Cardiovascular Diseases ; diagnosis ; genetics ; Humans ; MicroRNAs ; blood ; genetics

Sperm DNA fragmentation index (DFI) refers to the percentage of DNA strand breaks in the total sperm. Many studies suggest that elevated DFI can lead to male infertility and early spontaneous abortion. High-DFI patients are more likely to fail in assisted reproduction and preliminary treatment or prevention methods have been developed for this population. This review focuses on the impact of DFI on clinical pregnancy outcomes and progress in the studies of its treatment.
Abortion, Spontaneous ; Chromatin ; DNA Fragmentation ; Female ; Humans ; Infertility, Male ; Male ; Pregnancy ; Pregnancy Outcome ; Sperm Injections, Intracytoplasmic ; Spermatozoa

To investigate amethod which could prolong the efficient time of morphine and decrease side effect. Met hods:100 patients were randomly divided into four groups, receiving the different dispensation of analgesia. Analgesic solutions were given into epi dural space 510 minutes before operation was finished. Analgesic efficiency, efficient time, and side effects were recorded. esult: Sol utions diluted with hypertonia glucose injection might prolong the efficient time obviously (P＜0.01). When combined with bupivacaine or scopolamine the sid e effects were decreased. Conclusion: Morphine combined wi th bupivacaine or scopolamine diluted with hypertonis glucose injection, used in epidural analgesia, can bring longer efficient time and less side effects.

Intracerebral delivery of drugs for the treatment of central nervous system disorders is usually limited by the blood-brain barrier (BBB). Transdermal drug delivery systems (TDDS) have the advantage of improving patient compliance and avoiding first-pass effects compared to intravenous, oral and intranasal drug delivery, and are an emerging non-invasive drug delivery route that facilitates long-term drug delivery to patients. The discovery of direct subcutaneous targeting of lymphatic pathways to brain tissue has made TDDS a new brain-targeted drug delivery strategy. At the same time, the development of nano-delivery technology has further facilitated the application of TDDS for targeted drug delivery to the brain. This review summarizes the mechanism of transdermal drug delivery into the brain and the application of TDDS in the treatment of brain diseases, providing new ideas and methods for the treatment of central nervous system diseases.

Abstract: Objective　To analyze the epidemiological characteristics of late diagnosed HIV/AIDS cases (LD) in Sanya from 2010 to 2021, and to provide evidence for reducing the LD rate. Methods　The database was downloaded from the AIDS Prevention and Control Information System of China's Disease Prevention and Control Information System and newly reported HIV/AIDS cases between 2010 and 2021 in Sanya were included, identified LD according to the LD criteria proposed by Chinese Center for Disease Control and Prevention in 2014 and analyzed the relevant factors of LD. Results　From 2010 to 2021, a total of 710 research objects were included in this study. The proportion of LD was 33.4% (237/710), and decreased from 95.5% to 22.4% between 2010 and 2021 (χ2trend=34.777, P<0.001). Ethnic groups, educational level, sample sources and confirmed date were the relevant factors of LD of HIV/AIDS in Sanya City. The proportion of LD was 56.8% in Li ethnic group, which was higher than that in Han ethnic (OR=2.253, 95%CI=1.361-3.670). The proportion of LD of patients who were middle school and less was 55.5%, which were more likely to be LD than high school or above (OR=1.722, 95%CI=1.072-2.765). The proportion of LD was 56.8% in patients whose samples were from medical institutions or testing consultation were more likely to be LD than MSM (OR=5.564, 95%CI=3.278-9.444; OR=2.204, 95%CI=1.239-3.923). Compared with patients who were confirmed between 2018-2021, the patients derived from 2010 to 2013 had higher LD (OR=2.246, 95%CI=1.311-4.488). Conclusion　The LD of HIV/AIDS in Sanya cannot be ignored, especially the HIV/AIDS from counseling and testing and medical institutions. We should strengthen HIV testing, strengthen health education.

Child ; Exostoses, Multiple Hereditary ; genetics ; Female ; Humans ; Mutation ; N-Acetylglucosaminyltransferases ; genetics ; Pedigree

Adult ; Aneurysm, Dissecting ; complications ; Aortic Aneurysm ; complications ; Humans ; Lower Extremity ; physiopathology ; Male

Objective To identify risk factors associated with repeat use of pulmonary surfactant ( PS) in the treatment of respiratory distress syndrome ( RDS ) in the term and near-term neonate. Methods There were 130term and near-term new borns with RDS who were treated with pulmonary surfactant were enrolled. These infants were categorized into two groups: single-dose group (85 cases) and repeat-dose group (45 cases). The differences in basic information were compared between the two groups, and logistic regression analysis was used to identify the risk factors for repeat use of pulmonary surfactant.Results TherepeatutilizationrateofPSwas34.6℅.The incidence of asphyxia,maternal gestational hypertension, X-ray RDS grade 3-4, the age of first dose PS,respiratory support time in the repeat-dose group was significantly higher than in the single-dose group (P<0. 05). PaO2/FiO2 and the cure rate in the repeat-dose group were significantly lower than in single-dose group ( P<0. 05 ) . The incidence of sepsis, pulmonary hemorrhage, shock and patent ductus arteriosus ( PDA) in the repeat-dose group was significantly higher than in the single-dose group ( P<0. 05). Further logistic regression analysis showed that birth asphyxia ( OR=5. 674 , 95℅CI 1. 378 -23. 354 , the age of first dose of PS (OR=1.092, 95℅CI 1.002 -1.191)and PDA(OR =23.499, 95℅CI 2.348 -235.152)were the independent risk factors for repeat use of pulmonary surfactant.Conclusions Birth asphyxia,the age of first dose PS and PDA are the risk factors for repeat use of pulmonary surfactant in the treatment of RDS in the term and near -term neonate.

Objective To evaluate the overall failure rate of one or two-stage exchange arthroplasty for infections in total knee arthroplasty (TKA) and the predictors affecting the outcome of exchange.Methods Thirty-nine cases received one or two-stage exchange arthroplasty for periprosthetic joint infections after primary TKA in Shanghai Sixth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine and Southeast Hospital affiliated to Xiamen University from January 2012 to November 2014 were reviewed.Periprosthetic tissue and articular fluid of all patients were analyzed by bacterial culture.All patients were followed up for more than one year.C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),procalcitonin (PCT) and blood routine were tested every four weeks,and the evaluation on pain,total periprosthetic function,range of motion and deformation of arthroplasty were conducted.Differences between groups were analyzed using chi-square test or Student's t test when appropriate.A stepwise selection approach in logistic regression analysis was used to screen key predictors for outcome of one or two-stage exchange for infections in TKA.Results There were 39 patients who had undergone one or two-stage exchange for infections in TKA,including 20 males (51.3％) and 19 females (48.7％) with an average age of (62.4±11.7) years.Among the 39 patients,18 gram-positive strains were isolated from specimens,and 6 gram negative strains,2 Mycobacterium tuberculosis and 1 candida albicans.Ten of 39 reimplantations developed reinfection.Between the success and failure groups,there were significant differences in the time from primary TKA to revision (P =0.023),operative time (P =0.029),multidrug resistant organisms (P =0.045),the preoperative and post-operative ESR (P=0.002 and P＜0.001,respectively) and post-operative CRP (P=0.018).Multivariable logistic regression analysis demonstrated that time from primary TKA to revision (OR =0.96,95％CI:0.92-1.00,P=0.025),preoperative ESR (OR=0.97,95％CI:0.95-1.00,P=0.045) and post-operative ESR (OR =0.94,95％ CI:0.91-0.98,P =0.002) were independent indicators associated with the outcome of one or two-stage revision.Conclusions The failure rate after revision for infected TKA is relatively high.The time from primary TKA to revision,preoperative and post-operative ESR could predict the outcome of one or two-stage revision effectively.