Objective To investigate the clinical value of serum VEGF levels in the diagnosis and treatment of colon cancer.Methods Serum VEGF was detected by ELISA,and CEA and CA199 concentration were detected by CLEIA in 66 patients with colon cancer,55 patients with colon benign diseases and 50 health persons.The value of individual and joint detection for VEGF in colon cancer was evaluated.Analysis had been done on relationships between serum VEGF and pathology,treatment effects and prognosis.Results The levels of serum VEGF in colon cancer group [(318.5±148.6) ng/L] were significantly higher than those in control group [(125.7±49.4) ng/L] and benign colon diseases [(136.9±52.6) ng/L] (t =8.830,8.805,all P ＜ 0.01).There was a positive correlation between serum levels of VEGF and depth of tumor size,tumor invasion,lymph node metastasis and TNM stage (P ＜ 0.01).The susceptibilities of VEGF,CEA,CA199 were 61％,45 ％,53 ％.The sensitivity of detection was improved to 86 ％ when the combined detection of VEGF,CEA and CA199 (x2 =11.237,P ＜ 0.01).The serum levels of VEGF in patients with colon cancer was significantly decreased after treatment in the 3,7,10 day compared with that before operation [(272.3±88.1),(236.8±77.4),(173.1±59.9) vs (318.5±148.6) ng/L,t=2.173,P ＜ 0.05; t =3.961,P ＜ 0.01; t=7.464,P ＜ 0.01],respectively.Conclusion The VEGF was related to the onset and progression and metastasis of colon cancer.It has clinical significancy for diagnosis of colon cancer and judgment of curative effect and prognosis.

OBJECTIVETo investigate the prevalence of hyposexuality, erectile dysfunction (ED) and defective ejaculation (DE) in the old and middle-aged males in Pingliang area.

METHODSThis investigation included 1 539 men aged > or = 50 years from 6 urban districts and 20 villages in the suburbs of Pingliang City, Gansu Province. We recorded and analyzed their scores on IIEF-5 and Brief Male Sexual Function Inventory for Urology (O'Leary 1995).

RESULTSA total of 1 230 subjects met the investigation criteria. They averaged 62.5 +/- 9.6 years of age (range 50-89 years), and were divided into four age groups: 50-59, 60-69, 70-79 and > or = 80 years. The mean scores on IIEF-5 were 0-25 (9.4 +/- 8.6), sexual desire 0-8 (2.3 +/- 2.1), and ejaculation 0-8 (3.6 +/- 3.0). Hyposexuality, ED and DE were defined as sexual desire score < or = 2, IIEF-5 score = 0-21, and ejaculation score < or = 2, respectively. Based on these criteria, the incidence rates of hyposexuality, ED and DE were 57.96%, 92.27% and 36.91%, respectively, with statistically significant differences among different age groups (P < 0.01).

CONCLUSIONThe prevalence of ED, hyposexuality and DE, particularly the incidence of ED, is positively correlated with the increase of age in the old and middle-aged males in Pingliang area.

Aged ; Aged, 80 and over ; China ; epidemiology ; Erectile Dysfunction ; epidemiology ; Humans ; Male ; Mental Disorders ; epidemiology ; Middle Aged ; Prevalence ; Sexual Behavior ; Sexual Dysfunctions, Psychological ; epidemiology ; Surveys and Questionnaires

Objective To study the clinical therapeutic effectiveness and the mechanism of Shouti Oral Liquid on simple obesity children with hyperinsulinism. Methods Fourty - three patients were divided randomly into the treatment group (TG) and the control group (CG). TG took Shouti Oral Liquid and CG took metformin. The course of therapy lasted 6 months. The plasma lipid, body fats, insulin resistance index (IR) and some hormones related to obesity before and after therapy were measured and the changes were analyzed. Results The weight, F% , body mass index (BMI), leptin(LP), tumor necrosing factor (TNF - ?), FINS, IR all declined markedly than pre - therapy in both groups. The significant effect, normal effect and total efficiency were 22.7 % , 59.1 %, 81.8 % respectively in TG and9.5%,52.4%,61.9% in CG. The effect in TG was better than that in CG. A short course with Shouti Oral Liquid therapy did not have obvious side effect Conclusions There are lipid metabolism disorder, insulin resistance and high lever LP and TNF - ? obesity children with hyperinsulinism. The total effect with Shouti Oral Liquid is better than that with medicine in the control group and the mechanism was regulating lipid metabolism, decreasing LP and TNF-? and ameliorating insulin resistance.

ObjectiveTo explore the changes of systemic inflammatory response syndrome (SIRS)after cardiopulmonary resuscitation to provide basis for clinical prevention and treatment. MethodsForty rabbits were divided into the sham-operated group; the cardiac arrest for 4 minutes, 5 minutes and 6 minutes groups randomly (random number). Then the rabbits were anaesthetized, retrograde tracheal intubated .The cardiac arrest were induced by aphysia to all rabbits except the sham-operated group and the cardiopulmonary resuscitation were performed after 4, 5 and 6 minutes. The physiological parameters were evaluated at 24, 48, 72, 96 and 120 h after cardiac arrest. The serum samples were taken at the same to detect the level of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and white blood cell.The data were analysed by repeated measure variance. ResultsThe SIRS were presented at all cardiopulmonary resuscitation groups after 24 h of cardiac arrest. Compared to the sham-operated group, the level of TNF-α and CRP in resuscitation groups was significantly increased ( P ＜ 0. 01 ). To the group arrested for 4 minutes, the SIRS were higher at 24 ～ 48 h and dissipated at 72 h. To the groups arrested for 5 or 6minutes, SIRS were lasted for 96 h. ConclusionsSIRS is easy to recover if resuscitation was taken within 4 minutes after cardiac arrest. After 5 minutes, SIRS is severe and hard to recover. Serum TNF-α is a sensitive marker to evaluate SIRS and can be used as the supplymentary diagnosic marker of SIRS to providing early treament and prevention.

Objective To study the techniques and outcomes of using a retrograde pedicled vascularized radius bone flap based on the 1st,2nd intercompartmental supraretinacular artery (1,2ICSRA) for scaphoid nonunion through dorsal and palmar approaches.Methods Between March 2013 and April 2015,16 patients with scaphoid nonunion were treated by surgery through palmar and dorsal approaches.There were 14 males and 2 females with an average age of 29.1 years (range,19-51 years).The location of lesion was 6 cases on the left and 10 cases on the right.5 cases were treated with plaster fixation.11 cases weren't treated after wrists injured.The preoperative time was 6-26 months,with an average of 16.5 months.The operation was completed within one incision.The bone flaps based on 1,2ICSRA were taken through dorsal approach.The broken ends of the scaphoid fracture were cleaned,and the deformity was corrected with bone grafting and internal fixation through palmar approach.Time of fracture union and wrist pain resolution was evaluated.Wrist motion and grip strength were measured and compared.The result of the latest follow-up was used as the criterion for efficacy evaluation.The wrist pain was evaluated using visual analogue scale (VAS) and the postoperative wrist function based on the modified Mayo wrist score was recorded.Results Post-operative follow up ranged from 6-19 months,with an average of 11 months.Bone union was achieved in all the cases,so the healing rate was 100％.7 cases were healed in 11 weeks.5 cases were healed in 13 weeks.3 cases were healed in 15 weeks.1 case was healed in 17 weeks.The average healing time was 12.5 weeks.The humpback deformity of Scaphoid and DISI of 7 cases were corrected.The bending of wrist could reach 60.2°±3.2°,and the elongation could reach 51.3°± 3.5°.The radial deviation of wrist could reach 13.6°±1.42°,and ulnar deviation could reach 24.4°±1.8°.The range of grip strength was 29-64 kg,with an average of 45 kg.The 16 patients returned to normal work.The pain after wrist movement of 14 cases was completely disappeared,and the VAS was 0.Two cases felt slight pain when wrist was overworked,and the VAS were 0.9 and 1.2.The wrist joint function of patients recovered well.The modified Mayo score was 69-99,with an average of 90.75.The functional results were 12 excellent,2 good,and 2 fair,and the excellent and good rate was 87.5％ (14/16).No complications such as infection,failure of screws,orthopaedic arthritis or scaphoid necrosis were found during the follow-up period.Conclusion The technique of 1,2 ICSRA pedicled bone graft and palmar bone grafting for nonunion of scaphoid can provide convenience for us to deal with the broken ends of the scaphoid fracture,correct the malformation and graft bone through dorsal and palmar approaches.This method can protect the blood supply of the scaphoid,and promote scaphoid union.

Objective To determine the independent risk factors for sepsis in patients with large area burns.Methods The study enrolled 307 patients with large area burns treated from June 2014 to June 2015.Related variables included age,gender,visit time,emergency eschar open,burn index,tangential excision of eschar during shock stage,delayed resuscitation during shock stage,oxygen pressure(PaO2),carbon dioxide pressure (PaCO2),assisted ventilation mode,mechanical ventilation time,inhalation injury,prophylactic tracheotomy,continuous lactic acid rise,refractory hypernatremia,heart-lung disease history,and diabetes history.Correlation of the variables with the incidence of sepsis was observed.Independent predictors of sepsis in patients with large burns were differentiated using the Logistic regression analysis.Results Delayed resuscitation during shock period (OR =1.747,95％ CI 1.822-7.431,P ＜ 0.05),continuous lactic acid rise (OR =1.758,95％ CI 1.137-4.002,P ＜ 0.05),refractory hypernatremia (OR =2.985,95％ CI 1.074-6.782,P ＜ 0.05),moderate and severe inhalation injury(OR =14.764,95％ CI 0.892-47.323,P ＜ 0.05) and burn index (OR =5.017,95％ CI 1.075-23.572,P ＜ 0.05) were found be independently associated with sepsis in patients with large burns.Conclusions These independent risk factors for sepsis in large area burn patients deserve more attention.Early and timely treatment measures may reduce the incidence of sepsis.

Objective To evaluate the efficacy and safety of dorsal ligament reconstruction in treatment of old dorsal dislocation of distal radioulnar joint.Methods Seven patients with old dorsal dislocation of distal radioulnar joint were treated with dorsal ligament reconstruction using the palmaris longus tendon from March 2005 to May 2012 in our institute,including 4 males and 3 females with a mean age of 37 years.All patients had a history of wrist injury for more than 3 months and were diagnosed as isolated dislocation of distal radioulnar joint without fractures.During the operation a bone tunnel was made at dorsal ulnar side of radius near the ulnar notch,which was parallelized to long axial of ulna,two holes were drilled from dorsal to palmarulnaris side through the extensor carpi ulnaris sulcus of the ulna.The palmaris longus tendon was harvested and the strip of the tendon was penetrated through the radial hole.After the tips being crossed,put them through the holes of ulna,reduct the distal radioulnar joint by supinating the forearm,the strip of the tendon was sutured after being tightened,the reversed back the free end of the tendon to reconstruct the sheath of extensor carpi ulnaris tendon.Postoperatively,the upper extremity were kept in a long arm plaster in the position of elbow flexion 90° and forearm supination for 3 weeks,then the below elbow cast was replaced for another 3 weeks.Results Patients were followed-up for 1 year and 8 months 4 years and 2 months with the average of 2 years and 9 months.The rotation of wrist was improved and the handgrip strength was increased significantly.A functional evaluation was performed using the modified Mayo wrist scoring system.All patients had better wrists scores postoperatively (mean,93) compared to preoperatively (mean,68).All patients satisfied with the final result.Conclusion Dorsal ligament reconstruction should be a promise surgical modality for the old dorsal dislocation of distal radioulnar joint.

OBJECTIVETo investigate the prevalence of benign prostatic hyperplasia (BPH) in Pingliang City of Gansu Province.

METHODSWe performed a cross-sectional randomized study of 836 men aged > or = 40 years from 26 communities of Pingliang, obtained their IPSS, measured the prostate volume by transabdominal ultrasonography, recorded the maximum flow (Qmax) by uroflowmetry, and processed the data by one-way analysis of variance.

RESULTSTotally 820 subjects meeting the study criteria were included in the investigation. The men ranged in age from 40 to 83 years, averaging 61.5 years. The mean IPSS, prostate volume and Qmax were 9.3 +/- 7.8, (29.2 +/- 18.6) ml and (15.3 +/- 7.2) ml/s, respectively, all correlated with age. The prevalence of moderate-severe lower urinary tract symptoms (LUTS) was 46.8% (384/820). The prostate volume was > 20 ml in 63.5% (521/820), and Qmax <15 ml/s in 48.5% (398/805) of the subjects. The incidence rate of BPH, defined as IPSS >7, Qmax <15 ml/s and prostate volume > 20 ml, was 23.5% (193/820).

CONCLUSIONAmong the men aged > or = 40 years in Pingliang, LUTS and prostate volume were correlated positively, while Qmax negatively with age, and the prevalence of BPH was 23.5%.

Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Humans ; Male ; Middle Aged ; Organ Size ; Prevalence ; Prostate ; pathology ; Prostatic Hyperplasia ; diagnosis ; epidemiology

Objective To explore the clinical application effect of multiple end-to-side anastomosis in free anterolateral thigh perforator flap transplantation.Methods From January,2013 to October,2017,29 cases were applied the technology of multiple end-to-side anastomosis to the same recipient vessel in anterolateral thigh perforator flap transplantation for wound repair.Fifteen cases treated with multiple end-to-side anastomosis on flap arteries,and 2-3 arteries were anastomosed,with the average of 2.13.Nine cases were treated with venous multiple end-to-side anastomosis,and 2-4 veins were anastomosed,with the average of 3.11.Five cases treated with arterial and venous multiple end-to-side anastomosis,and 4-6 vessels were anastomosed,with the average of 5.20.Distribution of wounds:10 cases with hands and wrists wounded,15 cases with forearms and elbow joints wounded,and 4 cases with lower legs and feet wounded.The soft tissue defect size was 5 cm×13 cm-11 cm×27 cm,and the flap area was 6 cm× 15 cm-12 cm×29 cm.Postoperative followed-up was performed every 3-6 months to review flap survival.Results All flaps of 29 cases survived.Venous congestion occurred in 2 flaps within 48 h after the operation,among which,1 was overcomed after released the dressing and sutures,and the other underwent surgical exploration.The venous end-to-side anastomotic stomas were unobstructed,and hematoma was formed.After the hematoma compression was removed,circulation was recovered and the flap survived.With followed-up for 6 months to 2.5 years,both donor site and recipient site of the flaps healed well and the injured distal limbs had no hemodynamic disorder.Conclusion The application of multiple end-to-side anastomosis to the same recipient vessel for free transplantation of anterolateral thigh perforator flaps is safe and reliable.

Objective To report operative course and relative complications in a group of patients who underwent Excessive Pressure Regulation System (Ex-PRESS) glaucoma shunt implantation in the real world,and discuss the ralated factors and possible interventions in clinical practice.Methods Preferred Ex-PRESS glaucoma shunt implantation were performed on 11 eyes with deverse types of glaucoma.Operative course and relative complications were analyzed from recorded tapes and documents.The correlations between complications,types of glaucoma,and previous procedures were analyzed,the complications were appropriately managed.Results 11 patients with diverse types of glaucoma who underwent Ex-PRESS glaucoma shunt implantation were recruited for the study.Among them,2 patients had combined phacoemulcification surgery,1 patient had repeat shunt implantation.During the procedure,1 patient had dislocated shunt into anterior chamber;1 patient had shunt entirely inserted into anterior chamber with plunger.4 patients had hypotony and flat anterior chamber,2 of them had hyphema,2 experienced subchoroid detachment.1 patient had intraocular lens pupil clamping after combined cataract and glaucoma surgery;4 cases had flat filtering blebs and uncontrolled intraocular pressure during the follow-up period,2 of them had blocked drainage and proliferative anterior synechia around the head,which was found in the patients with primary angle-closure glaucoma who had previous operation history.The common long-term complication was external ostium occlusion (4/11).The complications of drainage are related to the type of glaucoma and the history of operation.Conclusions Other than the complications which present commonly in trabeculectomy procedure,there were some complications related to the Ex-PRESS glaucoma shunt.History of ocular surgery,surgical techniques and the type of disease were associated with the incidence of complications.