Since the teaching and research of sexual medicine in our country is conducted for not a long time,the available materials and information about it are not enough.In order to improve the quality of sexual medicine teaching and accumulate teaching experience,based on the teaching practice of sexual medicine in our school in the past,a brief summary and analysis about the teaching purpose,subject design,and the teaching method and effect of sexual medicine in our school are reviewed in the present article.

Objective To analyze the prevalence and economic burden of diabetes in Guandu district of Kunming. Methods We used probability proportional to size (PPS) sampling method to select representative sample of 4595 residents aged 18 or over from this district. Each participant received face to face questionnaire interview and physical examination. We applied different methods to measure the direct,indirect and intangible costs of diabetes. Results In the study population, the overall prevalence of diabetes was 6.2%,and females had higher prevalence of diabetes than males (6.2%vs. 5.6%, <0.05) . The DALY/1000 population of diabetes was 3.52, among which males and females were 5.18 and 6.70, respectively. Mean unit direct costs, indirect costs and intangible costs of diabetes were 3464.49 Yuan,84.48 Yuan and 4 045.97 Yuan,respectively. The total economic burden of diabetes was 401.84 million Yuan. Intangible costs represented the largest component of economic burden of diabetes,followed by direct costs. Conclusion The huge economic burden of diabetes has become the cause for concern in Guandu district. Effective measures are needed to reduce the economic burden of diabetes.

Objective To analyze the prevalence of diabetes and its impact on the quality of life (QOL) among Jingpo ethinic residents in Yunnan province.Methods Questionnaire survey and fasting blood glucose (FBG) testing were conducted among 1367 Jingpo residents aged ≥ 35 years selected with random sampling method in Mangshi municipality of Dehong prefecture in Yunnan province.The Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) was used in the survey.Results The prevalence rate of diabetes among the Jingpo residents was 4.1％,and 4.2％ for males,4.0％ for females.Among Jingpo diabetic patients,mean scores for the domains of physical functioning (PF),role physical (RP),bodily pain (BP),general health (GH),vitality (VT),social function (SF),role emotional (RE),mental health (MH),physical component summary (PCS) and mental component summary (MCS) were (84.64 ±16.81),(53.13 ±45.24),(71.70 ± 24.28),(49.46 ± 21.38),(65.09 ± 11.02),(90.08 ± 14.00),(79.17 ± 39.98),(70.29 ± 13.73),(57.12 ± 9.39) and (55.07 ± 6.58),respectively.The identified diabetic patients had significantly lower QOL scores for the doamins of PF,RP,BP and PCS than their counterparts,respectively (P＜0.05).The results of the multiple linear regression analysis showed that older Jingpo residents had lower scores in the domain of PCS and MCS (P＜0.01);men has lower scores in the domain of PCS and MCS than women (P＜0.01);the higher the level of education,the higher the scores of PCS and MCS (P＜0.01);married Jingpo residents had higher scores in domain of PCS than those of unmarried and divorced (P＜0.01);the diabetic patients had lower scores of PCS than their counterparts (P＜0.01).Conclusion It is necessary to strengthen the health education for the elderly and people with low level of education,and improve the management of patients with diabetes,so as to effectively improve the QOL of Jingpo ethnic minority residents.

Objective To compare the efficacy of four different methods to locate tracheal tube in the tracheal:modified transillumination method,21/23 cm rule,marked the intubation at a distance,and fiberoptic bronchoscope.Methods A prospective randomized controlled trial was conducted.120 endotracheally intubated adult patients with American Society of Anesthesiologists (ASA) classification Ⅰ-Ⅱ and admitted to Central Hospital of Fengxian in Shanghai from January to March 2015 were enrolled.The patients were randomly divided into four groups (n =30) and located by 21/23 cm rule,marked the intubation at a distance,fiberoptic bronchoscope and modified transillumination method (using homemade locator guided by a red laser fiber to position the depth of tube) respectively.An endotracheal tube was inserted and measured the distance of the tube tip to the carina (TTC),vocal cords to tracheal tube cuff (VC-TC) in three different neck positions,i.e.neck in flexion,neutral,and extension position.The number of improper position in four groups was recorded.Results There were no significant differences in gender,age,and body mass index among the four groups.Six of the 30 patients using marked tracheal tuba method failed to find vocal cords with laryngoscope,while the other three methods all completed successfully.① From neck flexion to extension,TTC was gradually increased,while VC-TC was gradually decreased.In neck flexion and extension positions,TTC distance in the 21/23 cm rule group was significantly shorter than that in the fiberoptic bronchoscope group (cm:1.44 ± 1.14 vs.2.11 ±0.54,3.01 ±1.18 vs.3.80±0.71,both P ＜ 0.05),and the distance was also shorter than that in modified transillumination method group (cm:1.44 ± 1.14 vs.1.93 ± 0.81,3.01--1.18 vs.3.45 ± 0.91,both P ＞ 0.05).VC-TC distance in the 21/23 cm rule group was significantly longer than that in the modified transillumination,the marked intubation,and the fiberoptic bronchoscope groups in neck neutral and extension positions,respectively (cm:3.07 ± 1.08 vs.2.28±0.76,2.29±0.90,2.49±0.86;2.64±0.94 vs.1.82±0.72,1.81-0.94,2.02±0.91,all P ＜ 0.05).TTC and VC-TC distances in three neck positions in the modified transiflumination group were shorter than those in the fiberoptic bronchoscope group without statistical significance.② If TTC was too short,an accidental bronchus intubation could happen,while if VC-TC was too short,an accidental damage of the vocal cord inducing by the cuff press could happen.In the 21/23 cm rule group,there were 7 cases that the tube wrongly inserted to bronchus in neck flexion,and 1 case in neutral and extension positions respectively.In the marked intubation group,there were 4 cases that the tube wrongly inserted into bronchus in neck flexion,and 1 case in neck neutral position,and there were 4 cases that the vocal cords were pressed by the cuffs in extension position.In the modified transillumintion and the fiberoptic bronchoscope groups,there was only 1 case that the tube wrongly inserted to bronchus in neck flexion respectively.Conclusions When neck position changed during trachea intubation,it was easier that the tube wrongly inserted to bronchus for 21/23 cm rule method to locate the position.Bronchus intubations and cuff press vocal cords could happen using the marked tube method,which was less be found using modified transillumination or fiberoptic bronchoscope methods.Finally,the modified transillumination methods can be used to locate with satisfactory effect.

Objective To learn the damage on infants and effect of treatment of congenital cytomegalovirus(CMV) infection and non-congenital cytomegalovirus infection which included perinatal infection and postnatal infection.Methods According to the diagnosis standard of cytomegalovirus infection in China,46 infants diagnosed CMV infection were retrospectively reviewed.In this research,CMV infection was diagnosed if serum CMV-IgM or CMV-pp65 in polymorphous leukocytes was positive.According to beginning time of CMV infection symptom,46 cases were divided into 2 groups: congenital infection and non-congenital infection,clinical features of 2 groups were compared.Ganciclovir was given to the infants with infantile hepatic syndrome of 2 groups,and compared liver transaminases and bilirulin with itself after treatment,side-effect was observed.Infants of 2 groups were followed up,and prognosis was compared.Results In 46 infants,21 were enrolled congenital infection group,25 were non-congenital infection group.CMV-IgM was positive in 38 cases of 46 patients,CMV-pp65 was positive in 19 cases of 43 patients,both CMVIgM and CMV-pp65 were positive in 11 cases.More congenital malformation were found in congenital group than non-congenital group,there was significant difference between 2 groups((P

Background Image clarity during near work is influenced by several factors,such as accommodative lag,pupil size and monochromatic aberrations.Since image clarity during extended reading at near distance has been cited as a possible inducement of myopia in childhood and a possible difference between myopic and emmetropic people throughout life,it is important to examine these factors in myopic and emmetropic myopic juvenile during reading at near distance. Objective The aim of this study was to investigate the relationships among wavefront aberrations,accommodative response and pupil size in early onset and progressive myopes eyes under the different reading status and explore the possible mechanism of the development of myopia as well. Methods Fiflyseven subjects aged from 12 to 16 years were enrolled and grouped as emmetropes,the onset of myopes and progressive myopes.Reading material were Chinese novels presented by rapid serial visual presentation at a distance of 25 cm. Accommodative response and pupil size were recorded by a Grand Seiko WV-500 autorefractor.The Image J software was used to calculate the pupil diameter.Wavefront aberrations were then measured with a WASCA wavefront analyzer. Results Aberrations and accommodative response showed large inter-subjeet variability.With accommodative stimulus of 4 diopter,the accommodative lag in the early-onset of myopes group and progressive myopes group were ( 1.72 ±0. 53) D and ( 1.74 ±0. 44) D, showing larger value in comparison with ( 0. 96 ±0. 55) D of emmetropes group( t＝4.25 ,t=4.47 ,P<0. 001). However,there were no significant differences in accommodative lag between the early-onset of myopes group and progressive myopes group( t = 0. 18, P>0. 05). The mean value of pupil diameter, total RMS value, high-order RMS value, spherical aberration and coma were all significantly reduced with the stimulus varied from 0 D to 4 D( P<0. 01). However,none of the pupil sizs,total RMS value,high-order RMS value,spherical aberration and coma had significant difference among different refractive groups( P>0. 05). Conclusion The early-onset of myopes and progressive myopes had larger accommodative lag. The lower sensitivity to defocus at near reading distance,inducing the larger accommodative lag and hyperopic defocus may be linked to the developing myopia.

OBJECTIVETo investigate the effects and safety of leflunomide combined with hormone therapy for refractory IgA nephropathy.

METHODSThirteen patients with refractory IgA nephropathy were treated with leflunomide and hormone therapy, and the clinical data were collected and evaluated before and in weeks 2, 4, 8, 12, 16, 20 and 24 during the treatment.

RESULTSLeflunomide therapy significantly improved proteinuria (Plt;0.001) and increased serum albumin in these patients (Plt;0.001) but caused no significant changes in serum creatinine (Pgt;0.05). Only mild tolerable adverse effects were observed.

CONCLUSIONLeflunomide combined with hormone therapy can be one of the safety and effective choices for treatment of refractory IgA nephropathy.

Adult ; Drug Resistance ; Drug Therapy, Combination ; Female ; Glomerulonephritis, IGA ; drug therapy ; Hormones ; therapeutic use ; Humans ; Immunosuppressive Agents ; therapeutic use ; Isoxazoles ; therapeutic use ; Male ; Middle Aged ; Proteinuria ; prevention & control ; Time Factors ; Treatment Outcome ; Young Adult

ObjectiveTo evaluate the effect of auscultation, partial pressure of carbon dioxide in end-expiration (PETCO2), transillumination technique to judge whether the endotracheal tube is misplaced into the esophagus. Methods A blinded randomized controlled trial was conducted. Sixty patients with American Society of Anesthesiology (ASA) gradeⅠ-Ⅱundergoing endotracheal intubation in Fengxian Central Hospital admitted from September 2014 to February 2015 were enrolled. Two endotracheal tubes with the same size were respectively inserted into the trachea and esophagus for the same depth after general anesthesia by the same person. Two blinded anesthetists with different experience checked the tube position using three methods including auscultation, PETCO2, and transillumination technique, respectively. The order of the tubes tested (trachea or esophagus) and the method used were randomized according to randomise numbers table. The experienced anesthetists conducted the test first, followed by an inexperienced anesthetist conducting the same methods. The numbers of right and wrong determinations with different methods by different anesthetists were recorded.Results Sixty patients underwent the procedures for 180 times, with intratracheal intubation for 90 times, and esophageal intubation for 90 times. It was shown that the results were not different in two groups [96.7% (174/180) vs. 92.2% (166/180),χ2 = 3.500,P = 0.057]. By using auscultation, the correct rate of experienced anesthetist was higher than that of inexperienced (95.0% vs. 78.3%,χ2 = 5.786,P = 0.013). Using PETCO2, both anesthetists were correct in all cases, and the accuracy was 100%. Using transillumination, the experienced anesthetist was mistaken in 3 cases (accuracy was 95.0%), while the inexperienced mistook in 1 case (accuracy was 98.3%), and no significant difference was found between two groups (χ2 = 0.500,P = 0.250). The correct rate of using transilluminaion was significantly higher than that of using auscultation (χ2 = 7.563,P = 0.004). The sensitivity and specificity of the auscultation was 70.0% and 80.0%, that of transillumination technique was 96.7% and 93.3%,and PETCO2 was 100%, respectively, for two groups.ConclusionsPETCO2 is the most reliable method for determining tube position, and it is superior to auscultation and transilluminaion. Transillumintaion technique is superior to auscultation, irrespective of anesthetists' experience, while the accuracy of auscultation showed an obvious relationship with the anesthetists' experience.

Background Retinal development continues during the early postnatal period in mammals.Correct arrangement of layers and precise location of various cells in the retina are vital for forming normal visual function during critical period plasticity.Spectral-domain optical coherence tomography(SD-OCT)provides highquality in vivo retinal imaging and the possibility to measure retinal thickness longitudinally. Objective The present study was to investigate the changes of retinal thickness during critical period plasticity in rats. Methods In vivo consecutive scanning of retinal image was performed in 10 SPF Sprague-Dawley rats at postnatal day 14(P14),P18,P21,P24 and P42 with SD-OCT,and retinal histopathological examination was used to detect retinal morphologic changes at the same postnatal ages in 20 matched rats.The whole retinal thickness,the thickness from inner limiting membrane(ILM)to inner plexiform layer(IPL),the thickness of inner nuclear layer(INL)and the thickness from outer nuclear layer(ONL)to retinal pigment epithelium(RPE)were measured using Cirrus HD-OCT system and HMIAS-2000 Imaging System in retinal sections.The measurement parameters by Cirrus HD-OCT and those by hematoxylin-eosin staining were compared.The use of animals followed the Statement of National Institute of Health (USA). Results In vivo high-resolution images of rat retinas with SD-OCT compared well with histology,which enabled quantitative comparison of the SD-OCT and histological data during critical period plasticity in rats.From P14 to P42,the retinal thickness gradually decreased with the increase of rat ages(F=15.425,P=0.000),and so were the thickness from ILM to IPL,the thickness of INL and the thickness from ONL to RPE(F=3.973,P=0.007;F=17.529,P=0.000;F=7.038,P=0.000).The retinal thickness,thickness of INL.thickness from ONL to RPE measured by Cirrus HD-OCT were significantly correlated with those measured by retinal sections among P14,P18,P21,P24 and P42 rats(r=0.794,P=0.000;r=0.784,P=0.000;r=0.681,P=0.000). Conclusion SD-OCT is a demonstratably valuable technology to study the structure of retinas in rats.The retinal thickness is shown to reduce in thickness throughout the development of the retina during critical period plasticity due to the decrease in thickness of INL and the distance from the ONL to RPE,as illustrated by OCT scanning.

Objective To investigate the relationship between portal vein pressure and liver regeneration after 90% portal branch ligation in rats.Methods Forty-five male SD rats underwent 90% portal branch ligation (including 5 rats underwent sham operation),and then the changes of portal vein pressure and weight of unligated hepatic lobes were detected.The morphological changes of hepatocytes of the unligated hepatic lobes were observed under a light microscope.Proliferative cell nuclear antigen(PCNA)index was detected by immunohistochemistry,and hepatocyte apoptosis of the unligated hepatic lobes by TUNEL method.All data were analyzed by Pearson rank correlation analysis and t test.Results Thirty-eight out of 40 rats survived(95%).The ligated hepatic lobes diminished progressively,whereas the unligated hepatic lobes regenerated.Preoperative portal vein pressure was(9.1±1.8)cm H_2O(1 cm H_2O=0.098 kPa),and it was increased significantly shortly after the ligation and reached (15.8±2.7)cm H_2O 12 hours later(t=6.847,P＜0.05).The portal vein pressure decreased from(13.6±2.3)cm H_2O at day 1 to(9.3±2.0)cm H_2O at day 28.Preoperative positive PCNA index was 7%±3%,which was significantly lower than 14%±5%at postoperative 12 hours,21%±6%at day 3 and 26%±7%at day 5(t=9.129,P＜0.05),and it began to return to normal at day 5.Few apoptotic hepatoeytes were observed in preoperative liver tissue and unligated hepatic lobes.The expression of PCNA in unligated hepatic lobes and portal vein pressure had apositive correlation at postoperative day 1,3,5(r=0.913,0.896,0.908,P<0.05)and a negative correlation at postoperative day 14(r=-0.926,P<0.05).Conclusions The regeneration of hepatocytes in unligated hepatic lobes is activated after 90% portal branch ligation,and the regenerated liver compensates the weight loss of the ligated hepatic lobes.Liver is regenerated mainly by speeding hepatocyte proliferation rather than reducing hepatocyte apoptosis.Changes of portal vein pressure may play an important role in liver regeneration.