Objective To evaluate the therapeutic effects and adverse events on treatment of primary premature ejaculation (PE) with paroxetine hydrochloride and/or tamsalosin .Methods 225 cases of healthy men ,a history of lifelong PE and an intravaginal e‐jaculation latency time(IELT) < 120 sec were included in this study .The patients were divided into three groups(with 75 cases in each group) .Group A were given paroxetine hydrochloride 20 mg/d for 8 weeks ;group B were given tamsalosin 0 .2 mg/d for 8 weeks ;group C were given paroxetine hydrochloride and tamsalosin for 8 weeks .The effects and adverse events were evaluated by the overall change and fold increase in average IELT and the mean change in all four measures of the premature ejaculation profile (PEP) .Results The reliable data from 198 patients were achieved .The mean IELT after treatment were significantly improved in all groups than that of before treatment (P<0 .05) .The mean IELT in group C was increased for 8 .15 min after treatment .The in‐creased folds of mean IELT in group C (8 .02 folds) was significantly higher than that in group B (1 .98 folds)and group A (6 .92 folds)(P<0 .01) .The mean PEP scores that include measures of perceived control over ejaculation ,satisfaction with sexual inter‐course ,ejaculation‐related personal distress ,ejaculation‐related interpersonal difficulty were significantly improved in all groups after treatment .The mean PEP scores in group C had more significant improvements than that in group A and B .The prevalence of ad‐verse events in group A ,B ,C were 10 cases(13 .3% ) ,2 cases(2 .6% ) and 9 cases(12 .0% ) ,respectively .Conclusion Paroxetine hydrochloride combined with tamsalosin lead to better therapeutic effects and could be a priority selection for the treatment of pri‐mary PE .

Objective To investigate the relationship between carotid artery atherosclerosis and risk factor in a young and middle-aged population in China who received health checkup.Methods A total of 762 cases of young and middle-aged adult were recruited between April and October in 2013.These subjects had no hypertension,diabetes,coronary heart disease,cerebrovascular disease,and connective tissue disease,etc.Their Blood pressure,serum glucose (Glu),total cholesterol (TC),triglyceride (TG),and low density lipoprotein cholesterol (LDL-C) were measured and carotid artery ultrasonography was performed.Of the 762 cases,589 were male,173 were female,mean age was (46 ± 9) years.For blood pressure,blood lipids,the t test was performed to detect the difference between arteriosclerosis group and non arteriosclerosis group in different age groups.Logistic regression was performed to reveal the risk factors with carotid arteriosclerosis.Results Of the 762 subjects,205 had carotid artery atherosclerosis; 30.2％ (178/589) of them were men and 15.6％(27/173) of them were women,with a significant difference between two groups,(x2=14.522,P=0.000).In the younger than 40 years old group,the diastolic blood pressure has statistical significance between carotid arteriosclerosis and non carotid arteriosclerosis group (t=-2.789,P＜ 0.05); blood sugar had statistically significant difference between the two groups (t value was-2.256,-2.930,-2.174,respectivly,P＜0.05).Multiple regression analysis revealed that the independent risk factors for carotid artery arteriosclerosis were age,sex,DBP,and Glu.The regression coefficients were 0.993,0.711,0.047,0.334 seperately.The ROC curve of age was analyzed,the area under the ROC curve was 0.731,cut-off was 51 years old.Conclusions Routine carotid artery ultrasound should be performed for older than 50 healthy middle-aged men,to determine whether arteriosclerosis exists,especially for people with abnormal blood glucose or elevated DBP.

Objective To establish a practicable and easily mastered emergency department overcrowding (EDO) assessment system suitable for domestic ED setting by determining the validity and usefulness of the national emergency department over-crowding study (NEDOCS) tool in a 2000-bed tertiary care academic institution in China in comparison with visual analogue scale (VAS) in order to address the worldwide grave concern of EDO.Methods In a period of 6 months,data of subjective and objective EDO assessed simultaneously three times a day (1:00,9:00,17:00) were collected.The data were analyzed by using Bland-altmann method and Kappa test to determine the coincidence between VAS and NEDOCS assessments.Results The VAS-p value evaluated by physicians was significantly lower than VAS-n value evaluated by nurses [(6.49 ± 1.82) vs.(7.12 ± 1.78),P ＜ 0.01].The reliability analysis showed that Kappa value was as low as 0.112 (P ＜0.01) suggesting there was a great discrepancy between VAS-p value and VAS-n value.VAS-m (average value of VAS-p and VAS-n) was taken for comparing different evaluation systems.The significant correlation was found between the VAS-m and NEDOCS (r =0.7l4,P ＜0.01).However,the Bland-Altman plot showed the 95％ limit of coincidence was in an extensive range (-32.47 to 71.42) suggesting discrepancy existed between two methods.Conclusions The present study suggested there was a significant discrepancy between the two subjective assessments of ED crowding (VAS-p vs.VAS-n).There might be a fatal flaw existed in the assumptions of the original VAS method for EDO measurement.Using the Bland-Altman plot analysis,the results showed that NEDOCS did not authentically reflect the staff' s sense of overcrowding in the ED.It is very important and urgent to establish an objective and effective EDO evaluation system for ED management.

Objective To test the expression level of CD69+CD4+CD25-T cells in peripheral blood from patients with autoimmune pancreatitis,and further analyze its clinical significance.Methods Peripheral blood samples from 32 patients with AIP diagnosed in hematological department,Changhai Hospital and 32 health individuals examined at the same time were collected from September 2014 to December 2016,they were classified as experimental and control groups,separately.Peripheral blood mononuclear cells (PBMCs) was acquired by density gradient centrifugation,CD69+ CD4 + CD25-T cells in PBMCs were tested by flow cytometry,and the expression level of cytokines in plasm was by ELISA.The comparison of varies between the two groups was measured by two independent samples' t test.The relationship between the two measurement data was measured by pearson correlation coefficient.Results The expression levels of CD69 + CD4 + CD25-T in experimental and control groups were 10.36％±3.68％ vs 3.99％±1.45％ (t=9.110,P＜0.0001).The expression level of TGF-β was 399.86±121.88 vs 143.87±56.22 pg/ml (t=10.79,P＜0.000 1),both with statistical significance.The levels of CD69+CD4+CD25-T in experimental was positively correlated with TGF-β (r=0.653,P＜0.001) and negatively with IL-4,IFN-γ,IL-2 (r=-0.442,-0.567,-0.351,P＜0.05) and there was statistical significance.Conclusion CD69+CD4 +CD25-T cells might involve the immunopathology of AIP and could be the potential biomarker for clinical diagnosis and therapy.

Objective To explore the change of microRNA let-7b in heat acclimatization/heat stroke rat models and its relation with HSP70,IL-6,TNF-α,TGF-3 and IL-12,and analyze its clinical significance.Methods 60 male rats with almost the same anal temperature,weight,and weeks' age were selected from Laboratory Animal Center in the Second Military Medical University.They were randomly divided into control,heat acclimatization,heat stroke groups averagely.Heat acclimatization/heat stroke rat models were built in hot climate simulated animal tank,blood was collected from cordis apex and serum was separated.Real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) was used to test microRNA let-7b in serum,enzyme-linked immunosorbent reaction (ELISA) was to measure the protein level of HSP70,IL-6,TNF-α,TGF-β and IL-12 in serum.Kruskal-Wallis H test was used to analyze quantitative data in the three groups,Spearman rank correlation coefficient was used to reveal relation between two variables in heat stroke group.Results M values of miRNA let-7b in control,heat acclimatization,heat stroke groups were 0.99,1.04 and 1.93 separately,Q values were 0.30,0.25 and 0.44 (x2 =38.95,P＜0.001),separately,with statistical significance.The results of pairwise comparison showed no statistical difference in control and heat acclimatization (P＞0.05),but there were differences in control and heat stroke,heat acclimatization and heat stroke groups statistically (P＜0.05).Spearman correlation analysis showed that in heat stroke group,let-7b was positively related with HSP70,TNF-α and IL-6 (rs =0.579,0.498 and 0.609,P＜0.05) with statistical significance.Conclusion miR let-7b might involve in the pathology of heat stroke,it provided a potential biomarker for monitoring patients in high temperature and humidity clinically.

Objective To study the variation in numbers of patients attended in the Emergency Department (ER) of a large - scale teaching hospital during weekends or holidays and workdays in order to find out an objective criterion for the assessment of ER overcrowding and the regularity of ER overcrowding.Methods It was a prospective observational study of variation in number of.patient attended in ER during different periods of time round the clock observed from May 1 through October 31 in 2008 -2010 with 110000 emergency patients annually.The roles of diurnal rhythm,holiday phenomenon and medical coverage in the variation in numbers of patients were observed.The multiple logistic regression analysis was used to define the criterion of ED overcrowding.Results During workdays,the regularity of variation in number of critically ill patients seen to in ER was distinctive,the number of patients peaked in the period of 20:00 -22:00 and bottomed out in the period of 4:00 -6:00,while overcrowding scores of both peak and bottom were carried out 2 hours later.The number of emergency patients significantly increased at weekends and long holidays in a form of double peaks,from 10 am to 12 pm and 8 pm to 10 pm.The number of emergency patients was obviously determined by the provisions of medical coverage,but it was only true to non - critical patients,while the number of critical patients did not noticeably change during weekends or holydays.Multivariate regression analysis showed that the number of emergency patient attended in ER ( B =0.027,P ＜0.01 ) and the rate of emergency bed occupancy ( B =5.25,P ＜0.01 ) in the period of two hours significantly correlated with the ER overcrowding in the coming period of two hours (B =0.027,P ＜0.01,B =5.25,P ＜ 0.01,respectively).Conclusions The demand for critical care resources varies up and down all the time.The variation in volume of critical patients is quite regular during workdays and weekdays or holydays.It is important to separate critical patients from non - critical patients in order to divert non - critical patients quickly.Prediction of overcrowding in ER can be made with knowledge of the number of patient attended and the rate of bed occupancy,if the provisions of medical coverage unchanged.This regularity of variation in number of patients can be used as a practical guidance to rational allocation of critical care resources and improvement of patient throughput.

Objective To find out parental locus of control and mental health affecting students test anxiety. Methods The samples were from 5 middle schools including 1000 students,and their parents. They were investigated with the general life scales, Sarason's test anxiety scale, Symptom checklist 90 (SCL-90)and Parenting Locus of Control Scale(PLOC). Results The ratio of test anxiety: the mild was 28.8%, moderate was 45.0%, severe was 26.2% ,and felt anxiety was 55.8%. Ratio of test anxiety was higher in the boy students (X2=9.284, P =0.010) ,and heavier(F:16.42±6.70; M:15.18 ±6.51, t=2.716, P=0.007). Student test anxiety was significantly positively correlated with their parental mental health (r fatherl～11=0.166～0.272, Pfather l～11= 0.000;r mother 1～11=0.182～0.242, P mother 1～11= 0.000); Student test anxiety positively correlated with the effectiveness cof parents education, father's belief on the fate, eontrol of fathers for their children, locus of control from fathers (r1～5=0.075～0.143; P1-5=0.000～0.030);felt anxiety positively correlated with self-expect ,pressure from their mothers,over take care attitude from their parents,self-pressure from their parents( r1～6=0.068～0.230; P1-6=0.000～0.050) ,and negatively correlated with respect attitude of parents for their child, Marital relations,Communication time between the students and their parents,attitude of mother for learning( r1-7=-0.074～-0.140;P1～7=0.000～0.034). Felting test anxiety was served as a dependent factor, some factors enter the regression equation,and they were somatization of father, psychotic mother, the pressure from parents, mother over expectations, self-expectations ,the child control from student's father by Logistic regression analysis ( OR1～16=0.675～3.029;P1-6=0.000～0.007). Conclusion Students test anxiety is a common problem in male and female students. Mental health and locus of control from students' parents show test anxiety has somatization of father, psychotic mother, the pressure from parents, mother' expectations,self-expectations, the control of father for the child 6 risk factors.