Objective:To explore the long-term effect of Zhenzhu Tiaozhi capsule（FTZ） on hemoglobin A1c（HbA1c）in patients with type 2 diabetes mellitus （T2DM） based on real-world data. Method:T2DM patients who were provided with FTZ （FTZ group） and those receiving conventional hypoglycemic drugs （control group） were extracted from the hospital information system （HIS） of the First Affiliated Hospital of Guangdong Pharmaceutical University， followed by propensity score matching （PSM） for balancing the confounding factors between groups. With HbA1c as the efficacy evaluation index， the difference in efficacy between the two groups was compared using t-test and χ² test. For repeated measurement data of the same patient， the difference in efficacy and the stability of FTZ against HbA1c were analyzed by generalized estimating equation （GEE）. The factors that might affect the efficacy of FTZ against HbA1c were subjected to multivariate linear regression analysis （MLRA）， and the subgroup analyses were then conducted after the stratification of relevant factors. Result:There were 46 patients included in the FTZ group and 1 208 patients in the control group. PSM yielded 42 pairs of samples with balanced covariates between groups. As revealed by one-year observation， ① HbA1c in the FTZ group after treatment was 6.51%±1.09%. No significant difference was observed either in pre- and post-treatment comparison in the FTZ group or in its comparison with the control group. At the same time， the HbA1c compliance rate in the FTZ group was 73.8% after treatment. No significant difference was observed either in pre- and post-treatment comparison in the FTZ group or in its comparison with the control group. ② The GEE results showed that the post-treatment HbA1c levels in the two groups were not significantly different from each other. Moreover， the HbA1c level remained stable over treatment time. ③ MLRA and subgroup analyses results demonstrated that FTZ was more effective in patients with high baseline HbA1c ［β=-0.530，95% confidence interval（CI） -0.850～-0.209，P<0.01］ or those who were complicated with hypertension （β=-0.918，95%CI -1.614～-0.222，P<0.05）. Conclusion:In the real world， FTZ is able to control the blood sugar， and its effect is similar to those of conventional hypoglycemic drugs. Besides， it is capable of stabilizing the blood sugar for a long time.

Objectives: To evaluate the distribution by age and sex of serum high-sensitivity C-reactive protein (hsCRP) in an urban Chinese population and to provide a profile prediction for the risk of bacterial infection, inflammatory diseases, or tissue damages in the body. Methods: Serum hsCRP was determined using the Roche Tina-quant immuno-turbidimetric assay on a Hitachi 7600-010 automatic biochemical analyzer (Roche Diagnostics) in 1,572 males and 1,800 females, including 78 pregnant women, who were derived from the National Health and Nutrition Survey in 2010-2012. Results: The average hsCRP concentration in urban China was 0.68 mg/L for males and 0.65 mg/L for females. Significant differences in hsCRP were found among different age groups ( < 0.05). Monitoring results showed no significant differences among the 6-11, 45-59, and ≥ 60-year-old groups in the comparison of hsCRP between males and females in large cities. However, hsCRP concentration was significantly higher in men aged 12-17 and 18-44 years than in women. Conclusion The distribution of the hsCRP status of residents in large cities in China was influenced by age and gender, and the hsCRP levels of both sexes increased gradually with age. In addition, hsCRP concentration was higher in healthy pregnant women than in non-pregnant women. Basing on our results, we recommend that this parameter be included in future national and international screening for early detection of various illnesses.
Adolescent ; Adult ; Aged ; Biomarkers ; blood ; C-Reactive Protein ; metabolism ; Cardiovascular Diseases ; epidemiology ; Child ; China ; epidemiology ; Female ; Humans ; Inflammation ; epidemiology ; Male ; Middle Aged ; Pregnancy ; Prevalence ; Urban Population ; statistics & numerical data ; Young Adult

Objective To investigate the effects of intravitreal injection of conbercept on diffuse macular edema (DME) of diabetes mellitus.Methods Together 51 diabetic patients (51 eyes) with diffuse macular edema were collected between July 2016 to July 2017,and randomly divided into three groups (n =17):group A,in which patients received solely intravitreal injection of 0.5 mg conbercept,group B,those who was intravitreally injected with 0.5 mg of conbercept and modified macular grating photocoagulation,and group C,patients undergoing modified grid photocoagulation (GPG).Then,before treatment and 1 week,1 month,3 months and 6 months after treatment,all patients were examined by optical coherence tomography for determining central macular thickness (CMT),followed by fundus fluorescein angiography (FFA),the best corrected visual acuity (BCVA),slit lamp,intraocular pressure for compare the efficacy and safety of the three procedures.Results All the three treatments improved BCVA,CMT,retinal neovascularization (RNV) leakage in diffuse DME patients,but group A and B were better than group C (both P ＜ 0.05),while there was no significant difference in BCVA improvement between A and B group (P ＞ 0.05),whereas the improvement in CMT of group B patients was better than that of group A [(197.47 ±45.26) μm vs.(205.59 ± 47.33) μm] (P ＜ 0.001),and this was true of RNV leakage [(9.91 ±3.18)mm vs.(13.24 ±4.87) rnm] (P＜0.001),without related complications.Conclusion Combination of modified macular grid photocoagulation and intravitreal injection of conbercept can quickly relieve diabetic macular edema and alleviate neovascularization,thus improving the patients' vision acuity,of which the efficacy is superior to the pure modified macular grid photocoagulation and conbercept injection.

OBJECTIVETo observe wet cupping therapy (WCT) on local blood perfusion and analgesic effects in patients with nerve-root type cervical spondylosis (NT-CS).

METHODSFifty-seven NT-CS patients were randomly divided into WCT group and Jiaji acupoint-acupuncture (JA) group according a random number table. WCT group (30 cases) was treated with WCT for 10 min, and JA group (27 cases) was treated with acupuncture for 10 min. The treatment efficacies were evaluated with a Visual Analogue Scale (VAS). Blood perfusion at Dazhui (GV 14) and Jianjing (GB 21) acupoints (affected side) was observed with a laser speckle flowmetry, and its variations before and after treatment in both groups were compared as well.

RESULTSIn both groups, the VAS scores significantly decreased after the intervention (P<0.01), while the blood perfusion at the two acupoints significantly increased after intervention (P<0.05); however, the increasement magnitude caused by WCT was obvious compared with JA (P<0.05).

CONCLUSIONSWCT could improve analgesic effects in patients with NT-CS, which might be related to increasing local blood perfusion of acupunct points.

We summarized our experience in transurethral seminal vesiculoscopy (TSV) for recurrent hemospermia by introducing surgical techniques, intraoperative findings, and treatment outcomes. TSV was performed in 419 patients with an initial diagnosis of persistent hemospermia at Shanghai Changhai Hospital (Shanghai, China) from May 2007 to November 2015. TSV was successfully performed in 381 cases (90.9%). Hemospermia was alleviated or disappeared in 324 (85.0%) patients by 3 months after surgery. Common intraoperative manifestations were bleeding, obstruction or stenosis, mucosal lesions, and calculus. Endoscopic presentation of the ejaculatory duct orifice and the verumontanum was categorized into four types, including 8 (1.9%), 32 (7.6%), 341 (81.4%), and 38 (9.1%) cases in Types A, B, C, and D, respectively. TSV is an effective and safe procedure in the management of seminal tract disorders. This study may help other surgeons to become familiar with and improve this procedure. However, further multicentric clinical trials are warranted to validate these findings.
Adult ; Ejaculatory Ducts/surgery* ; Endoscopy/methods* ; Hemospermia/surgery* ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Seminal Vesicles/surgery* ; Tomography, X-Ray Computed ; Treatment Outcome ; Urethra/surgery*

OBJECTIVETo investigate the effects of locking plate fixation through lateral deltoid approach for proximal humeral fracture combined with micro-invasive percutaneous plating (MIPPO) technique.

METHODSFrom April 2009 to March 2012,26 patients with proximal humeral fractures were treated with proximal humeral locking system plate fixation through lateral deltoid approach, including 17 males and 9 females with an average age of 58 years old ranging from 28 to 76 years old. The time from injury to operation was 3 to 10 days (averaged 5.6 days). According to Neer typing for the proximal humeral fractures, 7 cases had 2 parts of fracture,15 had 3 parts of fracture,and 4 had 4 parts of fracture. The Neer score for shoulder function was evaluated.

RESULTSAll patients were followed up,and the duration ranged from 10 to 21 months (averaged 13.6 months). All patients were achieved bony union,the average healing time was 12.5 weeks (ranged from 10 to 21 weeks). No humeral head necrosis and axillary nerve injury occurred. According to Neer scoring system,the total score was 88.36 +/- 7.82, pain 30.82 +/- 3.24, function 23.76 +/- 5.71, activity 17.59 +/- 5.36, anatomical position 7.03 +/- 2.39; the result was excellent in 18 cases, good in 5 cases, fair in 2 cases, poor in 1 case.

CONCLUSIONLateral deltoid approach combined with locking plate fixation for treatment of proximal humeral fracture has advantages of small invasion,less blood lossing, short operative time, stable fixation, high rate of fracture healing, and satisfactory functional recovery.

Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged ; Shoulder Fractures ; surgery ; Treatment Outcome

Objective:To investigate the effects of locking plate fixation through lateral deltoid approach for proximal humeral fracture combined with micro invasive percutaneous plating (MIPPO) technique. Methods:From April 2009 to March 2012,26 patients with proximal humeral fractures were treated with proximal humeral locking system plate fixation through lateral deltoid approach,including 17 males and 9 females with an average age of 58 years old ranging from 28 to 76 years old. The time from injury to operation was 3 to 10 days (averaged 5.6 days). According to Neer typing for the proximal humeral fractures,7 cases had 2 parts of fracture,15 had 3 parts of fracture,and 4 had 4 parts of fracture. The Neer score for shoulder function was evaluated. Results:All patients were followed up,and the duration ranged from 10 to 21 months (aver-aged 13.6 months). All patients were achieved bony union,the average healing time was 12.5 weeks (ranged from 10 to 21 weeks). No humeral head necrosis and axillary nerve injury occurred. According to Neer scoring system ,the total score was 88.36±7.82,pain 30.82±3.24,function 23.76±5.71,activity 17.59±5.36,anatomical position 7.03±2.39;the result was excel-lent in 18 cases,good in 5 cases,fair in 2 cases,poor in 1 case. Conclusion:Lateral deltoid approach combined with locking plate fixation for treatment of proximal humeral fracture has advantages of small invasion ,less blood lossing,short operative time,stable fixation,high rate of fracture healing,and satisfactory functional recovery.

OBJECTIVETo investigate the feasibility and effect of transurethral seminal vesiculoscopy in the diagnosis and treatment of refractory or recurrent hemospermia.

METHODSWe retrospectively analyzed 162 cases of refractory or recurrent hemospermia examined and treated by transurethral seminal vesiculoscopy. The patients ranged in age from 19 to 76 years and had a hemospermia history of 3 months to 11 years, admitted due to poor therapeutic results or recurrence after 4 weeks of antibiotic medication. All the patients underwent serum PSA examination, transrectal ultrasonography, seminal vesicle ultrasonography and pelvis CT or MRI before surgery.

RESULTSWine- or magenta-colored colloid and inflammation were found in one or both sides of the seminal vesicle in all the cases. Pathological biopsy revealed chronic inflammatory mucosa of the seminal vesicle in all the patients, and even calculi in the ejaculatory duct or seminal vesicle in 15 cases. Postoperative follow-up averaged 21.7 (12 -29) months. Hemospermia disappeared or was alleviated in 150 (92.64%) of the cases after 1-15 ejaculations, in which 7 experienced recurrence 3 months later. Four cases failed to respond, and 1 developed acute bilateral epididymitis after surgery. No such complications as retrograde ejaculation, urinary incontinence or rectal injury were observed postoperatively.

CONCLUSIONTransurethral seminal vesiculoscopy is a safe, effective and feasible new method for the treatment of refractory or recrudescent hemospermia.

Adult ; Aged ; Feasibility Studies ; Hemospermia ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Seminal Vesicles ; surgery ; Treatment Outcome ; Ureteroscopy ; methods ; Young Adult

OBJECTIVETo study the Chinese medicine (CM) syndrome typing of hyperlipidemia inpatients, thus exploring the CM syndrome typing laws.

METHODSThe clinical materials, including blood lipids, grading,complications, CM symptoms, and manifestations of tongue and pulse were recorded using self-formulated epidemiological questionnaire of CM syndrome in hyperlipidemia, and then these materials were statistically analyzed.

RESULTSGan-qi stagnation syndrome (66.46%) was the most often seen syndrome in the 316 hyperlipidemia inpatients. Gan stagnation Pi-deficiency syndrome (35.44%), Gan-Shen yin deficiency syndrome (16.77%), Pi-Shen yang deficiency syndrome (13.61%), inner stagnation of phlegm and stasis syndrome (13.29%), hyperactivity of yang and hypoactivity of yin syndrome (9. 18%) were 5 common syndromes of hyperlipidemia. Gan stagnation Pi-deficiency syndrome occupied an important position among all types and at various levels. Results from the lipid classification of hyperlipidemia showed that mixed type with low HDL-C was the most often seen (108/316, 34.18%), followed by mixed hyperlipidemia (81/316, 25.63%). Totally the mixing type accounted for 59.81% (189/316), higher than hypertriglyceridemia (16.77%) and hypercholesterolemia (23.42%).

CONCLUSIONSGan stagnation pi-deficiency syndrome might be the core syndrome affecting the lipid metabolism of hyperlipidemia. Mixed hyperlipidemia was the most often seen in clinics. Clinical medication should cover actions of decreasing TC and TG, and increasing HDL-C.

Adult ; Aged ; Female ; Humans ; Hyperlipidemias ; diagnosis ; Inpatients ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged

OBJECTIVEErectile dysfunction (ED) is now recognized as a comorbid condition, especially in men with cardiovascular disease or diabetes mellitus. This randomized controlled trial was to examine the effect of long-term small-dose tadalafil in the treatment of ED.

METHODSA total of 98 men older than 18 years with at least a 6-month ED history were enlisted and divided into two groups to receive once-daily treatment with tadalafil at 5 mg (n = 60) and 20 mg (n = 38), respectively, for 12 months. The effects of medication were analyzed and compared using IIEF, Global Assessment Questionnaire (GAQ) and Sexual Encounter Profile (SEP), and so were the safety and tolerance of the two doses.

RESULTSThere were no statistically significant differences in the therapeutical results between the 5 mg and 20 mg groups (P < 0.05). The IIEF-5 score was raised by 8.1 points in the former and 7.9 points in the latter; the YES answers to SEP2 in the two groups were 51.3% and 49.2% before the treatment and 82.6% and 84.9% after it. No serious adverse events were observed, except some common ones, such as rubeosis (11.9% vs 8.7%) and headache (5.3% vs 4.9%) in the 5 mg and 20 mg groups.

CONCLUSIONOral tadalafil at 5 mg once daily is efficacious with good tolerance in the treatment of ED, and it can be an alternative to on-demand medication for some men to eliminate the inconvenience of planned intercourse within a limited timeframe.

Adult ; Carbolines ; administration & dosage ; adverse effects ; therapeutic use ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Middle Aged ; Phosphodiesterase Inhibitors ; administration & dosage ; adverse effects ; therapeutic use ; Tadalafil ; Treatment Outcome