Objective:To analyze the clinical features of 63 azoospermic patients with microdeletion of azoospermia factor C region(AZFc) and their relationship with sex hormones.Methods:The clinical data of 63 azoospermic patients with AZFc microdeletion were retrospectively analyzed, including age, height, body weight, body mass index(BMI), testicular volume, and sex hormones.Results:Compared with normozoospermic men, height, body weight, and testicular volume revealed statistical differences in azoospermic patients with AZFc microdeletion( P<0.05). There were significant differences in FSH, LH, testosterone(T), and prolactin levels between two groups( P<0.05). BMI was negatively associated with FSH level( r=-0.251, P=0.04)and positively associated with estradiol(E 2)level( r=0.327, P=0.009). Age had a negative association with T level( r=-0.256, P=0.04). Testicular volume revealed a negative association with FSH level( r=-0.289, P=0.02). There were no association of height with T, E 2, FSH, and LH levels( P>0.05). Conclusion:It is more likely that azoospermic patients with AZFc microdeletion present overweight and earlier decreased androgen level. The adjustment of lifestyle and testosterone supplementation might be beneficial to the long-term quality of life in these patients.

Aim To observe the influences of ginsenoside Rg1 on the spontaneous contraction of small intestine smooth muscle of rabbits in vitro and explore the mechanism.Methods With the isothermal perfusion of small intestine in vitro,the influences of ginsenoside Rg1 on the spontaneous contraction of small intestine was observed and the mechanism of ginsenoside Rg1 was studied.Results Ginsenoside Rg1 reduced the amplitude of contraction of small intestine smooth muscle in rabbits in a dose-depended manner.Bay K8644 and nitro-L-arginine methylester(L-NAME)could completely block the inhibition of ginsenoside Rg1 on the contraction of small intestine smooth muscle.Ginsenoside Rg1 inhibited the intracellular calcium-depended contraction induced by rynodine in the Ca2+ free Tyrode's solution.Conclusions Ginsenoside Rg1 inhibits the contraction of small intestine smooth muscle of rabbits in vitro.The mechanism may be related to increase NO concentration in small intestine smooth muscle so that it inhibits extracellular Ca2+ inflowing via cell membrane and intracellular Ca2+ releasing via sarcoplasmic reticulum.

OBJECTIVE:To investigate the new management model of the hospital pharmacy established by application of vender managed inventory (VMI) model. METHODS:Concerned about the implementation of VMI model,its effects and prob-lems,new management model of hospital pharmacy were described after the hospital cooperated with two suppliers. The hospital is mainly in charge of the management and application of pharmaceutical staff and equipment,drug capital flow,and the selection and optimization of drug use list;focus on the training of pharmaceutical talents;improve drug quality management,pharmaceuti-cal administration,pharmaceutical care and rational drug use. Two suppliers are mainly in charge of drug logistics,and the alloca-tion of servicer,software and hardware(as automatic medicine dispensing machine);share logistic cost of supply chain. Drug in-formation flow was established by both hospital and supplier. RESULTS:After cooperation,pharmaceutical staff,related equip-ment and inventory cost(floating capital decreased by 10 million yuan each month)were decreased,and the efficiency of distribu-tion improved;the error rate of drug dispensing in outpatient pharmacy were decreased (decreasing from 0.39‰ to 0.12‰) after the establishment of automatic pharmacy. The establishment of early warning system for abnormal patients flowrate in pharmacy window shortened the time of getting medicine,and improved service level and satisfactory degree of patients (increasing from 84.91% to 93.62%). CONCLUSIONS:New management model of hospital pharmacy based on VMI model provides reference for public hospital reform and hospital-enterprise cooperation under New Medical Reform.

Aim To investigate the effect of ginsenoside Rg1 on gut injury following intestinal ischemia reperfusion in rats and the possible mechanism.Methods By using rat model of intestinal I/R injury, 30 male SD rats were randomly divided into 3 groups(n =10 in each group):sham-operation group, I/R group(control group)and ginsenoside Rg1 group(treatment group).The contents of tumor necrosis factor α(TNF-α), interleukin-6(IL-6), malondialdehyde(MDA), the activity of superoxide dismutase(SOD)in intestinal mucosa were measured respectively.Chiu's count was used to assess the changes in intestinal pathological morphology.Results TNF-α, IL-6, MDA contents and the intestinal injury score in control group were significantly increased compared to those in sham-operation group, while SOD contents in control group were significantly decreased compared to sham-operation group.Inversely, TNF-α, IL-6, MDA contents and the intestinal injury score in treatment group were significantly decreased compared to those in control group, while SOD contents in treatment group were significantly increased compared to control group.Conclusion Pretreatment with ginsenoside Rg1 has protective effect on intestinal ischemia-reperfusion injury in rats, which may be attributed to decreased contents of TNF-α, IL-6, MDA and increased levels of SOD.

Aim To observe the cardioprotection of chronic intermittent hypobaric hypoxia (CIHH) against ischemia/reperfusion injury in adult and young rats.Methods Adult and postnatal male Sprague-Dawley rats were divided randomly into four groups:control 28-day group (CON28),control 42-day group (CON42), CIHH 28-day treatment group (CIHH28), and CIHH 42-day treatment group (CIHH42). CIHH animals with maternal rats were put into a hypobaric chamber 2 days before birth to get 28 days and 42 days CIHH mimicking 3000 m altitude (P_B=525 mmHg,P_(O_2)=108.8 mmHg), 5 h daily, respectively.The control animals were kept in the same environment as CIHH rats with free access to water and food except hypoxic exposure. The isolated hearts were perfused in the Langendorff apparatus, undergoing 30 min global ischemia and 60 min reperfusion.Cardiac function was recorded continuously during the whole experiment. Parameters of left ventricular function included left ventricular developing pressure (LVDP), left ventricular end-diastolic pressure (LVEDP), maximal positive (+LVdp/dt) and negative (-LVdp/dt) velocity of left ventricular pressure, coronary flow (CF) and heart rate(HR).Results ① For adult rats, there was no significant difference in the parameters of left ventricular function between CIHH28 and CON28 groups. However, the recovery of cardiac function in CIHH42 rats was much better than that in CON42, including LVDP, LVEDP, ±LVdp/dt and CF (P<0.05). ② For young rats, the basic coronary flow (CF) in CIHH rats was significant higher than that in CON rats, while other parameters of cardiac function didn't change. The recovery of cardiac function in CIHH rats was much better than that in CON rats, including LVDP, LVEDP,±LVdp/dt and CF (P<0.05).Conclusion CIHH confers cardioprotection against ischemia/reperfusion injury in rat cardiomyocytes, which is predominant in CIHH42 group and significantly affected by the age of animals. Cardioprotective effects produce more easily in young rats by CIHH.

Objective To study the changes of P-selectin and E-selectin in pediatric patients with critical illness ,and analyze their relationship with the severity and prognosis of diseases.Methods Forprospective study,42 critically ill patients admitted in pediatric intensive care unit (PICU ) from September,2012 to March,2013 as critically ill group were enrolled,and blood specimens were collected with 24 hours after admission.Another 42 cases blood samples were collected from children's physical examination as control group.The severity of the critically ill patients were evaluated by Pediatric Critical illness Score (PICS)and Pediatric risk of score mortality (PRISM)-III.The levels of serum P-selectin and serum E-selectin were measured by double antibody sandwich enzyme-linked immunoassay (ABC-ELISA). Results P-selectin and E-selectin in control group children and critically ill patients group were (37.23 ± 8.99)ng/mL,(36.24 ±17.82)ng/mL,and (107.24 ±35.53)ng/mL,(114.93 ±40.17)ng/mL, respectively.There were statistical differences between two groups (P=0.000).The levels of P-selectin and E-selectin in acute phase were higher than that of levels in recovery phase in critically ill group (P =0.000).Negative correlation was observed between P-selectin concentration and the PCIS score (r =-0.673,P=0.000),as well as E-selectin (r=-0.548,P=0.000).P-selectin level and E-selectin level based upon PRISMⅢ≥10 group were significantly higher than they in PRISMⅢ <10 group (P=0.003,P=0.014).In critically ill children,the differences in P-selectin,E-selectin were significant higher in death patients (P=0.003;P =0.000).Compared with the non-sepsis illness group,the level of P-selectin and E-selectin in the severe sepsis patients were significantly higher (P =0.04,P =0.025 ). Conclusions The levels of P-selectin and E-selectin are closely related to the severity and prognosis in critically ill children.Measuring the level of P-selectin and E-selectin could be used as a judegment the severity and to understand pathological physiological process.

Objective To study the distribution of Candida infection and drug tolerance in intensive care unit(ICU). Methods A retrospective study was conducted. The critical patients admitted from January 2011 to December 2013 in ICU of the First Hospital of Jiaxing in Zhejiang Province were enrolled,and their clinical data with positive Candida culture and drug susceptibility results in specimens of sputum,urine,blood,ascites,bile, etc were collected. In the study of these 3 years in ICU,the situation of Candida infection,the distribution of positive specimen,the condition of distribution of different strains of Candida,and the Candida tolerance to antifungal drugs were analyzed. Results From 2011 to 2013,2 412 times of patients(including one patient had admitted into ICU for more than one time)were admitted into ICU in which 407 cases were of Candida infection(16.9%),and the rate of Candida infection was rising gradually in the 3 years〔2011 to 2013 Candida positive rates were 13.4%(77/573), 16.1%(146/907),19.7%(184/932)〕,the difference being statistically significant(P<0.01). In the 407 strains of Candida,166 strains(40.8%)were isolated from sputum,157(38.6%)from urine,53 strains(13.0%)ascites, 13 strains(3.1%)blood,11 strains(2.7%)bile,7 strains(1.7%)from other specimens. The strain distribution of Candida was mainly as follows:Candida albicans(174 strains),Candida glabrata(131 strains),Candida tropicalis (83 strains),Candida parapailosis(5 strains),Candida krusei(12 strains),and 2 strains of rare Candida portugal and Lipolztica. From 2011 to 2013,the highest tolerance of Candida albicans,Candida glabrata,Candida tropicalis to fluconazole,itraconazole,Fushita Yasu and other antifungal drugs was in 2013,and the lowest was in 2012,the rates of tolerance of the above 3 strains of Candida to amphotericin B being 0,to itraconazole being the highest(10.9%, 27.8%,9.6%,respectively),to Fushita Yasu the secondary(6.6%,11.0%,0,respectively)and to fluconazole the last(4.7%,7.4%,1.9%,respectively),and the rates of tolerance of Candida parapsilosis,Candida krusei,Candida Portugal,Candida lipolztica to amphotericin B,fluconazole,itraconazole,Fushita Yasu were all 0. Conclusion In ICU,the Candida infection is mainly in the respiratory tract and urinary tract,its rate of infection has a tendency of rising,and the rate of Candida tolerance to itraconazole is the highest.

Objective To analyze the clinical efficacy and technical key points of genioplasty for the deformities of the chin.Methods 153 patients with chin deformities were treated with the genioplasty,and the chin was moved in any direction,including sagittally,vertically and transversely;the key points of this procedure were summarized.Results There was no severe complication such as infection or nonunion observed.15 patients had ecchymosis and faded in 2 weeks;33 patients had hypaesthesia and recovered in 12 weeks.With the 12-24 months follow-up,all the patients healed well with satisfactory aesthetic results.Conclusions The genioplasty is a reliable and efficient method for the deformities of the chin,and it can significantly improve the appearance of the chin.

AIM:To observe protective effect of L-glutamine on myocardial cell injury induced by endotoxin. METHODS:22 male SD rats,weighting(250?30)g,were randomly divided into three groups:control group( n= 7),endotoxin group( n= 7),glutamine/endotoxin group( n= 8). Heart were isolated from rats and perfused on Langendorff apparatus with Krebs- Henseleit(K-H)buffer(Saturation 95%O 2+5%CO 2)at a constant pressure(8.33 kPa)and temperature(37℃). The activity of superoxide dismutase (SOD)and malondialdehyde (MDA)content of efflux from coronary artery, monophasic action potential(MAP)and contractile force were measured at certain timepoints (0 min,20 min,50 min,80 min). RESULTS: Monophasic action potential and contractile force were markedly improved in Gln/ET group. The activity of SOD and MDA level in Gln/ET group restored closely to that in control group. CONCLUSION:L-gluta mine protects myocardial cells from injure induced by endotoxin.

Objective:To systematically evaluate the real experience of caregivers in patients with hematopoietic stem cell transplantation.Methods:The Cochrane Library, PubMed, Scopus, Web of Science, PsycINFO, CBM, CNKI, VIP, and Wan Fang Data were searched for qualitative studies on caregivers' experience of hematopoietic stem cell transplant patients. The time limit for the search was from inception to June 2019. The results were assessed using a pooled integration approach using the Australian JBI Evidence-Based Health Care Center (2016) Quality Evaluation Standards Evaluation.Results:A total of 6 studies were included to refine 27 complete and definitive findings, and similar results were grouped into 8 new categories and integrated into 5 integrated results: the physical and mental experience of the caregiver, dilemmas and needs, caregivers′ coping style, social support in the care process, caregiver adaptation and growth.Conclusion:Medical staff should pay attention to the psychological state and potential needs of this group. In the process of transplantation, the caregiver should be self-regulated and better qualified as a caregiver.