OBJECTIVETo investigate the main factors that influence the results of sperm alkaline single-cell gel electrophoresis (SCGE), optimize the conditions, and standardize its procedures.

METHODSUsing alkaline SCGE, we detected the DNA fragments of sperm treated with different concentrations of H2O2 and determined the influences of the number of agarose gel layers, pH during DNA unwinding and electrophoresis, the time of DNA unwinding and electrophoresis, and cumulative sperm number on the results of sperm alkaline SCGE. Then we optimized the procedures, analyzed the repeatability of the optimized method, and examined 40 semen samples using the method.

RESULTSThree agarose gel layers could reduce the background. The optimal pH during DNA unwinding and electrophoresis was 10, and the best times for DNA unwinding and electrophoresis were 40 min and 30 min, respectively. Fifty sperm were adequate to ensure the reliability of the results. Based on the percentage of tail DNA, the intra- and inter-assay repeatabilities of the optimized sperm alkaline SCGE were 3.12% and 7.13%, and by the DNA damage score, they were 2.38% and 6.09%, respectively. Sperm DNA fragments were significantly increased in the infertile patients with oligoasthenoteratozoospermia as compared with healthy fertile males (P <0.05).

CONCLUSIONThe optimized sperm alkaline SCGE, highly repeatable and easy to be standardized, can be applied to the clinical detection of sperm DNA fragmentation in infertile men.

Asthenozoospermia ; genetics ; Comet Assay ; standards ; DNA Damage ; DNA Fragmentation ; Humans ; Hydrogen Peroxide ; toxicity ; Male ; Oligospermia ; genetics ; Oxidants ; toxicity ; Reproducibility of Results ; Sperm Count ; Spermatozoa ; drug effects ; enzymology ; Time Factors

Objective To investigate the quality of life and sexual function of cervical cancer patients following radical hysterectomy (RH) and vaginal extension.Methods Case-control and questionnaire-based method was employed in this study.Thirty-one patients of early-stage (Ⅰ b1-Ⅰ b2) cervical cancer who had undergone vaginal extension following classic RH in Peking Union Medical College Hospital from December 2008 to September 2012 were included in study group,while 28 patients with matching factors and RH only during the same period were allocated to control group.There was no significant difference between two groups in terms of clinical and demographic variables including age at diagnosis,tumor stage and follow-up time (P＞0.05).Patients were assessed retrospectively by validated selfreported questionnaires the European Organization for Research and Treatment of Cancer Cervix Cancer Module Questionnaire (EORTC QLQ-CX24) mainly for quality of life and sexual function for cervical cancer patients; the Sexual Function and Vaginal Changes Questionnaire (SVQ) further investigates sexual function and vaginal changes of patients with gynecologic malignancy at least 6 months after treatment.Results Vaginal length acquired by pelvic examination by gynecologic oncologists during follow-up visits was (10.0±1.3) cm and (5.9± 1.0) cm in study group and control group respectively (P=0.000).Sixty-eight percent (21/31) of cases in study group and 64％ (18/28) of cases in control group had resumed sexual activity at the time of interview,and the time interval between treatment and regular sexual activity was mean 6 months (range 3-20 months) and mean 5 months (range 1-12 months) in study and control group respectively,in which there was not statistical significance (P＞0.05).No difference was observed regarding pelvic floor symptoms (P＞0.05) while difficulty emptying bladder,incomplete emptying and constipation were most commonly reported.Both group presented with hypoactive sexual desire disorder [88％ (52/59)],orgasm dysfunction [72％(28/39)] and low enjoyment or relaxation after sex [51％(20/39)],which was not statistically significant (P＞0.05).Reduced vagina size and shorter vagina was more prominent in control group (12/18) than that in study group [19％ (4/21)] with statistical significance (P＜0.05),while no difference in sexual desire,vaginal lubrication,dyspareunia and sexual enjoyment (P＞0.05).Conclusions Patients with peritoneovaginoplasty following RH had much longer vagina and less self-perceived short vagina.Vaginal extension following RH does not worsen the pelvic floor symptoms.

Objective To evaluate the triage value of high-risk human papillomavirus (HR-HPV)detection in women with atypical squamous cells of undetermined significance (ASCUS).Methods Two huandred women with atypical squamous cells of undetermined significance (ASCUS) were selected by thinprep cell test(TCT) simultaneously using HPV DNA testing by hybrid capture Ⅱ (HC) and biopsy under the colposcopy,compared the HR-HPV DNA testing with final pathological diagnosis.CIN (cervical intraepithelial neoplasia) means cervical biopsy positive.Results The positive rate of cervical biopsy in HPV positive patients was 60.38％(96/159),and in HPV negative patients was 21.95％(9/41),the difference was obviously (P ＜ 0.05).Conclusion HR-HPV detection is a good triage approach for the patients with ASCUS.

Objective:To evaluate the effect of general practice service based on network platform in health management of patients with multiple chronic conditions (MCC).Methods:Based on network platform, the general practitioners provided health management service for 626 MCC patients in a petrochemical company in Panjin city of Liaoning province from June 2015 to June 2016. The individualized health management plan included health counseling, diet and exercise guidance, health information delivery, health file establishment, and rational medication guidance. After intervention the patient activeness, quality of life, clinical variables were evaluated.Results:Ninety participants dropped out of study (14.38%, 90/626), the questionnaire survey was conducted in rest 536 participants. After 1-year intervention, the scores of physical functioning, role-physical, general health, vitality, social functioning, role-emotional, mental health, and total scores in SF-36 were significantly increased ( F=12.350, 13.215, 10.515, 29.114, 42.972, 10.951, 89.783 and 33.311, respectively, all P<0.05); the values of BMI, waist, systolic and diastolic blood pressure, total cholesterol, triglycerides, low density lipoprotein cholesterol, fasting blood glucose were significantly decreased( F= 30.039, 33.849, 7.152, 27.453, 59.938, 214.270, 73.488 and 62.014, respectively, all P<0.05); the values of high density lipoprotein cholesterol were markedly increased ( F=16.491, P<0.01); the overall scores of activation were increased ( F=9.471, P<0.01), the level of activation was changed (χ 2=16.183, P<0.05); but there was no change in body pain ( F=1.486, P=0.227). There was a weak correlation between patient activation and the general health ( r=0.099, P=0.013), vitality ( r=0.101, P=0.011), mental health ( r=0.099, P=0.013). Conclusion:General practice service based on network platform is feasible and effective for patients with multiple chronic conditions, after the implementation, the activation and the health outcomes are improved significantly.

OBJECTIVETo investigate the characteristics of tidal breathing pulmonary function in children with tracheobronchomalacia (TBM).

METHODSIn this study, 30 children who were diagnosed with TBM using electronic bronchoscopy were enrolled in the observation group; 30 healthy children were recruited in the normal control group. For individuals in each group, the assessment of tidal breath pulmonary function was performed at diagnosis and 3, 6, 9, and 12 months after diagnosis.

RESULTSThere were no significant differences in tidal volume, inspiratory time, expiratory time, and inspiratory to expiratory ratio between the two groups (P>0.05). Compared with the control group, the observation group had a significantly higher respiratory rate and significantly lower ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/TE) and ratio of volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE). There was a time-dependent increase in TPTEF/TE and VPTEF/VE for TBM children from the time of initial diagnosis to 12 months after diagnosis.

CONCLUSIONSTidal breathing pulmonary function has characteristic changes in children with TBM. Tidal breathing pulmonary function tends to be recovered with increased age in children with TBM.

Age Factors ; Female ; Humans ; Infant ; Lung ; physiopathology ; Male ; Respiration ; Tidal Volume ; Tracheobronchomalacia ; physiopathology

BACKGROUNDTo evaluate the effects and toxicities of combination therapy of chemotherapy with hydroxycamptothecin (HCPT)+5-fluorouracil (5-FU)+cisplatin (DDP) and concurrent radiotherapy for advanced non-small cell lung cancer (NSCLC).

METHODSFrom September 1999 to May 2001, 31 patients with advanced NSCLC were enrolled in this study. They were given chemotherapy with HCPT 6mg/m² on days 1-5, 5-FU 300mg/m² on days 1-5, DDP 30mg/m² on days 1-3 and concurrent radiotherapy. The chemotherapy was repeated every 28 days as a cycle. Each patient should receive at least two cycles. The total dose of primary tumors varied up to DT 50-70 Gy/25-35f, and that of metastatic tumors up to DT 30-60 Gy/10-30f .

RESULTSAmong the 31 patients, 6 got complete response, 18 got partial response, 5 had stable disease and 2 had progressive disease, with an overall response rate of 77.4% (24/31). The median survival duration was 16.7 months. The 1- and 2- year survival rates were 54.7% and 30.2%, and 1- and 2- year local control rates were 61% and 40%, respectively. The main toxicities were marrow suppression and gastrointestinal symptoms.

CONCLUSIONSThe results suggest that HCPT-based chemotherapy combined with concurrent radiotherapy is effective for NSCLC and can improve the survival rate and life quality of the patients with lung cancer.

OBJECTIVETo evaluate the impact of hyphema secondary to high intraocular pressure on corneal pathology in rabbits.

METHODSThirty adult New Zealand rabbit were randomized into 3 equal groups, and in each rabbit, one eye served as the experimental eye with the other as the control eye. In the experimental eye, autoblood was injected into the anterior chamber to induce high intraocular pressure maintained for 3, 5, or 8 days. Only saline was injected into the control eye. After the injections, the cornea was observed with slit-lamp microscopy, and at 3, 5, or 8 days, the experimental and control eyes were taken from the 3 groups for microscopic examination of the corneas to detect the occurrence of cornea bloodstain with prolonged high intraocular pressure. Corneal edema, elastic fibers changes, growth of new blood vessels, changes of eosinophils, fibroblasts, lymphocytes and plasma cells, as well as the pathological changes of the corneal layers were observed and compared between the experimental and control eyes.

RESULTSMaintenance of high intraocular pressure for 8 days resulted in the most severe corneal edema and thickening, and histopathologically, the corneal stroma showed widened space between the elastic fibers and obvious fiber distortion. Neovascularization was seen in the marginal cornea where eosinophil infiltration occurred with a small number of lymphocytes, plasma cells and fiber cells. All the three groups showed more obvious edema in the posterior than in the anterior cornea.

CONCLUSIONProlonged hyphema with ocular hypertension results in aggravation of corneal edema, and corneal blood staining does not occur until 8 days of high intraocular pressure but corneal elastic fiber disruption can be seen, suggesting the impending irreversible pathological changes of cornea.

Animals ; Cornea ; pathology ; Edema ; pathology ; Female ; Hyphema ; complications ; pathology ; Male ; Ocular Hypertension ; complications ; pathology ; Rabbits ; Random Allocation

Aged ; Aged, 80 and over ; Endometriosis ; diagnosis ; pathology ; Female ; Humans ; Middle Aged ; Postmenopause ; physiology ; Retrospective Studies

Medical alliances constitute a vertical integration of regional medical resources, and an effective means to promote the tiered medical services. As one of the largest tertiary hospitals in Xinjiang, a hospital has gradually built a " 1+ 6+ N" medical alliance cooperative system fitting the geographical characteristics of Xinjiang since 2018. The system was based on the hospital, made county-level medical institutions as the hub, primary medical and health units as the focus, and telemedicine as the bridge. It turned a telemedicine service platform as the medium, integrating such service segments, as offline practices of experts like clinical teaching, ward rounds, surgical guidance and discipline construction, and as online practices like remote consultation, remote diagnosis, remote education, and remote new technology training among others. Then these segments were integrated into such cooperative models as the remote cooperative medical alliances, specialist-cooperative medical alliances, inter-department co-construction medical alliances, precision-based assistance medical alliances, urban medical group type of medical alliances, and " alliance-consortium" integrated development medical alliances. These practices enabled the expansion and primary support of high-quality medical resources. By June 2022, the hospital had established cooperation via medical alliances with 285 medical institutions at all levels. The implementation of this cooperation mechanism has effectively improved the medical service capacity, diagnosis and treatment capacity of difficult and critical diseases, diagnosis and treatment homogeneity and remote diagnosis capacity in the region, as well as the smooth and orderly progress of the tiered medical services and two-way referrals within a medical alliance.

OBJECTIVETo explore the problems and describe clinical experiences associated with multichannel cochlear implantation in patients with cochlear ossification.

METHODSSeven cochlear implant cases with bilateral cochlear ossification from 1996 to 2006 in Beijing Tongren Hospital were retrospectively reviewed, 4 of which were the consequence of meningitis. Three patients' cochlear were completely ossified, 1 patient's tympanic scala was completely ossified, 1 patient's cochlear was partially ossified, and 2 patients' cochlear were partially fibrotic. This article addressed the components of the preoperative evaluation, surgical decision-making, and specific techniques for cochlear implant array insertion in all kinds of ossified cochlea.

RESULTSGusher was found in 1 case but less serious than that with inner ear malformations. The electrodes were inserted in the cochleostomy in full length in 4 cases, 1 case gave up, and the cochlear implant array were partially inserted in the remains. No serious complications occurred after implantation. All patients had auditory sensations. The impedance of the electrodes, the T level, C level and the hearing threshold were slightly higher than that of the normal cochlear implantation.

CONCLUSIONSThe key influencing factor of ossified cochlear patients were the degree of the disease and whether the electrode implanted completely or not. So, the profound sensorineural hearing loss patients after meningitis should be paid more attention. Patients with ossified cochlear could be benefit from cochlear implantation.

Adolescent ; Adult ; Cochlear Implantation ; Cochlear Implants ; Correction of Hearing Impairment ; methods ; Electrodes ; Female ; Humans ; Male ; Ossification, Heterotopic ; rehabilitation ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult