Peroxidsome proliferator-activated rreceptor γ(PPARγ) has characteristics of regulation of adipocyte differentiation and lipid metabolism.In recent years,more and more evidences suggest that PPARγ plays an important role in the regulation of immune and inflammatory response.The PPARγ expression increased in airway of asthma patients, and PPARγ was involved in airway inflammation and airway hyperresponsiveneas. Recent studies have shown that PPARγ ligands may have a role in the treatment of asthma.

BACKGROUND:Previous research has demonstrated that preoperative hormone therapy relieved clinicaI and pathological stages of prostatic carcinoma patients,reduced positive ratio of incisaI margin:however,it did not increase disease-free surviva J rate.Worth of preoperative hormone therapy for prostatic carcinoma remains unclear.OBJECTIVE:To assess the role of preoperative hormone therapy in localised prostate cancer.METHODS:Articles were searched from PubMed,Embase.Cochrane Library(No.4,2009),Chinese biomedicaf literature database,Chinese Scientific Journals full_text database,and Chinese Journal full-text database(published before October,2009).Randomized controlled trials which were diagnosed as Iocalised prostate cancer using pathology and cytology were included The sex and nationality were not limited.and patients did not have severe heart and lung diseases Prostatic carcinoma which occurred Later or repeatedly was excluded.Otherwise.randomized controlled trails which were coincidence with the inclusion criteria were also included.Review Manager 5.0 published by Cochrane was used for stafistical analysis.Overall survival rate.disease-free survivaI rate,positive surgical margin rate,positive lymph node rate.and seminal vesicle invasion rate were evaluated.RESULTS AND CONCLUSlON:Six randomized controlled trials totaling 1 027 padicipants were included.The result of meta analysis showed that there was no significant difference in overall surviva J rate[RR=0.94,95%C,(0.86,1.02)],disease-free survival rate[RR=1.02,95%CI(0.89,1.17)],positive lymph node rate IRR=0.86,95%CI(0.47,1.57)],and seminal vesicle invasion rate[RR=1.09,95%CI(0.74,1.59)]between single prostatectomy and preoperative hormone therapy plus prostatectomy,while there was significant difference in positive surgical margin rate[RR=0.46,95%CI(0.32,0.66)]This suggested that preoperative hormonal therapy prior to prostatectomy did not improve survival rate,positive lymph nodes rate and seminaI vesicle invasion rate:however.there was a significant reduction in the positive surgicaI margin rate.

Objective: Compared with ketamine anesthesia, to investigate sevoflurane inhalation combining laryngeal mask airway for anesthesia induction in pediatric cardiac surgery.
Methods:A total of 40 pediatric patients with congenital heart diseases received elective cardiac surgery in our hospital from 2013-08 to 2014-01 were studied. The children were from 6 months to 2 years of age and randomly divided into 2 groups, n=20 in each group. Sevolfurane group, the children inhaled the mixture of 8%sevolfurane and 100%O2, laryngeal mask airway was used upon losing consciousness for mechanical ventilation, the anesthesia was maintained by (3-4)% sevolfurane inhalation to facilitate central venous catheter placement. Ketamine group, the children received intramuscular injection of ketamine (7 mg/kg)+atropine (0.01 mg/kg). The peripheral venous line was established upon losing consciousness, the intravenous midazolam (0.1 mg/kg), pipecuronium (0.10 mg/kg), fentanyl (5 μg/kg) were applied, then tracheal intubation was performed for mechanical ventilation and the anesthesia was maintained by (0.5-1)%sevolfurane to facilitate central venous catheter placement.
Results: Sevoflurane group had the shorter time for losing the consciousness than that in Ketamine group (48.90 ± 3.93) s vs (577.85 ± 116.41) s, P<0.05 and the shorter time for ifnishing the central venous catheter placement (11.15 ± 2.48) min vs (24.15 ± 4.02) min, P<0.05. The average blood pressure and heart rate were similar between 2 groups after laryngeal mask or tracheal intubation, P>0.05. The arterial PH value, PaCO2, BE and lactatein were similar between 2 groups, P>0.05.
Conclusion: Sevoflurane inhalation combining laryngeal mask airway could shortening anesthesia preparation time with simple management. It provided an important anesthesia option in pediatric cardiac surgery.

Reproductive health is a focus of the 21st century medical sciences. Researches on the correlation between psychological factors and male reproductive health may help discover the rules of the development of male diseases. This paper analyzes the social root-cause of the adverse psychological factors of men, discusses how psychological factors affect male reproductive health, and proposes some remedial measures for related psychological problems.
Humans ; Male ; Penile Erection ; psychology ; Psychology, Social ; Reproductive Medicine ; Sex Education ; Stress, Psychological ; physiopathology

Objective To evaluate the effect of aminophylline on the efficacy of extubation under ultra-fast track anesthesia ( UFTA) in pediatric patients with congenital heart disease ( CHD) undergoing surgical correction of anomaly. Methods Ninety American Society of Anesthesiologists physical status Ⅰor Ⅱ pediatric patients, aged<6 yr, undergoing surgical correction of anomaly, were randomized into 3 groups ( n=30 each) using a random number table method: group Ⅰ, group Ⅱ and group Ⅲ. After the end of surgery, normal saline was given in groupⅠ, 1 mg∕kg aminophylline was given in groupⅡ, and 2 mg∕kg aminophylline was given in groupⅢ. The condition of extubation in the operating room and respirato-ry rate at extubation were recorded. Mean arterial pressure, heart rate and bispectral index value were re-corded at the end of surgery, and at 9 and 15 min after administration. Results Compared with groupⅠ, the rate of successful extubation in the operating room, BIS value at 9 min after administration and respira-tory rate at extubation were significantly increased inⅡand Ⅲ groups ( P<0. 05) . There was no significant difference in the parameters mentioned above between group Ⅱand group Ⅲ ( P>0. 05 ) . Conclusion Aminophylline can increase the efficacy of extubation under UFTA in pediatric patients with CHD undergoing surgical correction of anomaly, and 1 mg is the recommended dose.

Objective:To examine the safety and clinical efficacy of ultrasound-guided irreversible electroporation (IRE) using the open surgery approach, after induction chemotherapy, in the treatment of locally advanced pancreatic cancer (LAPC) .Methods:The data of 64 LAPC patients who underwent ultrasound-guided IRE using the open surgery approach after induction chemotherapy at Department of Pancreatobiliary Surgery, Sun Yat-sen University Cancer Center from August 2015 to March 2019 were retrospectively analyzed. The study comprised of 30 males and 34 females, with median age of 58.5 years old (range: 34 to 87 years old) , were included in this study.The tumor was located in the pancreatic head and body/tail in 30 and 34 patients, respectively.The largest recorded tumor size was 6.1 cm (≤4.0 cm: n=35; >4.0 cm: n=29) .To create an electric field around the tumor, Two to six probes were parallelly inserted into each patient′s tumor, based on the size of the tumor, at a distance of 2 cm apart through the transverse mesocolon in a caudal-to-cranial direction.According to the numerical sequence of patients undergoing ultrasound-guided IRE, the first 15 cases and following 49 patients were categorized as the primary and secondary treatment group, respectively.T text or χ 2 test was analyzed to the data between two groups.The study endpoints were overall survival (OS) and progression free survival (PFS) , which were investigated using Kaplan-Meier method, and their differences were compared using log-rank test. Results:The overall length of hospital stay was (8.9±2.7) days (range: 5 to 20 days) . Four patients were lost to follow-up.The study follow-up rate was 93.8%, with a median follow-up time of 29.3 months (range: 13.5 to 55.7 months) .The median OS and PFS of the entire cohort was 24.6 months (95 % CI: 22.0 to 27.3 months) and 12.0 months (95 %CI: 8.8 to 15.2 months) , respectively.One month after IRE, abdominal pain was significantly relieved in 95.3% of the patients ( t=-28.55, P<0.01) .The rate of complications in the entire cohort was 20.3% and all were classified as grade B.Of them, pancreatic fistula, incisional infection, and upper gastrointestinal hemorrhage were observed in 7, 4, and 2 cases, respectively.The rate of complications for patients in the primary and secondary treatment groups were significantly different (10/15 vs. 6.1%) , respectively (χ 2=26.01, P<0.01) .Further, two deaths were observed after IRE in the primary treatment group, while none was observed in the secondary treatment group. Conclusions:Ultrasound-guided IRE using the open surgery approach after induction chemotherapy is found to be safe and effective in treating patients with LAPC.However, these findings should be validated in prospective randomized trials before wide clinical application.

Objective:To examine the safety and clinical efficacy of ultrasound-guided irreversible electroporation (IRE) using the open surgery approach, after induction chemotherapy, in the treatment of locally advanced pancreatic cancer (LAPC) .Methods:The data of 64 LAPC patients who underwent ultrasound-guided IRE using the open surgery approach after induction chemotherapy at Department of Pancreatobiliary Surgery, Sun Yat-sen University Cancer Center from August 2015 to March 2019 were retrospectively analyzed. The study comprised of 30 males and 34 females, with median age of 58.5 years old (range: 34 to 87 years old) , were included in this study.The tumor was located in the pancreatic head and body/tail in 30 and 34 patients, respectively.The largest recorded tumor size was 6.1 cm (≤4.0 cm: n=35; >4.0 cm: n=29) .To create an electric field around the tumor, Two to six probes were parallelly inserted into each patient′s tumor, based on the size of the tumor, at a distance of 2 cm apart through the transverse mesocolon in a caudal-to-cranial direction.According to the numerical sequence of patients undergoing ultrasound-guided IRE, the first 15 cases and following 49 patients were categorized as the primary and secondary treatment group, respectively.T text or χ 2 test was analyzed to the data between two groups.The study endpoints were overall survival (OS) and progression free survival (PFS) , which were investigated using Kaplan-Meier method, and their differences were compared using log-rank test. Results:The overall length of hospital stay was (8.9±2.7) days (range: 5 to 20 days) . Four patients were lost to follow-up.The study follow-up rate was 93.8%, with a median follow-up time of 29.3 months (range: 13.5 to 55.7 months) .The median OS and PFS of the entire cohort was 24.6 months (95 % CI: 22.0 to 27.3 months) and 12.0 months (95 %CI: 8.8 to 15.2 months) , respectively.One month after IRE, abdominal pain was significantly relieved in 95.3% of the patients ( t=-28.55, P<0.01) .The rate of complications in the entire cohort was 20.3% and all were classified as grade B.Of them, pancreatic fistula, incisional infection, and upper gastrointestinal hemorrhage were observed in 7, 4, and 2 cases, respectively.The rate of complications for patients in the primary and secondary treatment groups were significantly different (10/15 vs. 6.1%) , respectively (χ 2=26.01, P<0.01) .Further, two deaths were observed after IRE in the primary treatment group, while none was observed in the secondary treatment group. Conclusions:Ultrasound-guided IRE using the open surgery approach after induction chemotherapy is found to be safe and effective in treating patients with LAPC.However, these findings should be validated in prospective randomized trials before wide clinical application.

Objective:To investigate the clinical effect of free fibula flap transplantation in repairing the defect of mandibular osteoradionecrosis (ORN).Methods:A total of 151 mandibular ORN patients undergoing free fibular flap transplantation were selected from August 2005 to September 2020 in the Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University. Among them, 109 patients were males and 42 patients were females, aged (54.1±10.1) (ranged 31-85) years old. The clinical data of the patients was collected and the survival rate of the flaps and postoperative function were calculated to evaluate the surgical efficacy. The χ 2 test was used for difference analysis. Results:Among the 151 patients, mandibular ORN caused by radiotherapy for nasopharyngeal carcinoma accounted for 79.5% (120/151). The average time for mandibular ORN appeared was 5(6) years after radiotherapy. Facial artery [57.2%(87/152)] and superior thyroid artery [32.9%(50/152)] were the main anastomotic arteries in the recipient area. There was no significant difference in the necrosis rates of the two flaps [10.3%(9/87) and 12.5% (5/50), respectively, P=0.949]. The main anastomotic veins in the recipient area were the external jugular vein [48.4%(135/279)] and the common facial vein [26.5%(74/279)]. Twenty-five cases (16.6%) had one vein anastomosed, and 126 cases (83.44%) had two veins anastomosed. There was no significant difference in the flap necrosis rate between the two conditions [20.0%(5/25) and 7.1%(9/126), respectively, P=0.100]. Ninety-seven cases (64.2%) used the peroneal musculocutaneous-fascia composite flap to repair the maxillofacial soft and hard tissue defects. Thirteen cases (8.6%) underwent the restorations with digital virtual surgery design, of which 5 cases were repaired with dental implants at the same time. After the operations, lower respiratory tract infection occurred in 17 patients (11.3%), and upper respiratory tract obstruction occurred in 3 cases (2.0%). The survival rate of the flap after operation was 90.7% (136/151), and 21 patients (13.9%) had flap vascular crisis. Delayed healing of maxillofacial wounds occurred in 33 cases (21.9%). After 3 to 24 months of follow-ups, 110 patients (76.9%) had no fistula inside/outside the oral cavity, 118 patients (82.5%) had an improvement in opening mouth of increasing (≥0.5 cm) after surgery, 135 patients (94.4%) had pain relief, 97 cases (67.8%) could eat normal diet, semi-liquid or soft food, and 137 cases (95.8%) were satisfied or basically satisfied with the treatment effects. Conclusions:The free fibular flap transplantation is an effective method to repair mandibular ORN defects. Preoperative vascular assessment is helpful for the selection of recipient vessels. Facial artery, superior thyroid artery, external jugular vein and common facial vein can be used as the main recipient vessels. The repair of the peroneal musculocutaneous-fascia composite flap facilitates the closure of internal and external fistulas. Digital technology can help to restore the maxillofacial shape more accurately, improve the patient′s occlusal and chewing function and enhance the quality of life of mandibular ORN patients.

Objective: To investigate the effects of maternal exposure to ambient fine particles (PM_2.5) in Fuzhou during pregnancy on immune responses to ovalbumin (OVA) in neonatal rats and the possible mechanisms. Methods: Pregnant Sprague-Dawley rats were randomly assigned into four groups (ten in each): filtered air (FA) plus normal saline (NS), airborne PM_2.5 plus NS (PM_2.5-NS), FA plus OVA (FA-OVA) and PM_2.5 plus OVA (PM_2.5-OVA) groups. Pregnant dams in the PM_2.5 exposure groups were placed in a PM_2.5 exposure chamber in which the PM_2.5 concentration was equal to the ambient air from the beginning of gestation till delivery, whereas the other dams inhaling air without particulate matters were put into a clean chamber. OVA sensitization was conducted through intraperitoneal injection of OVA at 50 μg per dam at 4 and 9 days of gestation, followed by inhalation of atomized 1% OVA for 30 min at 18, 19 and 20 days of gestation. Dams without OVA sensitization were given NS in the same way. Levels of interleukin (IL)-4, IL-5 and interferon-γ (IFN-γ) in neonatal rats' plasma were measured by enzyme-linked immunosorbent assay just after birth. Protein levels of transcription factors GATA-3 and T-bet in lung were analyzed by Western-blotting. Changes in microRNA(miR)-146a and miR-146b in spleen were detected by real-time polymerase chain reaction. Histological changes in lung were observed under light microscope. One-way analysis of variance and LSD test were used as statistical methods. Results: (1) IL-4 level in plasma was significantly increased in PM_2.5-NS [(18.56±7.04) ng/L], FA-OVA [(34.04±7.06) ng/L] and PM_2.5-OVA groups [(45.67±8.18) ng/L] as compared with that in FA-NS group [(10.51±2.88) ng/L], and the level of IL-4 in PM_2.5-OVA group was higher than that in PM_2.5-NS and FA-OVA groups (F=54.667, P<0.001). Significantly increased IL-5 level in plasma was found in FA-OVA and PM_2.5-OVA groups as compared with that in FA-NS group (F=6.253, P=0.023). Among the four groups, FA-OVA group showed significantly increased IFN-γ level in plasma (F=28.604, P<0.001). (2) GATA-3 level in lung tissues was significantly increased in PM_2.5-NS (31.09±3.54), FA-OVA (35.24±5.00) and PM_2.5-OVA groups (47.81±3.63) as compared with that in FA-NS group (24.19±3.12), and higher in PM_2.5-OVA group than in PM_2.5-NS and FA-OVA groups (F=96.581, P<0.001). T-bet level was significantly lower in FA-OVA and PM_2.5-OVA groups than in FA-NS group. Moreover, PM_2.5-OVA group showed decreased T-bet level as compared with that in PM_2.5-NS and FA-OVA groups (F=30.852, P<0.001). (3) Expression of miR-146a in spleen was significantly enhanced in PM_2.5-NS (1.72±0.27), FA-OVA (1.56±0.37) and PM_2.5-OVA groups (3.06±0.52) than in FA-NS group (1.05±0.25). Moreover, PM_2.5-OVA group showed enhanced expression of miR-146a as compared with that in PM_2.5-NS and FA-OVA groups (F=42.276, P<0.001). Changes in the expressions of miR-146b were similar to those in miR-146a (F=28.776, P<0.001). (4) Stenosis or disappearance of alveolar spaces, accompanied with infiltration of inflammatory cells in interstitial substance and congestion in alveolar septum, was seen in FA-OVA and PM_2.5-OVA groups and conditions in the latter group were more severe. Conclusions Intrauterine exposure to ambient PM_2.5 negatively affects fetal lung development and immunological function in rats, especially when the dams are sensitized with OVA during pregnancy.