Objective To investigate the clinical curative effects of duloxetine combined with thioctic acid on diabetic painful peripheral neuropathy. Methods Sixty-two patients with diabetic painful peripheral neuropathy were divided into three groups by random digits table: group A(22 patients, duloxetine combined with thioctic acid group), group B (20 patients,duloxetine group) and group C (20 patients,thioctic acid group). The other treatments were same. All patients were treated for six weeks. The pain remission level and nerve conductive velocity were compared among three groups. Results The pain level in three groups was significantly alleviated after treatment (P ＜ 0.01 ). The general effective rate was 86.4%(19/22),70.0% (14/20) and 50.0% (10/20) in group A,group B and group C,respectively (P ＜ 0.05). Visual analogue scales (VAS) in group A was significantly lower than that in group B and group C from the second week after treatment (P ＜ 0.05 ). Nerve conductive velocity was improved in both group A and group C after treatment (P＜0.01),but there was no significant difference between two groups (P＞0.05). In group B,compared with that before treatment,nerve conductive velocity had no significantly improved after treatment (P＞ 0.05). Conclusion Duloxetine combined with thioctic acid can enhance the clinical curative effects on diabetic painful peripheral neuropathy.

Objective To study the effect of poly- DL- lactic acid (PDLLA) absorbable membrane on preventing adhesion after repair of peripheral nerve injury. Methods 60 SD rats were divided into 2 groups randomly: the suturing+ PDLLA group (experimental group) and the purely suturing group (contrast group), with 30 rats in each group. Their sciatic nerves were cut off and then sutured microsurgically. In the experimental group, the anastomotic stoma was encapsulated with PDLLA membrane; in the contrast group, there was no such a treatment. We conducted gross observations and histological examinations at 2, 4, 8, 12, and 16 weeks after operation, neural electrophysiological examinations at 12 and 16 weeks after operation, and image analysis by computer at 16 weeks after operation. Results The scar proliferation and adhesion near the anastomotic stoma in the experimental group were less extensive than those in the contrast group; regenerative nerve fibers grew more straight and orderly manner. Electrophysiological examinations and image analyses by computer also showed that the experimental group achieved better results than the contrast group. Conclusion Poly- DL- lactic acid (PDLLA) absorbable membrane can prevent scar proliferation and adhesion after repair of peripheral nerve and promote nerve functional recovery effectively.

Objective To evaluate bulbourethral sling procedure in the treatment of post prostatectomy incontinence. Methods 5 patients with post prostatectomy incontinence underwent the bulbourethral sling procedure.Preoperatively 1 patient was completely incontinent and 4 patients required a mean of 3.5 pads per day.The mean duration of incontinence was 4.5 years. A sling tension of a mean of 500 g was used to correct incontinence. Results 4 patients have been completely dry,whereas postoperative difficulty in voiding occurred in the other patient and was corrected by subsequent transurethral bladder neck revision resulting in free passage of urine and continence. Conclusions The bulbourethral sling procedure is an effective means in the treatment of post prostatectomy incontinence.

Objective To investigate the quality of life in young patients with hemodialysis and influencing factors .Methods Totally 128 young patients aged 18-44 years old with maintenance hemodialysis were performed the questionnaire investigation by using the self‐designed demographic information questionnaire ,Medical Outcomes Study Health Status Short Form (SF‐36) , Herth Hope Index(HHI)and Social Support Rating Scale(SSRS) .Results The mean total score of physical health in the hemodial‐ysis young patients was (202 .49 ± 53 .94) points and the mean total score of mental health was (190 .85 ± 77 .81) points .In the va‐rious dimensional scores of living quality ,the scores of physical functioning and bodily pain were highest ,while the scores of physi‐cal function and emotional function were lowest ,moreover the scores of various dimensions were lower the the national norm (P<0 .01) .The multiple regression analysis showed that the quality of life was significantly correlated with hope level ,social support and economic condition ,which could explained 62 .8% of living quality variation amount .Conclusion The quality of life in hemodi‐alysis young patients needs to be improved .The medical care workers formulate the intervention measures ,meanwhile should pay attention to enchance patients′hope leve and social support .At the same time it is appealed that the government helps to solve the patients′economic problem in order to better improve their living quality and promote them return to society .

Objective To study the application of androgens,AMH for female infertility diagnosis value.Methods Used chemiluminescence to detect androgen testosterone (To),androstenedione (AND),17 (HS)To hydrogen sulfate therapy (17HS),sex hormone binding globulin (SHG)and resistance To seedling le’s hormone (anti-Mullerian hormone,AMH)of 258 cases of patients with female infertility.According to the reason of infertility,female infertility patients were divided into observation group (158 cases of endocrine infertility)and control group (100 cases of tubal factor infertility)and two groups of data had statistical analysis with t test.Used Pearman’s correlation method to analyse the relationship between serum AMH level and AND,SHG in patients wirh female infertility.and used ROC curve to evaluate efficiency of AND and AMH to the diagnosis of female infertility.Results ①The indicators To observation group AND control group,AND,AMH and SHG were (1.25±0.41 vs 0.25±0.15)nmol/L,(4.9±0.62 vs 1.80±0.51)nmol/L,(13.6±3.5 vs 6.4±1.81)ng/ml and (64.2±32.1 vs 89.3±30.2)nmol/L,respectively.Compared with the control group,observation group To,AND and AMH were significantly higher than the control group (t=13.02,11.36,9.35,P values<0.01),but SHG was significantly low-wer than thecontrol group(t=7.35,P<0.01).②Between the biology to produce ets (AMH:7.63~10.1 ng/ml,AND:0.3~3.3 ng/ml,17 HS:18~144μg/dl,SHG:80~560 nmol/L)as the standard,in the observation group:17 HS increased 17.7%,AND increased 72.2%,AMH increased 87.9% and SHG 51.2% reduction.③AMH level and the AND existed positive correlation (r=0.579,P<0.05),negatively correlated with SHG (r=0.763,P<0.05).④AMH,AND and SHG diagnosis of infertility area under the ROC curve (AUC),were 0.921,0.863 and 0.736 respectively,best cutoff value were11.26 ng/ml,4.62 nmol/L and 32.62 ng/ml respectively,and sensitivity of 89.7%,72.9% and 59.6%.Specific degrees were 86.2%,86.2% and 75.6% respectively,and accuracy of 87.1%,87.1% and 81.6%.Jointed inspection of AND,AMH and SHG in the diagnosis of infertility,the sensitivity of the specific degree were 96.3% and 90.2% respectively.Conclusion It showed that AMH,AND and SHG have diagnostic value of internal secretory infertility with ROC curve analysis.De-tection of combined AMH,AND and SHG is more meaningful to the early diagnosis and treatment of infertility.

Objective To investigate serologic screening for sexually transmitted infections (STI) in men who have sex with men (MSM) and provide evidence for intervention in the population. Methods A questionnaire investigation was conducted in MSM. Serologic specimens were taken to detect antibodies to HIV, syphilis, herpes simplex virus (HSV)-2, hepatitis C virus, and hepatitis E virus, as well as HBsAg. Results A total of 138 MSM were screened. HIV antibody was negative in all of them. TPPA was reactive in 23 (16.7%) men, among which RPR was positive in 10 (7.2%). The antibodies to HSV-2-IgG, hepatitis C virus, and hepatitis E virus, and HBsAg were found in 7.8%, 0, 16.1% and 9.7% of the men, respectively. Conclusions STIs are identified in this group of MSM. It is important to provide preventive intervention for this population.

Background and purpose: MORC2 (microrchidia family CW-type zinc finger 2, MORC2) is a newly identified chromatin remodeling protein that plays key roles in DNA-based biological processes including gene transcription and DNA damage repair. However, its functional role in breast cancer development and progression re-mains unknown. ALDH1A3 (aldehyde dehydrogenase 1 family member A3), a member of the aldehyde dehydrogenases (ALDH) superfamily, is a putative breast cancer stem cell marker, but its regulatory mechanism in breast cancer is poor-ly characterized. This study aimed to investigate the effects of knockdown of endogenous MORC2 on the expression levels of ALDH1A3 and the breast cancer stem-like phenotype in MCF-7 cells. Methods: Human breast cancer MCF-7 cells were infected with negative control short hairpin RNAs (shNC) and specific shRNAs targeting human MORC2 (shMORC2), followed by selection with puromycin to generate stable MORC2 gene knockdown cell lines. Western blot and real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) were used to examine the protein and mRNA levels of ALDH1A3 in MCF-7 cells stably expressing shNC and shMORC2. Microsphere formation and fluo-rescence-activated cell sorting (FACS) assays were used to analyze the effects of knockdown of MORC2 on the breast cancer stem-like phenotype. Results: Western blot and RTFQ-PCR analyses revealed that the protein and mRNA levels of ALDH1A3 were significantly down-regulated in shMORC2 expressing cells as compared with shNC -transfected control cells. Moreover, mammosphere formation assay showed that knockdown of endogenous MORC2 in MCF-7 cells significantly reduced the ability of cells to form microspheres. Consistently, FACS assays demonstrated that shMORC2-transfected cells had a lower proportion of ALDH-positive stem cells as compared with shNC expressing cells. In contrast, knockdown of MORC2 did not significantly affect the CD44+CD24- stem cell population. Conclusion:MORC2 promotes a breast cancer stem-like phenotype through, at least in part, regulating ALDH1A3 expression.

Objective To evaluate the efficacy of transpubie access using pedicle tabularized la-bial urethroplasty for urethral reconstruction in female patients with urethral strictures associated with urethrovaginal fistulas.Methods Eight cases of urethral strictures were treated using pedicle labial skin flaps for urethral reconstructions.All cases were the mid-urethral strictures associated with ure-throvaginal fistulas.A single face pedicle flap was obtained from the labia minus or majus in 5 women,and double face pedicle labial flaps were used in 3 patients.Results There were no serious complica-tions.Two patients complained of dysuria symptoms for 2 weeks and one patient experienced stress incontinence which resolved after 4 weeks.The patients were followed up for 6 to 130 months (mean 52) postoperatively.All patients had normal micturition following catheter removal with urinary peak flow greater than 15 ml/s(17.4-42.0 ml/s).Conclusion Pedicle labial urethroplasty might be a reliable technique for the management of complex urethral strictures associated with urethrovaginal fis-tulas.

Objective This study was to discuss various operative approaches for the repair complicated posterior urethral strictures. Methods 34 patients with posterior urethral strictures and associated ure-throrectal fistulas (URFs) were reviewed. The etiology of urethral strictures and fistula was due to pelvic fracture in 26 patients, iatrogenic in 6 cases and fall injury in the remaining 2 cases. The patients were treated by using a simple perineal approach (4 patients), a transperineal inferior pubectomy approach (21 patients) and combined abdominal transpubic perineal approach (9 patients) and URF repair and anastomotic urethroplasty were performed simultaneously in all cases. Results One-stage repair was successful in four patients (100%) using a simple perineal approach, in 19 of 21 (90. 48%) using the transperineal-inferior pubectomy approach and 7 of 9 (77. 78%) using the transpubic-perineal approach. Of the 34 patients, recurrent urethral strictures developed in two cases, recurrent URFs developd in two patients. Conclusions Surgical approaches for the special complex urethral strictures should be based on the location of the URF, its etiology and length of the urethral strictures, as well as a history of previous repairs. The transperineal-inferior pubic approach may be appropriate as a first-line procedure.

Objective To summarize the experience and evaluate the efficacy of treatment of urethral stricture using direct visual internal urethrotomy (DVIU).Methods The clinical data of 361 patients (age range 16 -72 years, mean age 38 years) with urethral stricture who underwent urethrotomy from 1990 to 2010 was retrospectively analyzed.The disease course ranged from three months to 78 months with a mean of 16 months.The stricture length ranged from 0.2 to 2.0 cm (mean 1.1 cm).Stricture length was split into four main groups:stricture length≤0.5 cm in 63 (group 1 ), stricture length ranging between 0.6 and 1.0 cm in 175 ( group 2), stricture length ranging between 1.0 and 1.5 cm in 85 ( group 3 ) , and stricture length ranging between 1.6 and 2.0 cm in 38 ( Group 4).Of the 238 patients with length less than 1.0 cm there were 148 who's scar thickness were less than 1.0 cm, and 90 who's scar thickness were greater than 1.0 cm.Of the 123 patients with length less than 2.0 cm there were 69 who's scar thickness was less than 1.0 cm, and 54 who's scar thickness was greater than 1.0 cm.Results Three patients with DVIU failed because of long occlusion and false passage.Three hundred and twenty patients were followed-up from 12 to 120 months (mean:42).Re-openiag procedures were performed on 174 patients (54.4%) due to recurrence.The re-openiag procedure rate was 3.3%, 49.7%, 83.3% and 97.1% in Group1, Group2,Group3 and Group4, respectively.On the basis of scar thickness, of the 207 patients with stricture length less than 1.0 cm, 38 of 136 patients (27.9%) with scar thickness less than 1.0 cm underwent opening operation, and 43 of 71 patients (60.6%) with scar thickness more than 1.0 cm underwent opening operation.One hundred and thirteen patients with stricture length more than 1.0 cm, 33 of 42 patients (78.6%) with scar thickness less than 1.0 cm underwent opening operation, and 60 of 71 patients (84.5%) with scar thickness more than 1.0 cm underwent opening operation.Conclusions Good efficacy can be achieved in patients whose urethral stricture length is less than 0.5cm or whose stricture length and scar thickness is less than 1.0 cm using DVIU.