Objective To compare the clinical efficacy between liposuction combined with circumareolar small incision and three-port endoscopic surgery for the treatment of Simon Ⅱ gynecomastia (GYN). Methods Comparative case data of 120 patients with GYN were retrospectively analyzed, 61 patients in the open group underwent circumareolar small incision mastectomy after liposuction, and 59 patients in the endoscopic group underwent three-port endoscopic mastectomy after liposuction. The two groups were compared in terms of surgery-related indexes, occurrence of postoperative complications and patient satisfaction. Results The unilateral operation time of the open group was shorter than that of the endoscopic group, the unilateral gland resection weight in the open group was more than that in the endoscopic group, the hospitalization cost of the open group was less than that of the endoscopic group (all P<0.01). There was no significant difference in unilateral liposuction volume, drainage volume on the first postoperative day, and time to drain removal between the two groups (P>0.05). The incidence of complications in the open group and the endoscopic group were 8.2% and 13.6% respectively, and there was no significant difference between the two groups (P>0.05). The difference in the overall satisfaction scores between the two groups was not statistically significant (P>0.05). Conclusions Liposuction combined with circumareolar small incision or three-port endoscopic surgery both has good cosmetic effects in the treatment of Simon Ⅱ GYN. The operation with circumareolar small incision is simple, has a shorter operation time, costs less, and does not require special equipment, which is suitable for promotion and application in medical institutions.

Background::Although existing mycological tests (bronchoalveolar lavage [BAL] galactomannan [GM], serum GM, serum (1,3)-β-D-glucan [BDG], and fungal culture) are widely used for diagnosing invasive pulmonary aspergillosis (IPA) in non-hematological patients with respiratory diseases, their clinical utility in this large population is actually unclear. We aimed to resolve this clinical uncertainty by evaluating the diagnostic accuracy and utility of existing tests and explore the efficacy of novel sputum-based Aspergillus assays. Methods::Existing tests were assessed in a prospective and consecutive cohort of patients with respiratory diseases in West China Hospital between 2016 and 2019 while novel sputum assays (especially sputum GM and Aspergillus-specific lateral-flow device [LFD]) in a case-controlled subcohort. IPA was defined according to the modified European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Sensitivity and specificity were computed for each test and receiver operating characteristic (ROC) curve analysis was performed. Results::The entire cohort included 3530 admissions (proven/probable IPA = 66, no IPA = 3464) and the subcohort included 127 admissions (proven/probable IPA = 38, no IPA = 89). Sensitivity of BAL GM (≥1.0 optical density index [ODI]: 86% [24/28]) was substantially higher than that of serum GM (≥0.5 ODI: 38% [39/102]) ( χ2 = 19.83, P < 0.001), serum BDG (≥70 pg/mL: 33% [31/95]) ( χ2 = 24.65, P < 0.001), and fungal culture (33% [84/253]) ( χ2 = 29.38, P < 0.001). Specificity varied between BAL GM (≥1.0 ODI: 94% [377/402]), serum GM (≥0.5 ODI: 95% [2130/2248]), BDG (89% [1878/2106]), and culture (98% [4936/5055]). Sputum GM (≥2.0 ODI) had similar sensitivity (84% [32/38]) (Fisher’s exact P = 1.000) to and slightly lower specificity (87% [77/89]) ( χ2 = 5.52, P = 0.019) than BAL GM (≥1.0 ODI). Area under the ROC curve values were comparable between sputum GM (0.883 [0.812-0.953]) and BAL GM (0.901 [0.824-0.977]) ( P = 0.734). Sputum LFD had similar specificity (91% [81/89]) ( χ2 = 0.89, P = 0.345) to and lower sensitivity (63% [24/38]) ( χ2 = 4.14, P = 0.042) than BAL GM (≥1.0 ODI), but significantly higher sensitivity than serum GM (≥0.5 ODI) ( χ2 = 6.95, P = 0.008), BDG ( χ2 = 10.43, P = 0.001), and fungal culture ( χ2 = 12.70, P < 0.001). Conclusions::Serum GM, serum BDG, and fungal culture lack sufficient sensitivity for diagnosing IPA in respiratory patients. Sputum GM and LFD assays hold promise as rapid, sensitive, and non-invasive alternatives to the BAL GM test.

A 55-year-old female patient took acarbose, benazepril, and levamlodipine besylate intermittently and aspirin enteric-coated tablets and atorvastatin calcium regularly due to type 2 diabetes mellitus and hypertension, etc. After changing to bezafibrate for lipid-lowering and Gansulin 30R for glucose lowering (other treatments continued), the patient developed muscle soreness of both lower limbs and dark brown urine 7 days later. Laboratory tests showed aspartate aminotransferase (AST) 213 U/L, creatine kinase (CK) 8 655 U/L, CK-MB 555 U/L, lactate dehydrogenase (LDH) 579 U/L, α-hydroxybutyrate dehydrogenase (α-HBDH) 505 U/L, and myoglobin (MYO) 135 μg/L. Rhabdomyolysis was considered, which might be related to bezafibrate. Then bezafibrate was stopped. The patient was asked to drink plenty of water and urinate frequently, and the symptomatic and supportive treatments such as rehydration, alkalization of urine, liver protection, and kidney protection were given. After 11 days of drug withdrawal, her symptom of muscle soreness was relieved and the color of urine became lighter; laboratory tests showed CK 105 U/L and MYO 119 μg/L. After 18 days of drug withdrawal, the patient′s myalgia disappeared, urine color returned to normal; laboratory tests showed AST 37 U/L, CK 75 U/L, CK-MB 45 U/L, MYO 75 μg/L, and LDH 241 U/L.

A 55-year-old female patient took acarbose, benazepril, and levamlodipine besylate intermittently and aspirin enteric-coated tablets and atorvastatin calcium regularly due to type 2 diabetes mellitus and hypertension, etc. After changing to bezafibrate for lipid-lowering and Gansulin 30R for glucose lowering (other treatments continued), the patient developed muscle soreness of both lower limbs and dark brown urine 7 days later. Laboratory tests showed aspartate aminotransferase (AST) 213 U/L, creatine kinase (CK) 8 655 U/L, CK-MB 555 U/L, lactate dehydrogenase (LDH) 579 U/L, α-hydroxybutyrate dehydrogenase (α-HBDH) 505 U/L, and myoglobin (MYO) 135 μg/L. Rhabdomyolysis was considered, which might be related to bezafibrate. Then bezafibrate was stopped. The patient was asked to drink plenty of water and urinate frequently, and the symptomatic and supportive treatments such as rehydration, alkalization of urine, liver protection, and kidney protection were given. After 11 days of drug withdrawal, her symptom of muscle soreness was relieved and the color of urine became lighter; laboratory tests showed CK 105 U/L and MYO 119 μg/L. After 18 days of drug withdrawal, the patient′s myalgia disappeared, urine color returned to normal; laboratory tests showed AST 37 U/L, CK 75 U/L, CK-MB 45 U/L, MYO 75 μg/L, and LDH 241 U/L.

In 2015 , policy reforms on centralized drug purchasing system have been released one by one , and the quality of medicines has been highly valued .Centralized drug purchasing system distinguishes different qualities of drugs mainly through bidding grouping , in order to achieve “uality priority”.However , there are yet some existing problems in group bidding policy at present , such as lack of a unified hierarchy , no scientific indicators and so on , which inevitably weaken the leading role of centralized purchasing policy over the quality of medicines .This paper , focuses on the study of group bidding , and the existing main problems are found through the statistical analysis of rel-evant policies introduced in different provinces .Finally, it explores some optimization strategies for “Group Bidding”which is of paramount importance .

Objective To evaluate whether S-100β protein could be a serum marker for traumatic spinal cord injury (SCI). Methods From June, 2013 to October, 2014, 24 patients with complete SCI were measured the serum S-100β protein concentrations with en-zyme-linked immunosorbent assay, one week, three and six months after SCI. Serum from ten healthy persons was as normal control. Re-sults The serum S-100βprotein concentrations increased one week and 3 months after SCI (Z>4.273, P<0.001). Conclusion The increase of serum S-100βprotein may help assessing early impairment after complete SCI.

ObjectiveTounderstandthetrendsandepidemiologicalcharacteristicsofsexuallytransmitteddiseases(STDs)inChinaandprovidescientificbasisformakingcontrolstrategies.MethodsDuringtheperiodof1991～2001,thecase-reportingdataof8kindsofnotifiableandmonitoringSTDs,collectedfrom31provinces,autonomousregionsandmunicipalities,wereanalyzedwithepidemiologicalmethods.Results①Epidemictrends:Duringthisperiod,theincidenceof8kindsofSTDssteadilyincreasedfrom175528(15.48per100000population)in1991to859040(68.91per100000population)in2000.Theaverageannualgrowthofincidencewas19.30%,witharangeof2.59%～36.88%.However,thereportedcasesin2001were795612withadecreaseof7.38%comparedwiththosein2000,anditwasthefirstdecreasesinceSTDcaseswerereportedfrom1987.②Geographicaldistribution:Thehigh-incidenceareasweretheZhujiangRiverDelta,YangtzeRiverDelta,MinjiangRiverValley,NortheasternChina,andBeijing,Tianjin,andChongqingManicipalities,withtheincidencerateofover70～100casesper100000populationafter1997,andtherewereveryhighratesofincidenceover1000casesper100000populationinsomeareas.Thelow-incidenceareaswerenorthChina,partsofCentralChina,NorthwesternChinaandSouthwesternChina,withtheincidenceratesoflowerthan30～50per100000population.③Populationdistri-bution:Themaletofemaleratiodecreasedfrom1.60∶1～1.69∶1intheearly1990sto1.35∶1～1.40∶1inthelate1990s.STDincidencerateswerehighestinthe20～39agegroup,andthereportedSTDcasesofthisagegroupaccountedforover80%oftotalcases.ConclusionSexuallytransmitteddiseasesinChinahavebecomeaseriouspublichealthproblemandtheeffectiveinterventionprogrammesagainstSTDsmustbeimplementedacrossthecountry.