【Objective】 A new type of testicular hydrocele reversal resection is described under the concept of trans-interfascial plane surgery, in order to improves the understanding of the anatomical level of testicular hydrocele surgery and to optimize the surgical approach. 【Methods】 During Jan. and June 2021, 15 patients with primary testicular hydrocele were treated with hydrocelectomy and gubernaculum preservation.Demographic information, indications of treatment, success rate and complications were collected.The anatomical structures were analyzed using intraoperative findings and photographs. 【Results】 All operations of 15 patients were successful, with the surgery time of 25-48 minutes, with an average of (34.0±6.2) minutes.No patients experienced scrotal hematoma or incision infection.There were no relapses during the 3-month follow-up after surgery.The anatomical points observed during surgery were as follows: we further confirmed that the internal spermatic fascia completely surrounded the testis, epididymis, and the spermatic cord; this layer was an avascular plane, the cremaster muscle and fascial layer between the internal and external spermatic fasciae were absent; intraoperative preservation of the gubernaculum helped to fix the testicles in its natural position. 【Conclusion】 Our novel technique of hydrocelectomy is reliable, and the precise anatomical description of the concept of trans-interfascial plane surgery can help to improve the related surgical techniques.

Objective To explore the application value of simultaneous multi-slice(SMS)technique in diffusion tensor imaging(DTI)for evaluating brain glioma.Methods Thirty-four brain glioma patients were prospectively enrolled,and brain conventional DTI and SMS-DTI were acquired.The subjective scores of image quality,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were compared between SMS-DTI and conventional DTI,so were the numbers of whole brain fiber bundles,tumor relative fractional anisotropy(rFA)and relative mean diffusivity(rMD)obtained based on SMS-DTI and conventional DTI.Results Among 34 patients,there were 23 cases of high-grade glioma and 11 cases of low-grade glioma.No significant difference of subjective scores of image quality,tumor edge clarity nor magnetic susceptibility artifacts was found between SMS-DTI and conventional DTI(all P＞0.05).SNR and CNR on SMS-DTI were both lower than those on conventional DTI(both P＜0.05).No significant difference of the numbers of whole brain fiber bundles,rFA nor rMD of gliomas with different pathological grades was detected based on SMS-DTI compared with those on conventional DTI(all P＞0.05).Conclusion SMS applicated in DTI for evaluating brain gliomas was able to shorten acquisition time under the condition of ensuring image quality and quantitative analysis accuracy.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

OBJECTIVE: To evaluate the prospective association between cumulative resting heart rate (cumRHR) and rapid renal function decline (RRFD) in a cohort of individuals aged 60 and older. METHODS: In the Tianjin Chronic Kidney Disease Cohort Study, the individuals who underwent three consecutive physical examinations between 2014 and 2017, with estimated glomerular filtration rate (eGFR) greater than 60 mL/min per 1.73 m² and aged 60 years or older were enrolled. A total of 27,564 patients were prospectively followed up from January 1, 2017 to December 31, 2020. The 3-year cumRHR was calculated. The primary outcome was RRFD, defined as an annualized decline in eGFR of 5 mL/min per 1.73 m² or greater. Logistic and restricted spline regression models and subgroup analysis were used to investigate the association of cumRHR with RRFD after adjusting for all confounders. RESULTS: During a median follow-up of 3.2 years, a total of 4,347 (15.77%) subjects developed RRFD. In fully-adjusted models, compared with the lowest quartile of cumRHR, the odds ratio (OR) for the highest was 1.44 (1.28-1.61), P < 0.001. Furthermore, each 1-standard deviation (27.97 beats/min per year) increment in cumRHR was associated with a 17% (P < 0.001) increased risk of RRFD, with a linear positive correlation (P for non-linear = 0.803). Participants with a 3-year cumRHR ≥ 207 (beats/min) * year (equivalent to ≥ 69 beats/min per year in 3 years) were found to be at a higher risk of RRFD. CONCLUSIONS The cumRHR is significantly associated with a higher risk of RRFD among older adults. These results might provide an effective goal for managing and delaying the decline of renal function in the older adults.

Background Natural product sanguinarine chloride (SC) can significantly alleviate liver fibrosis and acute liver injury in mice, but whether it has a protective effect on mouse liver injury caused by sodium arsenite (SA) has not been studied. Objective To verify if SC may present preventive and therapeutic effects on SA-induced liver injury in mice. Methods A total of 140 SPF male Kunming mice were randomly divided into two sub-studies, which included a prevention sub-study and a treatment sub-study. In each sub-study, a blank group (normal saline), a model group (5 mg·kg⁻¹ SA), and a positive control group (11.375 mg·kg⁻¹ bicyclol and 182 mg·kg⁻¹ glutathione), as well as SC low, medium, and high dose groups (25, 50, and 100 mg·kg⁻¹) were arranged with 10 mice in each group. In the prevention sub-study, the blank group was given normal saline, the model group was given SA, and the other groups (the SC low, medium, and high dose groups and the positive control group) were given the corresponding treatment 30 min before gavage of SA, once a day, for 28 d. In the treatment sub-study, except for the blank group which was given normal saline, the other groups were given SA for 28 d, then the model group was given normal saline, and the other groups were given the corresponding treatment every day for 28 d. After the experiment, the mice were sacrificed to evaluate selected physiological and biochemical indicators in serum and liver tissue and to observe histopathological changes after HE staining. Results In either sub-study of preventive effect or treatment effect: compared with the blank group, body weight, liver weight, liver coefficient, as well as serum alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), malondialdehyde (MDA), glutathione peroxidase (GSH), and superoxide dismutase (SOD) among all SC groups were not significantly different (P>0.05); but compared with the model group, the SC groups showed increased body weight (P<0.01), decreased liver weight and liver coefficient (P<0.01), reduced ALT, AST, TBIL, and MDA (P<0.05 or P<0.01), and increased GSH and SOD with (P<0.05 or P<0.01) or without significance; compared with the positive control group, no differences were found in the above indicators (P＞0.05). The result of histopathological evaluation showed that the SC groups had a clear liver lobule structure, neatly arranged hepatic cords, and less infiltration of inflammatory cells. Conclusion SC has both preventive and therapeutic effects on SA-induced liver injury in mice.

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

Objective To understand the current status of synthetic drug use and associated factors among men who have sex with men (MSM) at high risk of HIV infection.Methods A crosssectional study was conducted in Guangzhou,Wuxi and Shenzhen through January to August 2017.MSM at high risk of HIV infection were recruited from attendants at the health clinics,through internet advertisement and snowball sampling method.Eligible MSM were the ones who had met the following criteria:≥ 18 years old,having either 2 male sex partners,or condomless anal sex with a casual male sex partner,or a STD historg during the past 6 months.Data regarding demographic,sexual behavior,HIV/STD testing history and previous drug use were collected by sely-administered questionnaires.Blood was also drawn for HIV testing.Results Of the 603 MSM at high risk of HIV,25.5％ (154/603,95％CI:22.0％-29.0％) of them had used drugs in the past 6 months,including 29.1％ (88/302,95％CI:24.0％-34.3％) in Guangzhou,26.3％ (40/152,95％CI:19.2％-33.4％)in Shenzhen,and 17.4％ (26/149,95％CI:11.3％-23.6％) in Wuxi.'Rush'(85.1％,131/154) was the most commonly used drug.Results from the multivariable logistic regression revealed that drug use was associated with the following factors:having multiple casual sexual partners (aOR=3.24,95％CI:1.29-7.43) and alcohol use (aOR=1.78,95％CI:1.12-2.80) in the past 6 months after adjusting for age,education and monthly income.Conclusions Drug use seemed common among MSM population at high risk of HIV infection and was associated with higher risk behavior that leading to HIV infection.Synthetic drug use among MSM deserved more attention.

Objective:To observe the effect of intermittent oro-esophageal tube feeding (IOE) on dysphagia patients with cerebral small vessel disease.Methods:Sixty such patients were randomly divided into an experimental group ( n=30) and a control group ( n=30). In addition to the routine basic treatment and swallowing function training, the control group was given nasogastric tube feeding, while the experimental group was provided with IOE. Before and after two weeks of the treatment the swallowing function and nutritional status of both groups were evaluated along with the incidence of pneumonia, ability in the activities of daily living and general quality of life. Results:Before the intervention, there were no significant differences between the two groups in any of the measurements. Afterward significant improvements were observed in all of the measurements in both groups, but the experimental group had improved significantly more than the control group in terms of each measure.Conclusions:IOE is superior to NG in improving the nutrition and swallowing function of patients with dysphagia and cerebral small vessel disease. It betters their ability in daily life activities and their quality of life.