Objective To investigate the changes of brain deep gray matter nucleus volume and iron content in patients with type 2 dia-betes mellitus(T2DM)based on quantitative MR technology,and their correlation and mediating effect with cognitive impairment.Methods A total of 60 T2DM patients(T2DM group)and 61 healthy controls(HC)(HC group)were prospectively selected.The volume of brain deep gray matter nucleus of 3D-T1 sequence map was measured by artificial intelligence(AI)automatic segmentation technique,the corresponding region of interest(ROI)was manually drawn and quantitative susceptibility mapping(QSM)value was measured on QSM,the cognitive score,QSM value and volume of nucleus were compared by independent sample t test and rank sum test,and the correlation analysis of imaging indexes with differences between the two groups was made.The mediating effect between fasting blood glucose(FBG)and Montreal cognitive assessment(MoCA)score was analyzed.Results The MoCA and mini-mental state examination(MMSE)scores in the T2DM group were lower than those in the HC group(P＜0.05),the volumes of bilateral caudate nucleus,putamen,globus pallidus,thalamus,and right hippocampus in the T2DM group were lower than those in the HC group(P＜0.05),and the QSM values of left caudate nucleus,thalamus and bilateral globus pallidus in the T2DM group were higher than those in the HC group(P＜0.05).In the T2DM group,the volumes of bilateral thalamus and right hippocampus were positively correlated with MoCA score(left thalamus:r=0.326,P=0.012;right thalamus:r=0.373,P=0.004;right hippocampus:r=0.509,P＜0.001),and the QSM value of left thalamus was negatively correlated with MoCA score(r=-0.263,P=0.044).The mediating effect of right hippocampus volume and left thalamus QSM value was significant(P＜0.05),and the direct effect of FBG on cog-nitive score was significant(P＜0.05).Conclusion Brain deep gray matter nucleus atrophy and brain iron deposition are closely related to T2DM and cognitive impairment,and there is a mediating effect.Brain iron deposition will increase the risk of cognitive impairment in T2DM.

Objective To investigate the changes of brain deep gray matter nucleus volume and iron content in patients with type 2 dia-betes mellitus(T2DM)based on quantitative MR technology,and their correlation and mediating effect with cognitive impairment.Methods A total of 60 T2DM patients(T2DM group)and 61 healthy controls(HC)(HC group)were prospectively selected.The volume of brain deep gray matter nucleus of 3D-T1 sequence map was measured by artificial intelligence(AI)automatic segmentation technique,the corresponding region of interest(ROI)was manually drawn and quantitative susceptibility mapping(QSM)value was measured on QSM,the cognitive score,QSM value and volume of nucleus were compared by independent sample t test and rank sum test,and the correlation analysis of imaging indexes with differences between the two groups was made.The mediating effect between fasting blood glucose(FBG)and Montreal cognitive assessment(MoCA)score was analyzed.Results The MoCA and mini-mental state examination(MMSE)scores in the T2DM group were lower than those in the HC group(P＜0.05),the volumes of bilateral caudate nucleus,putamen,globus pallidus,thalamus,and right hippocampus in the T2DM group were lower than those in the HC group(P＜0.05),and the QSM values of left caudate nucleus,thalamus and bilateral globus pallidus in the T2DM group were higher than those in the HC group(P＜0.05).In the T2DM group,the volumes of bilateral thalamus and right hippocampus were positively correlated with MoCA score(left thalamus:r=0.326,P=0.012;right thalamus:r=0.373,P=0.004;right hippocampus:r=0.509,P＜0.001),and the QSM value of left thalamus was negatively correlated with MoCA score(r=-0.263,P=0.044).The mediating effect of right hippocampus volume and left thalamus QSM value was significant(P＜0.05),and the direct effect of FBG on cog-nitive score was significant(P＜0.05).Conclusion Brain deep gray matter nucleus atrophy and brain iron deposition are closely related to T2DM and cognitive impairment,and there is a mediating effect.Brain iron deposition will increase the risk of cognitive impairment in T2DM.

【Objective】 To investigate the relationship between serum reproductive hormones and sperm parameters and outcomes of micro-testicular sperm extraction (Micro-TESE). 【Methods】 Clinical data of 1 091 patients treated in our hospital during Jan. and Dec.2021 were retrospectively analyzed. According to the sperm concentration,the patients were divided into non-obstructive azoospermia (NOA) group (group A,n=418),normal sperm concentration group (group B,n=615),mild to moderate oligospermia group (group C,n=18),severe oligospermia group (group D,n=18),and obstructive azoospermia group (group E,n=22). In group A,244 cases treated with Micro-TESE were grouped into the sperm-acquired group (Micro-TESE positive group,n=82) and non-sperm-acquired group (Micro-TESE negative group,n=162),and according to the pathological types of testicular tissue,the patients were divided into normal testicular tissue with hypospermatogenesis group (HYPO group,n=129),maturation arrest group (MA group,n=10),and support-only cell syndrome group (SCO group,n=122). Differences in semen parameters and reproductive hormone levels were compared,and relationship between reproductive hormones and sperm parameters and Micro-TESE outcomes was determined with Pearson correlation analysis. 【Results】 In the sperm concentration subgroup,the testicular volume of group A was lower than that of group B and group E (P<0.05); the levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in group A were the highest (P<0.05),but the level of testosterone (T) was the lowest (P<0.05); the levels of anti-mullerian hormone (AMH) and serum inhibin B (INHB) in group A were lower than those in group B and group E (P<0.05),the normal sperm morphology rate in group B was higher than that in group A and group E (P<0.05); the percentage of forward moving sperm in group B was the highest (P<0.05). Pearson correlation analysis revealed that sperm concentration,normal sperm morphology rate,and percentage of forward moving sperm were negatively correlated with age,FSH,LH (P<0.05),and positively correlated with testicular volume,T,AMH,and INHB (P<0.05). NOA patients were grouped according to testicular histology and pathology. The INHB in the SCO group was the smallest of the three groups (P<0.05); the FSH and LH levels in the SCO group were higher than those in the MA group (P<0.05),while the 17β-estradiol (E2) levels in the HYPO group were higher than those in the SCO group (P<0.05). NOA patients were grouped according to the results of Micro-TESE surgical treatment. There was a statistically significant difference in AMH and INHB levels between the Micro-TESE positive and negative groups (P<0.05). The binary logistic regression analysis of factors affecting the Micro-TESE outcomes of NOA patients showed AMH was negatively correlated with the Micro-TESE outcome (OR=0.904,95%CI:0.91-1.08,P<0.05). 【Conclusion】 Age,FSH,LH,AMH,and INHB are correlated with sperm concentration,normal sperm morphology rate,and percentage of forward moving sperm. The INHB level was the lowest in the SCO group. The results of Micro-TESE in patients with NOA can be predicted by serum AMH level.

As the rapid development of minimally invasive techniques, anesthesia, and enhanced recovery after surgery (ERAS), anorectal day surgery receiving more and more attention by improving efficiency of medical care while reducing cost and hospitalized infection. However, day surgery also faces the challenge of completing the whole process from patient admission to discharge within 24 hours. Therefore, establishing a reasonable and detailed day surgery process is the cornerstone to guarantee safe medical practice and patients satisfaction. National Clinical Research Center for Geriatric Disorders (Xiangya), together with China Ambulatory Surgery Alliance formulates the clinical practice guideline for anorectal day surgery 2019 edition. Here we make some interpretations of the guidelines on the detailed process of anorectal day surgery, including indication, preoperative examination, preoperative risk evaluation, health education, assessment of day surgery anesthesia and before leaving postanesthesia care unit (PACU), postoperative management, assessment of discharge and follow-up, for the convenience of various medical centers.

As the rapid development of minimally invasive techniques,anesthesia,and enhanced recovery after surgery (ERAS), anorectal day surgery receiving more and more attention by improving efficiency of medical care while reducing cost and hospitalized infection. However, day surgery also faces the challenge of completing the whole process from patient admission to discharge within 24 hours. Therefore, establishing a reasonable and detailed day surgery process is the cornerstone to guarantee safe medical practice and patients satisfaction. National Clinical Research Center for Geriatric Disorders (Xiangya), together with China Ambulatory Surgery Alliance formulates the clinical practice guideline for anorectal day surgery 2019 edition. Here we make some interpretations of the guidelines on the detailed process of anorectal day surgery, including indication, preoperative examination, preoperative risk evaluation, health education, assessment of day surgery anesthesia and before leaving postanesthesia care unit (PACU), postoperative management, assessment of discharge and follow?up, for the convenience of various medical centers.

As the rapid development of minimally invasive techniques,anesthesia,and enhanced recovery after surgery (ERAS), anorectal day surgery receiving more and more attention by improving efficiency of medical care while reducing cost and hospitalized infection. However, day surgery also faces the challenge of completing the whole process from patient admission to discharge within 24 hours. Therefore, establishing a reasonable and detailed day surgery process is the cornerstone to guarantee safe medical practice and patients satisfaction. National Clinical Research Center for Geriatric Disorders (Xiangya), together with China Ambulatory Surgery Alliance formulates the clinical practice guideline for anorectal day surgery 2019 edition. Here we make some interpretations of the guidelines on the detailed process of anorectal day surgery, including indication, preoperative examination, preoperative risk evaluation, health education, assessment of day surgery anesthesia and before leaving postanesthesia care unit (PACU), postoperative management, assessment of discharge and follow?up, for the convenience of various medical centers.

Objective To observe the effects of intensive insulin treatment on islet β cell apoptosis associated protein bcl-2 and bax in type 2 diabetic rats.Methods 36 Wistar rats were randomly divided into two groups : normal control group and high fat diet group.Rats in normal control group fed by basical feedstuff.Rats in high fat diet group fed by high fat and basical feedstuff.After 10 days,rats in high fat group were injected with STZ.After 3 days,rats in high fat group were randomly divided into two groups:diabetes control group and insulin treatment group.The course of treatment was 4 weeks.After 10 days by fat milk intragastfic administration, after 3 days of STZ injection and after 4 weeks treatment, each index was measured.After experiment, pancreatic tissue bel-2 and bax were detected through immunohistocbemical method.Results After 4 weeks intensive insulin treatment,the bcl-2 was significantly increased at(6.20 ± 2.05 )% in insulin treatment group than diabetes control group.The bax was significantly decreased at ( 2.68 ± 1.04 ) % in insulin treatment group than diabetes control group ( P < 0.05 ).Conclusion The method of insulin intensive treatment could increase islet βcell bcl-2 and decrease bax in type2 diabetic rots, Insulin intensive treatment could decrease islet β cell apoptosis.

Objective To compare the number of lymph node dissected by intraoperative lymphatic mapping guided D2 gastrectomy and that by standard D2 gastrectomy plus lymphadenectomy in patients of advanced gastric cancer. Methods In this study 20 advanced gastric cancer cases received intraoperative peritumor injection of carbon nanoparticles suspension ( group 1 ) and D2 lymphadenectomy was guided by the black-stained lymph nodes. 21 cases undergoing standard D2 lymphadenectomy served as controls (group 2). The number of lymph nodes removed and the condition of lymphatic metastasis in two groups, blackstained lymph nodes in group 1, and postoperative complications were compared. Results The average lymph nodes dissected in group 1 (35. 1 ± 13.4) were higher than in control group (26.2 ±7.8). The differences were statistically significant (t =2. 126, P =0. 034). The number of removed N2 and N3 lymph nodes in group 1 were more than that in control group. The total black-stained ration of lymph nodes was 52. 7% in group 1. The positive rate of lymph nodes was higher in black-stained lymph nodes (27.6%) than in unstained lymph nodes ( 10. 8% ) in group 1 and in control group ( 16. 9% ). The differences were also statistically significant ( x2 = 6. 034, P = 0. 016; x2 = 5. 142, P = 0. 023 ). Postoperative afferent loop obstruction developed in one case in group 1. Conclusions Lymphatic mapping guided D2 radical gastrectomy plus lymphadenectomy increases the number of lymph nodes dessected and improves the efficiency of positive lymph nodes excision for patients of advanced gastric cancer.

The hydroxypropyl methylcellulose (HPMC) matrix tablet containing metoprolol succinate (MS) as a model drug was obtained by wet method compression tablet. The effects of the amount and viscosity of HPMC, the preparation method, compressing pressure, the amount of ethycellulose (EC), the pH of dissolution medium and the speed of basket rotation on the drug release from the matrix tablets were evaluated. The results showed that the release rate of metoprolol succinate from HPMC matrix tablets followed Higuchi equation. The release mechanism was in line with the synthetical effect of diffusion and corrosion. Drug release was influenced by the amount and viscosity of HPMC, the amount of EC in matrices, the preparation method and compressing pressure, etc. Drug release was not influenced by the pH of dissolution medium used, and not by the speed of basket rotation, either.
Delayed-Action Preparations ; Drug Compounding ; Hypromellose Derivatives ; Methylcellulose ; analogs & derivatives ; chemistry ; Metoprolol ; administration & dosage ; analogs & derivatives ; pharmacokinetics ; Pharmaceutic Aids ; chemistry ; Pharmaceutical Preparations ; chemistry ; Tablets ; Viscosity