Traditional Chinese Medicine Diagnosis and Treatment of Neuropathic Pain from Theory of Chronic Pain Entering Collaterals / 中国实验方剂学杂志

Neuropathic pain is a clinical symptom with complex mechanisms and high incidence. The commonly used analgesics have limited efficacy and can cause serious side effects. The theory of chronic pain entering collaterals was proposed by YE Tianshi， a famous physician focusing on warm diseases in the Qing dynasty， on the basis of the ancient therapies for pain. This theory is particularly suitable for the diagnosis and treatment of neuropathic pain in view of the clinical course and manifestations. The chronic neuropathic pain can enter the Yin collateral in deeper sites. The pathogenesis of neuropathic pain is summarized as a deficiency in origin and excess in superficiality. The root cause is the dysfunction of Zang-Fu organs， mainly the liver, kidney and heart， while the superficial causes are phlegm and stasis caused by the obstructed Qi and blood movement due to the consumption of Qi and blood in collaterals. Accordingly， the therapies such as dispelling blood stasis， resolving phlegm， and dredging collaterals should be adopted. This paper expounds the traditional Chinese medicine （TCM） pathogenesis and treatment of neuropathic pain， enriching the knowledge and providing new ideas for the TCM prevention and treatment of this disease as a collateral disease.

IgG4 related disease involving the adrenal glands: a case report / 中华泌尿外科杂志

IgG4-related diseases have a low incidence and are easily misdiagnosed as tumors in clinical treatments. A 26-year-old male patient was admitted to the hospital because of a left adrenal tumor found in health examination for more than 5 months. The tumor in the left adrenal region could be seen from abdominal CT, and the retroperitoneal laparoscopic resection of the left adrenal tumor was performed. Postoperative pathology was consistent with IgG4-related diseases, and serum IgG4 was abnormally high. After 2 months’ follow-up, serum IgG4 returned to normal, and no special discomfort.

Analysis of the cost structure of inpatients in a hospital in Tianjin based on DRGs / 中华医院管理杂志

Objective To analyze the impact of the comprehensive reform of public hospitals in Tianjin on the cost structure of inpatients at a tertiary general hospital.Methods Homepage data of the medical records from January 2015 to June 2018 were selected from a tertiary general hospital in Tianjin.The Beijing version of diagnosis related groupings(BJ-DRGs) was used to compare the expense structure of these inpatients before and after such a reform.Wilcoxon signed rank sum test,Z test and Pearson correlation analysis were performed for each index.Results Since the reform,the number of hospital discharges and that of DRGs had remained basically stable,while the case mixed index(CMI) weight increased slightly(from 1.0065 to 1.0386);the total hospitalization expenses,medical expenses,nursing expenses,management expenses and consumables expenses had increased.On the other hand,the expenses of medication and medical technology decreased,and the differences of these expenses were statistically significant (P ＜0.05).The time consumption index (0.87) and drug consumption index (0.80) were always lower than average,but the cost consumption index (1.38) remains above average with a slight rise.Conclusions The reform of public hospitals in Tianjin has encouraged such hospitals to improve their service procedures by adjusting such measures as pricing of medical services,and promoted their proactive management of hospitals.Hence the initial goal of "controlling costs,adjusting structure,and reducing costs" has been met.However,cost rise control still deserves major attention.

Lateral cervical lymph node mapping in papillary thyroid carcinoma: a prospective cohort study / 中国肿瘤临床

Objective: To explore the value of nanoparticles (CN) in lateral cervical lymph node mapping in papillary thyroid carcinoma using carbon. Methods: Thyroid cancer patients with suspicious lymph node metastasis but without typical signs of metastatic disease from March 2016 to November 2017 in Fudan University Shanghai Cancer Center were prospectively included in the cohort. Neck dissection was performed in all patients (compartmentsⅡ-Ⅴ). Suspicious lateral lymph node metastasis was identified using pre-operative ultrasound or computed tomography. CN were used for lymph node mapping during surgery. Results: A total of 70 surgeries were performed in 67 patients, among which 57 were found to have lateral lymph node metastasis (81.4%). The median number of CN-dyed lateral lymph nodes was 6. Compartment IV had the highest number of CN-dyed positive lymph nodes as well as the highest rate of metastasis, followed by compartmentⅢ. In compartmentsⅢandⅣ, the incidence of lymph node metastasis was significantly higher in the CN-dyed group than in the CN-undyed group (P<0.001). When the final pathology of neck dissection was set as the gold standard, lateral CN-dyed lymph node biopsy was found to have a sensitivity of 86.0%; its negative predictive value was 61.9% and its overall accuracy was 88.6%. Conclusions:Injection of CN during surgery was a potential method of mapping lateral lymph nodes in papillary thyroid carcinoma. CompartmentⅢ-ⅣCN-dyed lymph node biopsy had a satisfactory sensitivity and thus, served as a reasonable range for lymph node biopsy.

Hemoglobin level is a risk factor of non-alcoholic fatty liver disease / 中华全科医师杂志

Total 732 subjects aged 30-60 years undergoing health check-up at Beijing Hospital Medical Examination Center in 2009,who had no history of non-alcoholic fatty liver disease (NAFLD) were recruited in the study.According to the quartile of hemoglobin (HGB) level,the subjects were divided into 4 groups:Q1:HGB ≤ 131 g/L (n =192),Q2:HGB ＞ 131 g/L and ≤ 140 g/L (n =178),Q3:HGB ＞ 140 g/L and ≤152 g/L (n =184),Q4:HGB ＞ 152 g/L (n =178).All participants were followed up for 4 years,the prevalence rates of NAFLD in groups Q1,Q2,Q3 and Q4 were 8.3％ (16/192),17.4％ (31/178),23.4％ (43/184) and 25.3％ (45/178),respectively (P ＜0.05).Logistic regression showed that the rates of NAFLD in groups Q2,Q3 and Q4 were 2.32 (1.22-4.41),3.36 (1.81-6.21) and 3.72(2.02-6.87) times higher as group Q1 (P ＜ 0.05).Multiple logistic regression analysis showed that the hemoglobin level,TG and BMI were the independent risk factors of NAFLD.

Preliminary application experience of resectoscope combined with laparoscopy in the treatment of paraganglioma of urinary bladder / 中华泌尿外科杂志

Objective To analyze the feasibility and safety in application of resectoscope combined with laparoscopy in the operation treatment of paraganglioma of urinary bladder.Methods 7 cases patients with paraganglioma of urinary bladder treated in our hospital from November 2014 to August 2018 were analyzed retrospectively.There were 5 males and 2 females,average age of 31.1 years (22-37 years),average body mass index was 22.3 kg/m2 (18.3-22.5 kg/m2).All the 7 cases patients complained of dizziness and palpitation after urination,average basal systolic blood pressure was 111.8 mmHg (97-124 mmHg),the average fluctuation of systolic blood pressure before and after urination was 64.9 mmHg(28-91 mmHg),the CT and cystoscopy prompt bladder tumor,the average diameter was 2.7 cm(2.1-3.5 cm).The average of plasma norepinephrine was 706.3 pg/ml(330-997 pg/ml);the average of plasma dopamine was 101.1 pg/ml(44-145 pg/ml);the average of 24h urinary vanilmandelic acid was 13.4 mg/24h (10.3-16.1 mg/24h).All the patients has controlled the blood pressure and dilate the blood vessels with phenoxybenzamine hydrochloride,accepted the operation of resectoscope combined with laparoscopy partial cystectomy and bladder sutura per abdomen after ample dilatancy.The patients had lithotomy position with trendelenburg,preparation of gas peritoneal cavity by transabdominal,inside the resectoscope by transurethral at the same time,mutilated bladder mucosa beside 1cm at the edge of the tumor,and cut full thickness bladder wall,take the extraperitional fat as the standard procedure;we could see the cutting edge clear at this time by laparoscopy,cut off the pelvic peritoneum,extraperitional fat and the tumor.The sample placed in bladder,close the bladder with absorbable or barbed wires,take out the sample by resectoscope.Results All the 7 cases patients operation was successfully completed,no cases has been transfered to open.The average time of operation is 85.3 min(65-100 min),the average amount of bleeding is 27.9 ml(10-50 ml).The average fluctuation of systolic blood pressure is 8.7 mmHg(6-15 mmHg).Bladder washout was stopped 24h after operation,catheter was removed 1 weeks after operation.There is no obvious complications occurred.The average hospital stay is 3.7 days (3-5 days).The average pain score of 4 cases 4h after operation is 3.8 (2-5),reevaluation 24h after operation is 2.3 (1-4).The average follow-up time is 7.9 months(2-15 months).All the 7 cases patients clinical symptoms disappeared,there is no fluctuation of systolic blood pressure before and after urination,there is no recurrence of the tumor.Conclusions To the paraganglioma of urinary bladder in fundus of bladder or anterior wall of bladder,we can accurate resection tumor by resectoscope combined with laparoscopy,reduce blood pressure fluctuations,reduce the surgical trauma and the distress of patients.It is a safety and effective minimally invasive surgery.

Clinical application of laryngeal nerve monitoring in thyroid cancer surgery / 中国癌症杂志

Recurrent laryngeal nerve palsy is one of the most serious complications associated with thyroid cancer surgery. This study aimed to assess the efficacy of intraoperative neural monitoring (IONM) in preventing recurrent laryngeal nerve palsy during thyroid cancer surgery, analyze and elaborate the theory, operation standard, application, benefits and disadvantage based on clinical practice.

Evaluating the applied effectiveness of Chinese diabetes risk score in physical examination of elderly population / 中华老年医学杂志

Objective To analyze the effect of Chinese diabetes risk score in health checkup of elderly population and to explore the risk factors of abnormal glucose metabolism in the elderly patients.Methods Chinese diabetes risk score(C-DRs)screening,glucose tolerance test(OGTT),blood biochemical parameters and history collection were performed in 1 181 elderly people participating the health checkup.The area under the ROC curve(AUC)was used to evaluate the accuracy of the screening method.The effect of different cumulative C-DRs on screening target population was reflected by the Gordon index.Multivariate logistic regression analysis was used to analyze relevant risk factors for the glucose metabolic abnormalities.Results The AUC of screening for diabetes was 0.749(95%CI:0.715-0.782),and the best cut-point value was 32.5 points.The sensitivity was 86.50%,the specificity was 60.84%,and the Gordon index was 0.47(P=0.000).The AUC of screening for the pre-diabetes was 0.760(95%CI:0.733-0.787),and the best cut-point was 33.5 points.The sensitivity was 70.89%,the specificity was 68.72%,and the Gordon index was 0.40(P=0.000).The AUC of screening for MS was 0.797(95% CI:0.772-0.823),and the best cut-point value was 32.5 points.The sensitivity was 83.62%,the specificity was 64.90%,and the Gordon index was 0.49(P=0.000).The AUC of screening for insulin resistance was 0.609(95%CI:0.645-0.734),and the best cut-point value was 30.5 points.The sensitivity was 81.25%,the specificity was 44.81%,and the Gordon index was 0.26(P=0.000).Multiple logistic regression analysis showed that age over 80 years,abdominal obesity(waist circumference,male ≥ 90 cm,female ≥ 85 cm),hypertension,hypertriglyceridemia,family history of diabetes were risk factors for abnormality of glucose metabolism in the elderly.The odd ratio values of the above were 1.557,1.543,1.495,1.569,1.625,1.715(all P<0.05).Conclusions Chinese diabetes risk score may be used to screen for diabetes,metabolic syndrome and insulin resistance in the elderly population.Old age,abdominal obesity,hypertension,hypertriglyceridemia and family history of diabetes are independent risk factors for abnormal glucose metabolism in the elderly population.

Four-year follow-up observation on the relationship between serum uric acid and the risk of nonalcoholic fatty liver disease / 中华健康管理学杂志

Objective To investigate the relationship between serum uric acid and the risk of nonalcoholic fatty liver disease.Methods A cohort study was performed among individuals who had physical examination at Beijing Hospital medical examination center during 2009.A total of 732 subjects without nonalcoholic fatty liver disease,30-60 years old,were selected.Subjects were divided into 4 groups (Q1,Q2,Q3,Q4) according to serum uric acid level.Theincidence of NAFLD in each group in 2013 were observed.Serum alanine aminotransferase,aspartate aminotransferase,triglycerides,total cholesterol,high density lipoprotein-cholesterol,low density lipoprotein-cholesterol,fasting plasma glucose,and imaging examinations were determined.Cumulative incidence ofNAFLD was compared between each group and effect of baseline serum uric acid on new-onset NAFLI was assessed by logistic regression analysis.Results The cumulative incidence of NAFLD increased irconjunction with the increase of baseline serum uric acid in 4 groups (Q1 8.70％,Q2 13.04％,Q3 19.23％,Q4 32.97％,x2=37.865,P＜0.05).Logistic regression showed that the incidence of nonalcoholic fattyliver disease was increased along with elevated levels of serum uric acid.Subjects in the Q2,Q3,Q4 groups showed an increased risk of NAFLD,relative risks were 1.575 (0.807-3.074);2.580 (1.329-54.701);5.164 (2.838-9.397),compared to those in Q1 group.Moreover,after adjustment for baseline factors (e.g.Age,sex),risk of NAFLD remained higher,with odds ratio at 1.234,and the difference was statistically significant.Conclusions Serum uric acid was found to be correlated with the prevalence of nonalcoholic fatty liver disease.Serum uric acid appeared to be an independent risk factor for NAFLD.

The progress of the research on the relationship between stanniocalcins and cancers / 中国癌症杂志

Stanniocalcin (STC) was ifrst found as a calcium- and phosphate-regulating hormone produced in bony ifsh by the corpuscles of Stannius. In mammals, the homolog STC-1 displays a relative high amino acid sequence identity (nearly 50%) with ifsh STC, and STC-2 has a lower identity (nearly 35%) with STC-1 and ifsh STC. Both STC-1 and STC-2 are expressed in a variety of tissues. The functions of STC have not been understood. But some ifndings have been reported on their cellular localization, gene structure, and expression in different physiological and pathological conditions, which will be clues in elucidating the functions of STC in mammals. Moreover, STC-1 and STC-2 are expressed in many tumor cell lines, suggesting other biological functions of STC in mammals other than mineral metabolism.

The role of stanniocalcin 2 in oral squamous cells carcinoma / 中国癌症杂志

Background and purpose:About 80%patients with oral and maxillofacial malignant tumor are oral squamous cell carcinoma (OSCC). OSCC is one of the most common cancers in the world with less than 50%survival rate over 5 years. This experiment aimed to explore the effect of stanniocalcin 2 (STC2) on apoptosis, proliferation, migration and invasion of OSCC cell. Methods:RNA interference (RNAi) vector pLKO.1-shSTC2 was constructed and transfected into KB cells. Cell proliferation and cell apoptosis were then assessed by CCK8, APC Annexin V/7-AAD and lfow cytometry. Differences of migration and invasion between KB scr and KB STC2i were examined by cell scratch and transwell tests. Finally, this study detected the apoptosis-associated proteins and metastasis-associated proteins by Western blot. Results:STC2 down-regulation plasmid was constructed and transfected into KB cells. CCK8 prolifera-tion assay revealed that the STC2 down-regulation inhibited KB cells proliferation. By treating with cisplatin, this study found that STC2 silence could facilitate cell apoptosis signiifcantly. With the knock down of STC2 gene, the expressions of Bcl-2, Caveolin-1 andβ-catenin were decreased but the expression of bax was obviously increased. Conclusion:These data suggest that STC2 may be involved in the apoptosis, proliferation, migration and invasion of OSCC KB cells. Simultaneously, it can signiifcantly weaken the sensitivity of KB cells to chemotherapeutic drug cisplatin.

Management Practice for Ethical Review of Clinical Research of Traditional Chinese Medicine / 世界科学技术-中医药现代化

From the point of view of ethics review work situation of our country, the existing capacity of our review of ethical problems in development are analyzed, a preliminary summary of the Chinese medicine ethics review ca-pacity development, systematically analyzes the Assessment Human Research Protection System of TCM and Chinese medicine clinical research ethics review platform evaluation work, and to improve the ethical review system to perfect supervision system, improve the medical ethics review standards and guidelines, carrying out the innovation and con-struction of ethical review professional knowledge training, to promote Chinese medicine ethics review certification and accreditation system construction work and Chinese medical ethics review of the clinical research objective, the practice of ethical review management of Chinese medicine are discussed.

Application of modified koyanagi technique with coverage by tunica vaginalis of testis in severe hypospadias / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical effect of modified Koyanagi technique with coverage by tunica vaginalis of testis in severe hypospadias.</p><p><b>METHODS</b>49 cases with severe hypospadias treated from Jan. 2009 to Sep. 2011 were retrospectively studied. 25 patients underwent Koyanagi technique with coverage by tunica vaginalis of testis. 24 cases underwent one-stage Duplay + Duckett technique in the same term. The patients were followed up for 7-24 months.</p><p><b>RESULTS</b>Among the 25 children treated with Koyanagi procedure, 20 cases were cured, 5 patients had postoperative complications, including urethral fistula in 3 cases,urethral stenosis in 2 cases. At the same time, in the Duplay + Duckett group, 17 cases were cured, 7 children had postoperative complications, including urethral fistula in 4 cases, and urethral stenosis in 3 cases. All the patients with urethral fistula were repaired successfully 6 months after the first surgery; The urethral stenosis were cured by dilatation within 1 to 3 months. The successful rate in the 2 groups had no significant difference(P >0.05).</p><p><b>CONCLUSIONS</b>Koyanagi technique with coverage by tunica vaginalis of testis is relatively simple with similar effect as Duplay + Duckett technique for severe hypospadias.</p>

Relationship between glycosylated hemoglobin and pulse wave velocity in non-diabetic elderly people / 中华老年医学杂志

Objective To explore the relationship between glycosylated hemoglobin and pulse wave velocity in non-diabetic elderly people.Methods Totally 163 subjects were included after exclusion of liver or kidney disfunction,diabetes mellitus or malignant tumor.They were divided into two groups:group A (HbA1c＜5.7％) (n＝54) and group B (HbA1c 5.7％-6.4％)(n＝109).The age,pulse wave velocity,systolic blood pressure,diastolic blood pressure,blood chemistry and hypertension were compared between the two groups.Multi factor analyse was conducted to analyze the relative factors for pulse wave velocity.Results Systolic blood pressure was higher in group B than in group A (P ＜ 0.05).Multi-linear stepwise regression analyses suggested that age,hypertension,glycosylated hemoglobin were positively related to pulse wave velocity in non-diabetic elderly people (β values were 20.382,144.061,93.195,all P＜0.10).Conclusions Glycosylated hemoglobin is related to arterial stiffness in non-diabetic elderly people,it can be used as a predictive and control target of cardiovascular and cerebrovascular disease in old people.

Risk of physical exercises in 18 to 65 years old adults living in Beijing urban areas / 中华健康管理学杂志

Objective To explore the exercise risk of urban residents aged18 to 65 years old.MethodsHealth screening and cardiovascular risk stratification were performed among adults18 to 65 years old in 2010by using exercise risk assessmentrecommendedbyAmerican College of Sports Medicine.Result A total of15 498 subjects were recruited 9293 males and 6205 females,mean age (44.8 ±11.1) years,8929(57.6％ ) in the lower risk group,5323(34.3％ ) in the moderate risk group,and 1246(8.1％ ) in the higher risk group.The proportion of those in the higher risk group was increased with age.Conclusion Risk assessment and Physical Activity Readiness Questionnaires should be used before physical activity programme is initiated,especially in middle aged or elderly people.

Association of body mass index, age and sex with blood pressure in residents from Bejing area / 中国综合临床

Objective To investigate the association of body mass index (BMI),sex and age with blood pressure in non-physical labor population from Beijing area.Methods 14 237 subjects (67.06% male) ranged from 18.0-93.0 years (mean (SD):49.8(10.2)) wero recruited in the health examination in Beijing hospital. Statistical analysis wag performed using SPSS 12.0 software.Results The average BMI wag 22.30 ks/m~2 (SD: 3.08).Systolic blood pressure and diastolic blood pressure increaged with the increasing of BMI.The prevalence of hypertension in males <60.0 years wag considerably higher than that of female (24.28% and 13.77% for male and females, respectively, P=0.000).However,there were no significant statistical differences for the pmvalence between male and female older than 60.0 years (P=0.268).Multiple logistic regression showed that in males,using the group with BMI<18.0 kg/m~2 as reference group,in the groups of BMI 18.0-23.9,24.0-27.9,≥28.0 kg/m~2, OR wag 1.709 (95% CI:0.920-3.173),3.154(1.703-5.839),5.125 (95%CI:2.805-9.696),respeetively.In females.OR for hypertension in the groups of BMI 18.0-23.9,24.0-27.9,≥28.0 kg/m~2,OR was 1.988(95%CI:1.033-3.824),5.703(2.962-10.982),14.358(95%CI:7.334-28.106),respectively.Conclusions BMI is associated with hypertension.Prevention and eontrol of the risk factom of hypertension e.g.overweight and obesity is an important public health issue in China.

A Clinical Study of Faropenem on Treatment of Acute Bacterial Infections / 天津医药

Objective: To evaluate the clinical efficacy and safety of domestic faropenem in the treatment of acute bacterial infections. Methods: A multicenter, randomized, double blind and double simulation clinical study was conducted to compare the efficacy and safety of faropenem and cefaclor in the treatment of acute bacterial infection. Patients in trial group(n = 122) were given faropenem 250 mg，and in control group (n = 118) were given cefaclor 200 mg，3 times daily for 7 to 10 days.Results: The clinical cure rates were 33.61% and 27.12% in trail and control groups respectively and the clinical effective rates were 87.70% and 83.05% respectively. There was no significant difference in terms of clinical effectiveness between the two groups（P > 0.05）. The adverse reaction rates were 7.32% in trial group and 3.36% in control group（P > 0.05）. The adverse reaction of the trial group was mainly exaltation of aminotransferase, which did not affect the therapy. No severe adverse reaction was found.Conclusion: Domestic faropenem is effective and safe for the treatment of bacterial respiratory tract and urinary tract infections.

Analysis of Dyslipidemia in 12908 Subjects in Enterprises in Beijing / 中国康复理论与实践

@#Objective To explore dyslipidemia in the people in the part of enterprises in Beijing.Methods Total cholesterol, triglyceride, high-density lipoprotein cholesterol, etc., in blood were detected in the physical examination of 12908 subjects in enterprises in Beijing. Dyslipidemia was analysed for the distribution of gender and the trend of age.Results The findings showed that the occurrence of hypercholesteremia is 21.3% with 20.3% for male vs 23.0% for female; hypertriacylglycerolemia is 30.4% with 36.19% for male vs 20.49% for female; and low level of high-density lipoprotein is 6.5% with 9.4% for male vs 1.6% for female. The trend of dyslipidemia increased with age. The subjects with coronary artery disease and related high risk diseases, who need medicine care, occupied 80.6% of the subjects with dyslipidemia.Conclusion Dyslipidemia increases with age and so regular detection of lipid is necessary especially for the subjects with coronary artery disease and related high risk diseases.

A case-control study on effects of irbesartan and amlodipino on insulin sensitivity in obese hypertensive pa-tients / 中国综合临床

Objective To observe the effects of irbesartan and amlodipine on insulin sensitivity in obese hypertensive patients. Methods 157 moderate hypertensive patients were divided into two greups,which received irbesartan or amlodipine for 16 weeks. The changes of blood pressure,heart rate and weight were observed. Insulin re-sistance was computed using the homeostasis model assessment (HOMA-IR). Results There was no difference in antihypertensive efficacy between the two groups(P>0.05). After 16 weeks of treatment ,the insulin resistance index decreased by 8.7±2.4 vs 6.1±2.6 (P<0.01) and body mass index decreased(28.1±3.8) kg/m2 vs (27.2± 3.2 ) kg/m2 (P<0.05 ) and mean heart rate raised by (73.1 ±10.0 ) kg/m2 vs ( 79.1±11.4) kg/m2 ( P < 0.01 ) in irbesartan group while no such changes were found in amlodipine treated group. Conclusions In obese hypertensive patients,irbsartan and amlodipine exert similar antihypertensive effect, but irbesartan may help to improve some obe-sity-related metabolize disorder,so the obese hypertensive patients may benefit more from irbsartan than from amlo-dipine.

Study on changes of proliferation and apoptosis of spermatogenic cell in idiopathic oligospermia / 中华泌尿外科杂志

Objective To investigate the pathophysiological mechanism of proliferation and apoptosis in spermatogenic cell of idiopathic oligospermia. Methods Forty one patients with oligospermia were included in the trial.Testicular tissues,which were obtained with Tru Cut needle biopsy,were observed under light microscope.Expressions of p16 and PCNA,incidence of apoptosis in spermatogenic cells were detected by immunohistochemistry and in situ 3′ DNA end labeling technique. Five testicular samples which were proved to be normal by examination served as controls. Results Proliferation index (21.6?13.1)% in testes of patients was lower than the normal controls (45.4?5.7)%, P