Disorders of sex development(DSD) include anomalies of sex chromosomes,gonads,reproductive ducts,and genitalia.Here,the term "intersex" is avoided because of its imprecision.The purpose of this review is to assist health care professionals in the provision of treatment,education,and support to children born with DSD and to their families.The goal of DSD treatment is to achieve the long-term physical,psychological,and sexual well-being of the patients.In the case of DSD it involves several principles.Providing medical and surgical care to deal with a complication that threatens to the patient's physical well-being;minimizing the potential for the patient and family to feel ashamed,stigmatized,or overly obsessed with genital appearance;delaying elective surgical and hormonal treatments until the patient can actively participate in decision-making;telling the truth to the family and the child and addressing psychosocial distress of the children and their parents.This approach is termed as "patient-centered".

With increasing demands and recognition, emergency medicine has advanced rapidly in China in recent decades. The education and training of professionals in this field are important for the further development of emergency medicine. With an attempt to investigate the way to strengthen residency training system in emergency medicine, this article reviews its potential development direction, training modes, learning materials, and quality control.
China ; Emergency Medicine ; education ; organization & administration ; Internship and Residency ; methods ; standards ; trends

Exposure to thermal environment is one of the main concerns for manned space exploration. By focusing on the works performed on thermoregulation at microgravity or simulated microgravity, we endeavored to review the investigation on space thermal environmental physiology. First of all, the application of medical requirements for the crew module design from normal thermal comfort to accidental thermal emergencies in a space craft will be addressed. Then, alterations in the autonomic and behavioral temperature regulation caused by the effect of weightlessness both in space flight and its simulation on the ground are also discussed. Furthermore, countermeasures like exercise training, simulated natural ventilation, encouraged drink, etc., in the protection of thermoregulation during space flight is presented. Finally, the challenge of space thermal environment physiology faced in the future is figured out.
Aerospace Medicine ; Body Temperature Regulation ; Environment ; Exercise ; Humans ; Space Flight ; Weightlessness ; Weightlessness Simulation

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hematopoiesis ; drug effects ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Middle Aged ; Phytotherapy ; Schisandraceae

Birth Weight ; Fetal Growth Retardation ; genetics ; Humans ; Molecular Biology

OBJECTIVETo compare the effectiveness and safety of transurethral resection of the prostate (TURP) and transurethral enucleative resection of the prostate (TUERP) in the treatment of benign prostate hyperplasia (BPH).

METHODSA total of 630 BPH patients with indication of surgery were randomly assigned to receive TURP (n = 305) and TUERP (n = 325), respectively. There were no significant differences preoperatively in age, prostate volume, International Prostate Symptom Score (IPSS), and Qmax between the two groups (P > 0.05). The prostate resection rate, operation time, postoperative complications, and quality of life (QOL) of the patients were recorded and statistically analyzed.

RESULTSCompared with TURP, TUERP showed a significantly higher rate of prostate resection ([47.0 +/- 13.3] vs [60.1 +/- 12.3]%, P < 0.05), shorter operation time ([57.9 +/- 15.9] vs [40.4 +/- 14.2] min, P < 0.05), and shorter bladder irrigation time ([2.7 +/- 0.6] vs [2.2 + 1.1] d, P < 0.05). Significant differences were found between the pre- and post-operative levels of serum sodium and hemoglobin in the TURP group ([141.2 +/- 3.5 ] vs [136.9 +/- 4.7] mmol/L, P < 0.01; [137.6 +/- 8.8] vs [124.8 +/- 9.6] g/L, P < 0.01), but not in the TUERP group. Three months after operation, IPSS, QOL, and Qmax were all markedly improved in both groups (P < 0.01), but with no significant differences between the two groups (P >0.05).

CONCLUSIONTUERP is better than TURP in the treatment of BPH for its advantages of higher resection rate of the prostate, shorter operation time and bladder irrigation time, less intraoperative blood loss, fewer postoperative complications, and faster recovery.

Objective To observe insulin synthesis and secretion in INS-1 under high glucose, and to clarify the effect of PTH1R. Methods After successful construction of recombinant PTH1R-siRNA vectors in INS-1 cell, insulin secretion and intracellular insulin content of control group, siPTH1R-Negative control group, PTHrP group, and siPTH1R group under 25 mmol/L glucose were measured by radioimmunoassay in INS-1 cell. Intracellular calcium were detected by Fluo-3/AM and the capability of glucose transport was calculated by assaying the uptake of [3H]-2-deoxy-D-glucose in cells.Results Compared with control group, and siPTH1R-NC group, PTHrP group showed increased capability of insulin secretion; PTHrP group had higher intracellular insulin levels than others; PTHrP group showed increased intracellular calcium; the uptake of [3H]-2-deoxy-D-glucose under high glucose after 48h of PTHrP group was increased(all P＜0.01). Conclusion There is a close relationship between PTH1R activation and insulin secretion and synthesis, PTH1R activation may be one of the protective mechanisms in maintaining function of β-cell under high glucose.

Objective: To investigate the effects of bovine plasma fibronectin on the proliferation and differentiation of rat osteoblasts. Methods:Rat osteoblasts were cultured and identified. AlamarBlue were used to determine the effect of various concentration of bovine plasma fibronectin on the proliferation of the osteoblasts. ELISA method was used to determine the alkaline phosphatase activity of the cells. Results: Fibronectin stimulated the proliferation of rat osteoblasts at 40 ?g/ml (P

[Objective]To discuss the injury severity and treatment of 236 patients with upper limb injuries in Wenchuan Earthquake.[Method]The basic informations of patients with upper limb injures in Wenchuan Earthquake,and the injury mechanisms,clinical symptoms and treatment were collected and analyzed.[Result]In 236 cases of patients with upper limb injuries,there were 208 patients,378 cases with fracture,and 64 cases with open fracture.There were 35 cases of clavicle fracture,31 cases of scapula fracture,113 cases of humerus fracture,46 cases of ulna fracture,87 cases of radial fracture and 66 cases of carpometacarpai phalangeal fracture.Fifty cases received debridement and suture,60 cases received fracture reduction and internal fixation and 7 cases received external fixation.Totally,19 limbs were carried on amputation,and only one patient died of hyperkalemia and combined injury.[Conclusion]Analysis of patients with injury mechanisms,clinical symptoms and treatment can provide advices for rescuing and treating of patients with upper limb injuries in earthquake or other disaster cases.

Bayes Theorem ; Public Health ; Translational Medical Research