Late-onset hypogonadism (LOH) is a clinical and bio-chemical syndrome associated with advancing age in males and seriously affects the quality of life of some of the patients. A classical therapeutic option for LOH is testosterone supplementary treatment (TST). Its effectiveness has been verified, whereas its long-term safety remains to be further evaluated. With deeper insights into LOH, many new therapeutic strategies have been proposed, which include the treatments with gonadotropins, testosterone precursors (such as dehydroepiandrosterone [DHEA]), non-aromatizable androgens (such as dihydrotestosterone [DHT]), antiestrogens (such as aromatase inhibitors and estrogen receptor antagonists), and Chinese medicine. Meanwhile, studies on the transplantation of Leydig stem cells, selective androgen receptor modulators (SARMs), and selective estrogen receptor beta (ERbeta) agonists have shed new light on the treatment of LOH.
Humans ; Hypogonadism ; drug therapy ; surgery ; therapy ; Male ; Testosterone ; therapeutic use

0.05).Duodenal perforation did not occur in 2 groups.Conclusions TP may significantly reduce the frequency of apnoea and vomiting and improve feeding tolerance in VLBWI,it can be used in VLBWI with suspected gastroesophageal reflux.

Objective To explore clinical effect and safety of intermittent androgen suppression treatment of advanced prostate cancer in elderly patients.Methods 78 patients with advanced prostate cancer were enrolled,and randomly divided into the observation group and the control group (n=39 each).Patients in observation group were treated with intermittent androgen suppression treatment.Patients in control group were treated with persistent androgen suppression treatment.Results The time of therapy was much longer in observation group than in control group (P＜ 0.001).Quality of life was better in observation group than in control group (P＜0.05).The incidences of adverse reactions including anemia,fever and abnormal liver function were lower in observation group than in control group (all P＜0.05).Conclusions Intermittent androgen suppression treatment prolongs time to androgen-independent progression,improve the quality of life,reduce drug dosage and the incidence of adverse reactions in the treatment of advanced prostate cancer in the elderly.

Objective To evaluate the diagnostic value of urine-based prostate cancer antigen 3 ( PCA3 ) score in detecting prostate cancer during initial prostatic biopsy .Methods Urine was collected after digital rectal examination ( DRE) ( three strokes per lobe ) from 248 men before prostate biopsy .The specimens were collected between January 2010 and December 2012.The expression of PCA3 mRNA and prostate specifc antigen (PSA) mRNA was determined by quanti-tative real time polymerase chain reaction ( qRT-PCR ) .PCA3 scores were calculated by PCA 3 mRNA/PSA mRNA × 1000 .The ability of the PCA3 score to predict the biopsy outcome was assessed with AUC-ROC analysis and compared with the serum PSA levels.Results The rate of positive prostate biopsy was 32.3%(80 patients with positive prostatic biopsy versus 168 patients with negative prostate biopsy ) .PCA3 scores were significantly higher in patients with positive biopsy than in those with negative biopsy results (P<0.001).The ROC curve analysis demonstrated that the area under the ROC curve (AUC) of serum total PSA (tPSA), PCA3 score and the duplex model combining tPSA and PCA 3 score was 0.620, 0.693 and 0.724, respectively.Further analysis of the diagnostic performance of PCA3 score revealed that at a cut-off of 90.2456, the sensitivity was 67.5%and the specificity was 61.9%for discriminating positive biopsy from negative biopsy. The duplex model combining tPSA and PCA 3 score represented a better approach than tPSA alone in PCa diagnosis by pros-tatic biopsy (P=0.011), but there was no statistically significant difference between tPSA and PCA 3 score (P=0.160). In addition , a comprehensive diagnostic model based on multiple risk factors of prostate cancer combined with PCA 3 score could further improve the predictive accuracy of prostate cancer .Conclusion PCA3 could be a good predictor of prostate cancer in initial prostate biopsy in Chinese population .The comprehensive diagnostic model can improve the diagnostic potency .Further large-scale multicenter studies in China are needed to confirm our findings .

?AIM:To investigate the correlation between dry eye and different degrees of diabetic retinopathy ( DR ) in type 2 diabetic patients.?METHODS: In the cross-sectional study, 340 patients (340 eyes) with type 2 diabetes were enrolled. Tear film function tests including tear meniscus height, tear film breakup time ( BUT ) , fluorescein staining, Schirmer Ⅰtest were performed followed by surveying questionnaires about dry eye. Retinal status was evaluated by retinal color photography and indirect ophthalmoscopy exam with dilated pupils to evaluate DR and whether companied by macular edema.?RESULTS:The prevalence of dry eye was 49. 41%. The mean duration of diabetes in patients with dry eye was 11.15±7.07a, while 6.92±5.45a without dry eye(P<0.01). Dry eye had the positive correlation to the development of DR. The incidence of dry eye in people with mild nonproliferative diabetic retinopathy ( NPDR ) , moderate NPDR, severe NPDR and proliferative diabetic retinopathy (PDR) was 1. 097 times, 1. 724 times, 2. 86 times and 5. 43 times respectively, compared with people without DR. The occurrence of dry eye in people with macular edema increased by 3. 697 times compared with people without macular edema.?CONCLUSION: Dry eye was more prevalent in people with type 2 diabetes. The incidence of dry eye increased gradually with the occurrence and development of diabetic retinopathy.

OBJECTIVETo evaluate a expanded reverse island flap with a saphenous neuro-vascular pedicle for repairing the defects of the feet and ankles.

METHODSAn expanded reverse island skin flap, with the Six saphenous neuro-vascular pedicle, was designed to repair the skin defects on the feet and ankles.

RESULTSpatients with the defects of the feet and ankles were treated with the expanded saphenous island flap and all of the The expanded reversed island skin flaps were survived. The largest flap size was 12 cm x 10 cm.

CONCLUSIONSflap could be a good option for repairing the defects of the feet and ankles.

Adolescent ; Adult ; Ankle Injuries ; surgery ; Child ; Female ; Femoral Nerve ; surgery ; Graft Survival ; Humans ; Male ; Middle Aged ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; innervation ; Young Adult

Objective To study feasibility in extraction of calcific sign within pulmonary nodules with pattern classification.Meth-ods 49 cases with pulmonary nodules (benign in 16 and malignant in 33)confirmed by pathology or clinical follow-up were included in this study and all cases underwent chest CT examinations.CT images were interpreted double-blind by two associate chief radiolo-gists to draw a conclusion that there were any calcification within pulmonary nodules.Meanwhile,the calcifications in the regions of interest(ROI)on CT images were estimated with extraction of the sign of gray value,geometric and lung markings in ROI,and based on pattern classification algorithm at supporting vector machine(SVM).Results According to the results assessed by senior radiologists for classification within pulmonary nodules,the area under ROC curve was 0.95 which was extracted by automatic pat-tern classification algorithm,the extraction performance was stable(k=1),and was goodness fit with visual observation by doctors (k=0.939).Conclusion The ability of automatic pattern classification in detecting calcification within pulmonary nodules is about the same as that of visual assessment by senior doctors.

Autosomal dominant polycystic kidney disease (ADPKD) is a most common inherited renal disease, about 50% with a family history, although the exact etiology not yet clear. To date, ADPKD, a multisystem disorder without effective preventive and therapeutic means, has been shown to be detrimental to human health. Recent studies show that severe oligoasthenozoospermia, necrospermia, immotile sperm, azoospermia, epididymal cyst, seminal vesicle cyst, and ejaculatory duct cyst found in male ADPKD patients may lead to male infertility, though the specific mechanisms remain unknown. Structural anomaly of spermatozoa, defect of polycystin, mutation of PKD genes, and micro-deletion of the AZF gene could be the reasons for the higher incidence of abnormal semen quality in male ADPKD patients. Assisted reproductive techniques can increase the chances of pregnancy, whereas the health of the offspring should be taken into consideration. This article presents an overview of reproductive issues concerning infertile male ADPKD patients from the perspective of the morbidity, pathophysiological mechanism, diagnosis, and management of the disease.
Cysts ; pathology ; Ejaculatory Ducts ; pathology ; Female ; Humans ; Infertility, Male ; physiopathology ; Kidney ; pathology ; Male ; Mutation ; Polycystic Kidney, Autosomal Dominant ; physiopathology ; Pregnancy ; Reproductive Techniques, Assisted ; Semen Analysis ; Spermatozoa ; pathology

Objective To explore the risk factors for asthma in children.Methods A 1:1 matched and hospital-based case-control study was conducted to analyses risk factors for asthma in 300 pairs of children by logistic regression analysis. Results The result of univariate Logistic regression analysis showed that there were 17 related factors for children asthma, including disease history of parents in respiratory system,family income,atopie character,history of acute respiratory infections, eating habit,the amount of sea foods intakes,foam plastics,family decoration,the way of exhaust fume in kitchen,the exhaust effectiveness,raising pet in house,family history of asthma,family history of allergic rhinitis,family history of food allergy,dust allergy of parents,systemic therapy after the first attack.With multivariate Logistic regression analysis,7 factors were entered the model,6 risk factors including father's history of respiratory diseases(OR 3.771,95%CI 1.533～9.278),low family income(OR 1.503, 95%CI 1.258～1.795),atopy(OR 3.788,95%CI 2.368～6.058),meat-eating habit(OR 2.042,95%CI 1.481～2.815),asthma history of family members(OR 1.710,95%CI 0.988～2.958),the family history of allergic rhinitis(OR 1.991,95%CI 1.234～3.211), and 1 protective factor of raising pet in house(OR 0.443,95%CI 0.265～0.739).The coefficients of these factors in multivariate logistic regression model were 1.327、0.407、1.322、0.714、0.536、0.689、and-0.814 respectively.Conclusion Children asthma was a multi-factorial complex disease,and the interaction of environmental and genetic risk factors played an important role in the onset of this disease.

Objective To compare the outcomes of powered-assisted septoplasty with CO_ 2 laser-assisted septoplasty. Methods Thitry patients with limited deviation of nasal septum were analyzed retrospectively. Among 30 patients, 18 underwent powered-assisted septoplasty and the rest underwent CO_ 2 laser-assisted septoplasty. The surgical results were assessed by the visual analogue scale (VSA) and acoustic rhinometry. Results VSA scores significantly improved in both groups after surgery (P