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 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

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.

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

Objective To evaluate the in vitro activity of seven imidazole antifungals against clinical isolates of common Candida species.Methods According to the Clinical and Laboratory Standards Institute (CLSI) microdilution method M27-A3,the in vitro activity of luliconazole,ketoconazole,miconazole,econazole,clotrimazole,sertaconazole and bifonazole was determined among 183 clinical isolates belonging to 5 species of Candida.Results The minimal inhibitory concentration range was 0.03-8 (geometric mean:0.067) mg/L for ketoconazole,0.03-16 (geometric mean:0.071 ) mg/L for miconazole,0.03-8 (geometric mean:0.207) mg/L for econazole,0.03-8 (geometric mean:0.061 ) mg/L for clotrimazole,0.03-16 (geometric mean:0.187) mg/L for sertaconazole and 0.03 -＞16 (geometric mean:1.050) mg/L for bifonazole. Luliconazole exhibited a superior activity against the 5 species of Candida in vitro,with the MIC range being 0.03-8 mg/L,geometric mean MIC 0.087 mg/L,MIC50 0.06 mg/L and MIC90 0.5 mg/L,respectively.However,some Candida isolates were identified to be relatively insensitive to these tested antifungals,including luliconazole.Conclusion All the tested imidazole antifungals,except for bifonazole,show an excellent activity against Candida species in vitro,but there exist a few Candida strains with relative insensitivity.

Objective To investigate the stability of immunophenotyping in the course of relapse or at treatment failure of patients with acute lymphoblastic leukemia(ALL) and that of immunophenotyping of positive minimal residual disease(MRD).Methods From Aug.2000 to Dec.2007,33 children with ALL who relapsed or treated failure were enrolled. These children were detected MRD by flow cytometry. The immunophenotyping of children who relapsed or treated failure were compared with that of initial therapy;the immunophenotyping of MRD relapsed was compared with that of initial therapy.Results 1.In 23 out of 27 cases (85.18%) with B-ALL,changed at least 1 antigen between diagnosis and relapse.Six children with CD45 down-modulation and 2 children with CD45 up-modulation.Two children with CD19 down-modulation and 1 child with CD19 up-modulation.Six children with CD34 down-modulation and 4 children with CD34 up-modulation. Five children with CD10 down-modulation and 7 children with CD10 up-modulation.2.Six children with T-ALL had the same expression in CD45 between relapse and treatment failure. 3.These were 15 children had the least 1 case MRD,25 cases MRD were detected,these was 1 case up-modulation in CD45,1 case down-modulation in CD19,2 cases up-modulation and 8 cases down-modulation in CD34,3 cases up-modulation and 6 cases down-modulation in CD10.Conclusions Immunophenotyping of children with ALL may change at relapse and treatment failure. The frequency of change in B-ALL is higher than that of in T-ALL,but the change can not impact the detection of MRD.

Constructing prokaryotic expression vector pKY-RMBAY by gene recombination and research its optimizing productive conditions.By PCR technology synthesizing the gene of the RMBAY with preference codon of E.coli and the RMBAY gene was inserted into high efficiency expression vector pKYB-MCS.Expressed fusion proteins in E.coli ER2566 were purified with Chitin-Beads column.Fusion proteins binding on Chitin-Beads was cut on N-terminus of intein due to the induction of ?-mercaptoethanol and the target peptide RMBAY was released.The RMBAY was identified by mass spectrum.Experiment results showed RMBAY can be high efficiently expressed in E.coli ER2566,with optimizing productive conditions the yield of the RMBAY may be 6.7mg/L fermentation product and its purity is greater than 98%.The molecular weight of RMBAY is 3.887 kDa by mass spectrum and that accords with its theory value.