Male lower urinary tract symptoms is a collective term for a group of symptoms associated with lower urinary tract disorders characterized by frequent urination, urgent urination, and difficulty of urination, of which the common causes are benign prostatic hyperplasia or overactive bladder. With the aging of the global population, the incidence of male lower urinary tract symptoms is increasing year by year. Based on the theoretical connotation of " zang-fu extraordinary connection", the relationship between the lungs and the bladder, the spleen and the small intestine, and the kidneys and the sanjiao with the formation of male lower urinary tract symptoms is explained from three perspectives. It is believed that lung qi depression and closure, disturbance of qi transformation in bladder, and insufficient spleen transport occur, the small intestine is dysfunctional, kidney yang is exhausted, and obstruction of the sanjiao waterway are the basic pathogenesis of male lower urinary tract symptoms. It is emphasized that the location of the disease should be identified. If it is related to the lungs and the bladder, then the disease should be treated by lifting the pot to lift the lid and diffusing the lung qi to benefit the bladder with Wuling Powder plus perilla leaf and bitter apricot seed; if it is related to the spleen and the small intestines, then the disease should be treated by raising the clear and directing the turbid downward and improving the spleen qi in order to support the small intestines with Shenling Baizhu Powder; if it is related to the kidneys and the sanjiao, then the disease should be treated by seeking the yang within the yin and warming and tonifying the kidney qi in order to dredge up the sanjiao with Bawei Shenqi Pill. According to the patient's condition, treatment can be combined with acupuncture, exercise, and other therapies. This paper can provide reference for clinical treatment of male lower urinary tract symptoms.

The theory of "brain-heart-kidney-semen chamber" axis is proposed based on the basic theories of traditional Chinese medicine， the modern physiological characteristics of men's diseases， and clinical practice. According to this theory， dysfunctions of the brain， heart， kidney， and semen chamber are the core mechanisms for the occurrence of premature ejaculation， and the loss of control of the opening and closing of the seminal orifices due to the dysfunction of the semen chamber is the final link in the occurrence of premature ejaculation. The treatment of premature ejaculation based on the theory of "brain-heart-kidney-essence chamber" axis highlights the overall regulation of the Zang-fu organs involved in the disease， while focusing on the simultaneous treatment of the mind and body. By exploring the biological basis of the "brain-heart-kidney-essence chamber" axis and premature ejaculation， we propose that the biological basis of premature ejaculation and the axis is mainly related to the function decline of the local brain area， neuromodulation malfunction， central neurotransmitter imbalance， endocrine disorders， and enhanced sensory afferents of the penis. This study aims at providing a new approach for the prevention and treatment of premature ejaculation by traditional Chinese medicine and a scientific basis for the development of more effective therapeutic methods.

This study was aimed to discuss the dynamic variation of soluble sugar contents, sucrose metabolizing en-zyme activities and gene expression quantities during the fruits development of A momum villosum, in order to pro-vide the basis of improvement of the fruit yield. Fresh fruits at three different development processes (30 DAF, 60 DAF, 90 DAF) were used to investigate changes of soluble sugar components and sucrose metabolizing enzyme activ-ities by HPLC and UV spectrophotometry. Combining with the high-throughput sequencing expression profile data of three fruit development period, the trends of three key enzymes gene expressed in sugar metabolism were analyzed. The results showed that the fruit sugar components were dominated by fructose, glucose and sucrose. The concentra-tion of hexose (fructose and glucose) gradually decreased in peel. But in seeds the concentration of hexose decreased at first and then increased. The content of sucrose and the net activities of sucrose synthase (synthesizing direction minus decomposing direction) in peel and seeds were gradually increased. The expression trends of key enzyme gene in sugar metabolism examined by RNA-seq quantification showed that sucrose phosphate synthase and sucrose syn-thase gene increased and then kept constant, but the invertase gene expression trend was gradually rising. Conse-quently, sucrose synthase was the key enzyme catalyzing sucrose synthesis and decomposition. The activity of sucrose synthase and sucrose contents in peel and seeds reached the highest peak in the end of fruit mature.

Objective To identify the reliable reference genes for gene expression analysis of the pericarp and seed of Amomum villosum Lour. by using real-time fluorescence quantitative polymerase chain reaction ( qRT-PCR). Methods Using the fruits ( separated into peels and seeds) of A. villosum at three different developmental periods as the experimental material, 5 candidate reference genes (β-actin, EF-1α, GAPDH, PGK, TUA) with steady expression were screened out by the high throughout sequencing of transcriptome and expression profile data. The qRT-PCR technique was applied to study the expression levels of 5 candidate reference genes in different samples. The stability of the candidate reference genes were evaluated by GeNorm and NormFinder software. Results The 5 reference genes had different stabilities in the pericarp and seed of A. villosum Lour. at different development periods . The order of the steadiness of reference genes showed by GeNorm was EF-1α = TUA>PGK>GAPDH>β-actin. The results of NormFinder revealed that EF-1α was the most stable, followed by TUA, and the order of the other three genes was as same as the results of GeNorm. Conclusion EF-1αand TUA could be used as double reference genes for the normalization of gene expression in A. villosum fruits at different developmental periods by using qRT-PCR.

Objective To observe the effect of early rehabilitation therapy on recovery from reoperation for recurrent lumbar disc herniation (RLDH).Methods Sixty-five cases who received surgery for RLDH between 2007 and 2009 were randomly divided into a rehabilitation group and control group.Both groups were treated with the same surgical approach and routine treatment.Early and comprehensive rehabilitation therapy was provided in the rehabilitation group during the perioperative period,including preoperative and postoperative muscle strength training,postoperative sitting and standing balance training,and acupuncture.The control group was instructed only in general exercise.Before the operation and 2 weeks and 3,6,12 and 24 months afterward,the surgical outcomes of all cases were assessed using the JOA score and the improvement rate in the JOA score.Any postoperative complications and intervertebral fusion were also observed.Results The average postoperative JOA scores of both groups were significantly higher than their preoperative scores.At all of the time points after the operation,the average JOA scores and all improvement rates in the rehabilitation group were significantly higher than those in the control group.Postoperative complications such as deep venous thrombosis,urinary retention and constipation were significantly less among the rehabilitation group than among the controls.All the intervertebral bone implants were well fused on time.Conclusion Early rehabilitation can significantly improve the effectiveness of RLDH reoperation and reduce the incidence of postoperative complications.It is recommended for clinical application.

OBJECTIVETo study the protective effect of panax notoginseng saponins (PNS) against apoptosis of the superficial cells of rat renal cortex following femoral fracture in rats.

METHODSNinety Wistar rats were randomized into 3 groups, namely the fracture group (n=36), fracture with PNS treatment group (n=36), and normal control group (n=18). At 1, 6, 12, 24, 36, and 48 h after femoral fracture, 6 rats from first two groups and 3 from the control group were sacrificed to observe renal pathologies with HE-staining. Immunohistochemistry and in situ hybridization were used to detect Bcl-2 and Bax expression, and TUNEL staining was employed to detect the distribution of apoptotic cells.

RESULTSIn the fracture group, the renal cortex showed telangiectasia and granular degeneration of proximal tubule, which were lessened in the PNS treatment group. Compared with the control group, the fracture group showed significantly increased Bcl-2 and Bcl-2 mRNA expressions in the renal cortex at 1-12 h (P<0.01) and increased Bax protein expression at 12-36 h (P<0.01) with increased Bax mRNA expression at 24-48 h (P<0.01). In PNS treatment group, Bcl-2 protein expression at 1 h and Bcl-2 mRNA expression at 12-48 h were significantly higher (P<0.01), but Bax protein and mRNA expressions at 24-48 h were significantly lower (P<0.01) than those in the fracture group.

CONCLUSIONFemoral fracture obviously affects Bcl-2 and Bax protein and mRNA expressions in the superficial cells of the renal cortex, PNS can suppress the cell apoptosis by down-regulating Bax expression and up-regulating Bcl-2 expression.

Animals ; Apoptosis ; drug effects ; Femoral Fractures ; pathology ; Kidney Cortex ; metabolism ; pathology ; Male ; Panax notoginseng ; chemistry ; Plants, Medicinal ; chemistry ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; RNA, Messenger ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Saponins ; isolation & purification ; pharmacology ; bcl-2-Associated X Protein ; genetics ; metabolism

Objective To study the protective effect of panax notoginseng saponins (PNS) against apoptosis of the superficial cells of rat renal cortex following femoral fracture in rats. Methods Ninety Wistar rats were randomized into 3 groups, namely the fracture group (n=36), fracture with PNS treatment group (n=36), and normal control group (n=18). At 1, 6, 12, 24, 36, and 48 h after femoral fracture, 6 rats from first two groups and 3 from the control group were sacrificed to observe renal pathologies with HE-staining. Immunohistochemistry and in situ hybridization were used to detect Bcl-2 and Bax expression, and TUNEL staining was employed to detect the distribution of apoptotic cells. Results In the fracture group, the renal cortex showed telangiectasia and granular degeneration of proximal tubule, which were lessened in the PNS treatment group. Compared with the control group, the fracture group showed significantly increased Bcl-2 and Bcl-2 mRNA expressions in the renal cortex at 1-12 h (P<0.01) and increased Bax protein expression at 12-36 h (P<0.01) with increased Bax mRNA expression at 24-48 h (P<0.01). In PNS treatment group, Bcl-2 protein expression at 1 h and Bcl-2 mRNA expression at 12-48 h were significantly higher (P<0.01), but Bax protein and mRNA expressions at 24-48 h were significantly lower (P<0.01) than those in the fracture group. Conclusion Femoral fracture obviously affects Bcl-2 and Bax protein and mRNA expressions in the superficial cells of the renal cortex, PNS can suppress the cell apoptosis by down-regulating Bax expression and up-regulating Bcl-2 expression.

Objective To study the protective effect of panax notoginseng saponins (PNS) against apoptosis of the superficial cells of rat renal cortex following femoral fracture in rats. Methods Ninety Wistar rats were randomized into 3 groups, namely the fracture group (n=36), fracture with PNS treatment group (n=36), and normal control group (n=18). At 1, 6, 12, 24, 36, and 48 h after femoral fracture, 6 rats from first two groups and 3 from the control group were sacrificed to observe renal pathologies with HE-staining. Immunohistochemistry and in situ hybridization were used to detect Bcl-2 and Bax expression, and TUNEL staining was employed to detect the distribution of apoptotic cells. Results In the fracture group, the renal cortex showed telangiectasia and granular degeneration of proximal tubule, which were lessened in the PNS treatment group. Compared with the control group, the fracture group showed significantly increased Bcl-2 and Bcl-2 mRNA expressions in the renal cortex at 1-12 h (P<0.01) and increased Bax protein expression at 12-36 h (P<0.01) with increased Bax mRNA expression at 24-48 h (P<0.01). In PNS treatment group, Bcl-2 protein expression at 1 h and Bcl-2 mRNA expression at 12-48 h were significantly higher (P<0.01), but Bax protein and mRNA expressions at 24-48 h were significantly lower (P<0.01) than those in the fracture group. Conclusion Femoral fracture obviously affects Bcl-2 and Bax protein and mRNA expressions in the superficial cells of the renal cortex, PNS can suppress the cell apoptosis by down-regulating Bax expression and up-regulating Bcl-2 expression.

ObjectiveTo investigate the biomechanical characteristics of different types of fixation with bioactive cervical fusion cage made of hydroxyapatite and poly L-lactic acid in cervical spinal fusion.MethodsIliac crest bone,bioactive cervical fusion cage and bioactive cervical fusion cage with plate fixation were used for anterior interbody implants after anterior discectomy across C5-6 in six fresh human cervical spine specimens respectively,and the range of motion of the cervical vertebrae interbody fusion were measured through the motional stability test.Results After discectomy,Bioactive Cervical Fusion Cage with plate fixation exhibited a significant increase in stability and a decrease of range of motion in angular motion than others in all motional directions ( P ＜ 0.005 ). Bioactive cervical fusion cage exhibited a decrease in stability and an increase of range of motion (6.25 ± 0.29) in angular motion than the intact spine (5.76 ± 0.40) in extension,but the difference was not significantly ( P ＞ 0.05 ).Bioactive cervical fusion cage exhibited a decrease in angular motion than iliac crest bone and a significant increase in stability in all motional directions except extension (P ＜ 0.005).ConclusionsBioactive cervical fusion cage' s biomechanical performance was excellent and bioactive cervical fusion cage with plate fixation was excellent in stability in all motional direction,and could remain initial stability of cervical vertebrae.

Objective To retrospectively describe the technique and review the surgical results of OsteoMed M3 titanium plate and screws used to secure the posterior elements in the open position after expansive unilateral opendoor laminoplasty.Methods Twenty-six patients with multilevel cervical disc herniation and canal stenosis were treated with an expansive unilateral open-door laminoplasty with OsteoMed M3 plate and screws.The follow-up period was over 1 year.The improvement of spinal function after surgeries under JOA was evaluated to analyse the effects and releated factors.Results All of 26 cases' follow-up period was over 1 year.The mean JOA score increased significantly from 9.40 ± 1.658 ( range,5 to 13 ) points before surgery to 13.80 ± 1.958 ( range,7 to 16) points at final follow- up ( t =- 21.137,P =0.000 ).Mean recovery rate was 57.9％.Postoperative radiography,magnetic resonance imaging and computed tomography scan demonstrated significantly increased sagittal diameter and canal expansion.Two cases without relief of nurological symptoms underwent an additional anterior multilevel corpectomy.One case with ossification of the posterior longitudinal ligament had not good enough neurologic improvement after surgery.No neurologic deterioration owing to hinge reclosure or major surgery-related complications were observed.It would reduce the recovery for those with old age,long history,worse symptoms,cervical kyphosis and abnormal signal in MR imaging.It was good for patients to do early active cervical exercises after surgery.Conclusion Unilateral open- door laminoplasty with OsteoMed M3 titanium plate and screws fixation effectively maintains expansion of the spinal canal and resists closure while preserving alignment and stability.This modified technique is easy to perform with a low complication,is and economic,and is good for clinical application.