ObjectiveSleep-related painful erections （SRPE） is a rare sleep disorder characterized by repeated awakening due to painful interruptions of penile erections during nighttime sleep， and its etiology is currently unclear. The purpose of this study is to explore the impact of potential risk factors on the incidence of SRPE. MethodsInformation was collected through questionnaires administered to patients who presented at the urology department and suffered from SRPE or did not suffer from SRPE. A total of 290 participants completed the study， including 145 controls and 145 cases. Logistic regression analysis was used to assess the impact of age， occupation， sleep initiation time per night， frequency of sexual intercourse per week， psychological status， erectile dysfunction， chronic prostatitis， prostate enlargement， lumbar spine disease， central nervous system disease， hypertension， diabetes and family history on the onset of SRPE. ResultsSingle-factor logistic regression analysis found that a history of chronic prostatitis， intellectual labor occupation， central nervous system disease， late sleep onset， frequency of sexual activity， and anxiety status might be related to the onset of SRPE. After incorporating these factors into a multivariate regression analysis model， it was found that having sexual activity ≥2 times/week （OR 95%CI = 0.326（0.179，0.592） and late sleep onset （after 24：00） （OR 95%CI = 0.494（0.265，0.918）might be protective factors for SRPE， while a history of chronic prostatitis（OR 95%CI = 3.779（2.082，6.859） might be a risk factor for SRPE. However， there was no significant statistical difference in the impact of central nervous system diseases and occupation on multivariate analysis. ConclusionChronic prostatitis and anxiety status may be independent risk factors for SRPE； having sexual activity ≥2 times/week and delaying sleep time appropriately may be independent protective factors.

ObjectiveTo analyze and sum up the medication rule and the core prescription of Professor LIU Minru in the treatment of polycystic ovary syndrome （intracellular lipid membrane congestion syndrome）and explore the effect mechanism underlying the medication. MethodTwo platforms were used to carry out data mining to analyze the characteristics and rules of Professor LIU's prescriptions for the treatment of this disease. Network pharmacology was used to further clarify active ingredients in the core prescription，and a traditional Chinese medicine-active ingredient-target network was constructed，with the potential mechanism of action analyzed. ResultA total of 321 prescriptions were included in the medical records，involving 178 Chinese medicinals and 28 kinds of formula granules.The Chinese medicinals mainly act on the liver and kidney meridians， whose main tastes were sweetness，pungency，and bitterness and properties were mainly warm，mild，and slightly cold.Commonly used medicine pairs include Dioscoreae Rhizoma-Rehmanniae Radix Praeparata，Chuanxiong Rhizoma-Angelicae Sinensis Radix，Bupleuri Radix-Aurantii Fructus，and Gleditsiae Spina-Curcumae Rhizoma.The commonly used formulas are Xuefu Zhuyutang，Siwugang，Yangjing Zhongyutang，etc. The core prescription is composed of 12 Chinese medicinals such as angelica，white peony，saponaria thorn，and epimedium，containing 74 active ingredients，including quercetin，luteolin，kaempferol，fisetin，and β-sitosterol.A total of 37 key targets were found，involving phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt），mitogen-activated protein kinase （MAPK），Janus protein tyrosine kinase （JAK）/signal transduction and activator of transcription （STAT），and other signaling pathways. ConclusionThe pathogenesis of this disease is complex.Professor LIU adheres to the pathogenesis of "kidney deficiency as the root cause，and phlegm retention as the symptom". Under the guidance of the academic ideology of "kidney Qi as the root，and protecting Yin as the foundation" and "nurturing Yin to support Yang"，she takes into account Yin and Yang in kidney tonic，replenishes and consolidates the essence and blood，and relieves manifestations by dissipating mass， activating blood， and regulating Qi. She has a rigorous thinking in formulating prescriptions. The core prescription has the characteristics of comprehensive regulation by multiple components at multiple targets in multiple pathways.

【Objective】 To explore the feasibility of establishing quantifiable evaluation system combined with PDCA in improving blood transfusion medical record. 【Methods】 A working group was set up in our hospital to establish an evaluation system for blood transfusion medical record according to relevant norms and literature. The data from September 2022 to February 2023 were used as the control group, and data from from April to May 2023 as the study group. PDCA was used to analyze the causes for poor quality of medical record. The quality of medical record was continuous improved for two months and the results were analyzed. 【Results】 Comparison between the research group and the control group showed that the score of blood transfusion consent (item A), blood transfusion application (item B), blood transfusion evaluation (item C), blood transfusion serious hazard (item F) increased respectively as 17.50±5.54 vs 21.08±3.75 (P<0.01), 16.22±2.05 vs 17.33±1.85 (P<0.01), 13.05±3.5 vs 14.72±1.97 (P<0.01), 7.9±1.44 vs 8.7±0.92 (P<0.01), and the total score of medical record was 85.36±7.5 vs 93.05±5.04 (P<0.01). The qualified rate of medical record increased from 82.2% to 98.3%(P<0.01). 【Conclusion】 The establishment of quantifiable blood transfusion medical record evaluation system combined with PDCA can help realize timely regulation and standardization of blood transfusion medical record.

OBJECTIVE: To investigate the serological and molecular characteristics of a pedigree carrying an allele for ABO*BW.11 blood subgroup. METHODS: The ABO blood type of 9 pedigree members were determined by serological methods. Exons 6 and 7 of the ABO gene were amplified by PCR and directly sequenced. The patient and her father were also subjected to clone sequencing analysis. RESULTS: Serological tests demonstrated that the proband and her younger brother had an ABw subtype, whilst her father and two daughters had Bw subtype. Clone sequencing found that the exon 7 of the ABO gene of the proband had a T>C substitution at position 695, which was identified as a BW.11 allele compared with the reference sequence B.01. This BW.11 allele was also identified in the proband's father, brother and two daughters. Due to allelic competition, the A/BW.11 and BW.11/O alleles demonstrated significantly different phenotypes. CONCLUSION The c.695T>C substitution of the ABO gene may lead to allelic competition in the Bw11 subtype. Combined molecular and serological methods is helpful for precise blood grouping.
ABO Blood-Group System/genetics* ; Alleles ; Female ; Genotype ; Humans ; Male ; Pedigree ; Phenotype

OBJECTIVE: To compare the effects of robotic and laparoscopic-assisted radical total gastrectomy on lymph node dissection and short-term outcomes in patients with Siewert type II adenocarcinoma of esophagogastric junction (AEG). METHODS: Inclusion criteria: the tumor center was located between 2 cm above and below the esophagogastric junction and was confirmed as adenocarcinoma by endoscopic biopsy. EXCLUSION CRITERIA: tumor with local invasion of the liver,spleen, pancreas or other organs; intraoperative finding of tumor dissemination or distant metastasis; patients undergoing palliative surgical treatment or preoperative neoadjuvant chemotherapy; patients with serious heart diseases, lung diseases, liver diseases, kidney diseases and other comorbidities; patients with multiple primary cancers;patients receiving emergency surgery. According to the above criteria, 82 patients with Siewert type II AEG who underwent gastrointestinal surgery at the Affiliated Hospital of Qingdao University from October 2014 to October 2018 were enrolled in the study. They were randomly divided into robotic surgery groups (41 cases) and laparoscopic group (41 cases) according to a computer-generated randomized allocation table. Both groups underwent radical total gastrectomy plus D2 lymph node dissection through the transabdominal esophageal hiatus approach. The intraoperative conditions and postoperative short-term outcomes were compared between two groups, including surgery time, intraoperative blood loss, length of esophagectomy, postoperative complications, postoperative gastrointestinal recovery time, length of hospital stay, postoperative unplanned reoperation rate and rehospitalization rate. Mean±SD is used for the measurement data that conforms to the normal distribution, and two independent sample t-tests are used to compare the two groups; the comparison of the count data is performed by the χ² test. RESULTS: There were 35 males (85.4%) with age of (62.3±10.0) years and body mass index of (24.4±3.2) kg/m² in the robotic surgery group. There were 37 males (90.2%) with age of (62.5±10.0) years and body mass index of (23.8±2.6) kg/m² in the laparoscopic group. No significant differences in the baseline data between two groups were found (all P>0.05). All the patients of both groups completed R0 resection successfully without conversion to laparotomy or perioperative death. Compared with the laparoscopic group, the robotic group had less intraoperative blood loss [(70.7±39.9) ml vs. (110.2±70.6) ml, t=3.118, P=0.003], longer resected esophagus [(3.0±0.7) cm vs. (1.9±0.5) cm, t=8.759, P<0.001], but longer setup time [(56.5±7.4) minutes vs. (36.0±6.6) minutes, t=4.241, P<0.001], and higher hospitalization costs [(122 317.31±57 789.33) yuan vs. (99 401.56±39 349.53) yuan, t=2.099, P=0.039], whose differences were statistically significant (all P<0.05). The total number of harvested lymph node in the robotic surgery group was 39.2±15.3,which was significantly higher than that in the laparoscopic group (33.0±12.1) (t=0.733, P=0.047). In the robotic group and the laparoscopic group, the mediastinal lymph node No.110 and No.111 were 3.6±1.2 vs. 1.5±1.0 and 3.7±2.0 vs. 1.8±1.1, respectively, with significant difference (t=10.138, P<0.001, t=8.227, P<0.001); axillary lymph node No.19 and No.20 were 2.3±1.2 vs. 1.1±0.9 and 2.0±1.0 vs. 1.0±0.1, respectively, with significant difference (t=7.082, P<0.001,t=8.672,P<0.001). There were no significant differences in the total number of abdominal lymph node and the number of lymph node in abdominal stations between two group (all P>0.05). The highest lymph node metastasis rate was approximately 20% and observed in No.1, No.2, No.3, and No.7, followed by No.8a, No.9, No.11p, and No.110 with around 5%. The lymph node metastasis rate in other stations (No.4sa, No.4sb, No.4d, No.5, No.6, No.11d, No.12a, No.19, No.20 and No.111) was less than 5%.There were no significant differences in postoperative complication rate, postoperative fever time, postoperative exhaust and defecation time, fluid diet time, and postoperative hospital stay (all P>0.05). There were 2 patients(4.9%) with unplanned reoperation and 1 patient (2.4%) with unplanned re-admission in the laparoscopic group,while 3 patients (7.3%)with unplanned reoperation and 2 patients (4.9%)with unplanned re-admission in the robotic surgery group, whose differences were also not statistically significant (χ²=0.240,P=0.675;χ²=0.346,P=1.000). CONCLUSION Robot-assisted radical total gastrectomy for Siewert II AEG is safe and feasible, which is characterized by more sophisticated operation, less blood loss and higher quality of lymph node dissection, especially for subphrenic and inferior mediastinal lymph nodes.
Adenocarcinoma ; classification ; pathology ; surgery ; Aged ; Esophageal Neoplasms ; classification ; pathology ; surgery ; Esophagectomy ; Esophagogastric Junction ; pathology ; surgery ; Female ; Gastrectomy ; Humans ; Laparoscopy ; Lymph Node Excision ; methods ; Male ; Middle Aged ; Retrospective Studies ; Robotic Surgical Procedures ; Stomach Neoplasms ; classification ; pathology ; surgery ; Treatment Outcome

Objective To assess the contribution of contrast-enhanced spectral mammography (CESM) in detecting breast carcinoma of dense breasts. Methods To retrospectively analyze the imaging and clinical data of 52 female patients with breast carcinoma which were confirmed by pathology in Tai'an Central Hospital of Shandong Province from April 2017 to April 2018.All cases classified as dense or uneven dense breasts by DM examination underwent Ultrasound (US), digital mammography (DM), CESM, dynamic contrast enhanced MRI (DCE-MRI).The breast imaging report and data system (BI-RADS) and breast density classification were both evaluated using the 5th edition of BI-RADS. The efficacy of US, DM, DM+CESM, DCE-MRI in detecting breast carcinoma (BI-RADS 5) was evaluated by χ2 test. Results Histopathology confirmed that 87 lesions were malignant and 35 lesions were benign. The sensitivity of US, DM, DM +CESM, DCE-MRI were 66.67％(58/87), 64.37％(56/87), 100.00％(87/87), 100.00％(87/87) and the specificity were 94.28％(33/35), 74.28％(26/35), 85.71％(30/35), 51.43％(18/35), respectively. There was statistically significant difference in specificity (χ2=9.545, P=0.002) and BI-RADS 5 category, detection 39.08％(34/87), 22.99％(20/87), respectively (χ2=5.263, P=0.022) between the DM + CESM group and DCE-MRI group. Conclusion In dense breasts, CESM has a high application value in breast carcinoma diagnosis.

Objective To investigate the etiology,clinical manifestations,imaging finding,pathology and treatment of primary bladder schwannoma.Methods A case of bladder schwannoma was reported and discussed in the literature.A 64-year-old male patient with painless gross hematuria for 4 months was admitted on October 5,2016.Enhanced computed tomography (CT) showed left anterior bladder wall lesions with mildly enhancement.Preoperative diagnosis was bladder cancer.The patient underwent transurethral resection of bladder tumor (TURBT).During surgery,a 3 cm × 3 cm polypoid soft tissue was found in the left side of bladder,which convex to the bladder with smooth surface and wide base.Results The bladder neoplasm was resected successfully.The intraoperative bleeding was about 100 ml.Postoperative pathology showed a large number of myloid spindle cells with immunohistochemical S-100 (+),considering source of mesenchymal tissue.No recurrence was noticed during the 3 months' follow-up.Retrieving domestic and foreign literature,we found 17 cases with bladder schwannoma from 1993 to 2016.Bladder schwannoma occurs in the age of 40-69 years old.There is no relationship with the agenda.It is often seen in the top or the side wall of the bladder with single growth and rare malignant.The clinical manifestations was mainly painless gross hematuria,CT and magnetic resonance imaging(MR) showed less specificity than other solid tumors of the bladder,which is difficult to identify.Partial cystectomy or TURBT is the main strategy.Postoperative pathology is the gold standard for diagnosis.The immunohistochemical stainings often showed S-100(+).Conclusions Bladder schwannoma is extremely rare in benign bladder tumor,and it could easily be misdiagnosed.The diagnosis should be performed by histopathological examination.Because it will become malignant,it is suggested that the positive treatment should be done.Treatment methods have not been clearly defined,and the effect of surgical resection is good.

The Hippo-YAP signaling pathway,an important signaling pathway of tumor suppressor,is featured by functions of adjusting the organ size and maintaining the dynamic balance between cell proliferation and apoptosis.Several researches have revealed that the Hippo-YAP signaling pathway can affect cell proliferation and apoptosis so as to participate in the development of tumor.This paper will review the effect and mechanism of Hippo-YAP signaling pathway in tumor.

Objective To investigate the expressions of matrix metallopro-teinase-7 (MMP-7),basic fibroblast growth factor (bFGF)in NSCLC,and to elucidate the correlations among MMP-7,bFGF and MVD, as well as their relationships with cancer metastasis in NSCLC.Methods The expressions of MMP-7,bFGF and MVD were detected by immunohistochemical SP method in 80 cases of NSCLC and 40 cases of normal lung tissue,compare the expression of MMP-7 and bFGF in NSCLC and normal lung tissue,and then invest the rela-tionship between their expression and lymph node metastasis in NSCLC.The MVD was investigated within the CD34 positive slides,check the relationship between MVD and the expression of MMP-7 ,bFGF in NSCLC, and also its relationship with histology type,differentiation degree,lymph node metastasis and TNM stage. Results The positive ratesof MMP-7 and bFGF were significantly higher in NSCLC than those in normal lung tissue (70.0% vs 1 2.5%,χ2 =35.276,P =0.000;65.0% vs 1 0.0%,χ2 =32.41 1 ,P =0.000).The posi-tive rates of MMP-7 and bFGF were also significantly higher in group with lymph node metastasis compared to those group without lymph node metastasis (83.0% vs 51 .5%,χ2 =9.1 39,P =0.003;80.9% vs 42.4%,χ2 =1 2.584,P =0.000).The numbers of MVD were significantly higher in cases with MMP-7 and bFGF posi-tive expressions than those in cases with MMP-7 and bFGF negative expressions (46.78 ±1 1 .1 1 vs 31 .1 2 ± 7.62,t =5.831 ,P =0.000;45.05 ±1 0.97 vs 34.77 ±8.56,t =5.364,P =0.000).The number of MVD in group with lymph node metastasis was also significantly higher than that in group without lymph node metasta-sis (61 .32 ±21 .61 vs 40.52 ±1 8.31 ,t =3.865,P =0.008).The number of MVD in staging Ⅲ-Ⅳ group was significantly higher than that in stagingⅠ-Ⅱgroup (55.28 ±1 5.64 vs 41 .73 ±1 6.48,t =2.531 ,P =0.01 3).Conclusion The expression levels of MMP-7 and bFGF in NSCLC are high,and the positive rates of MMP-7 and bFGF are correlated with the lymphnode metastasis.The numbers of MVD are significantly higher in cases with MMP-7 and bFGF positive expressions than those in cases with MMP-7 and bFGF negative expre-ssions.MVD is correlated with lymph node metastasis and the TNM stage.It suggests that the expressions of MMP-7,bFGF and MVD may involve in the invasion and metastasis of NSCLC.

Objective To observe the long-term toxicity of Jiuxin Fumai Injection and to investigate the safety of clinical medication.Methods The rats were given intramuscular injection with Jiuxin Fumai Injection in large,medium,small dosage(respectively 20,10,5g? kg-1)every day for two weeks,and normal saline group served as the normal control.Two weeks after drug withdrawal,the toxic reaction in rats was observed.Results After two-week continuous administration,all the animals were alive.Some animals were vomiting and getting excited when administered the large dosage and medium dosage injection.The blood sugar elevated,the thoracic gland coefficient lowered,the hepatic cells were cloudily swollen in the animals of large dosage group.Two weeks after drug withdrawal,the above phenomenon vanished.There was no obvious toxic reaction in the small-dosage injection group.Conclusion Long-term administration of Jiuxin Fumai Injection in large dosage shows certain toxic reaction in rats.The safe dosage for intramuscular administration is less than 5 g? kg-1? d-1.