Sexual function was studied in 48 male Type II diabetics together with 9 normal males as controls, all cases except 5 had various degrees of sexual dysfunction, which occurred predominatingly after, simultaneously with or before the onset of diabetic symptoms.The levels of plasma testosterone in diabetics were lower, and the plasma estradiol levels were higher than that of controls (p

Previous studies have showed that sulfonylureas possess a bidirectional effect on cardiovascular system:they can raise the coronary artery tone,aggravate ischemic injury to the cardiovascular tissues,and accelerate cardiac hypertrophy through closing cardiovascular ATP-sensitive K+ channels;meanwhile,they can also regulate glucolipid metabolism,modulate inflammatory reaction and inhibit atherosclerosis through activating peroxisome proliferator-activated receptors.Clinical-epidemiological study showed different opinions on whether sulfonylureas can increase the mortality of patients with cardiovascular diseases.

Objective To evaluate the possibility and efficiency of nanoparticles as a new vector in vascular endothelial growth factor (VEGF) gene transfection. Methods Nanoparticle-VEGF (Np/VEGF)complex was prepared with poly (D, L-lactide-co-glycolide) (PLGA) loading VEGF165 gene using the multiple emulsion (w/o/w) technique. The envelopment efficiency and size of the complex were determined. Rat myocardial cells were cultured in vitro, and the Np/VEGF was transfected into the cultured myocardial cells. Then RT-PCR and ELISA were used to evaluate whether the Np/VEGF increased the level of gene expression. Four New Zealand rabbits were used, the suspension of Np/VEGF was injected into myocardial tissue of rabbits after thoracotomy. 96h after the operation, the tissue sections of the implant sites were observed with transmission electron microscope (TEM) to determine the process of nanoparticles as vectors for gene transfer to cardiac myocytes. Results The envelopment efficiency and size of the Np/VEGF complex thus prepared were 1.87% and 25-300nm respectively. RT-PCR and ELISA showed that VEGF gene could be successfully transfected into myocardial cells by nanoparticle, and NP/VEGF significantly enhanced gene transfection efficiency, and it was more effective than plasmid. 96h after the operation, a great number of nanoparticles were observed in myocardial cytoplasm and nucleus with TEM, and many nanoparticles began to dissolve and degrade, suggesting that the DNA was released slowly from the nanoparticles localized in the cytoplasmic compartment, and was then transferred into the nucleus. Conclusions NP/VEGF can act as a vector to transfect VEGF gene in vitro and in vivo, it significantly enhanced gene transfection efficiency, and it was more effective than plasmid.

OBJECTIVEThis study aims to evaluate the effectiveness of arthrocentesis on Wilkes III stage patients. Clinical examinations and magnetic resonance imaging (MRI) findings before treatment and six months after treatment were compared and analyzed.

METHODSA total of 137 outpatients diagnosed with temporomandibular joint internal derangement (TMJID) associated with Wilkes III stage through clinical examination and MRI findings from January 2013 to December 2013 were randomly included. All the patients were successfully treated with arthrocentesis. Moreover, all the patients accepted clinical and MRI examination before arthrocentesis treatment and six months after. Clinical examination included visual analogue scale and opening degree, whereas MRI examination included articular disc morphology and effusion in the upper compartments. Statistical analysis was performed using SPSS 20.0.

RESULTSResults showed that the average score of visual analogue scale six months after treatment was significantly lower than that before treatment (P < 0.05). The success rate was 78.1% (107/137). The rate of disc deformity after arthrocentesis treatment was higher than that before the treatment. By contrast, the positive rate of effusion after arthrocentesis was significantly lower than that before the treatment (P < 0.05). Bilaminar zone adaptive changes (disk-like) were found in seven cases (5.1%, 7/137) after treatment.

CONCLUSIONArthrocentesis could effectively relieve pain of the TMJID patients. Furthermore, MRI results indicated that arthrocentesis could significantly decrease articular effusion. Arthrocentesis was effective for the treatment of Wilkes III stage in the short term. Adaptive changes in bilaminar zone occurred in a few patients. However, serious disc deformity with the passage of time is a trend that has been observed.

Arthrocentesis ; Humans ; Joint Dislocations ; Magnetic Resonance Imaging ; Outpatients ; Range of Motion, Articular ; Temporomandibular Joint Disc ; pathology ; surgery ; Temporomandibular Joint Disorders ; diagnosis ; surgery ; Treatment Outcome ; Visual Analog Scale

Aim To investigate the effect of irbesartan and spironolactone on expressions of connective tissue growth factor(CTGF),P-p38MAPK proteins during vascular remodeling in renovascular hypertensive rats(RHR).Methods Renovascular hypertension was induced by two kidney one clip(2K1C)operation.8 weeks later,RHRs were given irbesartan or(and)spironolactone for 8 weeks.After 8 weekstreatment,the morphometric measurements were performed in the mesenteric arterioles.Concertration of carboxyterminal propeptide of typeⅠprocollagen(PⅠCP)and N-terminal propeptide of type Ⅲ procollagen(PⅢNP)in blood serum was measured by enzyme linked immunosorbent assay method,and the media collagen area was assessed by collagne-specific Picro-sirius red staining with computerized video processing.Expressions of collagen type I,CTGF,P-p38MAPK proteins were detected using immunohistochemistry respectively.Results The arterial systolic pressure was attenuated significantly after the treatment of irbesartan,and this effect could not be enhanced by spironolactone.The media thickness over lumen ratio,media cross-sectional area over luminal area ratio of mesenteric arterioles,concertration of PⅠCP and PⅢNP,media collagen area,and expression of collagen typeⅠwere significantly increased in RHRs but ameliorated by irbesartan and spironolactone.Meanwhile,the expressions of CTGF,P-p38MAPK proteins were up-regulated in RHRs but blunted significantly after the treatment of irbesartan and spironolactone.The combined treatment had the synergic effects.Conclusions There is a synergistic effect of attenuating extracellular matrix(ECM)producing and amelioration of vascular remodeling(VR)by combined use of irbesartan and spironolactone.It maybe related to the expressions of CTGF and P-p38MAPK proteins down regulated by these two drugs.

Objective To assess and delineate the dosimetric shortcomings of conventional radiotherapy planning,as compared with the three dimensional treatment planning system, and to obtain a better technique in the treatment of lung cancers.Methods Thirteen patients with stage ⅢA ⅢB non small cell lung cancer were chosen in the present study. Using the Cadplan 6.0.8 treatment planning system , three different methods of radiotherapy planning: conventional planning, conventional and conformal planning, and conformal planning were designed for each patient. The total radiation dose was 66 ?Gy and DVHs were used to assess the dosimetric distribution in the gross tumor volume and the surrounding organs at risk. Results No significant dosimetric disparity in the target volume was found among the three designs, according to anticipated therapeatic requirements. The conformity indices were 0.13,0.24 and 0.35 for these three radiotherapy designs. The mean lung volumes which received radiation dose of≥20?Gy were 32%,26% and 25%.The mean maximum dose at the spinal cord were 42?Gy,49?Gy and 33?Gy.The mean esophageal volume which received radiation of ≥50?Gy were 32%,34% and 22%, and the mean radiation dose to the heart were 18?Gy,15?Gy and 12?Gy,respectively. Conclusions Conventional radiotherapy planning is able to meet the demands of dosimetric requirements for radiation treatment of lung cancers. The three dimensional conformal radiation therapy planning system is able to provide superior delivery of high dose to the target volume without inflicting too high a risk to the surrounding normal tissues and organs.

Objective To reasonably confirm the target of 3-dimensional conformal radiation therapy (3DCRT) for lung cancer. Methods While a patient was breathing, the motion of the primary lesion in the lung was observed by fluoroscopy. The extent of motion of the primary lesion during irradiation was evaluated by portal films. Three 3DCRT plannings for lung cancer, in which gross tumor volume (GTV) decided by a group of radiation oncologists and implemented, were taken as the standard. The GTV delineated by five radiation oncologits was compared with the standard by computing the radial line measurement variation (RLMV). Results From fluoroscopic observation in fifty-nine patients, the extent of lesion motion was the largest in cephalo-caudal direction, with 14.3 mm for lesions in the lower and 7.1 mm (median) for middle part of the lung. In lateral and antero-posterior directions, it was within 4. 0 mm. The motion error during irradiation was 4. 2 mm in lateral direction and 4.6 mm in cephalo-caudal direction. The random error, system error and total error for set-up uncertainty were 3.4 mm, 6.0 mm, and 6.9 mm. Compared to the standard, the discrepancy of GTV could be as large as 150% . The largest RLMV was observed in the area of lung hilar nodes. Conclusions The target of 3-dimensional conformal radiation therapy for lung cancer should be confirmed individually and delineated by a group of radiation oncologists. A more efficient fixing device is needed owing to the large total error for set-up.

Objective To prove with mathematical formula that the patient's blood electrolyte concentration shows a tendency to approach that of replacement-fluid after continuous renal replacement therapy (CRRT).Methods Electrolyte concentration of plasma,replacement-fluid and returning fluid were compared,and they were labeled as Cblood,Cnom,and Creturn respectively.The Creturn was calculated,and the relationship among them was demonstrated with comparison by mathematical formula.At last,according to their relationship,plasma change towards to the replacement fluid was analyzed.Results It was showed that Cblood＜Creturn＜Cnom or Cblood＞Creturn＞ Cnom,and according the relationship,it was derive that the trend of change in Cblood after circulation for m unit time was Cblood1 ＞Cblood2 ＞Cblood3 ＞ … ＞Cbloodm ＞Cblood or Cblood1 ＜ Cblood2 ＜Cblood3 ＜ … ＜Cbloodm ＜Cnom.The plasma electrolyte concentration would close to that of replacement fluid infinitely with the continue of CRRT.Conclusions With mathematical model,it is proved that the replacement fluid electrolyte concentration is the final target of the plasma.We must make up the replacement fluid correctly.And this results provide the basis for CRRT treatment of electrolyte disorder.

Objective To observe the role of nitric oxide(NO) in the immune regulatory effect of bone marrow mesenchymal stem cells(MSCs). Methods Bone marrow MSCs were isolated from Lewis rats by adherence screening. Concanavalin A (ConA) was adopted as the stimulator and T-lymphocyte isolated from peripheral blood of SD rats as the reactive cells. The changes of the ability of T-lymphocyte proliferation, when co-cultured with MSCs, were measured by CCK-8 assay. The inducible nitric oxide synthase (iNOS) mRNA and protein expression on MSCs and were detected by RT-PCR, Western blot. The contents of nitrites and the levels of Th1 type cytokine IFN-γand Th2 type cytokine IL-4 were measured by Griess test and ELISA respectively, in the co-cultured supernatant. Results T-lymphocyte proliferation was inhibited by co-cultured MSCs, which was concentration-dependent. In this study, the inhibition was most obviously group[ (79.03 ± 1.70)% ] (P ＞ 0.05 ). The I NOS mRNA expression, protein and nitrite levels were signifigroups, the proliferation rate of T-lymphocyte recovered. The content of IFN-γwas increased with the ratio decline of MSCs in the experimental group and IL-4 in each group has no significant difference( P ＞ 0.05 ).Conclusion MSCs inhibited T-lymphocyte proliferation by influencing Th1/Th2 balance, and the secretion of soluble factor NO, which secreted by MSCs, may plays an important role in the immune regulation.

Objective To identify clinicopathologic factors which predict survival following hepatectomy in HBV-related cirrhotic patients with early hepatocellular carcinoma (HCC).Methods A database was used to identify patients with histologically confirmed early HCC (≤5 cm,no nodal involvement,metastases,or major vascular invasion) who underwent surgical resection (excluding ablation or transplantation).Among 20 700 patients with HCC who were diagnosed at the Eastern Hepatobiliary Surgery Hospital from April 2005 to November 2010,537 (2.6％) patients with early HCC were studied retrospectively.Prognostic factors were evaluated using the Kaplan-Meier curves,Cox proportional hazards models and the receiver operating characteristic (ROC) curves.Results The study included 537 patients.The median tumor size was 2.9 cm,and 33％ of patients had tumors ≤2 cm.Most HCC lesions were solitary (63％) and had no evidence of vascular invasion (64％).Following surgery,the overall median and 5-year survival were 45 months and 33％ respectively.After adjusting for demographic factors and histological grade,tumor size ＞2 cm (hazard ratio [HR]:1.56),multifocal tumors (HR:1.34),and vascular invasion (HR:2.03) remained independent predictors of poor survival (all P ＜ 0.05).Based on these findings,a prognostic scoring system was developed that allotted 1 point each for these factors.Patients with early HCC could be stratified into 4 distinct prognostic groups (median and 5-year survival,respectively):0 points (97 months,96％),1 point (85 months,76％),2 points (76 months,54％),3 points (56 months,39％) (P ＜0.01).Conclusions The present study emphasized the importance of pathologic staging even in patients with small HCC.Anatomical resection of HCC should be the preferred surgical procedure in cirrhotic patients.