The paper summarized the successful experience such as preliminarily establishing cultivation mechanism of manufacture-learning-research cooperation for postgraduates of science of Chinese pharmacology of Guangzhou University of Chinese Medicine,ensuring innovation ability training for postgraduates,getting reasonable configuration for social education resources,and put forward existing problems in traditional Chinese medicine system,such as the loose management and faulty evalution system.Suggestion is to futher perfect relevant rules and regulations,clear and definite responsibility of school and enterprise,reserch regularly to impove ideological education of postgraduates,etc.In the way,we can achieve the aim of promoting high-level talents of traditional Chinese medicine industry.

This review provides an overview of the pharmacology mechanism of sildenafil. The efficacy and safety of the medicine are briefly summarized. The special conclusion was made for the usage of sildenafil to the particular patients such as those with hypertension or those taking any antihypertensive agent, with cardiovascular disease, with diabetes, with spinal cord injury, after radical prostatectomy and on chronic dialysis. In general, sildenafil is effective and safe for various ED patients.
Antihypertensive Agents ; adverse effects ; Diabetes Complications ; Drug Interactions ; Erectile Dysfunction ; drug therapy ; Heart Diseases ; complications ; Humans ; Male ; Phosphodiesterase Inhibitors ; therapeutic use ; Piperazines ; adverse effects ; therapeutic use ; Prostatectomy ; adverse effects ; Purines ; Sildenafil Citrate ; Spinal Cord Injuries ; complications ; Sulfones

OBJECTIVETo introduce the application of percutaneous epididymal sperm aspiration (PESA) in the differential diagnosis between obstructive and non-obstructive azoospermia, and to investigate the association of the results of PESA with testis volume and the level of serum follicle stimulating hormone (FSH).

METHODSA total of 118 patients with diagnosed azoospermia were included. Their testis volume was measured by model method, the serum gonadal hormone level examined by chemoluminescence assay, and the epididymal fluid obtained by puncturing the head of the epididymis with a size-7 butterfly needle.

RESULTSSperm was found in the epididymal fluid in 60 of the patients, 56 with normal and 4 with smaller testis volume, and 55 with normal and 5 with higher FSH level. No sperm was detected in the other 58 cases, 34 with normal and 24 with smaller testis volume, and 38 with normal and 20 with higher serum FSH level. The rate of successful PESA was significantly higher in patients with normal testis volume or normal serum FSH level than in those with smaller testis volume (P < 0.05) or higher serum FSH level (P < 0.05).

CONCLUSIONPESA is a quick, convenient and effective method for the differential diagnosis between obstructive and non-obstructive azoospermia.

Adult ; Azoospermia ; diagnosis ; Epididymis ; Follicle Stimulating Hormone ; blood ; Humans ; Male ; Middle Aged ; Punctures ; methods ; Spermatozoa ; Testis ; pathology

To systematically construct a guideline to provide a methodological guide for researchers to develop patient decision aids.

Through a literature review of international methodological guidance for developing patient decision aids, sorting out the similarities and differences in the processes and methods for developing patient decision aids, and combining them with the topic discussion of the working group, the initial guideline was drafted.

A total of 13 guidances was included, with the initial version containing 3 phases, 13 steps, and 48 points. We invited 19 multidisciplinary domain experts for forming consensus. The final version of the guideline contains 3 phases, 11 steps, and 24 points.

The guideline has great potential to guide the development of patient decision aids in China and is expected to fill the methodological gap in the field. In the future, several rounds of pilot testing of the guideline based on specific decision issues will be conducted, and the guideline will be further revised and improved.

Intra-abdominal infection (IAI) is a deadly condition in which the outcome is associated with urgent diagnosis, assessment and management, including fluid resuscitation, antibiotic administration while obtaining further laboratory results, attaining precise measurements of hemodynamic status, and pursuing source control. This last item makes abdominal sepsis a unique treatment challenge. Delayed or inadequate source control is an independent predictor of poor outcomes and recognizing source control failure is often difficult or impossible. Further complicating issue in the debate is surrounding the timing, adequacy, and procedures of source control. This review evaluated and summarized the current approach and challenges in IAI management, which are the future research directions.
Anti-Bacterial Agents/administration & dosage* ; Drainage ; Fluid Therapy ; Hemodynamics ; Humans ; Intraabdominal Infections/therapy* ; Laparoscopy ; Laparotomy ; Prognosis ; Sepsis

The clinical mortality rate of paraquat poisoning is high. At present, plasma paraquat concentration, urinary paraquat concentration, various scoring systems, and serological indicators are used to predict the prognosis of patients so that clinicians can estimate the condition of patient correctly and take appropriate treatment. Compared with other prediction Methods , serological indicators have the advantages of convenience, availability, low price, instant accuracy and repeatability, and have good predictive value for the prognosis of paraquat poisoning patients. In this paper, the research progress on the prognostic value of serological indicators in patients with paraquat poisoning in recent years is reviewed.

From January 2008 to January 2013, 11 patients with central renal tumors underwent ultrasound-guided open nephron sparing surgery (ONSS) without renal artery occlusion. We removed the lesions, and the cut edges of the tumors were negative. Thus, we deduced that ultrasound-guided ONSS is suitable for the cases with obscure tumor boundary or multiple lesions. It could achieve the purpose of thoroughly removing lesions, as well as to expand the application range of nephron sparing surgery.
Arterial Occlusive Diseases ; etiology ; prevention & control ; Carcinoma, Renal Cell ; surgery ; Female ; Humans ; Kidney Neoplasms ; surgery ; Male ; Nephrons ; surgery ; Postoperative Complications ; Renal Artery ; pathology ; surgery ; Surgery, Computer-Assisted ; adverse effects ; methods ; Ultrasonography

【Objective】 To investigate the clinicopathological features and prognosis of clear cell papillary renal cell carcinoma (CCPRCC). 【Methods】 The clinicopathological and follow-up data of 40 CCPRCC patients treated during Jun. 2011 and Oct.2021 were retrospectively analyzed. The prognosis was compared with that of 40 cases of clear cell renal cell carcinoma (ccRCC) and 19 cases of papillary renal cell carcinoma (PRCC) treated in the same period. Survival analysis was performed by Log-rank test and Kaplan-Meier survival curves were plotted. 【Results】 Among the 40 patients, 28 were male and 12 were female, aged 31-84 years; 38 cases had unilateral and 2 cases had bilateral tumors; 3 cases had multifocal lesions. All patients received surgery. The maximum diameter of the masses ranged from 3.0 to 95.0 mm, with an average of (27.6±18.1) mm. Pathological grade was Fuhrman 1-2 in all cases. Immunohistochemical tests were positive for CK7 and CA-IX. During the follow-up of 5-129 (average 56) months, 1 case died after bone metastasis, 2 had ipsilateral recurrence, and 1 developed primary esophageal cancer. CCPRCC patients had a significantly better prognosis than CCRCC (P<0.001) and PRCC (P=0.005) patients, while there was no significant difference in the prognosis between CCRCC and PRCC patients (P=0.93). 【Conclusions】 CCPRCC has low malignancy. The diagnosis relies on characteristic pathological and immunohistochemical features. Surgery is an effective treatment. CCPRCC has a better overall prognosis than CCRCC and PRCC.

BackgroundIntestinal fistula is one of the common complications of Crohn's disease (CD) that might require surgical treatment. The clinical characteristics and outcomes of CD with intestinal fistula are much different from CD alone. This study was to investigate whether the coagulation status of CD is changed by intestinal fistula.

MethodsData were retrospectively analyzed for 190 patients with a definitive diagnosis of CD who were registered at the Jinling Hospital between January 2014 and September 2015. Baseline clinical characteristics and laboratory indices of initial admission and 7 days after intestinal fistula resections were collected. Student's t-test and the Wilcoxon rank-sum test were used to compare differences between the two groups.

ResultsCompared with CD patients without intestinal fistula, prothrombin time (PT) in patients with intestinal fistula was significantly longer (12.13 ± 1.27 s vs. 13.18 ± 1.51 s, P < 0.001 in overall cohort; 11.56 ± 1.21 s vs. 12.61 ± 0.73 s, P = 0.001 in females; and 12.51 ± 1.17 s vs. 13.37 ± 1.66 s, P = 0.003 in males). Platelet (PLT) count was much lower in intestinal fistula group than in nonintestinal fistula group (262.53 ± 94.36 × 10/L vs. 310.36 ± 131.91 × 10/L, P = 0.009). Multivariate logistic regression showed that intestinal fistula was significantly associated with a prolonged PT (odds ratio [OR] = 1.900, P < 0.001), a reduced amount of PLT (OR = 0.996, P = 0.024), and an increased operation history (OR = 5.408, P < 0.001). Among 65 CD patients receiving intestinal fistula resections, PT was obviously shorter after operation than baseline (12.28 ± 1.16 s vs. 13.02 ± 1.64 s, P = 0.006).

ConclusionsIntestinal fistula was significantly associated with impaired coagulation status in patients complicated with CD. Coagulation status could be improved after intestinal fistula resections.

Background: Treatment with the dipeptidyl peptidase-4 inhibitors (DPP4i) and angiotensin receptor blockers (ARBs) in patients with type 2 diabetic nephropathy (DN) has not been well characterized. This study aimed to assess the renoprotection of this combined treatment in DN patients. Methods: A total of 159 type 2 DN patients from 2013 to 2015 were enrolled retrospectively from a prospective DN cohort at the National Clinical Research Center of Kidney Diseases, Jinling Hospital (China). Fifty-seven patients received DPP4i and ARB treatment, and 102 patients were treated with ARBs alone. All patients were followed up for at least 12 months. Statistical analyses were performed using Stata version 12.0. Results: There were no significant differences at baseline for age, sex, body mass index, duration of diabetes, fasting blood glucose (FBG), hemoglobin A1c (HbA1c), and estimated glomerular filtration rate (eGFR) between the two groups. Antihypertensive and antidiabetic medication use was similar in each group except calcium channel antagonists (P = 0.032). No significant changes in FBG and HbA1c were observed in the two groups after treatment. The eGFR decreased slower in the DPP4i + ARB group than in the ARB group at 12 months (Δ12 months: -2.48 ± 13.86 vs. -6.81 ± 12.52 ml·min·1.73m, P = 0.044). In addition, proteinuria was decreased further in the DPP4i + ARB group than in the ARB group after 24 months of treatment (Δ24 months: -0.18 [-1.00, 0.17] vs. 0.32 [-0.35, 0.88], P = 0.031). There were 36 patients with an eGFR decrease of more than 30% over 24 months. After adjusting for FBG, HbA1c, and other risk factors, DPP4i + ARB treatment was still associated with a reduced incidence of an eGFR decrease of 20% or 30%. Conclusions The combined treatment of DPP4i and ARBs is superior to ARBs alone, as evidenced by the greater proteinuria reduction and lower eGFR decline. In addition, the renoprotection of DPP4i combined with ARBs was independent of glycemic control.
Aged ; Angiotensin Receptor Antagonists ; therapeutic use ; Diabetic Nephropathies ; drug therapy ; Dipeptidyl-Peptidase IV Inhibitors ; therapeutic use ; Female ; Humans ; Losartan ; therapeutic use ; Male ; Middle Aged ; Prospective Studies ; Retrospective Studies