Objective Through testicular biopsy and detection of serum sex hormone levels in patients with azoospermia,to explore the relationship between spermatogenic function of testis,testicular volume and serum LH and FSH levels.Methods 80 cases of azoospermia patients adimitted from Jan.2012 to Dec.2014 were collected as the research object.Immunization method was used to detect the serum sex hormone leve,testis model was adopted to detect testicular volume,and routine disinfection was given to make testicular biopsy.According to testicular biopsy results,patients were divided into normal spermatogenic function group (group A),spermatogenic dysfunction group (group B),sertoli-cell-only syndrome group (group C);percutaneous sperm group (group D),and puncture azoospermia group (group E).At the same time,50 cases of healthy male were selected as the control group and they received sperm routine examination and sex hormone detection.Correlation between spermatogenic function of testis,testicular volume and serum LH and FSH levels were studied.Results Serum levels of LH and FSH had no significant difference among group A,group B and the control group (P＞0.05).Serum level of LH and FSH was significantly higher in group C than that in group A,group B and the control group,and the differences had statistical significance (P＜0.05).Serum level of LH and FSH in group D had no significant difference compared with that of the control group (P＞0.05).Serum level of LH and FSH in group E was significantly higher than that in group D and the control group,and the difference had statistical significance (P＜0.05).The level of LH and FSH was significantly higher in abnormal testicular group than that in normal testis group,and the difference had statistical significance (P＜0.05).Spearman correlation analysis showed that the spermatogenic function of testis was negatively correlated with serum LH and FSH levels (r=-0.473,-0.441,P＜0.05).Testicular volume was negatively correlated with serum LH and FSH levels(r=-0.643,-0.715,P＜0.05),and the difference had statistical significance.Conclusion The determination of serum LH and FSH levels has important clinical value for predicting testicular spermatogenic function in azoospermia patients,and can be used to guide clinical puncture and prognosis judgement.

Objective To investigate the quality of life (QOL) in elderly patients with chronic diseases living at home and its influencing factors.Methods 1856 elderly patients with chronic diseases living at home were selected by random cluster sampling from two communities.All patients were investigated by SF-36 questionnaire and self-made questionnaire.Results The average QOL scores were (63.8±15.1) in elderly patients with chronic diseases living at home.Scores of SF-36's eight dimensions were respectively (67.8± 22.6) in physiological function,(47.3± 39.4) in role physical,(90.2±14.3) in bodily pain,(52.3±11.9) in general health,(64.1 ± 17.1) in vitality,(74.0 ± 20.9) in social function,(49.7 ± 39.5) in emotional function,(65.0 ± 16.9) in mental health.Scores of SF-36 in each dimension were lower in patients aged 75 years and above than in patients aged 60-74 years (all P＜0.05).Scores of SF-36's dimensions including physical function,bodily pain,vitality,social function and mental health in patients aged 75 years and above were lower in males than females (all P＜0.05).Multiple stepwise regression analysis showed that the major influencing factors for the QOL in elderly patients with chronic diseases living at home were movement,hobbies,age,caregivcr,family support,number of chronic diseases,education status,and alcohol consumption (all P＜0.05).Conclusions The major influencing factors for quality of life in elderly patients with chronic diseases living at home are included demographic,behavior and family factors,etc.Comprehensive community interventions should be taken to improve the quality of life in this elderly population.

Objective To investigate the rates of depression and its risk factors in elderly hypertensive patients and healthy residents in Fuzhou.Methods 882 elderly primary hypertensive patients aged 60 years and over and 1230 healthy elderly residents were assessed by the geriatric depression scale (GDS) and a self-made general information questionnaire, and SPSS 16.0 was used to analyze data.Results The average score of depression and the incidence of depression were higher in elderly hypertensive patients than in healthy elderly residents [(12.43±5.01) vs.(11.53±5.13), 64.4％ vs.55.3％, t=-3.849, x2=16.386, P＜0.01].Compared with healthy controls, scores of depression were higher for all age groups in elderly married male patients, with low levels of education (junior middle school or below), a monthly income less than 2000 yuan, and partial or no medical insurance coverage (P＜ 0.05 for all).Scores of depression were higher in elderly hypertensive patients who had smoking or drinking habits, social activity, hobby, or physical exercise than in healthy controls, (P＜0.05 for all).Scores of depression were also higher in elderly hypertensive patients who had family support, barely enough or adequate family expenses or family support than in healthy controls, regardless of living conditions (P＜0.05 for all).Multiple stepwise regression analysis showed that risk factors for depression in elderly hypertensive patients were family support, age, medical insurance coverage, family expenses, living conditions, hobbies, and gender, while risk factors for depression in healthy elderly residents were family support, interests, medical insurance coverage, and age.Conclusions The incidence of depression is higher in elderly hypertensive patients than in health elderly people in communityin Fuzhou.Family support, hobbies, medical insurance coverage and age are the common risk factors for depression in both elderly hypertensive patients and healthy residents.Family expenses, living conditions and gender are important risk factors for depression in elderly hypertensive patients.

ObjectiveTo investigate the protective effects of epigallocatechin gallate (EGCG) in a mouse model of Parkinson's disease induced by 1-Methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP).Methods32 C57BL/ 6 male mice were randomly divided into 4 groups: Model group was administrated with 16 mg/kg MPTP (i.p., four times, 2 h interval); Sham group was treated with saline; EGCG treatment group was given EGCG (5 mg/kg) after MPTP administration; normal group was just given EGCG (5 mg/kg) as treatment group. After given EGCG for 3 weeks, behavioral tests, tyrosine hydroxylase (TH) immunohistochemistry staining and the HPLC for dopamine (DA) and its metabolites were used.ResultsThe present results indicated that oral administration of EGCG significantly improved the behavioral impairement in mice induced by MPTP (P<0.05). And in the EGCG treatment group, there were more TH-positive neurons than in model group. In addition, levels of DA and its metabolites in striatum decreased significantly in MPTP group (P<0.05). Though the concentration of DA and its metabolites in EGCG treatment group tended to increase, however, there was no significance between EGCG treatment and model group.ConclusionEGCG could improve the behavioral impairment in a mouse model of Parkinson's disease induced by MPTP and protect against the loss of the dopamine neurons in the substantia nigra (SN).

Objective To compare the analgesic effects of epidural Morphine versus lumbosacral plexus block in patients undergoing hip joint replacement.Methods A total of 94 ASA Ⅰ ～ Ⅱpatients undergoing hip surgery with combined spinal epidural anesthesia(CSEA) were selected and randomized into 4 groups:Group M received a single epidural injection of 2 mg Morphine for analgesia,Group MN1 received an epidural injection of 1 mg Morphine combined with lumbosacral plexus block,Group MN2 received an epidural injection of 2 mg morphine combined with lumbosacral plexus block,and Group N received lumbosacral plexus block.All patients were administered intramuscular parecoxib for 3 days after surgery and,if the visual analogue scale(VAS)≥4,additional intramuscular tramadol.Patient-controlled intravenous analgesia(PCIA) was applied if pain relief was insufficient after Tramadol treatment.Postoperative analgesic effects,the ability to ambulate and side effects were monitored.Results VAS scores gradually increased in the 4 groups after surgery and were higher between the morning of the 1st day and the evening of the next day than at 4 hours after surgery in all the 4 groups.There were no significant differences in VAS scores between rest and exercise conditions in any of the 4 groups.Ambulatory VAS scores were lower in Groups MN1 and MN2 than in Groups M and N 6 hours after surgery,while resting VAS scores had no significant differences between the 4 groups.Resting and ambulatory VAS scores were both lower in Groups MN1 and MN2 than in Groups M and N 6 hours after surgery,while they had no significant differences between either Groups MN1 and MN2 or Groups M and N 4-8 hours after surgery.Resting and ambulatory VAS scores were lower in Groups M,MN1 and MN2 than in Group M on the morning of the day after surgery,and more patients in Group N needed early tramadol and PCIA for rescue analgesia.Muscle strength was lower in Groups MN1 and MN2 than in Groups M and N 4 hours and on the morning of the day after surgery.No significant differences between the groups were found in standing ability 6 hours after surgery and in motor activity on the morning of the day after surgery.The incidence of urinary retention was higher in Groups M and MN2 than in Groups MN1 and N,and was higher in Group MN1 than in Group N.The incidence of pruritus was higher in Groups M and MN2 than in Group N.There was no significant difference in Ramsay sedation scores and postoperative nausea and vomiting (PONV) between the groups.Conclusions Epidural morphine combined with lumbosacral plexus nerve block can provide better analgesic effects than a single dose of epidural morphine or lumbosacral plexus nerve block in elderly patients undergoing hip joint replacement.Although the synergy of the combination has certain influence on early muscle strength recovery,it does not affect early postoperative rehabilitation training.With the combined use of parecoxib and lumbosacral plexus nerve block,epidural injection of 1 mg and 2 mg morphine provides similar analgesic effects,but epidural injection of 2 mg morphine results in a higher incidence of urinary retention.Thus,a small dose of epidural morphine combined with lumbosacral plexus nerve block is recommended for postoperative analgesia in elderly patients receiving hip joint replacement.

Seven emotions generation relates to the interaction between individual and external objective matters,which is accompanied with interaction between internal desire and external matters.The activity of seven emotions bases on essence of zang-fu organs,being regulated by five zang viscera.Heart is the upstream controller,liver is the key organ to maintain normal emotionds,spleen and stomach is the hub of emotional activities,lung is the auxiliary organ, kidney is origin of emotional generation.Five zang viscera's cooperation and interaction generate the seven emotions.

Objective To assess the value of early evaluation of left ventricular global systolic function in patients with metabolic syndrome(MS) by three-dimensional speckle tracking echocardiography (3D-STI).Methods 33 healthy subjects and 41 MS subjects who didn't have the left ventricular remodeling were recruited in this study,and the myocardial motions were tracking by 3D-STI.The parameters of left ventricular global longitudinal peak systolic strain(LS),circular peak systolic strain(CS),radial peak systolic strain(RS) and area peak systolic strain (AS) and the values of body mass index (BMI),waist circumference,waist-to-hip ratio and biochemical indicators were compared between the two groups.Results Compared with controls,LS of MS group was significantly decreased (P ＜ 0.01),while no significantly differences were found in CS,RS,and AS(P ＞0.05).The BMI,waist circumference and waist-to-hip ratio were positive correlated with LS (r =0.559,0.617,0.681,P ＜0.01).Conclusions 3D-STI could early evaluate the changes of left ventricular global systolic function for metabolic syndrome patients,and longitudinal peak systolic strain could be the most sensitive index.

Objective To study the expression difference of the insulin-like growth factor-I (IGF-I)and IGF-binding proteins-3,4,5(IGFBP-3,4,5)in the peripheral and local areas in senile hip fracture and discuss the correlation between the expression and the fracture types. Methods The study involved the senile patients (over 65 years) with hip fractures to compare the expressions of peripheral and local IGF-I and IGFBP-3,4,5 and observe the correlation between expression and fracture type.Results The serum and local specimens of 46 patients were collected,with lower level of BMD,IGF-I and IGFBP-3,5 in the intertrochanteric fracture group than the femoral neck fracture group(P<0.001)and with higher level of serum and local IGFBP-4 in the intertrochanteric fracture group than the femoral neck fracture group (P<0.001).Only local IGFBP-4 mRNA had positive correlation with serum markers (R=0.544,P<0.001). Conclusions The expression difference of IGF-I and IGFBP in the peripheral and local serum may be one of pathogenesis leading to different types of hip fractures.Except for the IGFBP-4,the other factors may affect the bone metabolism of the senile hip fractures through different regulatory mechanisms.

Objective To investigate whether rat adipose-derived stem cells (rASCs) could resist human xenoantibody-dependent complement-mediated lysis and to explore its possible mechanisms.Method SD rat ASCs were isolated,rASCs at passage 2 to 8 were used for the following studies and rat lymphocytes were harvested as control cells.α-Gal expression was detected by flow cytometry.After incubation of rASCs with 20％ normal human serum (NHS) or heat inactivated normal human serum (HINHS),flow cytometry was used to detect cytotoxicity,IgG or IgM binding,and C3c,C4c and C5b-9 deposition.Result We successfully established the method to isolate and culture rASCs.The morphology of rASCs remained unchanged after passages.rASCs were positive for tell surface markers of CD44 and CD90,while negative for CD45 and MHC-Ⅱ.As compared with rLCs,rASCs significantly resisted human natural antibody and complement-mediated lysis when incubated with 20％ NHS in vitro (20.42％ ± 2.80％ vs 51.84％ ± 6.70％,P ＜ 0.01).Mechanistically,rASCs expressed lower level of α-Gal (13.97 ± 0.33 vs.24.47 ± 3.03,P＜0.05),which was correlated with decreased binding of human xenoreactive IgG and IgM (IgM:9.4 ± 2.0 vs.107.2± 4.8,P＜0.01; IgG:5.73 ± 1.0 vs.27.49 ± 3.9,P＜0.01) and reduced deposition of complements C3c,C4c and C5b-9 (C3c:294.6 ± 38.02 vs.1924 ± 509.4,P＜0.05; C4c:35.23 ± 3.1vs.177.3 ± 37.17,P＜0.05; C5b-9:5.63 ± 1.74 vs.37.05 ± 7.4,P＜0.01).Conclusion These data demonstrated that the resistance of rASCs to human xenoantibody and complement-mediated lysis is associated with low expression of xenoantigen a-Gal and inhibition of MAC (membrane attack complex) formation.

Objective To investigate the current situation and related risk factors of healthcare-associated infection (HAI),so as to provide evidence for making prevention and control measures of HAI.Methods On November 26, 2014,a combination method of bedside visiting and medical record reviewing was adopted to survey HAI status, pathogen examination,and antimicrobial application in all hospitalized patients in a tertiary first class military hospi-tal.Results A total of 1 657 hospitalized patients were investigated,66 patients developed 71 times of HAI,HAI rate and HAI case rate were 3.98% and 4.28% respectively.The top 4 departments with HAI prevalence rates were departments of neurosurgery (24.49%),hematology(19.05%),cadre ward(13.73%),and burn surgery (10.91 %).The top 5 HAI sites were lower respiratory tract (40.85%),urinary tract(23.94%),upper respirato-ry tract(12.68%),surgical site(9.86%),and gastrointestinal tract(5.63%).Of 66 cases of HAI,39 (59.09%) patients sent specimens for culture,a total of 48 pathogens were cultured,the major isolated bacteria was Esche-richia coli (n = 10,20.84%),followed by Staphylococcus aureus ,Klebsiella pneumoniae ,and Pseudomonas aeruginosa ,each was 7 (14.58 %)respectively.The usage rate of antimicrobial agents was 34.40%,specimen de-tection rate in patients receiving therapeutic and therapeutic+prophylactic antimicrobial agents was 59.28%.Risk factors for HAI were age <2 years old or >60 years,with respirator,tracheotomy,urinary tract catheterization, arteriovenous catheterization,hemodialysis,and surgery,difference was significant(all P <0.05).Conclusion Mo-nitoring on key departments and key sites of HAI should be strengthened,antimicrobial agents should be used rationally based on pathogenic detection results,specimen pathogenic detection rate should be improved,and effective prevention and control measures needs to be taken according to the risk factors of HAI.