OBJECTIVETo study the safety, effectiveness and feasibility of suprapubis-assisted umbilical laparoendoscopic mini-dual-site surgery (SAU-LEMDS) in the treatment of varicocele.

METHODSThis study included 80 varicocele patients aged 24 - 44 (mean 28.5 +/- 2.6) years, 25 cases of grade I, 45 cases of grade II and 10 cases of grade III, 58 cases in the left side, 6 in the right and 16 in both sides, and all with asthenospermia. The patients were treated by SAU-LEMDS under subarachnoid anesthesia combined with general anesthesia in a supine position with a head-down-feet-up slope of 15 degrees. Two 5 mm trocars were inserted bilaterally at the umbilical edge, one with a 5 mm 30 degrees laparoscope placed in it, and another into the abdominal cavity below the pubic hairline with a 5 mm laparoendoscopic clipper placed in it. The operation procedure was similar to that of standard laparoscopic ligation of spermatic veins, with reservation of the spermatic artery and double-ligation of spermatic veins. And the procedure was repeated for the contralateral lesion in the bilateral cases. Postoperative follow-up was conducted for the incidences of orchiatrophy and testicular hydrocele and changes of seminal parameters.

RESULTSAll the operations were successful, with the mean operation time of (10 +/- 5.0) min (range 8 to 25 min) for the unilateral cases and (18 +/- 6.5) min (range 15 to 30 min) for the bilateral cases, the mean blood loss of (1.5 +/- 0.5) ml (range 1 to 2 ml), and the mean postoperative hospital stay of (2 +/- 0.5) d (range 1.5 to 3 d). The patients were followed up for 6 -24 (12 +/- 2.5) months, which showed significant improvement in sperm motility as compared with the baseline ([28.53 +/- 5.21] vs [19.62 +/- 3.56]%, P < 0.05), with 28 cases (35.0%) restored to normal. Recurrence was found in 4 cases (5.0%). Testicular hydrocele occurred in 7 cases (8.75%), but orchiatrophy in none. The scars in the umbilicus and suprapubis were invisible because of the wrinkles and pubic hair.

CONCLUSIONSAU-LEMDS is safe, effective and feasible for the treatment of varicocele. It is superior to umbilical laparoendoscopic single-site surgery (U-LESS) for its less invasiveness, simpler operation, and better cosmetic appearance.

Adult ; Asthenozoospermia ; Humans ; Laparoscopy ; adverse effects ; methods ; Length of Stay ; Ligation ; methods ; Male ; Operative Time ; Postoperative Period ; Recurrence ; Spermatic Cord ; blood supply ; Testicular Hydrocele ; etiology ; Treatment Outcome ; Umbilicus ; Varicocele ; surgery ; Veins

·AIM:To study the influence factors and management of anterior chamber gas bubble during femtosecond flap creation for laser-assisted in situ keratomileusis ( LASIK) .·METHODS: Totally 9671 eyes of 4859 patients with femtosecond LASIK were included in this study. Preoperative, intraoperative and postoperative parameters of anterior chamber gas bubble patients were analyzed and compared.·RESULTS:A total of 51 cases (0. 53%) occurred anterior chamber gas bubble during femtosecond flap creation. There was no statistical difference between uncorrected visual acuity of postoperative 1mo (-0. 076 ± 0. 09 ) and preoperative best corrected visual acuity (-0. 08±0. 04; t=-0. 34,P=0. 74). And 33 eyes (65%) did not affect the pupil tracking, but there were 18 eyes ( 35%) unable to track the pupil successfully. There was no statistical difference in uncorrected visual acuity of postoperative 1mo between trace group (-0. 06 ± 0. 08 ) and no trace group(-0. 11 ± 0. 09; t = 1. 82, P = 0. 07). The highest incidence of anterior chamber gas bubble was at 9 point, followed by 3 point. There were no statistical differences in spherical equivalent refraction, corneal curvature, corneal diameter, anterior chamber volume, anterior chamber depth and intraoperative femtosecond laser energy between anterior chamber gas bubble eyes and the contralateral eyes (P>0. 05).·CONCLUSION: Anterior chamber gas bubble formation during femtosecond flap creation for LASIK is an uncommon event. It may affect the eye tracking. There is no obvious effect on early postoperative visual acuity if intraoperative disposed properly. The direct or indirect factors of anterior chamber gas bubble formation are unclear.

OBJECTIVETo observe the effect of acupuncture combined physical training and relearning on stroke patients.

METHODSA multi-center, randomized controlled trial design was adopted. A total of 364 stroke patients were recruited and randomly assigned to the experimental group (184 cases) and the control group (180 cases). Patients in the experimental group received acupuncture combined with physical training and relearning, while those in the control group only received physical training and relearning. All received four weeks of treatment. Effects on Fugl-Meyer motor function, neurological impairment, activities of daily living difference were compared before treatment, after treatment, 2 and 5 months after follow-ups between the two groups.

RESULTSTotally 353 patients completed this trial, 179 in the experimental group and 174 in the control group. (1) compared with before treatment, brief Fugl-Meyer motor functions scores and FIM scored obviously increased, and scores for neurological impairment obviously decreased in the two group. Besides, the increment of brief Fugl-Meyer motor functions scores and FIM scores was obviously higher in the experimental group than in the control group at month 2 and 5 of follow-ups; scores for neurological impairment was obviously lower in the experimental group than in the control group. The increment of FIM scores was obviously higher in the experimental group than in the control group at month 5 of follow-ups (P < 0.05, P < 0.01). (2) There was statistical difference in inter-group comparison of total Fugl-Meyer motor functions scores and FIM scores, or scores for neurological impairment (P < 0.01). The improvement of Fugl-Meyer motor functions grading and neurological impairment grading was obviously superior in the experimental group at month 2 and 5 of follow-ups. The distribution of FIM grading was also better in the experimental group at month 5 of follow-ups (P < 0.05, P < 0. 01).

CONCLUSIONSBoth acupuncture combined exercise training and relearning and physical training and relearning could effectively promote the rehabilitation of stroke patients, reduce their neurological impairment degrees, improve motor functions and independent capacities. Better long-term efficacy could be obtained by acupuncture combined exercise training and relearning.

Activities of Daily Living ; Acupuncture Therapy ; Biomedical Research ; Exercise Therapy ; Humans ; Research Design ; Stroke Rehabilitation ; Treatment Outcome

OBJECTIVETo explore the awareness, treatment and control rates of dyslipidemia among Chinese adults aged over 18 in 2010, and to analyze the prevalent features.

METHODS97 409 subjects aged over 18 were recruited from 162 monitoring sites around 31 provinces in China mainland in 2010, applying multi-stage stratified cluster random sampling method. Information about subjects' history of dyslipidemia, treatment and control were collected by face-to-face interview; and each subject's fasting venous blood was drawn in the morning before having food, to test total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C). In total, 51 818 cases of dyslipidemia ever or now, including 2235 subjects who once suffered from dyslipidemia but had their blood lipid controlled to normal, were screened out. And the awareness, treatment and control rates were calculated by complex weighting.

RESULTSThe awareness rate of dyslipidemia among Chinese adults was 10.93%, while the stratified rates were 6.00%, 16.75% and 18.74% in the groups of subjects aged 18 - 44, 45 - 59 and over 60 years old, respectively (χ² = 1293.02, P < 0.01); 10.32% and 11.71% among males and females, respectively (χ² = 18.67, P < 0.01); 16.59% and 8.17% in groups from urban and rural areas, respectively (χ² = 618.38, P < 0.01); and 12.22%, 11.75% and 8.26% in groups from eastern, central and western China, respectively (χ² = 117.04, P < 0.01). The treatment rate of dyslipidemia was 6.84% among Chinese adults, while the stratified rates were 3.55%, 10.73% and 12.05% in the groups of subjects aged 18 - 44, 45 - 59 and over 60 years old, respectively (χ² = 858.72, P < 0.01); 6.37% and 7.43% among males and females, respectively (χ² = 16.69, P < 0.01); 10.17% and 5.21% in groups from urban and rural areas, respectively (χ² = 327.51, P < 0.01); and 7.33%, 7.52% and 5.41% in groups from eastern, central and western China, respectively (χ² = 50.71, P < 0.01). The control rate of dyslipidemia was 3.53% among total subjects, while whose stratified rates were 1.64%, 5.49% and 6.94% in the groups of subjects aged 18 - 44, 45 - 59 and over 60 years old, respectively (χ² = 554.12, P < 0.01); 2.57% and 4.75% among males and females, respectively (χ² = 131.04, P < 0.01); 5.23% and 2.70% in groups from urban and rural areas, respectively (χ² = 165.13, P < 0.01) ; and 4.21%, 3.89% and 2.17% in groups from eastern, central and western China, respectively (χ² = 91.45, P < 0.01).

CONCLUSIONThe awareness, treatment and control rates of dyslipidemia have been comparatively low among Chinese adults, especially among the population who were young, or who were from rural area or western China.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Dyslipidemias ; epidemiology ; prevention & control ; therapy ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Rural Population ; Young Adult

OBJECTIVETo study the levels of blood lipid among Chinese adults in 2010 and analyze the epidemiological features.

METHODSFasting serum levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C) were determined for 90 395 subjects aged 18 and over who were selected by multi stage cluster random sampling method from 162 surveillance sites of 31 provinces of China mainland in 2010. After complex weighting, the differences of levels of serum total TC, TG, HDL-C and LDL-C were analyzed in different age, gender and geographic regions.

RESULTSAfter complex weighting, the levels of serum TC in Chinese adults was (4.04 ± 1.08) mmol/L, with (3.86 ± 1.03), (4.29 ± 1.11) and (4.33 ± 1.09) mmol/L in the groups of 18 - 44, 45 - 59 and over 60 years old (F = 177.56, P < 0.01), respectively. The level of serum TC was (4.06 ± 1.09) mmol/L and (4.03 ± 1.07) mmol/L in males and females (F = 2.38, P > 0.05), respectively; (4.08 ± 1.13) mmol/L and (4.03 ± 1.06) mmol/L in urban and rural areas (F = 0.51, P > 0.05), respectively, and (4.13 ± 1.11), (4.03 ± 1.01) and (3.93 ± 1.11) mmol/L in areas of east, middle and west respectively (F = 2.56, P > 0.05). The levels of serum TG was (1.33 ± 1.28) mmol/L, with(1.26 ± 1.24), (1.48 ± 1.46) and (1.35 ± 1.05) mmol/L in the groups of 18 - 44, 45 - 59 and over 60 years old (F = 85.98, P < 0.01), respectively. The level of serum TG was (1.45 ± 1.48) mmol/L and (1.21 ± 1.01) mmol/L in males and females (F = 172.01, P < 0.01), respectively, (1.34 ± 1.26) mmol/L and (1.33 ± 1.28) mmol/L in urban and rural areas (F = 0.16, P > 0.05), respectively, and(1.30 ± 1.25), (1.35 ± 1.23) and (1.35 ± 1.36) mmol/L in areas of east, middle and west (F = 0.69, P > 0.05) respectively. The levels of serum HDL-C was (1.11 ± 0.31) mmol/L, with (1.09 ± 0.30), (1.13 ± 0.33) and (1.14 ± 0.33) mmol/L in the groups of 18 - 44, 45 - 59 and over 60 years old (F = 27.81, P < 0.01), respectively. The level of serum HDL-C was (1.08 ± 0.32) mmol/L and (1.14 ± 0.30) mmol/L in males and females (F = 178.66, P < 0.01), respectively, (1.11 ± 0.31) mmol/L and (1.11 ± 0.32) mmol/L in urban and rural areas (F = 0.09, P > 0.05), respectively, and (1.12 ± 0.32), (1.12 ± 0.31) and (1.09 ± 0.32) mmol/L in areas of east, middle and west (F = 1.06, P > 0.05) respectively. The levels of serum LDL-C was (2.27 ± 0.78) mmol/L, with (2.15 ± 0.74), (2.42 ± 0.80) and (2.46 ± 0.81) mmol/L in the groups of 18 - 44, 45 - 59 and over 60 years old (F = 129.84, P < 0.01), respectively. The level of serum LDL-C was (2.30 ± 0.78) mmol/L and (2.24 ± 0.78) mmol/L in males and females (F = 25.06, P < 0.01), respectively, (2.33 ± 0.82) mmol/L and (2.24 ± 0.76) mmol/L in urban and rural areas (F = 3.48, P > 0.05), respectively, and (2.35 ± 0.80), (2.25 ± 0.74) and (2.17 ± 0.77) mmol/L in areas of east, middle and west (F = 4.58, P < 0.05) respectively.

CONCLUSIONThe levels of serum lipid of middle aged male, female after menopause and people living in eastern region were higher than other Chinese adults. Effective measures should be taken earlier to control serum lipid levels.

Adolescent ; Adult ; Age Distribution ; Asian Continental Ancestry Group ; China ; epidemiology ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Cross-Sectional Studies ; Dyslipidemias ; epidemiology ; Female ; Humans ; Lipids ; blood ; Male ; Middle Aged ; Sex Distribution ; Triglycerides ; blood ; Young Adult

OBJECTIVEObesity is a major risk factor for type 2 diabetes, many indexes can be used to describes obesity and predict diabetes. This research attempts to identify the best indicator of obesity to screening diabetes in Chinese population.

METHODSA cross-sectional data of 8121 subjects aged 35-60 years were included in this research belongs to the Diabetes Appropriate Technology Intervention Study. Anthropometric indicators including body weight, height, waist circumferences (WC), body fat index (BFI) and visceral fat index (VFI) and blood biochemical indicators after an overnight fast [fasting blood glucose, total cholesterol, high-density lipoprotein (HDL) cholesterol, and triacylglycerol] were measured. BMI (body mass index) and Weight to Height Ratio was calculated.

RESULTSSubjects with obesity had a higher risk of physician diagnosed diabetes (OR=2.50, 95% CI 1.83-3.43), new diagnosed diabetes (OR=4.23, 95% CI 2.91-6.15) and pre-diabetes (OR=1.75, 95% CI 1.31-2.34) compared to those with normal Body mass index (BMI). There was a significant trend of increased risk of all diabetes status with increased waist circumference (WC). The waist-to-height ratio (WHtR) yielded the most significant association with new diagnosed diabetes and physician diagnosed diabetes than other indices.

CONCLUSIONCentral obesity is significantly correlated with diabetes. VFI was most correlated with pre-diabetes while WHtR is an efficient screening index than BMI and WC in Chinese community diabetes screening.

Adipose Tissue ; physiology ; Adult ; Aged ; Asian Continental Ancestry Group ; Blood Glucose ; Body Mass Index ; China ; epidemiology ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; epidemiology ; etiology ; pathology ; Female ; Humans ; Male ; Middle Aged ; Obesity ; complications ; Waist Circumference ; Waist-Hip Ratio

OBJECTIVETo understand the prevalence of hypercholesterolemia, high blood low density lipoprotein cholesterol, low blood high density lipoprotein cholesterol and hypertriglyceridemia among Chinese adults in 2010.

METHODSLevels of triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C) and total cholesterol (TC) were determined in fasting serum for subjects who were selected by multi-stage stratified cluster random sampling in from 162 surveillance points of 31 provinces in 2010. Prevalence of hypercholesterolemia, high blood LDL-C, low blood HDL-C and hypertriglyceridemia of 97 409 subjects was analyzed.

RESULTSAfter the complex weighting, prevalence of hypercholesterolemia in Chinese adults was 3.3%, with 2.2%, 4.7% and 4.7% in the groups of 18 - 44, 45 - 59 and over 60 years old (P < 0.01), respectively, 3.4% and 3.2% in males and females (P > 0.05), respectively, 4.2% and 2.9% in urban and rural areas (P < 0.01), 4.2%, 2.4% and 3.1% in areas of east, central and west (P < 0.01). Prevalence of high blood LDL-C was 2.1%, with 1.3%, 3.0% and 3.6% in the groups of 18 - 44, 45 - 59 and over 60 years old (P < 0.01), respectively, 2.1% in both males and females (P > 0.05), 3.0% and 1.8% in urban and rural areas (P < 0.01), and 2.9%, 1.5% and 1.8% in areas of east, central and west (P < 0.01), respectively. Prevalence of low blood HDL-C was 44.8%, with 46.9%, 42.6% and 41.2% in the groups of 18 - 44, 45 - 59 and over 60 years old (P < 0.01), 50.6% and 38.9% in males and females (P < 0.01), respectively, 45.4% and 44.6% in urban and rural areas (P < 0.05), and 43.5%, 43.3% and 48.6% in areas of east, central and west (P < 0.01). Prevalence of hypertriglyceridemia was 11.3%, with 10.1%, 14.2% and 10.8% in the groups of 18 - 44, 45 - 59 and over 60 years old (P < 0.01), respectively, 13.8% and 8.6% in males and females (P < 0.01), respectively, 12.1% and 10.9% in urban and rural areas (P < 0.01), and 11.0%, 11.7% and 11.2% in areas of east, central and west (P < 0.05).

CONCLUSIONLow blood HDL-C and hypertriglyceridemia are two major types of dyslipidemia in Chinese adults.

Adolescent ; Adult ; Age Distribution ; Asian Continental Ancestry Group ; China ; epidemiology ; Dyslipidemias ; epidemiology ; Female ; Humans ; Hypercholesterolemia ; epidemiology ; Hypertriglyceridemia ; epidemiology ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Sex Distribution ; Young Adult

Objective: To investigate the application values of immunophenotypic analysis and molecular genetics in the diagnosis of acute promyelocytic leukemia (APL) . Methods: The retrospective analyses of flow cytometric (FCM) immunophenotypic anyalysis, chromosome karyotype and chromosome fluorescence in situ hybridization (FISH) of 798 outpatient or hospitalization APL patients referred to our hospital between May 2012 and December 2017 were performed to further study the application values of FCM and molecular genetics in the diagnosis of APL. Results: The sensitivity and specificity of FCM were 91.9% and 98.7% respectively. The typical characteristic immunophenotype for APL was as of follows: a high SSC, absence of expression of cluster differntiation (CD) CD34 and HLA-DR, and expression or stronger expression of CD33, consistent expression of CD13, CD9, CD123, expression of CD56, CD7, CD2 (sometimes) . The rest 10% of the cases harbored atypical APL phenotypes, generally accompanied by CD34 and/or HLA-DR expression, decreased SSC and often accompanied by CD2 expression, it was difficult to definitively diagnose APL by this FCM phenotype, and their diagnoses depended on the results of genetics or molecular biology tests. Compared with normal individuals, complex karyotypes APL with t (15;17) translocation, other variant translocations and variant t (11;17) , t (5;17) had no significant differences in terms of their FCM phenotypes. Conclusions: FCM could rapidly and effectively diagnose APL. Despite the fact that complex karyotypes with various additional chromosomal abnormalities were detected in approximately one third of APL cases in addition to the pathognomonic t (15;17) (q22;q21) , they had no observable impact on the overall immunophenotype. Molecular and genetic criteria were the golden criteria for the diagnosis of APL. About 10% of immunophenotyping cases relied on molecular genetics for diagnosis.
Flow Cytometry ; Humans ; Immunophenotyping ; In Situ Hybridization, Fluorescence ; Leukemia, Promyelocytic, Acute/diagnosis* ; Retrospective Studies

Objective To observe the expression of extracellular matrix metalloproteinase inducer (EMMPRIN) in the unstable plaque of patients with acute coronary syndrome (ACS),and the impact of leukotriene B4 (LTB4) on the EMMPRIN expression in macrophages.Methods The EMMPRIN expression was detected by immunohistochemistry in 11 unstable plaques from patients with ACS.Protein expression of EMMPRIN was evaluated by Western blot on macrophages differentiated from THP-1 which were stimulated with LTB4 in the absence or presence of LTB4 antagonist U75302.There are 8 study groups:1-THP-1,2 -8-the macrophages derived from THP-1,2 - 6- macrophages were stimulated by LTB4 (0,10-10,10-9,10-8 and 10-7mol/L) for 24 h,7 -8-the macrophages were pretreated by 10-6 mol/L or 10-7 mol/L U75302 2 h before the LTB4 ( 10-7 mol/L) stimulation.Results Abundant EMMPRIN expression was detected in macrophages and smooth muscle cells of unstable plaques from ACS patients.As to the THP-1 derived macrophages,EMMPRIN expression was significantly upregulated in a concentration-dependent manner in LTB4 stimulated groups,which was significantly higher in group 3 -6 than in the THP-1 group ( group 1 ) and macrophages group ( group 2 ) ( all P ＜ 0.05 ) and pretreatment with U75302 significantly reduced the LTB4 induced upregulation of EMMPRIN in a dose-dependent manner (P ＜ 0.05).Conclusion EMMPRIN expression is enhanced in macrophages and smooth muscle cells on unstable coronary artery plaques from ACS patients.LTB4 could stimulate EMMPRIN expression on THP-1 derived macrophages suggesting that LTB4 and EMMPRIN might be both involved in the formation and progression of unstable plaques,future studies are warranted to explore if LTB4 and EMMPRIN antagonists are effective or not for treating patients with ACS.

OBJECTIVE: To evaluate the clinical efficacy of Huangqi Sijunzi decoction (HQSJZD) for treating cancer-related fatigue (CRF) of spleen and stomach Qi deficiency type after chemotherapy in patients with breast cancer. METHODS: A total of 94 breast cancer patients who developed CRF of spleen and stomach Qi deficiency type after chemotherapy were randomized into chemotherapy group (n=47) and traditional Chinese medicine (TCM) + chemotherapy group (n=47). The patients in chemotherapy group received the AC or EC regimen and non-drug interventions including psychological counseling, and those in TCM + chemotherapy group received oral administration of HQSJZD in addition to chemotherapy for 21 days as a treatment cycle, after which improvement of fatigue was assessed using Modified Piper Fatigue Scale. The active ingredients and targets of HQSJZD were screened using the TCM System Pharmacology Analysis Platform (TCMSP); the CRF- and breast cancer-related disease targets were retrieved based on data from the GeneCards, NCBI gene and OMIM databases to construct the component-target network and the protein-protein interaction (PPI) network. GO functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes KEGG pathway enrichment analysis of the target genes were performed to construct the component-disease-pathway-target biological network. The binding strength of the major drug ingredients and CRF key targets were predicted using AutoDock software. RESULTS: The scores for somatic fatigue, emotional fatigue and cognitive fatigue, along with the overall fatigue score, showed more significant improvements in TCM+chemotherapy group than in chemotherapy group (P < 0.001), and the response rate reached 89.4% in the combined treatment group. We identified 250 targets for HQSJZD, 2653 CRF-related genes, 15 329 breast cancer-related genes and 161 prescription-disease intersected targets, from which topological analysis identified 66 potential key targets. GO and KEGG enrichment analyses predicted multiple pathways related with the disease. Molecular docking results suggested that the core ingredients of HQSJZD showed high affinities to the key targets AKT1, CASP3, IL6, JUN and VEGFA, among which AKT1 might be the most important target for HQSJZD to treat CRF. CONCLUSION HQSJZD can obviously improve CRF symptoms in breast cancer patients possibly by regulating multiple signaling pathways including PI3K-Akt through AKT1.
Breast Neoplasms/drug therapy* ; Drugs, Chinese Herbal/pharmacology* ; Female ; Humans ; Medicine, Chinese Traditional ; Molecular Docking Simulation ; Network Pharmacology ; Phosphatidylinositol 3-Kinases