Objective: To investigate the association of serum leptin level with erectile dysfunction (ED). Methods: A total of 38 out-patients complaining ED were graded by using IIEF-5 questionnaire. The mean IIEF-5 score of the patients was (12.3±2.4)and no one was higher than 21. The patients were divided into 3 groups according to their scores. The fasting serum leptin levels were determined by ELISA in 38 patients (patient group) and 15 healthy controls (control group). Their body weights and heights were measured for body mass index(BMI). Results: Serum leptin levels were significantly correlated with BMI in both groups, regardless of patient ages and history. The mean leptin level in patients was (10.16±8.67) μg/L, which was significantly higher than that in the healthy controls ([4.81± 3.66] μg/L, P<0.05) after adjusting the effect of BMI. The leptin levels in the mild, moderate, and severe ED groups were (6.98±4.99) μg/L, (10.3±9.51) μg/L and (13.1±10.02) μg/L, respectively, with that of the mild group being significantly lower than those of the latter two groups (P<0.05). Conclusion: It is indicated that human serum leptin level may have a potential value in diagnosing ED.

BACKGROUND: Most of the patients suffered from degenerative lumbar instability are treated by exposure both sides and bilateral pedicle screw fixation,which bring highly operative risk,large blood loss and great medical expenditure to patients.OBJECTIVE: To explore the clinical efficacy of single cage plus unilateral pedicle screw placement for treating lumbar degenerative instability.METHODS: Totally 51 cases with lumbar degenerative instability underwent single cage plus unilateral pedicle screw placement were selected,including 32 males and 19 females,aged ranging from 41 to 72 years.47 cases had single segment involved and 4cases had two segments involved.All cases experienced unilateral laminectomy and transforamenal lumbar interbody fusion.The therapeutic effect was assessed by Japanese Orthopaedic Association(JOA)score system.RESULTS AND CONCLUSION: The blood loss was 90-430 mL.The surgical time was 100 minutes(85-120 minutes)for single segment and 150 minutes(120-170 minutes)for double segments.The patients were allowed to early ambulation at 2-3 days after operation.Two cases did not get improvement on back-leg pain,but there was no abnormality from CT and MRI recheck,one case felt pain relieved after anti-symptom treatment for 3 months while the other did not relieve.The average JOA scores at pre-operation and 1 year follow-up was 11(7-13 scores)and 25(18-27 scores),respectively.The total improvement rate of JOA was larger than 50%.44 cases were evaluated as fusion and 7 cases as possible fusion.The average fusion time was 5.4 months(4.3-7.1 months).Postoperative X-ray showed no evidence of pedicle screw loosening,broken,or cage displacement.Single cage plus unilateral pedicle screw placement is characterized by simple operation,small blood loss,short operation and few interference to spine,which is a better method for treating lumbar degenerative instability.

Heart Failure ; prevention & control ; Humans ; Mitochondria

OBJECTIVETo explore the methods and outcomes of a minimally posteromedial transverse incision in the hip knee flexion for the treatment of tibial avulsion fracture at the insertion of posterior cruciate ligament (PCL).

METHODSTwenty-one patients with tibial avulsion fracture at the insertion of PCL treated with a minimally posteromedial transverse incision in the hip knee flexion by cannulated screw fixation from March 2010 to March 2013 were retrospectively analyzed. There were 13 males and 8 females with an average age of 35.1 years old (ranged, 20 to 56 years). Eleven cases caused by traffic accident, 3 caused by falling, 4 caused by sport, 3 caused by heavy pounds. The injury duration ranged from 3 hours to 9 days with a mean of 3.5 days. The results of posterior drawer test were positive in all patients. Lysholm score was used to evaluated knee joint function.

RESULTSAll operations were successful without infection, vessel and nerve injuries and all incisions healed by first intention with the mean length of 5.8 cm (ranged, 5 to 6 cm). All patients were followed up from 7 to 23 months with an average of 12.7 months. The results of posterior drawer test were negative in all patients. X-ray films showed that all fractures healed. The Lysholm score was improved from preoperative 40.76±9.55 to 95.86±2.33 final follow-up (t=30.07, P=0.000).

CONCLUSIONTreatment of tibial avulsion fracture at the insertion of the posterior cruciate ligament through a minimally posteromedial transverse incision in the hip knee flexion with cannulated screw fixation is a better surgical procedure with the advantages of minimal incision, sufficient exposure, effective fixation, small scar and satisfactory effects.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Hip Joint ; surgery ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Posterior Cruciate Ligament ; surgery ; Tibial Fractures ; surgery

Objective To explore the prognostic value of the content of lentil lectin-reactive alphafetoprotein-L3(AFP-L3)in early-stage hepatocellular carcinoma(HCC).Methods According to the content of alpha.fetoprotein(AFP)and AFP-L3 before the treatment,97 patients with early-stage HCC were divided into group A(AFP＞20 μg/L & AFP-L3＜15%,n=29),group B(15%≤AFP-13≤50% & 20 μg/L≤AFP≤200 μg/L,n=16),group C(AFP-13＞50%& AFP＞200 μg/L,n=13),group D(AFP-L3＞50% & 20 μg/L≤AFP≤200 μg/L,n=24)and group E(15%≤AFP-L3≤50%& AFP＞200 μg/L,n=15).The degree of tumor differentiation,the 1-,2-,3-year survival rates and tumor-free survival rates of the patients were analyzed.Results The degree of tumor differentiation.3-year survival rate and tumor-free survival rate of patients in group A were significantly higher than those in the other 4 groups(χ2=21.051,10.043,4.450,6.977,25.566,P＜0.05).The degree of tumor differentiation,1-,2-,3-year survival rates and tumor-free survival rates of the patients in group C and D were significantly lower than those in other 3 groups(χ2=7.938,3.488,9.085.P＜0.05).Conclusions The increase of AFP-L3 content is closely related to poorly differentiated HCC and bad prognosis.especially when the AFP Ievel is low.The detection of AFP-L3 content before and after operation is beneficial to the evaluation of the prognosis of HCC patients.

ObjectiveTo investigate the value of “streaks” sign in diagnosis of central neurocytoma.MethodsFifty-two cases of central neurocytoma confirmed by pathology from 2008 to 2011 were collected.In 52 cases,both MRI and CT scan were performed on 12 patients,MRI only on 36 patients and CT only on 4 patients.MRI and CT features were analyzed retrospectively.ResultsIn MRI,the “streaks” sign was found in 39 cases,accounting for 81.25％(39/48).In CT,the“streaks” sign was found in 11 patients,accounting for 68.75％(11/16).The “streaks” sign in CTwas also found in MRI.ConclusionsThere is a certain specificity of“streaks” sign in central neurocytoma imaging.In combination with other imaging findings,it can be helpful for an accurate preoperative diagnosis of the disease.

Objective To investigate the imaging appearances of non-ossifying fibromas in healing stage and its clinical value.Methods The imaging features of non-ossifying fibroma in healing stage in 10 cases followed-up clinically(2 cases of them were verified by pathology after operation) were analyzed. All of the cases were examined by radiography,4 cases were examined by CT, 1 case underwent MRI. Results All of the cases were located in long bone of lower extremity. 8 cases were in tibia,2 cases were in femur. 5 cases were shown as homogeneous sclerosis,lucent areas were presented in sclerotic foci in 5 cases. 5 cases were unchangeable after followed-up 1 to 4 years .Conclusion The non-ossifying fibroma is being sclerotic stabilized foci after puberty , no operation is necessary for the healed form non-ossifying fibroma.

Objective: To biomechanically compare the initial stability of two cervical interbody cages with different surfaces on human specimens.Methods: Flexibility of twenty-three cervical motion segments (two groups) were tested in axial rotation, flexion/extension and lateral bending, intact and after implantation of a cervical interbody fusion cage (SynCage-C Curved, SynCage-C Wedged). An implant pullout concluded testing. Changes in range of motion (ROM) were analyzed.Results: Both cages were effective at reducing ROM in all directions, with no significant differences in effacency. The pullout force differed significantly between the two cages, the SynCage Curved being higher. Conclusion: Differences of surfaces of the two cages don't affect their initial stability. The cage with a better contoured surface had a higher pullout force.

Objective:To report the preliminary results of intensity modulated radiation therapy(IMRT)for 20 nasopharyngeal carcinoma patients.Methods:A total of 20 patients with nasopharyngeal carcinoma received IMRT in our hospital between January 2007 and April 2008.Five patients were of stage Ⅱ,13 patients were of stage Ⅲ,and 2 patients were of stage Ⅳ.The prescribed dose 69.96 Gy was delivered to the gross tumor volume(PTV)and positive neck nodes(PTVnd);59.36 Gy to the clinical target volume(PTV1),covering the upper neck and area around the nasopharynx;and 50.96 Gy to the low neck and supreclavicular area (PTV2).The dose to 50% of the parotid was≤35 Gy.The maximum dose to the lens.pituitary gland,temporo-mandibular joint,mandible,and temporal lobe was 9,54,60,70,and 60 Gy.The maximum dose to the brainstem,spinal cord,optic nerve and optic chiasma(PRV)was 54,40,54,and 54 Gy,respectively.All of the patients received 1 or 2 circles of chemothrapy before IMRT.Results:The median follow-up time was 14 months.The one-year overall survival was 94.1%.One patient died of osseous metastasis and respiratory failure and 3 patients developed distant metastasis.Acute toxicity was mostly Grade Ⅰ to Grade Ⅱ.Seventeen patients had grade Ⅰ xerostomia.Three patients suffered from grade Ⅰ acute oral mucosa reaction and 12 patients had grade Ⅱ acute oral mucosa reaction.Analysis of the dose-volume histograms (DVHs) showed that the mean dose delivered to the PTV,PTVnd,PTV1 and PTV2 was 73.4,74.1,67.8,and 54.1 Gy,respectively.The median dose to 50% of the right and left parotid glands was 43.9 Gy and 41.9 Gy,respcetively.The average value of maximum dose to the left and right lens was 8.06 and 8.12 Gy,respectively.The average value of maximum dose to the brainstem,spinal cord,left and right optic nerve and optic chiasma PRV was 60.6,46.6,50.0,55.0,and 56.0 Gy,respectively.Conclusion:IMRT can achieve satisfactory dose distdbution to nasopharyngeal carcinoma and surrounding tissues in NPC patients,protect normal tissues during the treatment and improve local control rate.

Objective To evaluate the safety and efficacy of the valve sparing aortic reimplantation in selected patients with acute type A aortic dissection(AAAD).Methods From October 2012 to March 2014, 65 AAAD patients with entry tear located in the sinus of Valsalva and/or genetic: syndrome underwent emergent operation.Of them, 34 patients had valve sparing aortic reimplantation(David Ⅰ group) , and 31 patients underwent aortic composite replacement(Bentall group).Results No operative mortality was observed in this study.In-hospital mortality(8.8％ vs.9.7％ , P ＞ 0.05) and morbidity (25.4％ vs.27.9％, P ＞0.05) were comparable between two groups.All the patients underwent arch replacement and stented elephant trunk implantation concomitantly.Mean cross-clamp time [(149 ± 23) min v s.(124 ± 21) min, P ＜ 0.05] was longer for David Ⅰ group, while mean cardiopulmonary bypass time[(186 ± 77) min vs.(193 ± 89) min, P ＞0.05] and mean operation time [(341 ± 137) min vs.(378 ± 174) min, P ＞ 0.05] had no significant difference between two groups.The blood transfusion was significantly reduced in David Ⅰ group than that in Bentall group[(1 180 ±490) ml vs.(1 790 ±560) ml, P ＜0.05].The mean follow-up was(17.6 ± 5.4) months(range, 8-26 months).In David Ⅰ group, one patient with genetic syndrome died of ruptured abdominal aortic aneurysm 18 months postoperatively.Two late deaths occurred in Bentall group due to intracranial hemorrhage after 9 months and ruptured infective pseudoaneurysm after 13 months respectively.In David Ⅰ group, average grade of aortic regurgitation 6 months postoperatively was 0.6 ± 0.4.At the latest visit, no pseudoaneurysm on anastomosis was observed.Besides two patients from Bentall group were in NYHA class Ⅱ , all the other patients presented in NYHA class Ⅰ.Conclusion David Ⅰ aortic root reimplantation can be performed safely and obtain excellent short-term results in selected patients with AAAD.Long-term results need continuing follow-up.