Objective By employing surgically induced varicocele(VC)in SD rats and an apomorphine(APO)test,we screened rats with erectile dysfunction(ED)after VC and explored method to establish VC and ED models.Methods Sixty rats were randomly divided into Control,Sham,and Model groups with 20 rats in each group.Using the Turner method,we partially ligated the left renal vein to induce left VC three times.APO tests were conducted to screen rats with ED after inducing VC.The numbers of erections,genital grooming,and yawning were observed and recorded.The diameter of bilateral spermatic veins were measured.Both testises and kidneys were weighed.HE staining was used to observe pathological changes of penis and left testis.The success rate of modeling was calculated in the Model group.Results A VC and ED model was successfully established in 15 out of 20 rats in the Model group with a success rate of 75％.After modeling,the diameter of the left spermatic vein in the model group was increased significantly(P＜0.01)and was significantly larger than that before modeling(P＜0.01).The diameter of the right spermatic vein in the Model group was increased(P＜0.05)and higher(P＜0.05)than that before modeling.The weight of the left testis in the Model group was significantly decreased(P＜0.01)compared with that of the right testis.No significant difference in the bilateral kidney weights were observed between or within groups(P＜0.05).In the Model group,the numbers of erections,yawning,and genital grooming decreased significantly(P＜0.01)with the time of modeling.Pathological changes of the left testis and penis were significant in the Model group.Conclusions The Turner method increases the diameter of the spermatic vein in rats,causing testis injury and weight loss,and APO tests can be used to screen rats with ED after VC induction.The combination of the two method is suitable to establish an animal model of VC with an ED status similar to humans.

Objective:To establish a nomogram prediction model for recurrence within 2 years after radical resection of hepatocellular carcinoma (HCC) based on clinical and ultrasonographic characteristics.Methods:Clinical data from 405 HCC patients (including 327 males and 78 females), aged 60 (53, 66) years old, who underwent radical hepatectomy in the Zhongshan Hospital, Fudan University, from January to December 2021, were retrospectively collected. The patients were divided into two groups: the training group ( n=283) and the validation group ( n=122). Based on recurrence within 2 years after surgery, the 283 patients in the training group were further categorized into the recurrence group ( n=73) and the non-recurrence group ( n=210). Among the 122 patients in the validation group, 33 had recurrence within 2 years, while 89 did not. Data on age, microvascular invasion, alpha-fetoprotein (AFP), AFP lentil lectin-reactive fraction (AFP-L3), protein induced by vitamin K absence or antagonist-II (PIVKA-II), tumor number, and enhancement homogeneity were collected. Logistic regression analysis was performed on the training group to identify risk factors associated with postoperative recurrence, and a nomogram model for predicting HCC recurrence was constructed based on these factors. Calibration curves were used to compare the consistency between predicted and actual outcomes in both the training and validation groups. Results:Multivariate logistic regression analysis revealed that younger age ( OR=0.976, 95% CI: 0.953-1.000, P=0.004), higher AFP-L3 ( OR=1.066, 95% CI: 1.014-1.120, P=0.012), higher PIVKA-II ( OR=1.000, 95% CI: 1.000-1.001, P=0.042), multiple tumors ( OR=0.399, 95% CI: 0.225-0.706, P=0.038), and heterogeneous enhancement ( OR=0.472, 95% CI: 0.243-0.916, P=0.045) were significant risk factors for recurrence after partial hepatectomy in HCC patients. The nomogram constructed based on these variables had a C-index of 0.87 (95% CI: 0.81-0.93) in the training group and 0.83 (95% CI: 0.77-0.89) in the validation group. The calibration curves for predicting recurrence within 2 years after partial hepatectomy in HCC patients showed a high degree of fit in both the training and validation groups, indicating a good agreement between predicted and actual outcomes. Conclusion:The nomogram model constructed based on preoperative clinical and ultrasonographic characteristics can effectively predict the risk of recurrence within 2 years after radical resection of HCC.

Objective:To study the learning curve in laparoscopic left lateral hepatic sectionectomy.Methods:The clinical data of 62 consecutive patients who underwent left lateral hepatic sectionectomy by a single operator from February 2015 to May 2022 in General Hospital of Northern Theater Command were retrospectively analyzed. There were 22 males and 40 females, with mean ±s.d. of (50.7±11.7) years. The learning curve was depicted and evaluated by using the cumulative summation test. The general information, operation and postoperative indicators of the growth level group and the master level group were compared.Results:The average operation time of the 62 consecutive subjects was (172.9±70.1) minutes. Intraoperative blood loss was 100 (50, 200) ml. Two patients were converted to open hepatectomy. Clavien-Dindo grade I postoperative complications occurred in 20 patients (32.3%), with grade Ⅱ in 1 patient (1.6%) and grade Ⅲb in another patient (1.6%). The learning curve reached its highest point on the 20th patient by using the cumulative summation test. The study subjects were then assigned into the growth level group (patient 1-20) and the master level group (patient 21-62). The master level group had a significantly wider spread of patient age [(52.9±11.0) years vs (46.1±11.9) years], decreased operation time [(146.8±55.6) min vs (227.9±66.7) min], shortened drainage tube removal time [4(3, 5) d vs 6(4, 7) d] and decreased postoperative hospital stay [5(5, 7) d vs 6.5(4, 9) d] (all P<0.05) when compared with the growth level group. Conclusion:Left lateral hepatic sectionectomy was safe and feasible, and a single operator went through a learning curve of 20 patients before he/she could master the operation more proficiently.

Objective:To explore the risk factors of recurrence after laparoscopic myomectomy and provide references for clinical prevention and treatment.Methods:The clinical data of 216 patients who underwent laparoscopic myomectomy in Ningjin County People′s Hospital from June 2016 to December 2018 were analyzed retrospectively. The recurrence rate at 12 months after the operation was followed up, and the risk factors influencing the recurrence after laparoscopic myomectomy were screened by univariate analysis and multivariate Logistic regression model.Results:After followed up for 12 months after the operation, 24 cases had recurrence, with a recurrence rate of 11.11%(24/216). Univariate analysis showed that the recurrence after laparoscopic myomectomy was significantly correlated with surgical age, age at menarche, number of fibroids, uterine size, and gonadrotropin releasing hormone agonist (GnRH-a) treatment after the operation ( P<0.05), but was not significantly correlated with body mass index, fibroid size, fibroid type, and pregnancy after the operation ( P>0.05). Multivariate Logistic regression analysis showed that surgical age ≥ 35 years old ( OR=1.289, 95% CI 1.013-1.641), age at menarche <13 years old ( OR=1.765, 95% CI 1.167 - 2.669), and number of fibroids ≥ 2 ( OR=2.487, 95% CI 1.442 - 4.288) were independent risk factors for recurrence after laparoscopic myomectomy ( P<0.05), while GnRH-a treatment after the operation ( OR = 0.696, 95% CI 0.510-0.951) was its protective factor ( P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve of surgical age ≥ 35 years old, menarche age <13 years old, and number of fibroids ≥ 2 for predicting recurrence after laparoscopic myomectomy was 0.641 (95% CI 0.573 - 0.705), 0.719 (95% CI 0.654 - 0.778) and 0.622 (95% CI 0.554 - 0.687), and age at menarche had the greatest diagnostic efficiency. Conclusions:Surgical age ≥ 35 years old, age at menarche <13 years old, and number of fibroids ≥ 2 are independent risk factors for recurrence after laparoscopic myomectomy. Intraoperative ultrasound and postoperative GnRH-a treatment can help reduce the risk of postoperative recurrence.

Objective To observe the effect of sitagliptin on carotid intima-media thickness (c-IMT) and serum hs-CRP and IL-6 levels in the patients with newly diagnosed type 2 diabetes mellitus. Methods 65 patients with newly diagnosed type 2 diabetes mellitus who were admitted to the outpatient clinic and were hospitalized in our hospital were selected. They were randomly divided into sitagliptin phosphate tablet group (experimental group) with 35 cases and metformin hydrochloride tablet group (control group) with 30 cases. All patients were given health education about diabetes, diet guidance and exercise. All patients were given drawing of venous blood at a fasting condition ≥10 h before treatment and 6 months after treatment to determine the following indicators: FPG, 2 hPG, hs-CRP, IL-6, TC, TG, HDL-c, LDL-c, HbA1 c, hs-CRP, IL-6, etc, and c-IMT was determined. Results There was no statistically significant difference in blood glucose, blood lipids, inflammation index and c-IMT between the two groups before treatment (P>0.05); after treatment, FPG, 2 hPG and HbA1 c were significantly lower than those before treatment in both groups, and the difference was statistically significant (P<0.01). There were statistically significant differences in FPG and HbA1 c between the two groups (P<0.01). There was no statistically significant difference in 2-hour postprandial blood glucose between groups (P>0.05). The c-IMT, hs-CRP and IL-6 levels in the experimental group after treatment were significantly lower than those before treatment, and the differences were statistically significant (P<0.05). There was no significant change in c-IMT in control group after treatment (P>0.05). hs-CRP and IL-6 had a decreasing trend compared with those before treatment, and the difference was not statistically significant (P>0.05). There were statistically significant differences in c-IMT, hs-CRP and IL-6 between the two groups after treatment (P<0.05). Spearman linear correlation analysis: c-IMT was positively correlated with hs-CRP levels and IL-6 (r=0.6585, P=0.000; r=0.571, P=0.000). There was no significant correlation between fasting blood glucose and glycosylated hemoglobin (P>0.05). Conclusion The DPP-4 inhibitor of sitagliptin has a clear hypoglycemic effect and can reduce c-IMT, hs-CRP and IL-6. The anti-inflammatory effects besides hypoglycemic effect may be involved in the reduction of atherosclerosis in the patients with diabetes mellitus.

Objective To investigate the radioactivity levels in foods in environmental protection area around a decommissioned uranium mine in Yunnan province,in order to timely discover the release of radioactive substances and to provide accumulated baseline data.Methods Radioactivity levels in grains,vegetables and fresh tea at 20 sampling points were measured in the environmental protection area within 3 km of a decommissioned the uranium mine.After field pretreatment and laboratory preparation,the radionuclides in samples were analyzed by means of γ spectrometry.Results Radionuclides in foods in the area mainly include natural radionuclides (238 U,232Th,226Ra,40 K) and man-made radionuclide (137 Cs).Radioactivity level of 238U,232Th,226Ra and 40K was (0.17 ± 0.05),(0.25 ± 0.17),(0.43 ±0.28)and (103.49 ±25.10)Bq/kg(fresh weight),respectively.Radioactivity levels of 232Th,226Ra,40K and 137Cs in fresh tea were all higher than those in grains and vegetables.Conclusions Radioactivity levels in foods around the area are lower than the relevant national limits.No man-made radionuclide other than 137Cs was found in the area.

Objective To explore the feasibility of electromagnetic navigation for hepatic ducts exploration by choledochoscope based on a three-dimensional (3D) printing model.Methods The retrospective descriptive study was conducted.The clinical data of 1 patient with obstructive jaundice combined with secondary biliary tract dilation who was admitted to the Beijing Tsinghua Changgung Hospital in April 2016 were collected.Digital imaging and standardized format data of enhanced computed tomography (CT) scan were collected,3D reconstruction of liver and bile duct were done under a 3D printing model,and then a hollow model of bile duct was achieved.Choledochoscope with internal electromagnetic probe was inserted into the printed hepatic ducts.Four points of anatomical markers in left and right hepatic ducts and common hepatic duct were chosen as fiducial markers for calibration and registration.Results After registration,the scope can be tracked in main hepatic segmental bile ducts.The locations of choledochoscope matched precisely the navigation results.Conclusion Electromagnetic navigation may bring accurate tracking effectiveness for choledochoscopic examination.

Objective To explore the effect of the teacher-student co-construction of skills training team in teaching of nursing skills for higher vocational nursing students. Methods About 129 students from grade 12 were enrolled in the control group, where the traditional teaching method was used. Another 136 nursing students from grade 13 were enrolled in the experiment group, where the teacher-student co-construction of skills training team was used. The two groups were compared in terms of test scores on nursing skills . Result The scores of the nursing skill in the experiment group were significantly higher than those of the control group (P < 0.05). Conclusion The implementation of teacher-student co-construction of nursing skills training team can improve the nursing skills of the nursing students, motivate students' initiative and creativity and enhance their sense of responsibility and other comprehensive quality.

Background: The demand for effective intervention for subhealth conditions is growing with increasing numbers of people being in a state of subhealth with a poor quality of life. Future research and evaluation of the treatment methods for subhealth conditions from the perspective of traditional Chinese medicine (TCM) may provide an important direction for developing effective management of these conditions. Objective: To evaluate the efficacy and safety of Xiaopi Yishen herbal extract granules (XPYS-HEG), a compound traditional Chinese herbal medicine for relieving fatigue and promoting a cheerful spirit for the treatment of people with fatigue-predominant subhealth due to liver-qi stagnation and spleen-qi deficiency. Design, setting participants and interventions: A multi-center, randomized, double-blinded, placebo-controlled clinical study was undertaken. The study period was 18 weeks, including 6 weeks for intervention and 12 weeks for follow-up. Participants were recruited from medical center and outpatient clinics of three hospitals in China, i.e. Xiaotangshan Hospital of Beijing, the First Affiliated Hospital of Henan University of TCM and the Affiliated Hospital of Liaoning University of TCM. Two hundred participants who met the criteria of fatigue-predominant subhealth and liver-qi stagnation and spleen-qi deficiency in TCM were allocated randomly to the treatment group (XPYS, n=100) and control group (placebo, n=100). Main outcome measures: The total score of Fatigue Scale-14 (FS-14) was used to evaluate the fatigue status of subjects and the extent of liver-qi stagnation and spleen-qi deficiency syndrome was also recorded. Results: Three cases in the XPYS group withdrew from the trial. There were 200 subjects who entered to full analysis set (FAS) analysis and 197 subjects fitted in the per-protocol set (PPS) analysis. (1) According to the score changes of FS-14, the effectiveness rates in the XPYS and placebo group were as follows: 14.0% vs 9.0% (FAS) and 14.4% vs 9.0% (PPS) for complete remission, 19.0% vs 15.0% (FAS) and 19.6% vs 15.0% (PPS) for obvious effects, 39.0% vs 26.0% (FAS) and 39.2% vs 26.0% (PPS) for effective, and 72.0% vs 50.0% (FAS) and 73.2% vs 50.0% (PPS) for complete efficacy. The efficacy of XPYS-HEG was superior to the placebo statistically (P<0.05). (2) According to the score changes of TCM syndrome, the effectiveness rates in the XPYS group and placebo group were as follows: 1.0% vs 0.0% (FAS) and 1.0% vs 0.0% (PPS) for complete remission, 20.0% vs 7.0% (FAS) and 19.6% vs 7.0% (PPS) for obvious effects, 29.0% vs 24.0% (FAS) and 29.9% vs 24.0% (PPS) for effective, and 50.0% vs 31.0% (FAS) and 50.5% vs 31.0% (PPS) for complete efficacy. The efficacy of XPYS-HEG was superior to that of placebo statistically (P<0.05). (3) The follow-up results at 12 weeks and 18 weeks showed that the efficacy of XPYS-HEG was superior to that of placebo statistically (P<0.05). (4) No adverse effects were found in the XPYS group. Conclusion: It can be concluded that XPYS-HEG is effective and safe for the treatment of people with fatigue-predominant subhealth due to liver-qi stagnation and spleen-qi deficiency.

BACKGROUND: Basic fibroblast growth factor (bFGF) can accelerate the bone marrow mesenchymai stem cells (BMSCs) proliferation and differentiation into nerve cells, which is considered as a mitogen of glial cells.OBJECTIVE: To investigate the survival and differentiation of bFGF gene modified BMSCs transplanted on rat models of cerebral ischemia by double immunofluorescence staining, and to study the differentiation trend of BMSCs into neuron-like cells and glial cells.DESIGN, TIME AND SETTING: The randomized control animal experiment was completed in the central laboratory of Experimental Animal Center of Central South University from July 2005 to March 2006.MATERIAL: Fifty Sprague-Dawley rats were divided into 4 groups at random: sham operation group (n=10), cerebral ischemia-reperfusion injury group (n=10), BMSCs group (n=i5) and bFGF modified BMSCs group (n=15). METHODS: Except sham operation group, rats in the other three groups were prepared for local cerebral ischemia-reperfusion models. Then BMSCs or bFGF modified BMSCs were intravenously transplanted into cerebral ischemic rats, and the same volume of DMEM were injected in the cerebral ischemia-reperfusion injury group. MAIN OUTCOME MEASURES: Survival rate and differentiation of grafted cells were observed by 5-bromo-2-deoxyuridine (BrdU)-NeuN, and BrdU-glial fibrillary acidic protein (GFAP) double immunofluorescence staining; the neurological scores and infarction volumes in each group. RESULTS: At 7 days after implantation, the number of BrdU/NeuN-positive cells and BrdU-GFAP-positive cells in the bFGF modified BMSCs group was higher than those on the BMSCs group (P < 0.05), but there were no significant differences in the co-expression cells by double immunofluorescence staining between the two groups (P > 0.05). At 7 days following reperfusion, neural function of cerebral ischemia rats were improved and infarction volume was reduced in both BMSCs group and the bFGF modified BMSCs group, and bFGF modified BMSCs group was superior to BMSCs group. CONCLUSION: BMSCs modified by bFGF can survive in cerebral ischemic region and differentiate into neuron and glial cells, which are more proper for repairing nerves.