Objectives To study the impact of initial age of treatment on testicular morphology and function in male pa-tients with multiple pituitary hormone deficiency using human chorionic gonadotropin (hCG) and human menopausal gonadotro-pin (hMG). Methods Patients with multiple pituitary hormone deficiency were treated with hCG and hMG while keeping other hormone levels normal. Correlations among their testicular volume, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and height, bone age were analyzed. Results After 6-month hCG and hMG treatment, the penis length of 54 male patients was significantly increased from (2.58 ± 0.69) cm to (4.19 ± 0.77) cm , and penis circumference was also increased from (3.71 ± 1.36) cm to (5.95 ± 1.26) cm;the testicular volume was increased from (1.76 ± 1.49) ml to (5.20±2.30) ml;height was increased from (147.01 ± 12.29) cm to (151.98 ± 11.52) cm and bone age was increased from (11.22 ± 2.71) years to (11.64 ± 2.72) years;the differences before and after treatment were statistically significant (all P<0.01). As the patients' age increased, their testicular volume and testosterone level increased slowly, and significant differences amongst each age group were found (P<0.05). The in-creased value of testicular volume, serum FSH and LH levels, and height growth tended to be negatively correlated to the initial age of therapy (r=-0.517~-0.334, P<0.05). Conclusions Early and proper treatment in male patients with multiple pituitary hormone deficiency using hCG and hMG improves testicular function and secondary sex characteristics.

Objective To study the effects of allogeneic blood transfusion on expression of CD40L on peripheral blood monocytes (PBMCs) in patients undergoing radical gastrectomy for gastric carcinoma. Methods Thirty patients classified as ASA physical status Ⅰ- Ⅱ undergoing radical gastrectomy for gastric carcinoma were randomly divided into three groups with 10 patients in each group : group A received no allogeneic blood; group B received leukodepleted blood; group C received allogeneic whole blood during operation or within 12 h after operation. The patients were premedicated with intramuscular phenobarbital sodium 0.1 g and atropine 0.5 mg. Anesthesia was induced with midazolam 0.06 mg ? kg-1 , fentanyl 2 ?g ?kg-1 , propofol 1.5 mg ?kg-1 and vecuronium 8mg and maintained with continuous infusion of propofol (100?g?kg-1?min-1) and vecuronium (5?g ?kg-1?min-1) and intermittent inhalation of 1l%-2% isoflurane. The patients were mechanically ventilated after tracheal intubation. Blood samples were taken before operation and 2, 5 and 10 days after operation. The PBMCs and plasma were separated from peripheral blood by Ficoll-Hypaque centrifugation. The PBMCs were washed and incubated with the patients own plasma (final-concentration 10% ) and PHA (final concentration 20 ?g?ml-1 ) at 37℃ in a 5% CO2 atmosphere for 48h. CD40Lexpression on PBMCs was quantified by flow-cytometry.Results The demographic data including sex, age, bodyweight and duration of operation and intraoperative blood loss were comparable among the three groups. There was no significant difference in the CD40L expression before operation among the 3 groups. In group A there was no change in CD40L expression after operation. In group B CD40L expression on PBMCs increased significantly on the 2nd postoperative day, but returned to preoperative level on the 5th postoperative day. In group C the CD40L expression on PBMCs kept increasing on the 2nd and 5th postoperative day and did not return to preoperative level on the 10th day. The increase in CD40L expression was significantly larger in group C than that in group B ( P

Objective To investigate the clinical efficacy of hemodialysis (HD) combined with hemoperfusion (HP) versus HD combined with hemodiafiltration(HDF) in treating uremic pruritus .Methods The randomized controlled trials(RCTs) on HD combined HP versus HDF in treating uremic pruritus were retrieved from the electronic databases of Cochrane library ,PubMed , Science ,CNKI ,Chinese Biological Medicine ,Wanfang and CNKI by computer .The domestic medical journals ,monographs ,meeting documents and academic dissertations were manually retrieved .The retrieval time limit was from their establishment to October 2015 .Meanwhile the obtained reference literature indexes were consulted .The two researchers independently screened the collected literatures according to the formulated inclusion and exclusion standards .The visual analogue scale (VAS) ,skin itchy effect judg‐ment criteria ,Dirk R Kuypers score ,PTH ,Ca2+ and P3 - were adopted as the evaluation standards .The Review Manager 5 .3 soft‐ware was used to conduct the meta‐analysis .Results Nine RCTs were finally included ,involving 405 patients .The meta analysis showed that HD+ HP had better effect than HD+ HDF in treating uremic pruritus and clearing blood BUN ,HD+ HDF had better effect than HD+ HP for maintaining Scr and P3 - clearing effect ,while no statistically significant difference was found in terms of PTH decrease and Ca2+ influence (P>0 .05) .Conclusion The dialysis mode of HD+ HP is more effective in treating uremic pruri‐tus .

OBJECTIVE:To observe the short-term efficacy and ADR of tenofovir disoproxil fumarate(TDF)in the treatment of multi-drug resistant chronic hepatitis B(CHB). METHODS:32 patients with multi-drug resistant CHB were analyzed retrospec-tively,and HBV drug-resistant genes were detected before treatment;there were a number of points to resistance;they were gave TDF orally. The recovery rate of serum alanine aminotransferase(ALT),HBV-DNA conversion rate,lactic acid and renal function were observed before and after treatment. RESULTS:The recovery rate of ALT reached 100% at 3 months,and the conversion rate of HBV-DNA reached 96.88%. The lactic acid levels and renal dysfunction was not found during treatment. CONCLUSIONS:TDF take effect quickly on multi-drug resistant CHB,and no obvious ADR is found.

BACKGROUND:Titanium ions have been proved to stimulate the secretion of bone remodeling-related factors from T lymphocytes;however, the effects of titanium ions on the early activation, intermediate activation, and cel cycle of T lymphocytes remain unclear. OBJECTIVE:To investigate the effects of titanium ions on the proliferation and activation of T lymphocytes in vitro. METHODS:Cel proliferation and cycle test:Jurkat E6-1 T lymphocytes in logarithmic phase were col ected and cultured in the medium containing 0 (control), 25 (low concentration), 50 (middle concentration), and 100μmol/L (high concentration) titanium ions for 24 hours to detect the cel relative proliferation rate and cel cycle. Cel activation trial:Jurkat E6-1 T lymphocytes were divided into two groups that were subdivided into four groups containing 0, 25, 50, and 100μmol/L titanium ions, respectively with or without phytohemagglutinin (PHA) pre-stimulation. The expressions of CD69 and CD25 were measured after cultured for 24 hours. RESULTS AND CONCLUSION:Titanium ions enhanced T lymphocytes proliferation in a concentration-dependent manner (P<0.05). Compared with the control group, the percentages of G0/G1 phase decreased and the proportions of cel s in S and G2/M phase increased significantly in the low, middle and high concentration groups (P<0.05). The proportion of G0/G1-phase cel s in the high concentration group was less and the proportion of G2/M phase cel s was higher than those in the middle and low concentration groups (P<0.05). With PHA pre-stimulation, the expression of CD69 in the high concentration group was higher than that in the middle and low concentration groups (P<0.05);whereas the difference of CD25 expression was not significant among four subgroups. Titanium ions promoted the expression of CD69 in a concentration-dependent manner (P<0.05), but there was no CD25 expression in each subgroup without PHA pre-stimulation. To conclude, titanium ions can significantly promote T lymphocyte proliferation and early activation in vitro, and moreover, induce S and G2/M phase arrest in T lymphocytes.

Neonatal hypoxic-ischemic encephalopathy as a standard term has been used for over 30 years,but now increasingly being questioned.Most experts recommend using neonatal encephalopathy instead of hypoxic-ischemic encephalopathy.The American College of Obstetricians and Gynecologists and The American Academy of Pediatrics published separately the report of Task Force on Neonatal Encephalopathy Neonatal Encephalopathy and Neurologic Outcome,Second Edition in 2014.Definition,diagnosis and treatment of neonatal encephalopathy and other content have been updated in the report.It is recommended that a comprehensive multidimensional assessment be performed of neonatal encephalopathy.This article will introduce the controversy about neonatal encephalopathy or hypoxic-ischemic encephalopathy and contents of the report of Task Force on Neonatal Encephalopathy.

As a widely accepted and convenient method,the Apgar score has been applied to assess the status of the newborn infants and the response to resuscitation since 1952.But the Apgar score has also been used inappropriately in infants to predict specific neurologic outcomes in many cases.The Apgar Score produced by American Academy of Pediatrics(AAP) in collaboration with American College of Obstetricians and Gynecologists(ACOG),updated policy statements of the Apgar score in October 2015.The Apgar score has limitations,and it is not appropriate to use it alone to establish the diagnosis of asphyxia;the method does not predict individual neonatal mortality or neurologic outcome.AAP/ACOG encourages the use of an expanded Apgar score reporting form that accounts for concurrent resuscitation interventions.

Objective To investigate the prognostic factors for clinical relapse in chronic hepatitis B (CHB) patients with hepatitis B e antigen (HBeAg) seroconversion after drug withdrawal and to establish a prognostic model.Methods Totally 201 CHB patients with HBeAg seroconversion after the antiviral therapy were enrolled.The epidemiological variables including age, gender and family history of hepatitis B were collected.Liver function and hepatitis B virus (HBV) DNA level one week before initiation of antiviral therapy, hepatitis B surface antigen (HBsAg) level at the time of drug withdrawal and the duration of antiviral therapy after HBeAg seroconversion were analyzed.The clinical relapse after 48 weeks of drug withdrawal was followed up.The patients were divided into relapse group and non-relapse group according to clinical variables at 48 weeks after drug withdrawal.The counting data were analyzed by chi-square test and the measurement data were analyzed by t test.The Logistic regression model was used to determine the prognostic factors for clinical relapse.The receiver operating charactenstic (ROC) curve was constructed to assess the performance of the prediction model.Results The clinical relapse rate was 16.42% (33/201) after 48 weeks of drug withdrawal.By multivariate analysis, age, the duration of antiviral therapy after HBeAg seroconversion and HBsAg level at the time of drug withdrawal were independent predictors (χ2=14.546, t=3.202, t=3.286, respectively;all P<0.05).The regression model Logit (P)=1.220×age-0.040×the duration of antiviral therapy after HBeAg seroconversion +0.004×HBsAg level at the time of drug withdrawal-5.426.The sensitivity and specificity with the cut-off value of-0.860 were 73.10% and 90.40%, respectively.Conclusions Age, the duration of antiviral therapy after HBeAg seroconversion and HBsAg level at the time of drug withdrawal are independent predictors for clinical relapse 48 weeks after drug withdrawal in CHB patients with HBeAg seroconversion after antiviral therapy.

Objective To evaluate the improved shunt insufficiency and clinical outcome using covered or bare stents for TIPS.Methods We searched all the main data base to identify trails of TIPS with covered or bare stents in improving shunt insufficiency and clinical outcome and evaluated the quality of included studies.Incidence of shunt insufficiency and clinical relapse relating to portol hypertension were analysed with Revman 4.2.Results Totally 1340 patients undergoing TIPS were included.Randomised controlled(12.8% vs 43.9%,P=0.004)trial and non-randomised controlled trials(11.6% vs 57.6%,P

AIM:To observe the clinical effect of combination therapy with ozagrel and low molecular weight heparin on progressive cerebral infarction.METHODS:96 cases with acute progressive cerebral infarction were randomly divided into treatment group(48 cases)and control group(48 cases).The control group was only administered with 80 mg sodium ozagrel,bid,for 14 days.And the treatment group was administered with 80 mg sodium ozagrel,bid,for 14 days and 0.4 mL low molecular weight heparin sodium injection,bid,for 14 days.The number of platelet,blood clotting routine and the severity of neuro-functional defect(NDS)of both groups were detected before and after 14 days treatmeat.RESULTS:After 14 days treatment,the NDS of treatment group was significantly lower than that of control group(P