Objective To investigate therapeutic effect of the low dose clomiphene treatment of idiopathic oligoasthenospermia and effect on sperm epididymal protein level 4.Methods183 cases of idiopathic oligoasthenospermia were divided into three groups, vitamin group of 61 patients were given vitamin E,clomiphene group(61 cases)treated with low dose clomiphene, combined group of 61 patients were given low dose clomiphene and vitamin E, lasted for 12 weeks.Semen volume, sperm density, sperm motility, sperm survival rate and sperm reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), human epididymis protein 4 (HE4), follicle stimulating hormone, luteinizing hormone, testosterone concentration were observed before and after treatment.After treatment, the patients were followed up for 1 year, the observation of the natural pregnancy rate after treatment.ResultsSperm density, sperm survival rate and sperm and a A+B grade sperm in the clomiphene group were significantly higher comparedwith the vitamin group (P< 0.05), sperm density, sperm survival rate and sperm and a A+B grade sperm in the combined group were significantly increasedcompared with clomiphene group and vitamin group (P< 0.05),levels of HE4 after treatment was significantly lower compared with before treatment (P< 0.05), And the difference between the three groups were statistically significant (P< 0.05).Follicle stimulating hormone, luteinizing hormone, testosterone in clomiphene group and combined group after treatment, were significantly increased compared with before treatment (P< 0.05), and the combined group had no statistically difference compared with clomiphene group.The pregnancy rate in 1 year of vitamin group, clomiphene group and combined group were 24.59%, 42.62% and 62.29% (P< 0.05).ConclusionClomiphene treatment of idiopathic asthenospermia is better than vitamin E, the combination of the two has a synergistic effect.

Objective To assess the clinical value of dual-energy CT (DECT) Volume software in quantitative analysis of urate crystals.Methods The DECT data of 60 gout patients based on the American College of Rheumatology diagnostic criteria were analyzed retrospectively.The volumes of urate crystals were quantitatively analyzed by using Volume software with two senior radiologists.The results were statistically analyzed.Results Seventy-two joints of 60 gout patients were scanned by DECT.40 of 43 joints had urate crystals in foot and ankle with the average volume of (0.621±0.742) cm3;18 of 19 joints had urate crystals in knee with the average volume of (0.842±1.086) cm3;10 of 10 joints had urate crystals in hand and wrist with the average volume of (0.796±0.583) cm3.There was no statistical difference for volume measurement between two doctors (P>0.05).The volumes of urate crystals in 4 patients with regular medication were reduced.Conclusion Volume software of DECT can quantitatively analyze urate crystals with a good repeatability, which has high application value in clinical diagnosis and treatment monitoring of gout.

Objective To investigate micro-inflammatory state and protein-energy wasting (PEW) states in maintenance peritoneal dialysis(MPD) patients,then analysis of the correlation between them.Methods Ninty-six cases of MPD patients in this Hospital were selected from March 2012 to September 2015.The status of nutrition were assessed by Quantitative Subjective and global Assessment(SGA),malnutrition-inflammation score(MIS) and albumin(Alb),micro-inflammatory state was assessed by enzyme-linked immunoassay(ELISA) method serum hypersensitive c-reactive protein (hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6).At the same time,various serological markers like serum Alb,serum total protein(TP),serum prealbumin(PA),hemoglobin(Hb),transferrin(TF),serum creatinine(Scr),urea nitrogen(BUN),cholesterol(Teh) were measured.Results The incidence of PEW in MPD patients was 36.50％,among which 62.86 ％ of them were over 65 years old,57.10％ were over 2 years of dialysis time and 40.00％ with diabetic nephropathy.MPD patients with hs-CRP＞5 mg/L accounted for 58.33％,of which over 65 year old accounted for 42.86％,MPD age longer than 2 years accounted for 60.71％,32.14％ of them with diabetic nephropathy.The proportion of diabetic nephropathy,average age,dialysis duration time,hs-CRP,TNF-α and IL-6 in PEW group were higher than non-PEW group(P＜0.05);BM,TP,Alb,PA,Hb,TCh,MAC and MAMC were lower ban non-PEW group(P＜0.05).Compared with the hs-CRP≤5 mg/L group,average age,the time of dialysis duration,TNF-α,IL-6 were higher and TP,Alb,PA,TF,Hb,the proportion of Kt/V≥1.72 were lower in the hs-CRP＞5 mg/L group.After the correction of age,sex,dialysis ages,it was found that the level of hs-CRP in MPD patients was negatively correlated with the level of Alb,PA,TF,Tch,Scr,TG;The level of IL-6 was negatively correlated with the levels of Alb,PA,TF,Tch,TG.The level of TNF-α in MPD patients showed different degrees of negative correlation with the leves of Alb,PA,TF,TG,Tch(all P＜0.05).Multivariate analysis showed that elderly,the time of dialysis duration,the microinflammatory state,and hypoalbuminemia were the independent risk factors of PEW.Conclusion PEW and micro-inflammatory state are very common in PHD patients.Patients with longer duration of dialysis,elderly or associated with diabetic nephropathy are more likely to suffer PEW and micro-inflammatory.Elderly,the time of dialysis duration,microinflammatory state,hypoalbuminemia are the independent risk factors of PEW.

The bioactivities, chemical composition and distribution of aerial parts of Panax species are different from the roots. The present paper summarized the phytochemical and analytical studies of aerial parts of Panax species, including P. ginseng, P. notoginseng, P. quinquefoliun and P. japonicus. This review aims so as to provide scientific evidences for further investigation of chemical profile, quality control and optimal utilization of these resources.
Chemistry Techniques, Analytical ; Drugs, Chinese Herbal ; chemistry ; Panax ; chemistry ; Plant Components, Aerial ; chemistry ; Quality Control ; Saponins ; analysis ; chemistry

A sensitive, fast and comprehensive method for the quality assessment of Semen Ziziphi Spinosae (SZS) standard decoction with characterization of its chemical components was developed and validated. UPLC-Q/TOF-MS/MS system was used to identify thirty-six chemical components of SZS standard de-coction which included nucleosides, phenolic acids, alkaloids, and flavonoids. Furthermore, a UPLC-PDA method was validated to simultaneously determine adenosine, protocatechuic acid, magnoflorine, ca-techin, protocatechin, vicenin II, spinosin, kaempferol-3-rutinoside, and 6'''-feruloylspinosin which re-present four species of characteristic compounds. The qualitative method had been validated according to Chinese Pharmacopoeia (2015 edition) in terms of lineary, repeatability, recovery and stability for all analytes, with the results showing good precision, accuracy and stability. In conclusion, the method using UPLC combined with MS and PDA provided a novel way for the standardization and identification of SZS standard decoction, and also offered a basis for qualitative analysis and quality assessment of the pre-parations for SZS standard decoction.

Under the guidance of strengthening medical undergraduates' practical ability and their competence in future jobs, Dalian Medical University has established a clinical medical talents practical ability training mode. This model has implementedThree Turnsclinical skills training pattern to strengthen the three stage (before, during and after practice) clinical skills training and concentrated on humanistic quality education through overall evaluations and set up clinical skill examination system to evaluate teach-ing effectiveness comprehensively and truly , which has effectively improved the quality of education by perfecting safeguard mechanisms and guaranteeing teaching quality.

Objective To explore the relationship between the radiological characteristics and clinical and pathological manifestations of intracranial juvenile xanthogranuloma. Methods The radiological and clinical characteristics of two intracranial juvenile xanthogranuloma cases were analyzed respectively. In combination with reviewing literatures, the radiological characteristics and discipline of intracranial juvenile xanthogranuloma disease were also analyzed. Results Intracranial juvenile xanthogranuloma disease was accidently detected in one case. The other case was detected with headache and numbness in face. No abnormal sign was found in skin. On plain CT isodensity signals appeared and on contrast-enhanced CT homogeneous enhancement was found.On MR imaging,masses showed isointense signals on T1WI and iso-or hypo-intensity signals on T2WI, and enhanced homogeneously. Lesions were solitary or multiple in the external of brain. After operation intracranial juvenile xanthogranuloma was confirmed by pathology, and no recurrence occurred. Conclusion Intracranial juvenile xanthogranuloma is a kind of rarely encountered disease with typically radiological characteristics, which is difficult to detect before surgery and can be confirmed by post-operative pathological and immunohistochemical examinations.[Chinese Medical Equipment Journal,2018,39(5):71-74]

OBJECTIVEEndoscopic sclerotherapy has emerged as an effective treatment for bleeding esophageal varices in adults and children but the long-term outcome is poorly defined in children. The present study aimed to study the long-term effect of endoscopic sclerotherapy in children with portal hypertension.

METHODSFifteen patients (age 3 to 14 years) with esophageal variceal bleeding underwent endoscopic injection treatments with 1% Aethoxy-sclerol since 1996. All subjects continued to receive the therapy by repeated intra and extravariceal endoscopic sclerotherapy at intervals of 3 - 4 weeks until the varices disappeared, and received regular endoscopic follow-up.

RESULTSFifteen patients had totally 43 injections, and were followed up from 40 to 86 months (mean 66 months) by endoscopy. Two patients received 2 injections and 5 received 3 before eradication of varices. The mean time needed for varices eradication was 3 to 6 months. Recurrence of varices and bleeding was seen in 3 patients who had duodenal ulcer.

CONCLUSIONEndoscopic sclerotherapy is a safe and effective treatment for pediatric esophageal varices.

Adolescent ; Child ; Child, Preschool ; Duodenal Ulcer ; complications ; Esophageal and Gastric Varices ; etiology ; therapy ; Esophagoscopy ; Gastrointestinal Hemorrhage ; etiology ; therapy ; Humans ; Hypertension, Portal ; complications ; Injections, Intralesional ; Polyethylene Glycols ; administration & dosage ; Recurrence ; Reoperation ; Sclerosing Solutions ; administration & dosage ; Sclerotherapy ; Time Factors ; Treatment Outcome

Adolescent ; Bone Neoplasms ; diagnosis ; Diagnostic Errors ; Humans ; Lymphoma ; diagnosis ; Male