Objective To explore the factors influencing the premarital medical examination in Chinese population and to discuss the related possible intervention strategies.Methods Data were collected through self-designed questionnaires on 2572 newly married respondents,selected under a stratified randomized sampling method,at Marriage Registration Office in 12 counties in Zhejiang province.Predictive factors were derived from the integrating complementary constructs of Health Belief Model,Theory of Reasoned Action as well as individual demographic characteristics.Multiple logistic multilevel analyses was used as the main statistical method,with individuals as the ' low' and counties as the 'high' levels.Results Behaviors on premarital medical examination showed a clustering trait at the county level (P=0.018) and variance partition coefficients (VPC) of each variables was between 15.40％ and 17.58％.There were no statistical significances found in the rates of premarital medical examination among gender,age,residence of Household Registration,education,income,health insurance and history of premarital medical examination.However,significant correlation was seen on occupation of the respondents.The rate of premarital medical examination among the respondents who had not attended medical examination during the last six moths was 1.31times (95％ confidence intervals,1.05 -1.65 ) more than those who had,with OR (odds ratio) as 1.51 (95％CI:1.14-2.00) for the pregnant respondents in their first marriage and 0.35 (95％CI:0.23-0.51 )for remarried respondents,compared with women at first marriage but remained unpregnant.Regarding premarital medical examination,the respondents reported greater benefits,less barriers,greater positive behavioral attitudes and normative beliefs to it,with an ORs as 2.32 (95％ CI:1.18-4.60),0.71 (95％CI:0.57-0.90),1.69 (95％CI:1.10-2.58) and 1.72 (95％CI:1.34-2.20)respectively,but with no significant association with perceived susceptibility,perceived severity and motivation to comply.Conclusion Factors such as individual perceived benefits,barriers,attitudes and normative beliefs etc.,were determinants of premarital medical examination accompanied by minor (16％) influence coming from the geographical environment.

Authors raised that staging based strategies and practice of integrative medicine (IM) by combining syndrome typing and disease identification, and choosing suitable measures in accordance with different persons and seasonal conditions after more than ten years' clinical practice and researches. Radical operation as prior (as evil eliminating) and strengthening vital qi in perioerative period are best strategy for promoting rapid rehabilitation of early stage prostate cancer patients. Strengthening body resistance to eliminate evil was used in treating advanced prostate cancer patients. For example, a comprehensive treatment program for hormone-dependent patients was combined with endocrinotherapy and Chinese herbs for synergisic efficacy-enhancing actions. In this way, these patients' quality of life (QOL) were improved and time to castration resistant prostate cancer (CRPC) was delayed, even some patients were clinically cured. There are lack of effective medicines and methods for CRPC patients. Greatly tonifying original qi is mainly used for improving their clinical symptoms and prolonging survivals. Practice has proved staging based strategies and practice of IM has favorable advantages in treating prostate cancer, especially showing prospect in prolonging survival and postponing progression of advanced prostate cancer patients. Besides, it also could provide beneficial considerations and inspiration for combination of syndrome typing and disease identification.
Disease Progression ; Humans ; Male ; Medicine, Chinese Traditional ; Neoplasm Staging ; Prostatic Neoplasms, Castration-Resistant ; diagnosis ; Quality of Life

Objective To explore the risk factors of systemic inflammatory response syndrome crisis (SIRS) after percutaneous nephrolithotomy (PCNL) in China. Methods Databases of CNKI, CBM, WanFan and VIP were searched to retrieve studies about systemic inflammatory response syndrome after percutaneous nephrolithotomy to October, 2016. Results 18 studies involving 5,323 patients were included. The results of meta-analysis showed that:a) univariate analysis indicated that renal insufficiency [O(R) =2.78, 95%CI (1.96 to 3.95), P = 0.000], preoperative positive urine culture [O(R) = 3.41, 95%CI (1.89 to 6.15), P = 0.000], preoperative routine urine leucocyte positive [O(R) = 3.78, 95%CI (3.02 to 4.72), P = 0.000], diabetes mellitus [O(R) = 2.14, 95%CI (1.33 to 3.45), P = 0.002], pelvic positive urine culture [O(R)= 5.14, 95%CI (2.46 to 10.73), P = 0.000] and operation time ≥120 min [O(R) = 2.31, 95%CI (1.40 to 3.82), P = 0.001] were the risk factors of SIRS; b) multivariate analysis showed that, preoperative positive urine culture [O(R) = 6.83, 95%CI (2.82 to 16.57), P = 0.000], preoperative routine urine leucocyte positive [O(R) = 5.43, 95%CI (3.51 to 8.41), P = 0.000], diabetes mellitus [O(R) = 2.85, 95%CI (1.45 to 5.58), P = 0.002], pelvic positive urine culture [O(R) = 4.30, 95%CI (1.30 to 14.21), P = 0.020] and operation time ≥120 min [O(R) = 2.72, 95%CI (1.62 to 4.59), P = 0.000] were the independent risk factors of MCAT. Conclusion The independent risk factors of SIRS for patients after PCNL are diabetes mellitus, preoperative positive urine culture, preoperative routine urine leucocyte positive, pelvic positive urine culture and operation time. However, due to the quantity and low quality of the included literature, the conclusion needs the support from high quality studies.

Scm in volume(42/60),multiple site involvement(44/60),blood type"O"(31/41),in comparison with those of survival group,and the difference was statistically significant.C-erbB-2,p16,p53,P-gp,CD_(44) and CD_(25)expression were not significantly different in these two groups. Conclusion The clinical stage, lymph node metastasis,lymphatic tumor emboli and/or neural involvement,infiltration depth,histological dif- ferentiation,tumor volume,involvement extension are important prognostic factors in patients with gastric can- cer,while the significance of cancer-related gene expression in gastric carcinomas needs to be studied further.

Objective To study the association between serum albumin level and first-onset AMI.Methods A total of 2172 patients with first-onset AMI served as an observation group and 3395 CHD-free patients served as a control group.The association between serum albumin level and first-onset AMI was analyzed by logistic regression analysis.Results The serum albumin level was significantly lower in observation group than in control group (40.0 g/L vs 41.4 g/L,P=0.000).On a continuous scale,when serum albumin level decreased by 1 standard deviation (～4 g/L),adjusted OR (95％CI) was 1.87 (1.75-2.01),1.85 (1.71-2.01),1.48 (1.26-1.74) for AMI in the total patients,male patients and female patients,respectively.On a categorical scale,Q1 (albumin level ≥43.8 g/L) was used as reference.Stratifying by age showed that adjusted OR (95％CI) was Q2 1.43 (1.12-1.82),Q3 1.95 (1.53-2.47),Q4 2.52 (1.95-3.27),Q5 4.51 (3.40-6.00) for AMI in patients aged ＜65 years and was Q2 1.61 (1.042.5),Q3 2.21 (1.48-3.31),Q4 3.34 (2.244.99),Q5 4.77 (3.22-7.08) in patients aged ≥65 years (P-for-trend ＜ 0.01).Stratifying by gender showed that serum albumin level was negatively associated with AMI in both sexes (P-for-trend ＜0.01).Conclusions Serum albumin level is negatively associated with the risk of first-onset AMI in a dose-response manner regardless of stratifying by age and/or gender.

OBJECTIVETo study the clinical effects of perioperative treatment by integrated traditional Chinese and Western medicine on postoperative parameters of TURP.

METHODSFrom Jun. 2002 to Oct. 2006, 238 cases of TURP were performed in our hospital, of whom, 179 (Group A) were treated by integrated traditional Chinese and Western medicine, and the other 59 (Group B) by Western medicine. The postoperative parameters of the 2 groups were recorded and compared.

RESULTSPostoperative catheter indwelling, hospital stay, Q(max) 4 w after TURP and incidence of bacteriuria (> 5 d) showed no significant difference (P > 0.05), while the incidence rates of overactive bladder and urgent urinary incontinence, hematuria time, dysuria time, IPSS score and QOL score 4 w after TURP were statistically different between the 2 groups (P < 0.05).

CONCLUSIONFor TURP patients, perioperative treatment by integrated traditional Chinese and Western medicine can reduce postoperative complications, increase the success rate of surgery and improve QOL score.

Aged ; Aged, 80 and over ; Antibiotic Prophylaxis ; methods ; Combined Modality Therapy ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Perioperative Care ; methods ; Postoperative Complications ; etiology ; prevention & control ; Prostatic Hyperplasia ; surgery ; Transurethral Resection of Prostate ; adverse effects ; Treatment Outcome

OBJECTIVETo investigate the management of incidental prostate cancer after TURP by laparoscopic radical prostatectomy (LRP).

METHODSBetween April 2005 and December 2011, we treated 4 cases of incidental prostate cancer with p504s (+) by LRP, 1 at 3 mon, while the other 3 at 1.5 mon after TURP.

RESULTSThe operations were successfully performed in all the 4 cases, all by extraperitoneal approach. Postoperative pathology showed prostate cancer in 2 of the cases with Gleason scores of 6-7, high-level epithelial neoplasia in 1, and no malignancy in the other. Postoperative observation and 1-79 mon follow-up visit revealed good urinary function but no obvious urinary incontinence, metastasis and erectile dysfunction.

CONCLUSIONWith practiced laparoscopic skills, laparoscopic radical prostatectomy may achieve satisfactory results in the treatment of incidental prostate cancer after TURP.

Aged ; Humans ; Incidental Findings ; Laparoscopy ; Male ; Middle Aged ; Prostatectomy ; methods ; Prostatic Neoplasms ; surgery ; Transurethral Resection of Prostate ; Treatment Outcome

OBJECTIVETo investigate the mechanism of the development of cisplatin resistance in a human esophageal squamous carcinoma cell line.

METHODSThe cytotoxicity of cisplatin in the cisplatin-resistant resistant cell line EC109/CDDP and its parental cell line EC109 was measured by MTT assay. Whole-cell cisplatin accumulation and Pt-DNA adduct formation were determined by inductively coupled plasma mass spectrometry (ICP-MS). Western blotting was used to investigate the protein expression of full length PARP, cleaved PARP, and copper transporter 1 (CTR1).

RESULTSEC109/CDDP cells was more resistant to cisplatin-induced cytotoxicity and apoptosis than EC109 cells. Compared with EC109 cells, EC109/CDDP cells exhibited less cisplatin accumulation and Pt-DNA adduct formation with also decreased CTR1 protein expression.

CONCLUSIONCisplatin induces drug resistant phenotype by decreasing the protein level of CTR1, which controls cell accumulation and cytotoxic effect of cisplatin.

Carcinoma, Squamous Cell ; metabolism ; Cation Transport Proteins ; metabolism ; Cell Line, Tumor ; Cisplatin ; pharmacology ; Down-Regulation ; Drug Resistance, Neoplasm ; drug effects ; Esophageal Neoplasms ; metabolism ; Humans

OBJECTIVETo investigate the location of heme oxygenase (HO) enzyme in the human testis, and explore the correlation of the expression of HO enzyme with azoospermia by analyzing its different expression levels in the testes of nonobstructive azoospermia, obstructive azoospermia and normal men.

METHODSWe detected the location of the cells expressing HO enzyme in the human testis tissue using immunohistochemistry, determined the mRNA and protein expression levels of HO-1 and HO-2 in the testes of azoospermia patients and normal healthy men by RT-fluorescence quantitative PCR (RT-FQ-PCR) and Western blot, and explored the correlation of HO expressions with the pathogenesis of azoospermia.

RESULTSHO-1 enzyme was expressed mainly in the Sertoli cells and HO-2 enzyme chiefly in the germ cells of the testis tissue. RT-FQ-PCR showed that the expression of HO-1 in the testis tissue was significantly lower in the nonobstructive azoospermia than in the normal and obstructive azoospermia groups (P < 0.05), with no significant difference between the latter two. Western blot revealed no obvious difference between the expression level of HO-1 protein and that of HO-1 mRNA. There were no differences in the expression level of HO-2 protein among the three groups.

CONCLUSIONThe expression level of HO enzyme is significantly decreased in the testis tissue of nonobstructive azoospermia patients, and the expression of HO-1 protein is consistent with that of HO-1 mRNA. As HO-1 protects the testis tissue against various stress injuries through its antioxidant, anti-inflammatory and anti-apoptotic effects, its decreased expression level may be correlated with spermatogenic dysfunction, and therefore considered as a possible mechanism of nonobstructive azoospermia.

Azoospermia ; enzymology ; metabolism ; Case-Control Studies ; Heme Oxygenase (Decyclizing) ; metabolism ; Heme Oxygenase-1 ; metabolism ; Humans ; Male ; Spermatogenesis ; Testis ; enzymology ; metabolism

Aim To prepare prostate cancer exosomes containing melittin and observe their uptake by prostate cancer cells. Methods Cells treated with starvation for different time were screened for exosome extraction. Exosomes from PC-3 cells were extracted by ultracentrifugation, and the extracted particles were examined by transmission electron microscopy, nanoparticle tracking analyzer(NTA), and Western blot. Melittin exosome system was prepared by repeated freeze-thaw method, incubation at room temperature as well as electroporation, and the size of encapsulation efficiency was measured by centrifugation. A high-performance liquid chromatography(HPLC)method was applied to assay the content of melittin exosomes(exo-mel). Fluorescence inverted microscopy was employed to evaluate the uptake of melittin exosomes by PC-3 cells, DU145 cells as well as LNCaP cells. Results The results of starvation treatment showed that 24 h starvation treatment was the optimal time point. TEM results showed that the exosomes were round or oval in shape with a distinct membranous structure, and the diameter was around 100 nm. The reagent protein concentration for NTA analysis of exosomes was 0.222 g·L-1. The results of Western blot for the marker proteins of exosomes showed that Alix and CD63 were positively expressed, which indicated that the exosomes could be obtained by starvation culture of PC-3 cells and ultracentrifugation. The results of entrapment efficiency showed that the entrapment efficiency of electroporation method was 17.51% ± 2.39%, that of repeated freeze-thaw method was 11.46% ± 1.02%, and that of room temperature incubation method was 3.93% ± 2.44%. The encapsulation efficiency of electroporation was the highest with significant difference(P<0.05). The uptake assay showed that PC-3 cells could efficiently take up exo-mel in a time-dependent manner, and DU145 cells and LNCaP cells also could take up exo-mel over time. Conclusions Exosomes can be accessed by starvation treatment and high-speed centrifugation, and the prostate cancer melittin exosome system prepared by electroporation method could be taken up by prostate cancer cells.