Objective: The study was designed to observe the effects of alanyl-glutamine (Aln-Gln) dipeptide on postoperative intestinal permeability and systemic inflammatory response.Methods: A prospective,randomized and controlled trial was taken.20 patients who underwent abdominal surgery were randomized into two groups: study group (intravenous administration of Aln-Gln dipeptide,0.5 g /(kg·d),for 4 days,n=10) and control group (equal normal saline as placebo,for 4 days,n=10).Temperatures,heart rates and respiration rates of all patients were daily recorded during administration.The white blood cell counts ,serum concentrations of glutamine (Gln),diamine oxidase (DAO) and interleukin-6(IL-6) and urine lactulose/mannito (L/M) ratio were measured before and after operation.Results: Serum Gln concentration was significantly decreased in control group and increased in study group on postoperative day 5.Urine L/M ratio,serum concentrations of DAO and IL-6 were significantly increased in control group and decreased in study group.The morbidity of SIRS was significantly decreased in the study group and the score of SIRS was also lower than in the control group.Conclusions: Administration of Aln-Gln dipeptide can increase the level of serum Gln,decrease the intestinal permeability,maintain the intestinal barrier and attenuate the systemic inflammatory response in the early period of postoperative patients.Aln-Gln dipeptide can be used in the fast track surgery to help patients recover rapidly.

Objective: The study was designed to observe the effects of alanyl-glutamine (Aln-Gln) dipeptide on postoperative intestinal permeability and stress response. Methods: A prospective, randomized and controlled trial was taken. 20 patients who underwent abdominal surgery were randomized into two groups: study group [intravenous administration of Aln-Gln dipeptide, 0.5 g/(kg?d), for 4 days, n=10 and control group (normal saline as placebo, for 4 days, n=10)]. Serum concentrations of glutamine (Gln), diamine oxidase (DAO), cortisol, interleukin-6(IL-6) and urine lactulose/mannito (L/M) ratio were measured before and after operation. Results: Serum Gln concentration was significantly decreased in control group and increased in study group on postoperative day 5.Urine L/M ratio was significantly increased in control group and decreased in study group.The serum concentrations of DAO,cortisol and IL-6 were significantly decreased in study group while compared with control group. Conclusion: Administration of Aln-Gln dipeptide can increase the level of serum Gln,decrease the intestinal permeability and attenuate the stress response in the early period of postoperative patients. Aln-Gln dipeptide can be used in the fast track surgery.

Objective: The study was designed to observe the effects of alanyl-glutamine(Aln-Gln) dipeptide on postoperative intestinal permeability and immmunologic function in abdominal patients. Methods: A prospective,randomized and controlled trial was taken.20 patients who underwent abdominal operation were divided into two groups: study group(intravenous administration of Aln-Gln dipeptide,0.5 g/(kg?d),for 4 days,n =10) and control group(equal normal saline as placebo,for 4 days,n =10).Serum concentrations of glutamine(Gln) and diamine oxidase(DAO),blood total lymphocyte count(TLC) and human leukocyte antigen(HLA)-DR and urine lactulose/mannito(L/M) ratio were measured before and after operation. Results: Serum Gln concentration was significantly decreased in control group and increased in study group on postoperative day 5.Urine L/M ratio and serum DAO level were significantly increased in control group and decreased in study group after operation.Blood TLC and HLA-DR expression in the study group were significantly higher than those in control group on postoperative day 5. Conclusion: Intravenous administration of Aln-Gln dipeptide can increase the serum Gln level,decrease the intestinal permeability,maintain the intestinal barrier and improve the immmunologic function in the early period of postoperative patients.Aln-Gln dipeptide can be used in the fast track surgery to help patients recover rapidly.

Objective To study the anti-inflammatory and analgesic effects of Baihuadan Analgesic Spray, so as to provide theoretical basis for further development of new drugs. Methods Prostaglandin E2 (PGE2) in the inflammatory tissues of mice with xylene-induced auricular inflammation and in the rats with albumen-induced pedal swelling were measured for the observation of anti-inflammation action of Baihuadan Analgesic Spray. The pain threshold in mouse hot-plate test and mouse acetic acid writhing test was determined to observe the analgesic effect of Baihuadan Analgesic Spray. Results Middle dose of Baihuadan Analgesic Spray (1 mg/mL) significantly reduced the auricular swelling rate induced by xylene in mice, improved the pain threshold of mice and prolonged pain latency in hot plate test (P < 0.05 or P < 0.01). High dose of Baihuadan Analgesic Spray (2 mg/mL) reduced the content of PGE2 in pedal inflammatory tissues (P < 0.05), and the effect on reducing the times of mouse writhing was obviously superior to that of the Voltaren Gel group. Conclusion Baihuadan Analgesic Spray has obvious anti-inflammatory and analgesic effects.

Objective To study the anti-neuroglioma effect of methyl-mercuric chloride(MMC) by observing the morphological changes of apoptotic neuroglioma cells induced with MMC in rats with brain neuroglioma.Methods The rat models of neuroglioma were established,and divided into two groups.The rats in experimental group were lavaged with MMC 1 week after injected with C6 glioma cells,10 mg?kg-1every day,the rats in control group were treated with sodium chloride at the same dose.24 d after inoculation all rats were sacrificed except natural death,the brain tissues were obtained,and the pathohistological changes were observed under light microscope and transmission electron microscope.Results The macropathological result showed that the tumor volume in experimental group was smaller than that in control group.Under light microscope,in experimental group the growth density of C6 ghioma cells was lower than that in control group,and the apoptotic cells with smaller volume and karyopyknosis were found.The result of transmission electron microscope showed that in experimental group,the glioma cells had some changes such as karyopyknosis,chromoplasm margination,nuclear fragmentation and vacuolar degeneration and so on.Conclusion MMC has inhibitory effect on the proliferation of C6 glioma in rats in vivo,its mechanism may be related to inducing the apoptosis of neuroglioma cells.

Objective To observe the therapeutic effect of arthroscopic debridement combined with oral use of Chinese medicine Guanjietong Tablets ( GT) for knee osteoarthritis in the early and middle stage. Methods Ninety knee osteoarthritis patients in the early and middle stage were evenly randomized into three groups, namely GT group, glucosamine sulfate group and blank control group. All of the three groups received arthroscopic debridement, and additionally, GT group and glucosamine sulfate group were given the corresponding medicine orally. We observed Lysholm knee scores of the three groups before operation, and 2 weeks, 3 months and one year after operation, and compared the knee joint space before operation and one year after operation showed by digital X-ray photograpy. Results ( 1) Lysholm knee scores in the three groups were increased 2 weeks, 3 months and one year after operation when compared with those before operation, the difference being significant (P<0.05) . Three months and one year after operation, the scores of GT group and glucosamine sulfate group differed from those of the blank control group (P<0.01). One year after operation, the scores of GT group differed from those of glucosamine sulfate group ( P<0.05). ( 2) The results of knee joint space showed by digital X-ray photography at knee position of weight loading indicated that the difference was insignificant between GT group and glucosamine sulfate group one year after operation ( P> 0.05) , but the difference between the two groups and the blank control group was significant (P<0.05). The difference of knee joint space was insignificant before operation and one year after operation in GT group and glucosamine sulfate group ( P>0.05) , while was significant in the blank control group ( P<0.05). Conclusion Arthroscopic debridement alone has certain short-term curative effect in treating knee osteoarthritis in the early and middle stage, but the effect will decline with the extension of time. Arthroscopic debridement combined with Guanjietong Tablets could delay the narrowing of joint space and maintain the clinical curative effect, which will delay the time for artificial joint replacement.

Objective To assess the causes of sildenafil failure and the feasibility of successfully rechallenging non-responding patients. Methods A total of 126 consecutive erectile dysfunction (ED) patients from Jan 2009 to Dec 2009 who claimed poor response to sildenafil (sildenafil 100 mg on demand, at lease 4 epiodes) were enrolled into the study. All patients received sexual reeducation and were treated with sildenafil, taken on a daily dose of 50 mg for 4 weeks. The International Index of Erectile Function-5 (IIEF-5), Rigiscan, serum testosterone or penile Doppler were used to evaluate ED and the cause of on-demand sildenafil failure. End point efficacy of rechallenging was evaluated using the IIEF-5 and the sexual encounter profile (SEP) 'Were you able to insert your penis into your partner's vagina?' and 'Did your erection last long enough to achieve successful intercourse?'. Results The recruited patients comprised of 41 cases with psychological ED, 39 cases with hypogonadism ED, 28 cases with diabetes mellitus ED and 18 cases with vascular ED. Compared with pretreatment and on-demand sildenafil baseline, daily administration of sildenafil significantly enhanced all efficacy outcome variables. The IIEF-5 was significantly improved after daily sildenafil (12.3 ± 2.9 vs18. 8±4.4, P＜0.01), 78 patients responded to daily sildenafil. The overall salvage rate was 61.9%(78/126). Conclusions Sexual reeducation and daily administration of sildenafil may be able to salvage many patients with ED who were sildenafil non-responders.

Objective To estabalish a new conception, Erectile Dysfunction-no sexual life (ED-NS), so as create an evaluating questionnaire, Self-estimation Index of erectile function-No sexual life (SIEF-NS) so as to investigate its clinical reliability. Methods The conception of ED-NS was identified and the SIEF-NS questionnaire was established. Patients who complained of ED-NS and normal controls were enrolled into the research and assessed the erectile function was assessed with SIEF-NS.The SIEF-NS includes 12 questions, such as sexual libido, general erectile function, nocturnal penile erection, erectile function during foreplay, erectile function during audio-video sexual stimulation,confidence, depression, etc and each question has 5 point scales. Results Sixty-one ED-NS patients and 57 controls were enrolled into the study and assessed erectile function with SIEF-NS. The mean score of each question and integral score of SIEF-NS in ED-NS patients were significantly different from normal controls (P＜0. 05). When the integral score was 35 points according to the ROC curve of integral score, the sensitivity of SIEF-NS was 88.5% and specificity was 96. 5%. Conclusions ED-NS is a new conception to define patients who have erectile dysfunction without sexual life. SIEFNS is suggested to be a useful method for the evaluation of ED-NS patients.

ObjectiveTo assess the cause of tadalafil failure and the feasibility of successfully rechallenging nonresponding patients.Methods A total of 80 consecutive erectile dysfunction ( ED ) patients who claimed poor response to tadalafil were enrolled into the study.A self-administered tadalafil-use questionnaire composed of eight questions was applied to assess how they had used tadalafil.Subjects were given thorough instruction based on individual answers and four doses of tadalafil 20mg.After a 2-week follow-up,end point efficacy of rechallenge was evaluated using the sexual encounter profile (SEP),which was recommended by international advisory panel in 2004.ResultsA total of 45 subjects had one or more areas of major suboptimal use of tadalafil:21.2％ did not know that sexual stimulation was necessary for tadalafil to work,87.5％ attempted to use tadalafil less than four times,57.5％ took a maximal dose less than 20 mg,and 84％ felt nervous or anxious.Of the 65 patients undergoing tadalafil rechallenge,30 patients answered “yes” to SEP2 and SEP3.The response rate to rechallenge was 46.2％ ( 30/65 ).ConclusionsInappropriate use of tadalafil was major cause of tadalafil non-pesponse.The efficacy of tadalafil could be improved to a better extent by education of patients.

Objective To evaluate the efficacy of microvasoepididymostomy for the treatment of obstructive azoospermia. Methods Ninety-eight patients were confirmed as obstructive azoospermia by infertility investigations.The mean (range) age was 31 (20-43) years.The mean duration of obstruetion was 4 years.All patients were seen by the surgeon for a complete history and physical examination.Semen analyses proved azoopermia,serum levels of sexual hormone were normal and testicular function for production of sperms were normal certified by biopsy.All patients with suspected epididymal or vasal obstruction were offered scrotal exploration.The decision for microvasoepididymostomy was made during surgery,based on the pateney of the vas towards the abdomen documented by saline and sperm fragments containing in the epididymal fluid on intraoperative light-microscopic examination.Microvasoepididymostomy was performed in 58 patients documented epididymal obstruction The initial semen analysis was then done after usually 3 months postoperatively.Patency was arbitrarily defined as＞10 000 sperm/mL in ejaculate in at least one semen analysis after surgery.Postoperative patency rate and postoperative impregnation rate were followed. Results Fifty patients were followed up for 3-29 months,8 cases lost.Sperm was found by semen analysis in 36 patients.Sperm density was 4×104-2×108 sperms/ml and motility was 2%-70%.Semen analysis reveals azoospermia in 6 patients and the patients were counseled to undergo further testing to determine the ultimate outcome of the procedure.Natural conception occurred in 14 patients followed for more than 12 months.The overall pateney rate was 72%(36/50).Among patients with a follow-up of＞6 months,the natural paternity rate was 28%(14/50).The median time to achieve a natural pregnancy was 6.6 (4.0-10.0)months. Conclusion A more favourable patency can be achieved using microsurgical intussusception vasoepididymostomy and a part of patients with obstructive azoospermia can be cured by this means.