Objective To evaluate the efficacy of testosterone supplementation for partial androgen deficiency in middle-aged men. Methods This prospective,double-blind,placebo-controlled,randomized clinical trial was conducted in our hospital.A total of 179 patients (mean age,41.8 years) were randomly divided into study group (n=136) and control group (n=43).The 136 patients in study group received andriol (80 mg,twice a day) for 3 months;while the 43 patients in control group received no special treatment.The changes of partial androgen deficiency in aging male (PADAM) scores,serum total testosterone (TT),free-T (fT) and relevant sexual hormone levels were assessed before and after treatment. Results In study group the PADAM scores at 1 and 3 months after treatment were significantly improved compare with those before treatment (P0.05). Conclusions Partial androgen deficiency in middle-aged men is clinically exist and testosterone supplementation for this condition is safe and effective.

Objective To investigate the prevalence of adult's chronic constipation in Tianjin city and to find out its associated pathogenetic factors. Methods During Aug. 2002 to Mar. 2003 the survey of chronic constipation in 7220 subjects aged≥18 in different part of the city and countryside were carred out by nine hospitals based on the clustering, randomly stratified sampling method. There were 118 items investigated in this survey including the possible factors associabed with pathogenesis of chronic constipation. The data were analyzed by Logistic regression. Results The prevalence of chronic constipation was 11.6% in total of 7220 cases which was significantly higher in females than in male(13.4% vs 9.7%, P =0.000) . The prevalence of chronic constipation increased with growing of age and related with occupation, exercises, psychological pressure, the habit of intake food and water. In addition,the chronic constipation was associated with reflux esophagitis and chronic gastritis. Conclusion The measures of changing life style, drinking more water, taking more vegetables and having a good habit of bowel evacuation may decrease the prevalence of chronic constipation.

BACKGROUND:There are many complications of limb salvage surgery in patients with osteosarcoma of the middle tibia, and the limb salvage surgery is one of the current difficulties in clinical treatment. OBJECTIVE:To evaluate the clinical efficacy of reconstruction with massive al ograft bone for osteosarcoma of the middle tibia by retrospectively reviewing relevant cases. METHODS:Seven patients with osteosarcoma of the middle tibia were treated. And we analyzed their clinical data retrospectively. Al patients completed the formal preoperative adjuvant chemotherapy and we confirmed that there was no distant metastasis before surgery. Al patients received large al ogeneic bone transplantation and internal fixation, and the gastrocnemius muscle flap coveraged graft bone in surgery. The average length of al ogeneic bone was 12.5 cm. Five patients received postoperative adjuvant chemotherapy completely, and two patients received partly. RESULTS AND CONCLUSION:The fol ow-up period was 18-36 months. One patient had local tumor recurrence at 1 year after transplantation, and died of lung metastases after amputation. One patient survived after resection of lung metastases that occurred at 1.5 years after transplantation. One patient died of lung metastases at 2 years after transplantation. The rest four patients were tumor-free. The mean Musculoskeletal Tumor Society (MSTS) score was 26.5, the mean International Society of Limb Salvage (ISOLS) graft score was 31. Among four underage patients, one had leg length deformities, with limb shortening 2 cm. There were no postoperative infections and pathological fractures. Using large al ogeneic bone for the repair of bone defects after tumor surgery of the middle tibia can have a good clinical efficacy under the premise of strict indications. Using gastrocnemius muscle flap to cover the bone graft during surgery is an effective measure to reduce postoperative complications.

Objective: To detect varicella-zoster virus ( VZV ) antibody levels among children aged 1 to 12 years in Lu'an City, Anhui Province, so as to provide insights into perfection of the varicella immunization strategy. Methods: Children aged 1 to 12 years were recruited from Lu'an City using the stratified random sampling method from July 2018 to February 2019, and subjects' demographics were collected using questionnaires. The inoculation of varicella vaccines was retrieved through the Anhui Immunization Information Management System or review of preventive immunization certificates, and the serum VZV IgG antibody was detected using enzyme-linked immunosorbent assay ( ELISA ). The seroprevalence and geometric mean concentration of the VZV-IgG antibody were estimated, and the changes of serum the VZV-IgG antibody levels were analyzed at different time intervals following varicella vaccination. Results: Totally 734 children were surveyed, with a mean age of ( 6.94±2.95 ) years, and the subjects included 412 boys ( 56.13% ) and 322 girls ( 43.87% ). There were 514 children ( 70.03% ) with a history of varicella vaccination, including 501 children ( 68.26% ) with one dose of varicella vaccine and 13 children ( 1.77% ) with two doses. There were 297 children ( 40.46% ) positive for VZV-IgG antibody, with seroprevalence of 40.46%, and the GMC of VZV-IgG antibody was 74.97 ( 95%CI: 65.55-85.75 ) mIU/mL. The seroprevalence of the VZV-IgG antibody were 34.55%, 42.91%, and 46.15% among the unvaccinated children and children receiving one dose and two doses of varicella vaccine, with the GMCs of 53.04, 86.31 and 114.46 mIU/mL, respectively. The mean time interval between inoculation of the last dose of varicella vaccine and blood sample collection was ( 5.21±2.79 ) years, and the lowest seroprevalene (31.48%) and GMC of the VZV-IgG antibody (49.96 mIU/mL) were found 4 years after inoculation of varicella vaccine. Conclusions The serum VZV-IgG antibody level is low among children aged 1 to 12 years in Lu'an City, and the seroprevalence of the VZV-IgG antibody is affected by age and doses of varicella vaccine. A 2-dose schedule of varicella vaccine is recommended for children.

Objective:To investigate the effect of early enteral nutrition combined with Bacillus in the treatment of patients with digestive tract perforation.Methods:59 patients with emergency digestive tract perforation were randomly divided into experimental group (EN plus Bacillus,n =31) and control group (TPN,n =28).The patients in the experimental group were given enteral nutrition plus Bacillus after first days (＜ 24 h),and the control group was treated with parenteral nutrition support on the first day after surgery.The average hospitalization time,length of ICU stay,incidence of complications,and serum C-reactive protein in the two groups were analyzed.Results:The average length of hospitalization time,ICU stay,recovery of bowel function and eating time were significantly shorter in the experimental group than in the control group(P ＜ 0.05).There was no significant difference in nutrition index between the two groups during the perioperative period (P ＞ 0.05).The C-reactive protein in the experimental group was significantly lower than that in the control group fourth days after operation (P ＜ 0.05).The incidence of postoperative wound infection in the experimental group was significantly lower than that of the control group (P ＜ 0.05).There was no significant difference in the incidence of other complications.Conclusion:Early administration of enteral nutrition combined with Bacillus can significantly shorten the intestinal function recovery time,decreasethe average hospitalization days,reduce the postoperative wound infection rate and thus improve the outcome of patients with digestive tract perforation.

Objective To investigate the prognostic value of preoperative neutrophil lymphocyte ratio (NLR) in patients with gastrointestinal stromal tumors (GIST).Methods The clinical-pathological data from 85 GIST cases were collected from the Second Affiliated Hospital of Wenzhou Medical University and retrospectively analyzed from June 2009 to December 2013.According to the exclusion criteria,79 cases were enrolled.Preoperative neutrophil and lymphocyte count was collected and NLR was calculated.According to the receiver operating characteristic (ROC) curve of NLR,GIST patients were divided into low NLR group (NLR ＜ 2.30) and high NLR group (NLR ≥ 2.30).Clinic-pathological features and five year disease free survival (DFS) were compared between the two groups.Results There was a statistical significant difference in tumor size and tumor risk between high NLR group and low NLR group (respectively,x2 =9.517,12.411,all P ＜ 0.05).Univariate analysis showed that the five year disease free survival rate of low NLR and high NLR group were 78％ and 32％ (x2 =18.749,P =0.000).By multivariate analysis a high NLR was identified as an independent risk factor of poorer prognosis for patients with GISTs (RR:3.516,95％CI:1.453-8.506,P=0.005).Conclusion A high preoperative NLR is an independent risk factor for the prognosis of GISTs.

Objective To study the relationship between heparanase( Hpa) , urokinase type plasminogen activator( uPA) expression and lymph node metastasis in thyroid carcinoma.Methods Immunohistochemieal SP method was used to analyze the expression of Hpa and uPA in 113 cases of thyroid carcinoma and 134 cases of be-nign thyroid nodules.The expression of Hpa and uPA in thyroid carcinoma and its clinical significance were ana-lyzed.Results The positive expression rate of Hpa and uPA in thyroid carcinoma and benign nodular thyroid tis-sue were 82.30%,16.42%and 89.38%, 11.19%.The positive expression rate of Hpa and uPA in carcinoma tissues with lymph metastasis and without metastasis were 93.94%,100% and 65.96%,74.47%.Expression of Hpa and uPA in thyroid carcinoma group was significantly higher than that of benign thyroid nodules group( P<0.001) .The rate of positive expression in lymph metastatic tissues were significantly higher than those in tissue without metastasis( P<0.001) .Hpa and uPA expression in thyroid carcinoma tissues was positively correlated( r=0.437, P=0.021).Conclusion The expression of Hpa and uPA is closely related with the occurrence and metastasis of thyroid carcinoma.

Objective To investigate the expression of heparanase (Hpa) in serum and tissue of patients with papillary thyroid carcinoma (PTC) and its clinical significance.Methods Immunohistochemical method (SP) and enzyme linked immunosorbent assay (ELISA) were used to detect the expression of Hpa protein in serum and tissues of 38 cases of PTC,37 cases of patients with benign thyroid nodules,and 30 normal controls.Results Expression of Hpa in PTC was higher than that of benign thyroid nodules (P＜0.01).Expression of Hpa in lymph node metastasis group was higher than that in group without lymph node metastasis (P＜0.05).Compared with the normal control group,the content of serum Hpa in patients with benign thyroid nodules had no significant difference (P＞0.05).Hpa content in serum of patients with PTC was higher than that of benign thyroid nodules group and the normal control group (P＜0.01).There was no statistically significant difference of the level of serum Hpa between groups with and without lymph node metastasis.Conclusions Detecting tissue and preoperative serum Hpa concentration is valuable for diagnosis of PTC.Hpa detection in tissues can be used to determine whether there was lymph node metastasis in PTC patients,while Hpa detection in preoperative serum can not judge whether there is lymph node metastasis.

Objective To evaluate the value of intermittent splenic artery occlusion in the treatment of iatrogenic splenic injury and the cause of ischemia reperfusion injury.Methods Experimental animals using dogs were divided into experimental group and control group according to whether the splenic artery was blocked.The animal model of iatrogenic splenic injury was established by general anesthesia.Experimental group was treated with intermittent splenic artery blockage combined with gelatin sponge oppression of the wound to stop bleeding.The first time of splenic artery occlusion was 15 min and continued for 10 min and for another 5 rmin if still bleeding.Then hemostatic effect after removing blocking and oppression was observed.Control group was only treated with gelatin sponge compression to stop bleeding.Blood samples and tissue samples were collected before blocking and after reperfusion for 2 hours in experimental group,and before compression and relieving the compression for 2 hours in control group.IL-1 (interleukin),SOD (superoxide disproportionation enzyme),MPO (myeloperoxidase),MDA (malondialdehyde) and caspase-3 (aspartame acid cysteine protease) were detected.Results The control group still had bleeding,while the experimental group had successfully stopped bleeding.Serum markers before and after occlusion in the experinental group were IL-1 (124.4 ± 106.8 vs.121.2 ± 105.1),SOD (4.7 ± 2.7 vs.5.2 ± 1.8) and MDA (8.8 ±6.5 vs10.8 ±7.5).There were no significant differences on serum markers in two groups after occlusion/oppression including IL-1 (121.2 ± 105.1 vs.162.8 ± 73.8),SOD (5.2 ± 1.8 vs.4.7 ± 2.8) and MDA (10.8 ±7.5 vs.9.6 ±6.6) (P＞0.05).Histological indicators before and after occlusion in the experimental group included MPO (0.62 ±0.23 vs.0.68 ±0.21) and Caspase-3 (0.90 ±0.29 vs.0.86 ± 0.26),and there was no statistical difference on MPO (0.68 ±0.21 vs.0.86 ±0.23 after two sets of experiments) and Caspase-3 level (0.86 ± 0.26 vs.1.21 ± 0.18) (P ＞ 0.05) in two groups after occlusion/ oppression.Conclusion The therapeutic effect of intermittent splenic artery occlusion combined with gelatin sponge compression hemostasis is safe and effective and without obvious ischemia reperfusion injury.

OBJECTIVEThe purpose of this study was to investigate the influence of cryogenic treatment and age-hardening heat treatment on the micro-Vicker's hardness of palladium-silver dental alloys.

METHODSA low-gold content dental casting alloy composed of Ag-Pd-Cu-Au was prepared for this study. Experimental specimens according to standard requirements were prepared following a standard dental laboratory casting procedure, cast specimens were heated to 900 degrees C and quenched in ice water. The specimens were then divided into 4 groups. They were subsequently subjected to different treatments, including age-hardening heat treatment, cryogenic treatment, heat treatment combined with cryogenic treatment. The non-treated group was used as control. The micro-Vicker's hardness value was examined. The significance of correlation was analyzed.

RESULTSThe micro-Vicker's hardness of specimens after age-hardening heat treatment, cryogenic treatment, heat treatment combined with cryogenic treatment increased by 129%, 13% and 141%, respectively, compared with that of the non-treated control group. Conclusion Age-hardening heat treatment and cryogenic treatment were effective in elevating the hardness of Ag-Pd-Cu-Au alloy.