OBJECTIVETo observe the clinical effects of the no-flip procedure with the Chinese Shang Ring when circumcising adult males with redundant prepuce or phimosis, and to discuss its advantages and disadvantages.

METHODSUsing the no-flip Shang Ring technique, we performed circumcision for 167 adult males aged 18 -72 (mean 27.8) years with redundant prepuce or phimosis, and analyzed the clinical data, including the operation time, postoperative complications, ring-removal time, and postoperative appearance of the penis.

RESULTSComplete follow-up data of 94 cases (56.29%) were obtained. The mean operation time was (5.03 +/- 0.71) minutes and the average ring-removal time was (18.83 +/- 6.70) days. The primary postoperative complications were edema (35 cases [37.23%] at 2 weeks and 9 cases [9.57%] at 4 weeks), including 2 severe cases (2.13%), and infection (3 cases [3.19%]). The pain scores were 2.01 +/- 2.46 during the procedure and 4.52 +/- 2.53 at 24 hours postoperatively. Slipping of the outer ring occurred in 1 case, and delayed removal of the ring in 30 cases (31.91%).

CONCLUSIONAdult male circumcision with the no-flip Shang Ring technique is recommended for its short operation time, simple procedure, fewer postoperative complications, less pain, and better incision appearance.

Adult ; Aged ; Circumcision, Male ; adverse effects ; instrumentation ; methods ; Edema ; etiology ; Humans ; Male ; Middle Aged ; Operative Time ; Pain, Postoperative ; etiology ; Penile Diseases ; etiology ; Penis ; abnormalities ; surgery ; Phimosis ; surgery ; Postoperative Complications ; Postoperative Period ; Prostheses and Implants ; Young Adult

Background:Despite the growing epidemic of heart failure (HF),there is limited data available to systematically compare non-cardiac comorbidities in the young-old,old-old,and oldest-old patients hospitalized for HF.The precise differences will add valuable information for better management of HF in elderly patients.Methods:A total of 1053 patients aged 65 years or older hospitalized with HF were included in this study.Patients were compared among three age groups:(1) young-old:65 to 74 years,(2) old-old:75 to 84 years,and (3) oldest-old:≥85 years.Clinical details of presentation,comorbidities,and prescribed medications were recorded.Results:The mean age was 76.7 years and 12.7％ were 85 years or older.Most elderly patients with HF (97.5％) had at least one of the non-cardiac comorbidities.The patterns of common non-cardiac comorbidities were different between the young-old and oldestold group.The three most common non-cardiac comorbidities were anemia (53.6％),hyperlipidemia (45.9％),and diabetes (42.4％) in the young-old group,while anemia (73.1％),infection (58.2％),and chronic kidney disease (44.0％) in the oldest-old group.Polypharmacy was observed in 93.0％ elderly patients with HF.Additionally,29.2％ patients were diagnosed with infection,and 67.0％ patients were prescribed antibiotics.However,60.4％ patients were diagnosed with anemia with only 8.9％ of them receiving iron repletion.Conclusions:Non-cardiac comorbidities are nearly universal in three groups but obviously differ by age,and inappropriate medications are very common in elderly patients with HF.Further treatment strategies should be focused on providing optimal medications for age-specific non-cardiac conditions.

OBJECTIVETo study the cost of the hypertensive outpatients.

METHODSThe study randomly selected 460 insured patients with hypertension and investigated their cost on each case in the out-patient department through 2002, based on the electronic system of medical insurance.

RESULTSAs a whole, the distribution of hypertensive outpatient expenditure takes on the positively skewed, with the median of 1 567.9 Yuan RMB. With the increase of age, the average expenses in each age group increased accordingly. In the study, the average number of outpatient attendances per patient was 19.5, the average expenses per visit was 115.4 Yuan RMB. In age groups 40 - 49 and 50 - 59, expenses of outpatient in male and female groups are obviously different in 2002 (Wilcoxon W(40 - 49) = 36, P(40 - 49) = 0.037; Wilcoxon W(50 - 59) = 374, P(50 - 59) = 0.023), as well as the number of out-patients (Wilcoxon W(40 - 49) = 52.5, P(40 - 49) = 0.007; Wilcoxon W(50 - 59) = 379, P(50 - 59) = 0.028). When considering the factors of gender and age at one time, the outpatient expenditures in the male group were significantly different between the different age groups (chi(2) = 22.3, P < 0.001), as well as the number of outpatients (chi(2) = 25.4, P < 0.001). In addition, the expenditure of drugs, which took a large proportion of the total expenditure of hypertensive outpatients (about 83.6 percent), was divided into three parts according to the degree of correlation with hypertension: direct expenses related to the with disease, the indirect expenses and the irrespective. The proportions of each part were 19.9 percent, 32.3 percent and 47.8 percent respectively.

CONCLUSIONWhen economic evaluation of community prevention is carried out, the cost and cost-benefit analysis based on the analysis of outpatient expenditure and the proportion of expenses on hypertension should be taken into account. Additionally, to provide appropriate mode of medicare, to impact the behaviors and expenditure of patients, and to provide low-cost but good effective drug are also essential and important factors.

Adult ; Age Factors ; Aged ; Aged, 80 and over ; Ambulatory Care ; China ; Female ; Health Care Costs ; statistics & numerical data ; Hospitals, Community ; economics ; statistics & numerical data ; Humans ; Hypertension ; economics ; therapy ; Male ; Middle Aged ; Outpatients ; statistics & numerical data ; Sex Factors ; Time Factors

OBJECTIVEIn order to study the diagnosis and treatment of HBV and HCV infection.

METHODSWe retrospectively analysed clinical data of 680 patients with cholangiocarcinoma from 1995 to 2001 and stated by SPSS software.

RESULTS(1) The fastigium of cholangiocarcinoma was 60 - 65 years old. The incidence of cholangiocarcinoma was higher in aged males and the sex ratio (male:female) was 1.36:1. (2) The proximal cholangiocarcinoma was most (41.6%) and distant cholangiocarcinoma was secondly (28.7%). (3) Most patients of cholangiocarcinoma were late. The resection rate was low and the rate of radical operation was 21.6% (147/680). (4) The incidence of proximal cholangiocarcinoma was higher in the positive Serologic marks for HBV and HCV and course of diseases was short. Moreover, the pathology of. positive Serologic marks for HBV and HCV trended to low-differentiation and invasion, metastasis and the resection rate was lower.

CONCLUSIONSCholangiocarcinoma is common in the aged males. The infection of HB(C)V and hilar cholangiocarcinoma are correlated and incline to the proximal bile duct. The hilar cholangiocarcinoma infected HB(C)V may have higher malignant degree in biological characteristics and more badly prognosis.

Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms ; epidemiology ; etiology ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; epidemiology ; etiology ; Female ; Hepatitis B ; complications ; Hepatitis C ; complications ; Humans ; Incidence ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo describe the mortality of colorectal and anal cancer in the Chinese population during 2004 - 2005.

METHODSMortality of colorectal and anal cancer from The 3rd National Death Retrospective Sampling Survey (2004 - 2005) were analyzed, with that the total population was 142 660 482 person-year and the number of death cases was 10 586. Crude death rate, age-standardized death rate by Chinese standard population (CASR) and world standard population (WASR), the constitute proportion to all cancer deaths and rank of cancer death were calculated and compared with The 1st (during 1973 - 1975) and The 2nd (during 1990 - 1992) National Death Retrospective Surveys.

RESULTSThe mortality of colorectal and anal cancer in China was 7.42/100 000 (10 586/142 660 482) during 2004 - 2005, accounting for 5.46% of total cancer deaths and ranked the 5th leading cause of death from cancer. CASR and WASR were 4.79/100 000 and 6.57/100 000, respectively. Gender specific mortality was higher for males with 8.38/100 000 (6114/72 970 241) than for females with 6.42/100 000 (4472/69 690 241). The crude death rates were 10.01/100 000 (4796/47 899 806) in urban areas and 6.11/100 000 (5790/94 760 676) in rural areas, moreover, the crude death rates in Eastern, Middle and Western part of China were 8.67/100 000 (4558/52 556 694), 7.19/100 000 (3580/49 781 225) and 6.07/100 000 (2448/40 322 563) respectively. Compared to the crude death rate 5.30/100 000 and CASR 4.54/100 000 during 1990 - 1992, the crude death rate and CASR from colorectal and anal cancer increased by 40.00% and 5.51%, whereas compared to the crude death rate 4.17/100 000 and CASR 4.27/100 000 during 1973 - 1975, the crude death rate and CASR had increased by 77.94% and 12.18% respectively.

CONCLUSIONThe mortality of colorectal and anal cancer has been increasing rapidly in China. The mortality is higher in males, and appears to be diverse in different areas.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anus Neoplasms ; epidemiology ; mortality ; Cause of Death ; Child ; Child, Preschool ; China ; epidemiology ; Colorectal Neoplasms ; epidemiology ; mortality ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Survival Rate ; Young Adult

OBJECTIVETo investigate the effect of angiotension II (AngII) on the activation of NLRP3 inflammasome and the expression of interleukin-1β (IL-1β) in human umbilical vein endothelial cells (HUVECs).

METHODSHUVECs cultured in vitro were treated with different concentrations of AngII for varying lengths of time to determine the optimal concentration and time for AngII exposure. To test the impact of different agents on the effect of AngII exposure, HUVECs were pretreated with AngII receptor blocker losartan, NAD(P)H inhibitor DPI and H(2)O(2) scavenger CAT, caspase 1 inhibitor YVAD, or NLRP3 siRNA for silencing NLRP3, and the protein levels of NOX4, NLRP3, caspase-1 and IL-1β in HUVECs were analyzed by Western blotting.

RESULTSAngII treatment at the optimal concentration (10(-9) mol/L) for 12 h significantly increased the protein levels of NOX4, NLRP3, caspase1 and IL-1β in HUVECs. Pretreatment with losartan, DPI, CAT, YVAD, or NLRP3 siRNA all attenuated the effects of AngII on the cells.

CONCLUSIONAngII can induce vascular inflammation by promoting the production of reactive oxygen species and activating NLRP3 inflammasome to increase the protein expression of IL-1β in HUVECs.

Adaptor Proteins, Signal Transducing ; pharmacology ; Angiotensin II ; pharmacology ; Blotting, Western ; Carrier Proteins ; metabolism ; Caspase 1 ; metabolism ; Human Umbilical Vein Endothelial Cells ; metabolism ; Humans ; Hydrogen Peroxide ; Inflammasomes ; metabolism ; Interleukin-1beta ; metabolism ; NADPH Oxidase 4 ; NADPH Oxidases ; metabolism ; NLR Family, Pyrin Domain-Containing 3 Protein ; RNA, Small Interfering ; Reactive Oxygen Species ; metabolism

Objective To establish the mouse embryonic fibroblast (MEF) cells lines with stable expression of MiR-100-3p inhibitor,which lays a foundation for its function research of the role of miR-100 in the interaction of environmental pollutants and Src homology 2 domain tyrosine phosphatases (SHP-2) gene mutation.Methods Designed and synthesized a particular DNA fragment as hsa-MiR-100-3p inhibitor,which was then cloned into the hU6-MCS-Ubiquitin-ECFP -IRES-puromycin vector.This vector was then co-transfected with lentiviral packaging vectors pHelper1.0 and pHelper2.0 into 293T to produce lentiviral particles.Finally,MEF cells were infected with the above-mentioned lentiviral particles and the stable cell lines expressing hsa-miR-100-3p inhibitor were selected by puromycin.The expression of green fluorescent protein (GFP) and the expression of miR-100 were detected which indicated its inhibition effect of lentiviral vector in MEF cells.Results The construction of the recombinant plasmid was confirmed by sequencing.The subsequent infection confirmed that the packaging of lentiviruses was successfully.MEF cells successfully infected with hsa-miR-100-3p inhibitor.Flow cytometry indicates the expression of green fluorescent protein (significantly inhibition the expression of miR-100) has reached 97.4％ and 95.1％,as well as proved by RT-PCR.Conclusion We successfully constructed the has-miR-100-3p lentiviral silencing vector,and established the stable inhibition cell lines which lay a foundation for its function research of miR-100.

Physical fatigue often appears after stroke, which may influence rehabilitation training and recovery. This paper introduced the causes, clinical manifestations and related factors of physical fatigue after stroke. Energy metabolism increases after stroke, which may play a role in physical fatigue after stroke, and can be managed in some ways. It is needed to research the application of energy metabolism measure in physical fatigue after stroke further.

Cerebral infarction is a clinical disease with corresponding neurological symptoms caused by cerebral ischemia and hypoxia caused by cerebral blood supply disorder. It is one of the most common cerebrovascular diseases and a serious threat to human health. The prevention and treatment of cerebral infarction has an important social significance. Angiogenesis is the key starting point for medical treatment of cerebral infarction, and signal transduction and transcriptional activators (STAT)/hypoxia inducing factor-1(HIF-1)/vascular endothelial growth factor (VEGF) pathway are important pathways to mediate angiogenesis after cerebral infarction. This paper took the angiogenesis as the starting point and the upstream molecules of STAT/HIF-1/VEGF signal pathway STAT3 and miRNA as the main study objects, and comprehensively discussed the results of chip sequencing, experimental research, traditional Chinese medicine (TCM) pathogenesis and TCM treatment. Based on the regulatory mode of "TF-miRNA" and the idea of "micro-whole", it is suggested that under the guidance of the basic theory of TCM, cubic compound prescriptions of TCM and its active components might activate the STAT/HIF-1/VEGF signal pathway through STAT3/miRNA feedback loop to promote angiogenesis after cerebral infarction, which puts forward a deep molecular mechanism and new direction for the treatment of cerebral infarction with TCM.

The mechanism for icaritin to improve postmenopausal osteoporosis (PMOP) has not been clarified. The aim of this study was to investigate the role of estrogen receptor α36 (ERα36) in the proliferation promotion and anti-apoptosis effects of icaritin on osteoblasts and the underlying mechanism of downstream signal transduction. The ERα36 knockdown human osteosarcoma MG63 cell model was constructed by transfection of shRNA vector. Cell proliferation was detected by CCK-8, the apoptosis was detected by flow cytometry, and the activation of ERK and AKT signaling pathways was detected by Western blot. The results showed that the effects of icaritin on the proliferation and apoptosis of MG63 cells were significantly decreased after ERα36 knockdown, and icaritin could up-regulate the levels of ERK and AKT phosphorylation in MG63 cells, which could be reduced by ERα36 knockdown. The effect of icaritin on the proliferation of MG63 cells was significantly decreased by pretreating the cells with U0126 (an ERK signaling pathway blocker) and LY294002 (an AKT signaling pathway blocker), respectively. Furthermore, anti-apoptotic effect of icaritin on MG63 cells was significantly decreased after the cells were pretreated with U0126, but not with LY294002. These results suggest that icaritin exerts proliferation promotion and anti-apoptosis effects on osteoblasts through ERα36 and its downstream ERK and AKT signaling pathways.