0.035). Most students thought that application of T-PACS could effectively improve the teaching and learning quality. Conclusions Application of T-PACS can improve the medical image reading ability of eight-year-program medical students and is worth further promoting.

Influence of schisandrone on levels of IL-1? and iNOS mRNA in hippocampus of rats with Alzheimer-like disease / 第二军医大学学报

Objective:To observe the influence of schisandrone on the levels of IL-1? and iNOS mRNA in the hippocampus of rats with Alzheimer-like disease(AD) and to investigate the probable prevention and therapy effect of schisandrone on AD. Methods: Totally 30 male SD rats, 8-12 weeks old, weighing 250-300 g, were randomly divided into 3 groups: blank control group,AD model group and schisandrone intervention group(n=10). The animal model of AD was established by 10 mmol/L amyloid-beta protein(A? 25-35 ) 5 ?l stereotactic injection into lateral cerebral ventricle of rats and the rats of schisandrone intervention group were administrated with corn oil with 1 mmol/L schisandrone. And then the levels of IL-1? and iNOS mRNA in the hippocampus were detected by RT-PCR. Results: The levels of IL-1? and iNOS mRNA in the hippocampus of rats with Alzheimer-like disease (0.333 7?0.122 3, 0.266 6?0.088 5) decreased obviously after administration of schisandrone (0.969 3?0.153 9, 0.666 0?0.121 1)(P