ObjectiveTo investigate the clinical effect and treatment experience of complicated acetabular fractures treated with open reduction with combined ilio-inguinal and Kocher-Langenbeck (K-L) approaches.MethodsSixty-six patients with complicated acetabular fractures were treated surgically with combined ilio-inguinal and K-L approaches from February 2004 to December 2009.Among them,45 cases were followed up for 8-45 months,with the average 26 months.ResultsOperation time was 1.4-5.7 h,with the average of 2.8 h.Intraoperative blood loss was 530-2300 ml,with the average of 1250 ml.According to Matta's score system,the excellent and good rate was 86.7％.According to modified Merle d' Aubigne and Postel score system,the excellent and good rate of function of hip was 86.7％.According to Brooker heterotopic ossification standard assessment system:Ⅰ degrees in 6,Ⅱ degrees in 3.According to Letournel and Judet clinical classification system,postoperative traumatic arthritis were 6 patients.Among them,3 patients with Ⅲ- Ⅴ period with symptoms of serious hip pain and joint activities obstacles were treated with total hip replacement secondly.Six cases of sciatic nerve injury and 9 cases of lateral femoral cutaneous nerve damage were recovered gradually after six months to a year.All incisions healed primarily.All got bony union,the healing time was 8 to 16 weeks,with the average of 10.4 weeks.None was complicated with femoral head necrosis.ConclusionFor the patients with complicated acetabular fractures,open reduction with combined ilio-inguinal and K-L approaches can get clinical advantages of revealed fully,fracture restoration convenient,fixed tightly,fewer complications and satisfactory result.

AIM AND METHODSThe purpose of this investigation was to determine the changes of erythrocyte deformability, band-3 protein and actin in the definite volume of erythrocyte membrane after high intensity running training and recovery in rats.

RESULTSLong-term training could significantly improve erythrocyte deformability and the quantity of membrane proteins. Erythrocyte deformability, band-3 protein and actin decreased transitorily at varying degrees after inadaptable high intensity exercise. One and two week training could improve erythrocyte deformability, the quantity of band-3 protein and actin after recovery.

CONCLUSIONAlterations of erythrocyte membrane protein after high intensity training could cause the change in erythrocyte membrane structure and hence influenced erythrocyte deformability. That was maybe one of mechanisms of training effecting erythrocyte deformability.

Actins ; metabolism ; Animals ; Anion Exchange Protein 1, Erythrocyte ; metabolism ; Erythrocyte Deformability ; Erythrocyte Indices ; Erythrocyte Membrane ; chemistry ; metabolism ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley

Abortion, Spontaneous ; diagnosis ; genetics ; metabolism ; Cyclin-Dependent Kinase Inhibitor p57 ; metabolism ; Diagnosis, Differential ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Hydatidiform Mole ; diagnosis ; genetics ; metabolism ; Immunohistochemistry ; Pregnancy ; Uterine Neoplasms ; diagnosis ; genetics ; metabolism

OBJECTIVETo evaluate wear resistance and hardness of three kinds of new composite resins.

METHODSThree kinds of new composite resins, Solidex, Spectrum, Filtek Z350, were tested. Enamel as control group. A refited MG-200 wear machine was used in this study. Scanning electron microscope (SEM) was used to observe the friction surface of each tested material. Hardness of each tested material was determined by Vickers indentation technique. The data of wear and hardness were analyzed by Mann-Whitney test and 1-way ANOVA. The relationship between the hardness of the composites and the amount of wear of them was determined by a regression analysis method.

RESULTSFiltek Z350 showed the lowest volumetric wear and highest Vickers hardness in the composites (P < 0.05). No significant differences in wear and hardness were observed between Solidex and Spectrum (P > 0.05). Significant relationships were observed between the hardness of the composites and the amount of wear of them (r = 0.968 6) (P < 0.05). Different wear characters of the friction surface of the tested materials were observed by SEM.

CONCLUSIONNanofilled composite was superior to the hybrid composite in wear resistance and hardness.

Composite Resins ; Dental Enamel ; Dental Materials ; Dental Restoration Wear ; Hardness ; In Vitro Techniques ; Materials Testing ; Surface Properties

Objective:To discuss the treatment options for patients with azoospermia factor (AZF)c microdeletion on Y chromosome.Methods:One hundred and eighty three patients,who were diagnosed as AZFc microdeletion on Y chromosome in Peking University Third Hospital,were recruited in our stu-dy.In order to get better treatment option for this kind of patients,we retrospectively analyzed their clinic data including the treatment process and pregnancy outcome and found out the characteristics of their se-men.Results:Among the 183 patients,sperms can be found in ejaculated semen in 105 patients (57.4%,105 /183).One hundred and three patients (98.1%,103 /105)were diagnosed as severe or extremely severe oligospermia.Regular medication was given to 98 patients,6 patients (6.1%,6 /98) of which got natural pregnancy.The other 99 patients who have sperms in their semen received intracyto-plasmic sperm injection (ICSI),68 patients (68.7%,68 /99)of which got pregnancy.Seventy eight patients were diagnosed as azoospermia among all the 183 patients.Forty nine patients received testicular sperm aspiration (TESA),and 21 patients choose to receive micro-TESE directly.Among the 49 patients with TESA,sperms were retrieved in 17 patients (34.7%,17 /49),and sperms were not retrieved in 32 patients (65.3%,32 /49),of which 12 patients (37.5%,12 /32)gave up treatment and 20 patients (62.5%,20 /32)choose micro-TESE.Among the 41 patients who choose to receive micro-TESE,ope-ration has been done on 19 patients,of which 11 patients (57.9%,11 /19)got sperms.Among the 11 patients,TESA has been done on 6 patients before micro-TESE,of which 4 patients (66.6%,4 /6)got sperms.ICSI has already been done on 7 azoospermia AZFc microdeletion patients who underwent micro-TESE,of which 4 patients (57.1%,4 /7)get pregnancy.Conclusion:AZFc microdeletion patients who had sperms were always diagnosed as severe or extremely severe oligospermia.ICSI was their first choice instead of drug therapy.For AZFc microdeletion patients who were diagnosed as azoospermia, TESA was one of their choices,however,the success rate is not high.Micro-TESE is still possible to get sperms even after the failure of TESA.Therefore,we may choose micro-TESE instead of TESA in some azoospermia patients in order to reduce surgical trauma on patients.

OBJECTIVETo study the impact of the chloride channel dysfunction of the cystic fibrosis transmembrane conductance regulator (CFTR) on the cytoskeleton of Sertoli cells in the mouse.

METHODSTM4 Sertoli cells were cultured and treated with CFTR(inh)-172 at the concentrations of 1, 5, 10 and 20 μmol/L for 48 hours. Then the cytotoxicity of CFT(inh)-172 was assessed by CCK-8 assay, the expressions of F-actin and Ac-tub in the TM4 Sertoli cells detected by immunofluorescence assay, and those of N-cadherin, vimentin and vinculin determined by qPCR.

RESULTSCFTR(inh)-172 produced cytotoxicity to the TM4 Sertoli cells at the concentration of 20 μmol/L. The expressions of F-actin and Ac-tub were decreased gradually in the TM4 Sertoli cells with the prolonging of treatment time and increasing concentration of CFTR(inh)-172 (P < 0.05). The results of qPCR showed that different concentrations of CFTR(inh)-172 worked no significant influence on the mRNA expressions of N-cadherin, vimentin and vinculin in the Sertoli cells.

CONCLUSIONThe CFTR chloride channel plays an important role in maintaining the normal cytoskeleton of Sertoli cells. The reduced function and expression of the CFTR chloride channel may affect the function of Sertoli cells and consequently spermatogenesis of the testis.

Actins ; metabolism ; Animals ; Benzoates ; pharmacology ; Chloride Channels ; physiology ; Cystic Fibrosis Transmembrane Conductance Regulator ; antagonists & inhibitors ; Cytoskeleton ; drug effects ; Male ; Mice ; Sertoli Cells ; drug effects ; metabolism ; Spermatogenesis ; Thiazolidines ; pharmacology ; Time Factors

OBJECTIVETo investigate the epidemiological changes of erectile dysfunction (ED) patients in the past five years.

METHODSIn 2003 and 2008, we conducted two questionnaire investigations on the epidemiological changes of ED outpatients in 11 Chinese cities in such aspects as age, disease course, ED severity, smoking and drinking habits, accompanying hypertension, diabetes and coronary heart disease (CHD), and sexual intercourse satisfaction.

RESULTSAccording to the valid copies of the questionnaire collected (808 in 2003 and 858 in 2008), the age pattern of the ED patients hardly changed in the past five years, over 60% aged 30 - 50 years. Compared with the results obtained in 2003, the second investigation showed obvious increases in the following numbers of the ED patients: by 13% in those with longer disease courses (5 - 10 yr), from 24.1 to 42.9% in those with moderate ED, from 20.4 to 29.9% in those with severe ED, by at least 10% in those with smoking and drinking habits, from 11.5 to 16.2% in those with hypertension, from 9.4 to 13.5% in those with diabetes, and from 57.6 to 73.3% in those without sexual satisfaction, while the number of those with CHD did not change significantly.

CONCLUSIONIncreased unhealthy living habits and erectile function impairing diseases have added to the incidence and severity of ED. There is still much work to be done in the prevention and early treatment of ED.

Adult ; China ; epidemiology ; Erectile Dysfunction ; epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Outpatients ; Penile Erection ; Surveys and Questionnaires ; Urban Population

BACKGROUNDErectile dysfunction (ED) is a common impairment among older men, and the prevalence rates increase sharply after age of 60 years. Most studies have focused on the prevalence rate or dangerous factors. The aim of this study was to investigate the basic epidemiologic data about ED patients with different ED courses. The purpose of this research was to understand the therapeutic effect of phosphodiesterase type 5 inhibitor (PDE5-I) and see how and why the ED course impact the progress of ED and the therapeutic effect of PDE5-I treatment.

METHODSFrom June 2008 to June 2009, 4252 questionnaires (Quality of Erection Questionnaire, QEQ) were gathered from 46 centers by urology or andrology doctors all around China. Patients with ED (age ≥ 20 years) filled in first half of the questionnaires when they came for the first time, and then completed the second half 4 weeks after PDE5-I therapy.

RESULTSED courses of most patients were less than 5 years (< 5 years, 74.0%; 5 - 10 years 20.8%; > 10 years, 5.2%). As ED course increasing, the incidence of the risk factors of ED, such as smoking, drinking, hypertension, diabetes, heart disease and hyperlipidemia also increase (P ≤ 0.01). PDE5-I was effective in improving the quality of sexual activities (P ≤ 0.01). Administration of PDE5-I improves satisfaction, enjoyment and frequency of sexual activities. The longer the ED course, the worse the therapeutic effect (< 5 years, 96.1%; 5 - 10 years, 94.9%; > 10 years, 89.0%) (P ≤ 0.01).

CONCLUSIONSThe ED course greatly affected the therapeutic effect of PDE5-1, the patients with ED should consult doctor at early stage of the disease. Administration of PDE5-I effectively improves the penile erection and the quality of sexual life of the patients hence should be considered as first-line medicine in the treatment of ED.

Adult ; Erectile Dysfunction ; drug therapy ; epidemiology ; physiopathology ; Humans ; Male ; Phosphodiesterase 5 Inhibitors ; therapeutic use ; Surveys and Questionnaires

BACKGROUNDInhalational anesthesia with sevoflurane for endotracheal intubation without muscle relaxant is now used widely for pediatric patients. This study assessed the efficacy and safety of induction with high concentration sevoflurane and of nasotracheal intubation without muscle relaxant in infants with increased or decreased pulmonary blood flow (PBF) and undergoing surgery for congenital heart diseases.

METHODSFifty-five infants aged 2 - 12 months, weighing 4.7 - 10.0 kg, and scheduled for congenital cardiac surgery were enrolled. Subjects were divided into those with increased (IPBF group, n = 29) and decreased (DPBF group, n = 26) pulmonary blood flow. All infants received inhalational induction with 8% sevoflurane in 100.0% oxygen at a gas flow rate of 6 L/min. Nasotracheal intubation was performed 4 minutes after induction. Sevoflurane vaporization was decreased to 4.0% for placement of a peripheral intravenous line and invasive hemodynamic monitors. Five minutes later, sedatives and muscle relaxant were administered and the vaporizer was adjusted to 2% for maintenance of anesthesia. Bispectral index (BIS) scores, circulatory parameters, satisfactory and successful intubation ratios, adverse reactions, and complications of intubation were recorded.

RESULTSTimes to loss of lash and pain reflexes were longer for the DPBF group (P < 0.01). Satisfactory intubation ratios were 93.1% and 61.5% for the IPBF and DPBF groups, respectively (P = 0.008). Successful intubation ratios were 96.6% and 76.9% for the IPBF and DPBF groups, respectively (P = 0.044). Following sevoflurane inhalation, blood pressures decreased significantly in the IPBF group but remained stable in the DPBF group. BIS scores declined to similar stable values, and a "nadir BIS" was recorded for both groups. No obvious adverse reactions or complications of intubation were noted perioperatively.

CONCLUSIONSInduction with high concentration sevoflurane, although faster for infants with IPBF, is safe for infants with IPBF or DPBF. However, nasotracheal intubation without muscle relaxant after induction with high concentration sevoflurane is less successful and less satisfactory for infants with DPBF and should be used with caution in this patient group.

Anesthetics, Inhalation ; Blood Circulation ; drug effects ; Female ; Heart Defects, Congenital ; surgery ; Humans ; Infant ; Intubation, Intratracheal ; Lung ; blood supply ; drug effects ; Male ; Methyl Ethers ; therapeutic use

OBJECTIVETo investigate whether training in the department of urology will help interns acquire more knowledge on male reproductive health in such aspects as male erectile dysfunction (ED), premature ejaculation, male infertility (PE), male contraception, and so on.

METHODSSixty interns receiving rotatory training in the Department of Urology of the Peking University Third Hospital were recruited to complete a questionnaire designed by ourselves. A comparison was made of their knowledge on male reproductive health before and after their training in the department by using the chi-square statistical test in SPSS 11.0 software.

RESULTSWith regard to ED in such questions as "Do you regard ED as a disease affecting the aging male?" and "Do you regard ED as a local symptom of some male systemic disease?", all the interns knew significantly better after trained in the department of urology. Concerning the definition of ED and the effect of sildenafil citrate on ED, no significant difference was found in their knowledge between pre-training and post-training. As to patients' questions about ED, most of them showed interest but rarely made any initiative inquiries, which was not significantly changed after the training. Regarding PE, most of them knew very little even after trained, but they all thought of it as a disease affecting life quality. As regards male infertility, although some knew something about its definition and the normal parameters of semen routine analyses, others remained quite ignorant. As for male contraception, most of them knew little even after trained in the department.

CONCLUSIONInterns generally acquire more knowledge on male reproductive health after trained in the department of urology. However, in regard to male infertility and male contraception, their knowledge is quite insufficient, which implies the need for strengthening the training in the related aspects.

Adult ; Health Knowledge, Attitudes, Practice ; Humans ; Infertility, Male ; Internship and Residency ; Male ; Reproduction ; Surveys and Questionnaires ; Urology ; education