Incidence of extrauterine growth retardation and its risk factors in very preterm infants during hospitalization: a multicenter prospective study / 中国当代儿科杂志

OBJECTIVES@#To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China.@*METHODS@#A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined.@*RESULTS@#The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05).@*CONCLUSIONS@#It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.

Yanghe Huayantang Reverses Tamoxifen Resistance in Breast Cancer Through ER/PI3K/Akt/mTOR Pathway / 中国实验方剂学杂志

Objective:To explore the possible mechanism of Yanghe Huayantang in reversing the drug resistance of breast cancer by observing the effect of Yanghe Huayantang on the transplant tumor of tamoxifen （TAM）-resistant breast cancer and its influences on the interaction pathway of estrogen receptor （ER）/phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/mammalian rapamycin target protein （mTOR）. Method:Fifty mice were randomly divided into 5 groups： blank group， model group， Yanghe Huayantang group， everolimus group， and Yanghe Huayantang+everolimus group. The model of kidney deficiency was established by bilateral ovariectomy， and the blank group was treated with sham operation. Three days after the establishment of the model， all the five groups of mice were inoculated with breast cancer TAM drug-resistant cells （MCF-7/TAM^-） to establish breast cancer TAM -resistant transplanted tumor model. After successful modeling， Yanghe Huayantang group received intragastric administration of Yanghe Huayantang （traditional Chinese medicine preparation 20 mL·kg^-1）， everolimus group received intraperitoneal injection of everolimus （10 mg·kg^-1）. Yanghe Huayantang + everolimus group received Yanghe Huayantang by intragastric administration and everolimus by intraperitoneal injection. The blank group and model group received intragastric administration and intraperitoneal injection of phosphate buffer （PBS）. Drug administration was lasted for 28 days in all groups， once a day. After administration， the tumor tissue was separated and weighed， and the tumor inhibition rate was calculated. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of tumor tissue. Immunofluorescence and Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） were used to detect the expression of PI3K， Akt， mTOR， ER protein and mRNA in tumor tissue. Result:Compared with the model group， the tumor volume and tumor weight of Yanghe Huayantang group decreased significantly on the 12th， 20th and 28th days （<italic>P</italic><0.01）， and the tumor inhibition rate increased significantly （<italic>P</italic><0.01）.Yanghe Huayantang group significantly reduced the density of tumor cells and caused tumor cell necrosis. Compared with the model group， Yanghe Huayantang group， everolimus group and Yanghe Huayantang+everolimus group inhibited the expression of PI3K， Akt， mTOR protein and mRNA （<italic>P</italic><0.05， <italic>P</italic><0.01）. Compared with the blank group， Yanghe Huayantang group， everolimus group and Yanghe Huayantang+everolimus group all inhibited the protein and mRNA expression of ER， and mRNA expression of ER in Yanghe Huayantang+everolimus group was significantly lower than that in the model group （<italic>P</italic><0.01）. Conclusion:Yanghe Huayantang can inhibit the growth of TAM-resistant breast cancer. The mechanism may be that Yanghe Huayantang can reverse the TAM resistance of breast cancer by down-regulating the expression of key molecules of ER/PI3K/Akt/mTOR cross-signal pathway.

Mechanism of Xiaojinwan Against Breast Cancer Bone Metastasis： An Exploration Based on Bioinformatic Analysis Combined with Cell Experiments / 中国实验方剂学杂志

Objective:To explore the mechanism of Xiaojinwan in treating breast cancer bone metastases through cell experiments and bioinformatic analysis. Method:The inhibitory effect of Xiaojinwan on MCF-7 cell viability was detected by cell counting kit-8 （CCK-8） assay. The key components and targets responsible for Xiaojinwan in inhibiting breast cancer bone metastases were predicted by network pharmacology and molecular docking. The active components and targets of Xiaojinwan were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCSMP） and SwissTarget Prediction， and the breast cancer bone metastases-related targets from GeneCards and DisGeNET. The results were imported into STRING for constructing a protein-protein interaction （PPI） network， followed by Gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis using DAVID. A network of the active components of Xiaojinwan-breast cancer bone metastases-related targets-pathways was constructed using Cytoscape 3.7.2. AutoDock 4 was employed for molecular docking. The protein expression levels of matrix metallopmteinase-9 （MMP-9）， hypoxia-inducible factor 1<italic>α </italic>（HIF1A）， and androgen receptor （AR） were assayed by Western blot. Result:Xiaojinwan inhibited the viability of MCF-7 cells and acted on breast cancer bone metastases through such processes as redox and protein autophosphorylation. KEGG enrichment analysis showed that HIF-1， vascular endothelial growth factor （VEGF） and phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） pathways were involved. As verified by molecular docking， the active components such as eucalyptin stably bound to AR and MMP-9. Western blot indicated that Xiaojinwan dose-dependently inhibited the expression of MMP-9 and HIF1A proteins in MCF-7 cells. Conclusion:Xiaojinwan acts on AR and MMP-9 through HIF， VEGF and other related signaling pathways， thereby improving hypoxia in tumor microenvironment， inhibiting angiogenesis， and reducing cell invasion and viability.

Time and dose effects of AKT inhibitor GSK2141795 on apoptosis of human hepatocellular carcinoma cell line Huh7 / 第二军医大学学报

Objective To explore the time and dose effects of AKT (a kind of protein serine/threonine kinase) inhibitor GSK2141795 on the apoptosis of human hepatocellular cell line Huh7. Methods Huh7 cells were treated with GSK2141795 at the concentrations of 0, 0.3, 1, 3, 10 and 30 µmol/L for 24 h. A concentration of 10 µmol/L GSK2141795 was selected to treat Huh7 cells for 0, 2, 6, 12, 24 and 48 h. The protein expression levels of AKT and phosphorylated AKTS473 (p-AKTS473) were determined by Western blotting and cell apoptosis was detected by flow cytometry. The expression levels of apoptosis-related proteins (Bad, Bcl-2 and Caspase-9) were measured by qPCR and Western blotting. Results With the increase of GSK2141795 concentration, AKT protein level in Huh7 cells was gradually decreased and the p-AKTS473 protein level was gradually increased within the range of 0-10 µmol/L. With the prolongation of GSK2141795 treatment time, the AKT protein level was gradually decreased and the p-AKTS473 protein level was gradually increased within the range of 0-24 h. At 48 h of treatment, the AKT protein and p-AKTS473 protein expression levels were increased compared with 0 h. With the increase of GSK2141795 concentration and treatment time, the proportion of apoptotic cells was gradually increased, the expression levels of apoptotic molecules Bad and Caspase-9 were gradually increased, and the expression level of apoptotic antagonist Bcl-2 was gradually decreased. Conclusion AKT inhibitor GSK2141795 can effectively inhibit AKT protein expression, and induce apoptosis of Huh7 cells through Bad-Bcl-2 pathway in a dose-and time-dependent manner. In addition, the expression level of AKT protein in Huh7 cells can increase again after long-term stimulation by GSK2141795, suggesting the existence of a negative feedback signal loop.

Therapeutic effect of Jinghuosu on oligospermia and asthenospermia / 中华男科学杂志

Objective@#To investigate the effects of the compound preparation Jinghuosu on oligospermia and asthenospermia.@*METHODS@#This multi-centered clinical study included 120 cases of mild to moderate idiopathic oligospermia or asthenospermia, all treated with oral Jinghuosu once a bag, bid, for 3 successive months. Before and at 1, 2 and 3 months after treatment, we detected sperm concentration, total sperm motility, progressive sperm motility and normal sperm morphology of each ejaculate, and recorded whether the patients had any adverse reactions.@*RESULTS@#After 3 months of treatment, all the patients showed obvious improvement in semen parameters, most significantly in sperm concentration, total sperm motility, and the percentages of progressive motile sperm and morphologically normal sperm (P <0.05). No significant adverse reactions were observed during the 3 months of medication.@*CONCLUSIONS@#Jinghuosu has a significant efficacy and no obvious adverse effect in the treatment of mild to moderate oligospermia and asthenospermia.

Clinical application of cefoperazone/sulbactam combined with thymosin α1 for the treatment of severe pneumonia caused by Acinetobacter baumannii / 中国感染控制杂志

Objective To evaluate the clinical efficacy and prognosis of cefoperazone/sulbactam combined with thymosin α1 in the treatment of severe pneumonia caused by Acinetobacter baumannii (A.baumannii).Methods 84 patients with severe pneumonia caused by A.baumannii were randomly selected,they were divided into treatment group(n =42,cefoperazone/sulbactam combined with thymosin α1 treatment) and control group(n =42,only cefoperazone/ sulbactam treatment).Procalcitonin(PCT),C-reactive protein(CRP),white blood cell(WBC) count,peripheral blood T lymphocyte subsets,interleukin-6(IL-6),interleukin-10(IL-10),immunoglobulin G (IgG),and APACHE II score of two groups before treatment and 7 days after treatment were compared,ventilator weaning success rate,length of ICU stay,and 28-day mortality were also observed.Results After 7 day treatment,compared with the control group,CD4 + T cells,CD4 +/CD8 +,IL-10,and IgG in the treatment group were all significantly higher (all P＜0.05);PCT,CRP,WBC,IL-6,and APACHE II score all significantly declined,difference were all significant(all P＜0.05).Ventilator weaning success rate in treatment group was higher than control group (64.29％ vs 38.10％),mean length of ICU stay was shorter than control group([12.41-± 2.25]d vs[18.23 ±-2.50]d),28-day mortality was lower than control group(19.05％ vs 45.24％),difference were all significant(all P＜0.05).Conclusion Cefoperazone/sulbactam combined with thymosin α1 for the treatment of severe pneumonia caused by A.baumannii can improve the immune function of patients,reduce inflammation,increase ventilator weaning success rate,shorten ICU stay,and decrease 28 day mortality.

Identification of late-onset hypogonadism in middle-aged and elderly men from a community of China / 亚洲男科学杂志(英文版)

In this study, we investigated the essential criteria for late-onset hypogonadism (LOH) syndrome based on the presence of symptoms associated with low testosterone levels in Han Chinese men. Blood tests for total testosterone (TT) and sex hormone-binding globulin (SHBG) were performed, and the aging male symptoms (AMS) questionnaire was conducted in a randomly selected cohort composed of 944 Chinese men aged 40 to 79 years from nine urban communities. Three sexual symptoms (decreased ability/frequency of sexual activity, decreased number of morning erections, and decreased libido) were confirmed to be related to the total and free testosterone levels. The thresholds for TT were approximately 12.55 nmol l-1 for a decreased ability/frequency to perform sex, 12.55 nmol l-1 for decreased frequency of morning erections, and 14.35 nmol l-1 for decreased sexual desire. The calculated free testosterone (CFT) thresholds for these three sexual symptoms were 281.14, 264.90, and 287.21 pmol l-1 , respectively. TT <13.21 nmol l-1 (OR = 1.4, 95%CI: 1.0-1.9, P = 0.037) or CFT <268.89 pmol l-1 (OR = 1.5, 95%CI: 1.1-20, P = 0.020) was associated with an increase in the aforementioned three sexual symptoms. The prevalence of LOH was 9.1% under the criteria, including all three sexual symptoms with TT levels <13.21 nmol l-1 and CFT levels <268.89 pmol l-1. Our results may improve the diagnostic accuracy of LOH in older men.

Reproductive health service utilization and social determinants among married female rural-to-urban migrants in two metropolises, China / 华中科技大学学报（医学）（英德文版）

Reproductive health (RH) education and services of female migrants in China have become an important health issue. This research aimed to investigate the RH knowledge and utilization among married female migrants, and to explore the influencing factors from the perspectives of population and sociology. We conducted a cross-section survey in Shenzhen and Wuhan, China, using the purposive sampling method. A total of 1021 rural-to-urban married migrants were recruited, with 997 valid survey results obtained. A face-to-face structured questionnaire survey was used, with primary focus on knowledge of fertility, contraception, family planning policy and sexual transmitted diseases/acquired immunodeficiency syndrome (STD/AIDs), and RH service utilization. The results showed that the RH service utilization (38.0%) was at a low level in married migrants and the accessibility of RH service was poor. Females who migrated to (OR=0.32) Wuhan obtained fewer RH consultations than those in Shenzhen. The workers with high school education received additional RH consultations and checkup services than those with other background education, apart from the white collar workers who received extra RH consultations and checkup services than the blue collar workers (P<0.05). We can draw a conclusion that the utilization of RH services in married female migrants remains at a low level in China. RH service utilization can be improved via the relevant health departments by enhancing the responsibility of maternal and health care in the community health service center.

Surgical treatment of azoospermia caused by iatrogenic injury to bilateral vas deferens / 中华男科学杂志

<p><b>Objective</b>To investigate the treatment of azoospermia induced by iatrogenic injury to the bilateral vas deferens.</p><p><b>METHODS</b>We retrospectively analyzed 11 cases of azoospermia caused by iatrogenic injury to bilateral vas deferens. The patients were aged 20－33 years, all diagnosed with azoospermia preoperatively and none with a history of pelvic operation. Seven of them had received bilateral inguinal hernia repair and the other 4 undergone bilateral orchidopexy in the childhood.</p><p><b>RESULTS</b>Intraoperative exploration of the bilateral inguinal region was performed in all the patients. Bilateral vas deference atresia was found in the inguinal canal in 6 cases, which was treated by microscopic vasovasostomy following removal of the atresic segment. Vas deferens residual was observed in or near the deep inguinal ring in the other 5 cases, with the distal vas deferens inaccessible, which was treated by bilateral vasovasostomy in 3 cases and unilateral vasovasostomy in 2 (for longer defect segment than could be anastomosed) following combined laparoscopic exploration of the abdominal cavity. The patients were followed up for 3－12 months postoperatively, during which sperm were detected in 7 cases, with sperm concentration ranging from 0.4×10⁶/ml to 35×10⁶/ml and grade a+b sperm from 15% to 46%.</p><p><b>CONCLUSIONS</b>For the diagnosis of azoospermia, especially in patients with no history of pelvic operation, special attention should be paid to iatrogenic injury to the vas deferens. For the treatment of the disease, non-tension vasovasostomy is essential and, when necessary, the vas deferens can be reconstructed by changing its anatomical path and shortening its length.</p>

Research on syndrome distribution features, etiologies, and pathogeneses of Japanese encephalitis / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore Chinese medical syndrome distribution features of Japanese encephalitis (JE), and to analyze its correlation between syndromes and features of etiologies and pathogeneses.</p><p><b>METHODS</b>Recruited were 277 patients with confirmative diagnosis of JE from Wuhan Medical Treatment Center, Children's Hospital Affiliated to Chongqing Medical University, Fifth People's Hospital of Guiyang City, Hangzhou Sixth People's Hospital, and Chengdu Hospital of Infectious Diseases between July to September 2012. Chinese medical syndrome distribution features were summarized from their general materials and detailed records of clinical data, including medical history, symptoms and signs, tongue fur, and pulse figures.The frequency of symptoms and signs was calculated according to mild, ordinary, severe, extreme severe degrees. The distribution of Chinese medical syndromes was summarized. And its correlation between syndromes and features of etiologies and pathogeneses were analyzed.</p><p><b>RESULTS</b>After clustering analysis, Chinese medical syndromes of JE could be categorized as four groups: toxicity accumulation in Fei and Wei syndrome (TAFWS), brain collateral impaired by poison syndrome (BCIPS), depression of toxicity in the pericardium syndrome (DTPS), exhaustion of yin and yang syndrome (EYYS). BCIPS and DTPS were dominated, accounting for 74.0% (205 cases). The main causes covered evil of summer heat [accounting for 92.42% (256/277 cases)], heat [accounting for 87.73% (243/277 cases)], and toxin [accounting for 99.64% (276/277 cases)].</p><p><b>CONCLUSIONS</b>The four Chinese medical syndrome types of JE met Chinese medical clinical features of encephalitis. It is induced by infestation of dampness-heat, resulting in toxicity accumulation in Fei and Wei, brain collateral impaired by poison, depression of toxicity in the pericardium. Yin fluid and blood is exhausted as time goes by. Qi and yin are impaired to form intermingled deficiency and excess, and finally causing exhaustion of yin and yang.</p>

Microsurgical management of male infertility in china: 15-year development and prospects / 中华男科学杂志

Male infertility is a common and complex disease in urology and andrology, and for many years there has been no effective surgical treatment. With the emergence of microsurgery and assisted reproductive medicine (IVF/ICSI), rapid development has been achieved in the treatment of male infertility. The Center for Male Reproductive Medicine and Microsurgery at Weill Cornell Medical College of Cornell University has been playing an important leading role in developing microsurgical techniques for the management of male infertility. The development of microsurgical treatment of male infertility in China has experienced the 3 periods of emerging, making, and boosting ever since its systematic introduction from Weill Cornell Medical College 15 years ago. At present, many Chinese hospitals have adopted microsurgery in the management of male infertility, which has contributed to the initial establishment of a microsurgical treatment system for male infertility in China. However, some deficiencies do exist concerning microsurgical treatment of male infertility, as in normalized technical training programs for competent surgeons, unified criteria for evaluation of surgical outcomes, and detailed postoperative follow-up data. This article presents an overview on the 15-year development of microsurgical management of male infertility in China, points out the existing deficiencies, and offers some propositions for the promotion of its development.

Late-onset hypogonadism among old and middle-aged males in a rural community of Zhejiang Province / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the epidemiology of late-onset hypogonadism (LOH) in old and middle-aged males in the rural area of Southern China.</p><p><b>METHODS</b>Using the age-stratified sampling method, we conducted a questionnaire investigation on androgen deficiency in aging males (ADAM), aging male symptoms (AMS) and IIEF-5 among 996 males aged 40 -80 years in a rural community of Jiashan county, Zhejiang Province from April to October 2012. We also determined the concentrations of serum total testosterone (TT), serum sex hormone binding globulin (SHBG) and serum albumin (ALB), detected the levels of free testosterone (cFT) and bio-available testosterone (Bio-T) by Vermeulen formula, and measured the volumes of the prostate and testis by ultrasonography.</p><p><b>RESULTS</b>The mean age of the males was 56.22 +/- 8.82 years. The positive rates of LOH were 62.86% and 23.05% based on ADAM and AMS, respectively, and the incidence of erectile dysfunction (ED) was 68.83%. There were significant differences among different age groups in the levels of luteinizing hormone (LH), SHBG, cFT and Bio-T, but not in TT concentration.</p><p><b>CONCLUSION</b>Ours was the first survey on the epidemiology of LOH among old and middle-aged males in the rural area of China. The incidence of LOH in the rural community of Zhejiang Province was lower than that in the urban areas reported in other studies, but the positive rate of ED showed no significant difference.</p>

Transurethral seminal vesiculoscopy for refractory or recurrent hemospermia: clinical analysis of 162 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and effect of transurethral seminal vesiculoscopy in the diagnosis and treatment of refractory or recurrent hemospermia.</p><p><b>METHODS</b>We retrospectively analyzed 162 cases of refractory or recurrent hemospermia examined and treated by transurethral seminal vesiculoscopy. The patients ranged in age from 19 to 76 years and had a hemospermia history of 3 months to 11 years, admitted due to poor therapeutic results or recurrence after 4 weeks of antibiotic medication. All the patients underwent serum PSA examination, transrectal ultrasonography, seminal vesicle ultrasonography and pelvis CT or MRI before surgery.</p><p><b>RESULTS</b>Wine- or magenta-colored colloid and inflammation were found in one or both sides of the seminal vesicle in all the cases. Pathological biopsy revealed chronic inflammatory mucosa of the seminal vesicle in all the patients, and even calculi in the ejaculatory duct or seminal vesicle in 15 cases. Postoperative follow-up averaged 21.7 (12 -29) months. Hemospermia disappeared or was alleviated in 150 (92.64%) of the cases after 1-15 ejaculations, in which 7 experienced recurrence 3 months later. Four cases failed to respond, and 1 developed acute bilateral epididymitis after surgery. No such complications as retrograde ejaculation, urinary incontinence or rectal injury were observed postoperatively.</p><p><b>CONCLUSION</b>Transurethral seminal vesiculoscopy is a safe, effective and feasible new method for the treatment of refractory or recrudescent hemospermia.</p>

Polymorphism of AR gene CAG copy number and late-onset hypogonadism in males / 中华男科学杂志

<p><b>OBJECTIVE</b>To analyze the association of the androgen receptor (AR) gene CAG-STR with late-onset hypogonadism (LOH), and explore the pathogenesis of LOH.</p><p><b>METHODS</b>Our investigation involved 1 000 men aged 40-70 years. We randomly selected 127 normal old and middle-aged males and 19 cases of LOH. We detected their levels of Triglyceride (TG), fasting blood glucose (FBG), serum total testosterone (tT) and free testosterone (fT), measured their body mass index (BMI), height, waist circumference (WC) and blood pressure, and examined the length of CAG repeats of the AR gene in the peripheral blood by PCR.</p><p><b>RESULTS</b>The numbers of CAG repeats ranged from 15 to 32, with a mean value 23.05 +/- 2.95. The mean BMI and FBG were significantly lower (P < 0.01), but TG, tT and fT remarkably higher in the normal than in the LOH men (P < 0.01), while the mean length of (CAG) n repeat polymorphism showed no statistically significant difference between the two groups (22.54 +/- 3.06 vs 23.23 +/- 2.24, P = 0.946). The frequencies of long alleles (n > or = 22) were significantly higher in the LOH than in the normal men (73.68% vs 48.82%, P < 0.05). The numbers of CAG repeats had no significant correlation with tT (r = 0.04, P > 0.05) and fT (r = 0.025, P > 0.05).</p><p><b>CONCLUSION</b>The AR gene CAG length showed polymorphism in LOH men. The long alleles (CAG)n (n > or = 22) repeat polymorphism in the AR gene may be a genetic factor for LOH, but it has to be confirmed by further investigation.</p>

Lower urinary tract symptoms and prostatic growth pattern among old and middle-aged males in Shanghai community / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the prevalence of lower urinary tract symptoms (LUTS) and the age-related growth pattern of the prostate among 40 -70 year-old males in Shanghai community.</p><p><b>METHODS</b>Using cluster and stratified random sampling and IPSS, we investigated the prevalence of LUTS among 1000 males aged 40 -70 years in the general population of Shanghai from November 2009 to June 2010. We measured the transverse, anteroposterior and vertical diameters of the prostate and its transition zone in each volunteer by transrectal ultrasonography and established the equation for the age-related growth pattern of the prostate.</p><p><b>RESULTS</b>In the 40 to 49-, 50 to 59- and 60 to 70-year groups, the incidence rates of moderate and severe LUTS (IPSS > or = 8) were 10.0%, 15.0% and 28.7%, respectively. The length, width, height and volume of the prostate and its transition zone were positively corrected with age (P < 0.05). The prostatic growth pattern equations based on the parameters of the transverse, anteroposterior and vertical diameters were Y = 1.6 x 10(-5)X3-0.002 1X2 + 0.074 6X + 0.677 2, Y = -2.4 x 10(-5)X3 + 0.003 3X2-0.1312X + 1.269, and Y = 1.6 x 10(-5)X3-0.001 8X2 + 0.073X- 0.690 9, respectively. The transverse and anteroposterior diameters of the prostate grew at a relatively similar rate, while the transverse diameter grew obviously faster than the vertical diameter before 60 years old, but the latter significantly increased and even exceeded the former after 60 years old.</p><p><b>CONCLUSION</b>The prevalence of LUTS among old and middle-aged males in Shanghai community is similar to that recently reported at home and abroad. The transverse and anteroposterior diameters of the prostate grow at a relatively similar rate, but the vertical diameter increases faster after 60 years old.</p>

Analysis of distribution characteristics and drug resistance of 2748 strains of pathogens isolated from burn patients / 中华烧伤杂志

<p><b>OBJECTIVE</b>To provide epidemiological data of the distribution characteristics and drug resistance of the pathogens isolated from burn patients in recent years for guiding rational use of antibiotics in clinic.</p><p><b>METHODS</b>Totally 2748 strains of pathogens were isolated from 1977 specimens (blood, catheter, wound excretion, etc.) collected from 478 patients hospitalized in Institute of Burn Research of Southwest Hospital from March 2003 to June 2011. After being identified by API strips, drug resistance of the 2748 isolated pathogens to 55 commonly-used antibiotics including gentamicin, tobramycin, piperacillin, amikacin, etc. was tested by K-B paper disk diffusion method. The WHONET 5.3 software was used to analyze the following subjects: the distribution of the pathogens with different types and different sources each year, the changes in drug-resistant rates of Gram negative bacilli, Gram positive cocci, and fungi to several antibiotics, and the changes in sensitive rates of Pseudomonas aeruginosa (PA), Staphylococcus aureus (SA), Acinetobacter baumannii (AB), Candida albicans (CA) to several antibiotics.</p><p><b>RESULTS</b>Among 2748 strains of pathogens, 1879 strains of Gram negative bacilli accounted for 68.38%, 628 strains of Gram positive cocci accounted for 22.85%, and 241 strains of fungi accounted for 8.77%. The isolation rate of strains from wound excretion ranked the first (1022 strains accounted for 37.19%), followed by those from respiratory tract (995 strains accounted for 36.21%) and blood (421 strains accounted for 15.32%). Strains isolated from other types of specimens were rare. Isolation rate of PA ranked the first (996 strains accounted for 36.24%), followed by SA (495 strains accounted for 18.01%) and AB (395 strains accounted for 14.37%). Isolation rate of AB showed a trend of increase year by year, but that of SA presented the opposite trend. Isolation rate of PA was quite stable. There were 484 strains of methicillin resistant SA among Staphylococci, accounting for 17.61%. Resistant rates of PA and AB to polymyxin B and polymyxin E were below 30.00%, and those of PA and AB to other antibiotics, such as the third generation cephalosporins, β-lactams, aminoglycosides, and quinolones, were from 57.91% to 100.00%. Resistant rate of AB to minocycline was 39.68%. From 2004 to 2011, sensitive rate of PA to quinolone antibiotics showed an increasing trend year by year, but that of AB to minocycline, netilmicin, imipenem, meropenem, tobramycin, and cefoperazone/sulbactam presented the opposite trend. Resistant rates of Enterococcus faecalis, Enterococcus faecium, and SA to teicoplanin and linezolid were less than 10.00%. Resistant rate of SA, Staphylococcus epidermidis and Enterococcus faecium to vancomycin was 0. Resistant rates of SA to quinupristin/dalfopristin, minocycline, fusidic acid, and compound sulfamethoxazole were low, respectively 0.82%, 9.35%, 2.21%, and 31.85%. Sensitive rates of SA to erythromycin, clindamycin, compound sulfamethoxazole, tetracycline, and minocycline showed an increasing trend year by year. Both infection rate and resistant rate of fungi were low. The resistant rates of CA to 5 kinds of antibiotics were less than 15.00%. The sensitive rate of CA to 5-flucytosine declined slightly, and those of CA to the other 4 antibiotics showed an increasing trend year by year.</p><p><b>CONCLUSIONS</b>The three dominant pathogens that cause infection in burn patients hospitalized in Institute of Burn Research of Southwest Hospital in recent years are PA, SA, and AB in order. PA and AB are outstandingly multidrug-resistant among the isolated strains. AB might replace PA as the main pathogenic bacterium that cause the death of burn patients with infection.</p>

Epidemiological features and risk factors of sepsis-associated encephalopathy in intensive care unit patients: 2008-2011 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Encephalopathy is a common complication of sepsis, and its onset can occur at any stage of sepsis and implies worse prognosis. However, the incidence, epidemiology, and pathogenesis of sepsis-associated encephalopathy remain controversial. The purpose of this study was to investigate the epidemiological features and risk factors for sepsis-associated encephalopathy.</p><p><b>METHODS</b>Our retrospective study included all patients with sepsis admitted to our intensive care unit from 2008 to 2011. After excluding 91 patients, 232 patients were assigned to either a sepsis-associated encephalopathy group or sepsis without encephalopathy group. Between-group differences in baseline patient data including vital signs, disease severity, pathogens, sites of infection, biochemical indicators, and time on a mechanical ventilator, intensive care unit (ICU) stay, and 28-day mortality rate were analyzed.</p><p><b>RESULTS</b>The incidence of sepsis-associated encephalopathy was 17.7%. The sepsis-associated encephalopathy group had significantly higher 28-day mortality (56.1% vs. 35.1%; P=0.013), spent a significantly longer time on a ventilator ((8.2±2.2) days vs. (2.9±0.4) days; P=0.021), and had a significantly longer ICU stay ((12.4±2.4) days vs. (7.1±0.6) days; P=0.042). Acute physiology and chronic health evaluation II score, Glasgow coma scale, heart rate, blood lactate, serum sodium, platelets, serum albumin, and pH values were related to the presence of encephalopathy. Patients with biliary tract infections and intestinal infections caused by Staphylococcus aureus, Enterococcus faecium, Acinetobacter spp, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia, were more prone to develop sepsis-associated encephalopathy.</p><p><b>CONCLUSIONS</b>Encephalopathy increases mortality rate in septic patients. Clinical intervention to reduce risk factors and thereby morbidity and mortality depends on a correct understanding of the differences between patients with sepsis and patients with both sepsis and encephalopathy.</p>

Efficacy and safety of long-term small-dose tadalafil in the treatment of erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVE</b>Erectile dysfunction (ED) is now recognized as a comorbid condition, especially in men with cardiovascular disease or diabetes mellitus. This randomized controlled trial was to examine the effect of long-term small-dose tadalafil in the treatment of ED.</p><p><b>METHODS</b>A total of 98 men older than 18 years with at least a 6-month ED history were enlisted and divided into two groups to receive once-daily treatment with tadalafil at 5 mg (n = 60) and 20 mg (n = 38), respectively, for 12 months. The effects of medication were analyzed and compared using IIEF, Global Assessment Questionnaire (GAQ) and Sexual Encounter Profile (SEP), and so were the safety and tolerance of the two doses.</p><p><b>RESULTS</b>There were no statistically significant differences in the therapeutical results between the 5 mg and 20 mg groups (P < 0.05). The IIEF-5 score was raised by 8.1 points in the former and 7.9 points in the latter; the YES answers to SEP2 in the two groups were 51.3% and 49.2% before the treatment and 82.6% and 84.9% after it. No serious adverse events were observed, except some common ones, such as rubeosis (11.9% vs 8.7%) and headache (5.3% vs 4.9%) in the 5 mg and 20 mg groups.</p><p><b>CONCLUSION</b>Oral tadalafil at 5 mg once daily is efficacious with good tolerance in the treatment of ED, and it can be an alternative to on-demand medication for some men to eliminate the inconvenience of planned intercourse within a limited timeframe.</p>

Long-term efficacy and safety of tamsulosin hydrochloride for the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia: data from China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Tamsulosin hydrochloride can significantly improve benign prostatic hyperplasia (BPH) symptoms after the first dose and achieve long-term efficacy in European and American populations; however, the corresponding studies from China are rarely seen. The purpose of this study was to evaluate the long-term efficacy and safety of tamsulosin hydrochloride 0.2 mg once daily in patients with lower urinary tract symptoms (LUTS) suggestive of BPH in China.</p><p><b>METHODS</b>Chinese patients with LUTS suggestive of BPH were enrolled in a 4-week placebo run-in period and subsequent 60-week open-label study. Tamsulosin hydrochloride 0.2 mg was administered daily during the period of the study. The efficacy and safety parameters were evaluated at the end of treatment period I (0 - 12 weeks) and period II (13 - 60 weeks). The BPH patients were divided into tamsulosin monotherapy group and combination therapy group which received concomitant medication of finasteride 5 mg once daily after the evaluation at the end of treatment period I.</p><p><b>RESULTS</b>A total of 113 patients were recruited to the study. Eighty-two patients received tamsulosin monotherapy and twenty-nine received combination therapy during the treatment period II. Tamsulosin hydrochloride produced a great improvement in mean maximum urinary flow rate (Q(max)) (1.7 ml/s, 3 ml/s) and a significant decrease in mean international prostate symptom score (IPSS) (4.1, 6.4) after 12-week and 60-week treatments, respectively. At the end of treatment period II, there were significant improvement in IPSS, quality of life (QOL) score, Q(max) and average flow rate (Q(ave)) for combination therapy group compared with the treatment period I (all P < 0.05). No serious adverse events (SAE) were recorded during the study.</p><p><b>CONCLUSION</b>Long-term tamsulosin hydrochloride therapy is a safe, effective and well-tolerated method for the treatment for LUTS suggestive of BPH in China.</p>

Suppression subtractive hybridization for the identification of differentially expressed genes in the hippocampus of the offsprings of lead exposed female rats / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To screen and identify differentially expressed genes in the hippocampus of the offsprings of lead exposed female rats in order to provide a theoretical basis for identifying learning and memory deficits related genes.</p><p><b>METHODS</b>RNA was extracted from the hippocampus of young rats with learning and memory deficits due to maternal lead exposure. Suppression subtractive hybridization was used to identify the differentially expressed genes in the hippocampus.</p><p><b>RESULTS</b>An effective subtracted library was constructed which consisted of approximately 200 clones. Sequencing for the library identified 93 clones harboring insertion fragments which included 43 different genes and 4 unknown genes. These genes might be related to learning and memory deficits due to maternal lead exposure.</p><p><b>CONCLUSIONS</b>The up-regulated genes in the hippocampus of young rats from pregnant rats under lead exposure include some housekeeping genes and some proteins involved in cellular protein folding, signal transduction, stress response and DNA methylation. These proteins might be directly related to a significant reduction in learning and memory abilities in the young rats.</p>