The effect of preoperative smoking and smoke cessation on wound healing and infection in post-surgery subjects: A meta-analysis.

A meta-analysis was performed to evaluate the preoperative smoking and smoke cessation on wound healing and infection in post-surgery subjects. A systematic literature search up to January 2022 incorporated 11 trials involving 218 567 subjects after post-surgery at the beginning of the study; 176 670 were smoke cessation or non-smokers, and 41 897 were smokers. Statistical tools like the dichotomous method were used within a random or fixed-influence model to establish the odds ratio (OR) with 95% confidence intervals (CIs) to evaluate the influence of preoperative smoking and smoke cessation on wound healing and infection in post-surgery subjects. Smoke cessation or non-smokers had significantly lower postoperative wound healing problems (OR, 0.59; 95% confidence interval, 0.43-0.82, P < .001), and surgical site wound infection (OR, 0.74; 95% CI, 0.63-0.87, P < .001) compared with smokers in post-surgery subjects. Smoke cessation or non-smokers had significantly lower postoperative wound healing problems, and surgical site wound infection compared with smokers in post-surgery subjects. Furthermore, evidence is needed to confirm the outcomes.

[Huanshao Capsules for oligoasthenospermia: A multicentered clinical trial].

Objective: To investigate the clinical efficacy and safety of Huanshao Capsules (HSC) in the treatment of oligoasthenospermia with spleen and kidney asthenia. METHODS: This randomized, open, multicentered, positive drug controlled clinical trial included 200 cases of oligoasthenospermia with spleen and kidney asthenia, which were assigned to a trial and a control group of equal number to be treated with HSC at the dose of 3 capsules tid and Wuziyanzong Pills at 6 g bid, respectively, both for 12 weeks. We compared the semen volume, sperm concentration, sperm count, sperm motility and percentage of progressively motile sperm (PMS) as the main therapeutic indicators as well as the pregnancy rate as the secondary therapeutic indicator between the two groups of patients before and at 4, 8 and 12 weeks after medication. RESULTS: Totally, 190 of the patients completed the clinical observation, 96 in the trial and 94 in the control group. Compared with the baseline, the patients of the trial group showed significant time-dependent increases at 4, 8 and 12 weeks after medication in the mean sperm concentration (14.78 vs 15.33, 20.98 and 28.78 ×106/ml, P < 0.05), percentage of grade a sperm (12.17% vs 15.05%, 21.17% and 26.97%, P < 0.05), PMS (24.78% vs 28.97%, 37.23% and 47.67%, P < 0.05), and sperm viability (38.64% vs 44.18%, 51.67% and 60.45%, P < 0.05). The pregnancy rate was significantly higher in the trial than in the control group 29.17% vs 18.09%, P < 0.05). CONCLUSIONS: Huanshao Capsules can improve the semen quality and pregnancy rate in the treatment of oligoasthenospermia patients with spleen and kidney asthenia, and therefore deserves a wide clinical application.

Diagnosis and treatment of adrenocorticotrophic hormone-independent macronodular adrenocortical hyperplasia: A report of 23 cases in a single center.

The aim of the present study was to present the treatment observations of patients with adrenocorticotrophic hormone (ACTH)-independent macronodular adrenal hyperplasia (AIMAH) from a single medical center. A total of 23 patients with AIMAH were retrospectively reviewed according to the clinical features of the patient. Physical symptoms and biochemical evidence of Cushing's syndrome (CS) were present in all the cases. High and low dose dexamethasone failed to suppress cortisone secretion on the suppression tests and ACTH levels were low in all the cases. Bilateral enlarged adrenal glands were observed with computed tomography scans in the 23 cases, which were determined to be bilateral adrenal macronodular hyperplasia by pathological analysis. Normal blood pressure was observed in eight patients in the 2-8 years following the bilateral adrenalectomy. A total of 15 cases underwent single side adrenalectomy and their blood pressures markedly decreased three years following surgery; medical treatment was administered to 12 of the 15 patients, while three patients underwent a contralateral adrenalectomy. Nelson's syndrome was not diagnosed for any of the cases. AIMAH has unique endocrinological, radiological and pathological features, presenting as an independent etiological factor of CS. Diagnosis of AIMAH is usually derived from pathological examination and long term remission may be achieved by unilateral adrenalectomy. Contralateral adrenalectomy should be performed in cases of recurrence, when followed with periodical examination of the symptoms and the serum concentration of cortisol.

Protective effect of 3-n-butylphthalide against hypertensive nephropathy in spontaneously hypertensive rats.

Previous studies have demonstrated that a natural product of celery seeds, 3­n­butylphthalide (NBP), has significant antihypertensive effects that are widely utilized in Chinese traditional medicine. The present study aimed to investigate the effects of NBP on hypertensive nephropathy, as well as the mechanisms underlying this disease in spontaneously hypertensive rats (SHRs). SHRs were treated orally with saline, NBP (15 or 30 mg/kg) or losartan (10 mg/kg) daily for 20 weeks, during which time blood pressure was measured every four weeks. At the end of the 20­week treatment, blood and urine samples were collected for biochemical analysis, and kidney tissues were obtained for histopathological analysis and immunohistochemistry. Enzyme­linked immunosorbent assays and western blotting were used to analyze the expression of transforming growth factor (TGF)­ß1 in blood and kidney tissues, respectively. The results showed that NBP effectively attenuated progression of hypertensive nephropathy by decreasing urinary albumin excretion and blood urea nitrogen levels. It significantly decreased blood pressure (although less markedly than losartan) and the incidence of glomerulosclerosis. In addition, it alleviated tubular impairment and significantly decreased oxidative stress, as well as the expression of pro­inflammatory cytokines and TGF-­ß1 in kidney tissues. In conclusion, the results suggested that NBP may slow the progression of hypertensive nephropathy by a variety of mechanisms.

The value of neutrophil elastase in diagnosis of type III prostatitis.

PURPOSE: To explore the value and significance of neutrophil elastase (NE) in diagnosis of type III prostatitis. MATERIALS AND METHODS: The prospective study recruited 123 patients diagnosed with type III prostatitis (IIIA, 36 cases; IIIB, 87 cases) and 84 healthy controls, between April 2008 and July 2012. NE concentrations in expressed prostatic secretions (EPS), EPS routine examination, bacterial culture and The National Institute of Health Chronic Prostatitis Symptom Index (NIHCPSI) score were detected in all the subjects. Difference of NE, CPSI score, and withe blood cell (WBC) count between 2 or more than 2 groups and relationships between NE concentrations and WBC count were all analyzed. RESULTS: There was significant difference in levels of NE (P < .05) between IIIA and IIIB groups, and obviously positive correlation between the level of NE and number of leukocyte in type IIIA prostatitis group was observed (P < .05). The values of CPSI score between IIIA and IIIB groups was statistically significant (P = .037). The levels of leukocyte mount, NE and CPSI were statistically significant between IIIA and the control group (P < .05). NE concentration and CPSI score were statistically significant between IIIB and control group (P < .05), while the numbers of leukocyte was not statistically significant (P = .360). CONCLUSION: The level of NE in EPS is a significant indicator in diagnosis of type IIIA and IIIB prostatitis.

Improvement of preoperative management in patients with adrenal pheochromocytoma.

OBJECTIVE: To investigate methods for improving the preoperative management of patients with pheochromocytoma. METHODS: We collected 155 cases diagnosed as adrenal pheochromocytoma and with hypertension. During preoperative preparation, 85 patients had antihypertensive therapy by using the selective α1-blocker doxazosin controlled-release tablets; 70 patients was controlled by using the nonselective α-blocker phenoxybenzamine; All 155 patients underwent qualitative diagnosis by determination of 24-hour urinary vanilmandelic acid (VMA) or [11C]meta-hydroxyephedrine (mHED) positron emission tomography computed tomography (PET-CT) and underwent computed tomography (CT) for tumor localization; RESULTS: In doxazosin group, with the exception of two patients who had radical fluctuations in blood pressure during surgery, other patients showed a smooth blood pressure control during surgery. No hypertensive crisis and hypotensive shock appeared after surgery. In phenoxybenzamine group, ten patients had sharp fluctuations in blood pressure during surgery, and no hypertensive crisis and hypotensive shock appeared after surgery. CONCLUSION: Compared with phenoxybenzamine, doxazosin has minimal adverse reactions, with high security as a preoperative preparation for adrenal pheochromocytoma, and it is easy to be taken. MHED PET-CT examination has a clear diagnostic value for patients with normal 24-hour urinary VMA.

Sexual function improvement in association with serum leptin level elevation in patients with premature ejaculation following sertraline treatment: a preliminary observation.

The objective of our work was to evaluate the effect of sertraline hydrochloride on serum levels of leptin and sexual function in patients with premature ejaculation (PE). A total of 124 patients with a history of PE at least 6 months, aged 20-50 years, were treated with sertraline hydrochloride. One hundred and four age-matched normal males without a history of PE were included control subjects and were untreated. Before and after the 8 week experiment, sexual performance parameters including the intravaginal ejaculation latency time (IELT) and the Chinese premature ejaculation index (CIPE) were collected from both PE patients and control subjects through a questionnaire survey and analyzed. Serum levels of leptin were measured. Correlations of serum leptin with Body Mass Index (BMI) were analyzed. Before sertraline treatment, serum levels of leptin were significantly higher (32.9 vs 8.8 µg/L, p<0.001) but IELT and CIPE score were significantly lower (54 vs 590, p <0.001; 8.7 vs 22.3, p <0.0001) in PE patients than control subjects. After 8 weeks of treatment with sertraline, serum levels of leptinl in PE patients were decreased markedly to 8.0 µg/L, which was not significantly different from the levels in control subjects (p >0.05); and IELT and CIPE score in PE patients were increased to the values similar to those in control subjects. The sensitivity and specificity values were 87.5% and 96.3% for leptin as a diagnosis target. These observations suggest sertraline as a selective serotonin reuptake inhibitor may offer an effective option for treating premature ejaculation.

Serum leptin and 5-hydroxytryptamine measurements for the diagnosis and treatment of premature ejaculation.

OBJECTIVE: To study the significance of measurements of plasma leptin and 5-hydroxytryptamine (5-HT) levels in the diagnosis of premature ejaculation (PE). METHODS: We compared plasma leptin and 5-HT levels, intravaginal ejaculation latency time (IELT) and Chinese Index of Premature Ejaculation-5 (CIPE-5) scores between 59 patients with PE and 64 healthy control men without PE. We then analyzed the correlations of plasma leptin and 5-HT levels with the IELT and CIPE-5 scores. The patients with PE were administered sertraline (50mg daily) for 8 weeks, and their plasma leptin and 5-HT levels, CIPE-5 scores and IELT were measured again. Comparative analyses of the data were performed between the experimental and control groups and between the pre- and post-treatment values. RESULTS: Plasma leptin levels were significantly higher (P <.0001), whereas plasma 5-HT levels (P <.0001), IELT (P <.0001), and CIPE-5 scores (P <.0001) were significantly lower in the experimental group than in the control group. Significant changes in leptin and 5-HT levels, IELT and CIPE-5 scores were observed after treatment in the experimental group. Plasma leptin levels negatively correlated with 5-HT levels, CIPE-5 scores, and IELT, whereas 5-HT levels positively correlated with IELT and CIPE-5 scores. CONCLUSION: Plasma leptin and 5-HT levels indicate the presence of PE and can be used as diagnostic markers for PE.

Clinical value of serum 5-HT level in diagnosis and treatment of premature ejaculation.

OBJECTIVE: To investigate serum 5-HT level in premature ejaculation (PE) patients and evaluate its clinical value in diagnosis and treatment of PE. METHODS: 71 patients were recruited in this study. Their serums were collected before and after sertraline treatment, while serums from 64 normal males were also collected as a control. Serum 5-HT level was detected by ELISA. SPSS 17.0 software was used to analyze the level of serum 5-HT and the ROC curve was drawn. RESULTS: The average serum 5-HT level of PE patients was 61.9 ng/ml in our study, which was significantly lower than that of the control group (120.6 ng/ml), with statistical significance (p < 0.01). After sertraline treatment, the average serum 5-HT level in PE patients was 98.9 ng/ml, which was significantly higher than that before sertraline treatment. Sensitivity and specificity for serum 5-HT as a predictive diagnostic tool for PE were 92.2 and 93.0%, respectively, and the cutoff value of serum 5-HT was 86.4 ng/ml. CONCLUSIONS: Our study showed that serum 5-HT level may be used as a functional diagnostic tool for PE and an indicator in PE treatment.