Background: Adrenal venous sampling (AVS) is essential for diagnosing unilateral aldosterone oversecretion in primary aldosteronism (PA). Traditionally, AVS relies on radioimmunoassay (RIA) to measure plasma aldosterone concentration (PAC), although RIA has limited specificity and considerable variability. This study evaluated the role of liquid chromatography-tandem mass spectrometry (LC-MS/MS) in AVS and its impact on clinical outcomes. Methods: Among 230 patients with PA (May 2020 to April 2023) who underwent AVS, successful sampling was achieved in 182 patients (79.1%) under unstimulated conditions and 206 patients (89.6%) under stimulated conditions. PAC levels from peripheral and adrenal veins measured by LC-MS/MS were compared with RIA results. Patient outcomes were categorized according to the Primary Aldosteronism Surgical Outcomes criteria. Results: LC-MS/MS showed significant correlations with PAC levels measured by RIA in AVS (r=0.40 [unstimulated] and r=0.56 [stimulated]; both P<0.001). However, lateralization concordance between RIA and LC-MS/MS was moderate, at only 57.7% (unstimulated) and 64.6% (stimulated). LC-MS/MS identified more unilateral disease than RIA under both unstimulated (61.5% vs. 37.4%, P<0.001) and stimulated conditions (36.4% vs. 9.7%, P<0.001). Patients achieving complete clinical success after adrenalectomy were more accurately identified by LC-MS/MS than RIA under stimulated (55.6% vs. 22.2%, P=0.035), but not in unstimulated conditions. Conclusion LC-MS/MS outperformed RIA in identifying unilateral disease, resulting in higher rates of complete clinical success in adrenalectomy patients when surgical decisions were based on LC-MS/MS lateralization results.

Objective:To investigate the design of a process indicator for anesthesia induction and its feasibility for a self-directed simulation-based teaching system, and to provide an efficient information technology-based teaching tool that enhances the quality of independent learning and training for anesthesiologists.Methods:Big data derived from electronic medical records were used for the design of the process indicator. Specifically, the design incorporated the coefficients of variations for three hemodynamic features, namely, systolic pressure, diastolic pressure, and heart rate after anesthesia induction. This approach aimed to characterize the quality of anesthesia management. A survey questionnaire was designed and administered to 23 anesthesiologists-in-charge or those with higher positions. These anesthesiologists evaluated the outcomes of anesthesia in 30 cases, thereby investigating the feasibility of the proposed indicators and potential future applications. Analysis of variance and correlation analysis were performed using SPSS 24.0 software, with a significance level set at α=0.05. Results:Based on the range of values for the process indicator of anesthesia induction, five groups were defined: stable, relatively stable, moderately stable, relatively unstable, and unstable. There were significant intergroup differences in the anesthesiologists' ratings, with an F value of 250.66 ( P<0.001), indicating that the integrated coefficient of variation (ICV) effectively discriminated stability levels between groups. The designed indicator showed a significant correlation with the average ratings of the anesthesiologists, with a Pearson correlation coefficient of 0.886 ( P<0.05). This further indicated the great consistency between the proposed indicator and anesthesiologists' judgments. Conclusions:The process indicator for anesthesia induction proposed in this study serves as a feasible measure for assessing the stability of anesthesia. It can be applied in a self-directed simulation-based teaching system, offering new insights and methods for promoting the training and learning of anesthesiologists.

Objective:To investigate the design of a process indicator for anesthesia induction and its feasibility for a self-directed simulation-based teaching system, and to provide an efficient information technology-based teaching tool that enhances the quality of independent learning and training for anesthesiologists.Methods:Big data derived from electronic medical records were used for the design of the process indicator. Specifically, the design incorporated the coefficients of variations for three hemodynamic features, namely, systolic pressure, diastolic pressure, and heart rate after anesthesia induction. This approach aimed to characterize the quality of anesthesia management. A survey questionnaire was designed and administered to 23 anesthesiologists-in-charge or those with higher positions. These anesthesiologists evaluated the outcomes of anesthesia in 30 cases, thereby investigating the feasibility of the proposed indicators and potential future applications. Analysis of variance and correlation analysis were performed using SPSS 24.0 software, with a significance level set at α=0.05. Results:Based on the range of values for the process indicator of anesthesia induction, five groups were defined: stable, relatively stable, moderately stable, relatively unstable, and unstable. There were significant intergroup differences in the anesthesiologists' ratings, with an F value of 250.66 ( P<0.001), indicating that the integrated coefficient of variation (ICV) effectively discriminated stability levels between groups. The designed indicator showed a significant correlation with the average ratings of the anesthesiologists, with a Pearson correlation coefficient of 0.886 ( P<0.05). This further indicated the great consistency between the proposed indicator and anesthesiologists' judgments. Conclusions:The process indicator for anesthesia induction proposed in this study serves as a feasible measure for assessing the stability of anesthesia. It can be applied in a self-directed simulation-based teaching system, offering new insights and methods for promoting the training and learning of anesthesiologists.

ObjectiveTo explore the effect of Modified Dahuang Zhechong Granule (MDZG) on the development and maturation of epididymal sperm in experimental varicocele (VC) rats.

METHODSSixty SD male rats were randomly divided into six groups of equal number, sham operation, VC model, Aescuven forte, and low-, medium- and high-dose MDZG. The model of left VC was made by the Turner method in all the rats except those of the sham operation group, followed by treatment with 0.9% normal saline for the animals in the sham operation and VC model groups, Aescuven forte tablets at 54 mg per kg of the body weight for those in the Aescuven forte group, and MDZG at 0.6, 1.2 and 2.4 g/ml for those in the low-, medium- and high-dose MDZG groups, all administered intragastrically qd for 8 successive weeks. Then, all the rats were sacrificed and their left epididymides harvested for examination of the quality of the epididymal sperm and the local microscopic and ultrastructural changes of the epididymal tissue.

RESULTSThe VC model rats showed significant apoptosis of the epididymal sperm cells, interstitial edema, microvascular dilatation, degeneration and degeneration of the epithelial cells, degeneration of some principal cells and basal cell vacuoles, and immature spermatids in the lumen. Sperm motility was significantly increased in the Aescuven forte and low-, medium- and high-dose MDZG groups as compared with the VC models (P <0.01). Both sperm concentration and motility were markedly higher in the high-dose MDZG than in the Aescuven forte group (P <0.05). Remarkable apoptosis of epididymal sperm cells was observed in the microenvironment of sperm development in the VC models, which exhibited no statistically significant difference from that in the rats of the medium- and high-dose MDZG groups.

CONCLUSIONSExperimental varicocele induced local apoptosis of epididymal sperm cells, interstitial edema and microvascular dilatation in the rat epididymis, while Modified Dahuang Zhechong Granule could improve the stability of epididymal sperm maturation and contribute to their development.

Aesculus ; chemistry ; Animals ; Apoptosis ; Drugs, Chinese Herbal ; pharmacology ; Edema ; chemically induced ; Epididymis ; drug effects ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sperm Count ; Sperm Motility ; drug effects ; Spermatozoa ; cytology ; drug effects ; Varicocele ; chemically induced ; drug therapy ; pathology

OBJECTIVETo investigate the hemostatic effect of spleen-invigorating, qi-replenishing and blood-containing formula on simvastatin-induced zebrafish hemorrhage model, and to compare with the effect of clearing heat and cooling blood formula.

METHODSZebrafishes from breed A B line were treated with 0.5 µmol/L simvastatin for 24 hours to establish zebrafishes hemorrhage model. Under strict blinded experimental conditions, the above mentioned zebrafishes were then treated with experimental drug of different concentrations at the maximum non-lethal dose. The intervention effect of spleen-invigorating, qi-replenishing and blood-containing formula was comprehensively assessed by examining the main observational parameters, such as bleeding reduction rate and hemostasis rate while referring to additional parameters, such as blood flow, improvement rate of blood flow, velocity of movement, improvement rate of motion, which are characteristics of spleen qi deficiency.

RESULTSWhen the hemostatic effect of experimental drug B1 at the concentrations of 500 and 1 000 µg/ml, zebrafish bleeding rates were 30% and 15%, the hemostatic rate was 60% and 80%, respectively; when the experimental drug B2 at concentration of 500 and 1 000 µg/ml, Zebrafish bleeding rates were 45% and 40%, the hemostatic rate was 40% and 47%, respectively, showing that experimental drug B1 was superior to B2 in terms of decreasing bleeding rate and improving hemostatic effect in zebrafish. In the equal concentration, the experimental drug B1 was superior to B2 in terms of increasing and improving the blood flow of hemorrhagic zebrafish. Promotion and improvement of motion: in equal concentration, experimental drug B1 was superior to B2 in terms of promoting the motion velocity and increasing the improving rate of motion in zebrafish.

CONCLUSIONThe spleen-invigorating, qi-replenishing and blood-containing formula displays a good hemostatic effect on simvastatin-induced hemorrhage of zebrafish. It also boosts the blood flow and motion velocity in hemorrhagic zebrafish, therefore, providing an experimental basis for the treatment of syndrome of spleen failing to control blood by spleen-invigorating, qi-replenishing and blood-containing formula.

Objective: To explore the feasibility and effectiveness of "one-puncture one-needle" transrectal ultrasound (TRUS)-guided prostate biopsy in the prevention of postoperative infections. METHODS: We retrospectively analyzed the clinical data about "one-puncture one-needle" (the observation group) and "one-person one-needle" (the control group) TRUS-guided prostate biopsy performed in the Second People's Hospital of Guangdong Province from January 2005 to December 2015, and compared the incidence rates of puncture-related infection between the two strategies. By "one-puncture one-needle", one needle was used for one biopsy puncture, while by "one-person one-needle", one needle was used for all biopsy punctures in one patient and the needle was sterilized with iodophor after each puncture. RESULTS: Totally, 120 patients received 6+1-core or 12+1-core "one-person one-needle" and 466 underwent 12+1-core "one-puncture one-needle" TRUS-guided prostate biopsy. There were no statistically significant differences between the two groups of patients in age, the prostate volume, the serum PSA level, or the detection rate of prostate cancer (P >0.05). Compared with the control group, the observation group showed remarkably lower incidence rates of puncture-related urinary tract infection (7.5% vs 0.9%, P <0.05), fever (5.0% vs 1.1%, P <0.05), bacteriuria (2.5% vs 0.2%, P <0.05), and total infections (16.7% vs 2.6%, P<0.05) postoperatively. Two cases of bacteremia or sepsis were found in each of the groups, with no significant difference between the two. CONCLUSIONS "One-puncture one-needle" TRUS-guided prostate biopsy can effectively prevent puncture-related infections.
Bacteremia ; etiology ; Biopsy, Fine-Needle ; adverse effects ; instrumentation ; methods ; Case-Control Studies ; Feasibility Studies ; Humans ; Male ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; pathology ; Retrospective Studies ; Sterilization ; methods ; Ultrasonography, Interventional ; Urinary Tract Infections ; prevention & control

OBJECTIVETo explore the clinical effects of Compound Xuanju Capsule (CXC) combined with sildenafil on erectile dysfunction (ED) that progressively fails to respond to sildenafil.

METHODSTotally, 36 ED patients who progressively failed to respond to sildenafil were randomly divided into a trial and a control group of equal number, the former treated with oral CXC at 3 g tid plus sildenafil at 50 mg an hour before sexual activity, while the latter with sildenafil alone at 100 mg an hour before sexual activity. After 2 months of treatment, we compared the patients' scores on IIEF-5 and their partners' scores on Treatment Satisfaction Scale (TSS) between the two groups.

RESULTSThe total rate of erectile function improvement was 94.44% in the trial and 88.89% in the control group (P > 0.05). The IIEF-5 score was 20.888 9 +/- 3.833 1 in the former and 18. 777 8 +/- 4.008 2 in the latter after treatment, significantly higher than 13. 166 7 +/- 3.601 5 and 13. 055 6 +/- 2.775 4 before treatment (P < 0.05). The post-treatment IIEF-5 scores of the patients and the TSS scores of their partners were markedly higher in the trial than in the control group (P < 0.05).

CONCLUSIONCompound Xuanju Capsule combined with sildenafil is effective for erectile dysfunction that progressively fails to respond to sildenafil.

Adult ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy ; Piperazines ; therapeutic use ; Purines ; therapeutic use ; Sildenafil Citrate ; Sulfones ; therapeutic use ; Treatment Outcome