1.Application evaluation of cardiopulmonary exercise test to guide comprehensive pulmonary rehabilitation in patients with pneumoconiosis
Congxia YAN ; Baoping LI ; Fuhai SHEN ; Hong CAO ; Jing LI ; Lirong ZHANG ; Zhiping SUN ; Bowen HOU ; Lini GAO ; Xinyu LI ; Chaoyi MA ; Xiaolu LIU
Journal of Environmental and Occupational Medicine 2024;41(1):47-53
Background At present, the practice of pulmonary rehabilitation for pneumoconiosis in China is in a primary stage. The basis for formulating an individualized comprehensive pulmonary rehabilitation plan is still insufficient, which is one of the factors limiting the development of community-level rehabilitation work. Objective To formulate an exercise prescription based on maximum heart rate measured by cardiopulmonary exercise test (CPET), conduct an individualized comprehensive pulmonary rehabilitation program with the exercise prescription for patients with stable pneumoconiosis, and evaluate its role in improving exercise endurance and quality of life, thus provide a basis for the application and promotion of pulmonary rehabilitation. Methods A total of 68 patients were recruited from the Occupational Disease Prevention Hospital of Jinneng Holding Coal Industry Group Co., Ltd. from April to August 2022 , and were divided into an intervention group and a control group by random number table method, with 34 cases in each group. All the pneumoconiosis patients participated in a baseline test. The control group was given routine drug treatment, while the intervention group received multidisciplinary comprehensive pulmonary rehabilitation treatment on the basis of routine drug treatment, including health education, breathing training, exercise training, nutrition guidance, psychological intervention, and sleep management, whose exercise intensity was determined according to the maximum heart rate provided by CPET. The rehabilitation training lasted for 24 weeks. Patients were evaluated at registration and the end of study respectively. CPET was used to measure peak oxygen uptake per kilogram (pVO2/kg), anaerobic threshold (AT), carbon dioxide equivalent of ventilation (EqCO2), maximum metabolic equivalent (METs), and maximum work (Wmax). The modified British Medical Research Council Dyspnea Questionnaire (mMRC), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Chronic Obstructive Pulmonary Disease Assessment Test (CAT), and Short Form of Health Survey (SF-36) were used to evaluate the potential effect of the comprehensive pulmonary rehabilitation program. Results Among the included 68 patients, 63 patients were having complete data, then 31 cases were assigned in the control group and 32 cases in the interventional group. Before the intervention, there was no significant difference in pVO2/kg, AT, EqCO2, METs, or Wmax between the two groups (P>0.05). At the end of the trail, the indicators like pVO2/kg [(19.81±2.38) mL·(min·kg)−1], AT [(14.48±2.33) mL·(min·kg)−1], METs (5.64±0.69), and Wmax [(85.25±14) W] of patients in the intervention group were all higher than those [(13.90±2.37) mL·(min·kg)−1, (11.70±1.94) mL·(min kg)−1, (3.97±0.70), and (61.77±14.72) W, respectively] in the control group (P<0.001); there was no significant difference in EqCO2 between the two groups (P=0.083). Before the trial, there was no significant difference in mMRC, SAS, SDS, PSQI, or CAT scores between the two groups (P>0.05). At the end of the trail, the mMRC score (1.16±0.57), SAS score (27.93±2.12), SDS score (26.48±1.44), PSQI score (1.08±0.88), and CAT score (4.34±3.28) of patients in the intervention group were lower than those [(2.03±0.83), (35.87±6.91), (34.23±6.65), (5.37±3.03), and (13.87±7.53), respectively] in the control group (P<0.001). The SF-36 scores of bodily pain (94.13±10.72), general health (87.50±5.68), vitality (95.31±5.53), mental health (99.88±0.71), and health changes (74.22±4.42) in the intervention group were higher than those [(71.87±32.72), (65.81±15.55), (74.52±16.45), (86.97±16.56), and (29.84±13.50), respectively] in the control group (P<0.001), and no significant difference was found in social functioning and role emotional scores (P>0.05). Conclusion Comprehensive pulmonary rehabilitation can increase the oxygen intake and exercise endurance of pneumoconiosis patients, ameliorate dyspnea symptoms, elevate psychological state and sleep quality, and improve the quality of life.
2.Multi-slice spiral computerized tomography image characteristics of coal workers with pneumoconiosis
Xinyu LI ; Baoping LI ; Fuhai SHEN ; Zhiping SUN ; Bowen HOU ; Lini GAO ; Qianqian LI ; Xiaolu LIU ; Chaoyi MA
Journal of Environmental and Occupational Medicine 2024;41(7):774-779
Background Multi-slice spiral computerized tomography (MSCT) can be used as an auxiliary diagnosis of chest radiography in diagnosis of pneumoconiosis, but there are few studies on the correlations between interstitial images and stage classification of coal workers' pneumoconiosis in the existing literature. Objective To present MSCT imaging manifestations and distribution characteristics of coal workers' pneumoconiosis and complications, evaluate correlations between coal workers' pneumoconiosis stages and pulmonary interstitial lesions, and provide a reliable imaging diagnosis basis for pneumoconiosis interstitial lesions. Methods From June 2022 to June 2023, a total of
3.Differential metabolites of bronchoalveolar lavage fluid from coal worker's pneumoconiosis patients
Chaoyi MA ; Baoping LI ; Fuhai SHEN ; Zhiping SUN ; Gang CHEN ; Guoxuan MA ; Yongmei ZHAO ; Bowen HOU ; Lini GAO ; Qianqian LI ; Xiaolu LIU ; Xinyu LI
Journal of Environmental and Occupational Medicine 2024;41(6):617-624
Background It is a research hotspot to study the changes of metabolites and metabolic pathways in the process of coal worker's pneumoconiosis (CWP) by metabonomics and to explore its pathogenesis. Objective To study the change of metabolites in bronchoalveolar lavage fluid (BALF) of patients with CWP and explore the metabolic regulation mechanism of the disease. Methods Patients with CWP who met the national diagnostic criteria according to Diagnosis of occupational pneumoconiosis (GBZ 70-2015) and underwent massive whole lung lavage were selected as the case group, and patients with tracheostenosis who underwent bronchoscopy were selected as the control group. BALF samples were collected from the cases and the controls. After filtering out large particles and mucus, the supernatant was stored in a −80 ℃ refrigerator. The samples were detected and analyzed by liquid chromatography-mass spectrometry after adding extraction solution, cold bath ultrasonication, and high-speed centrifugation, and the metabolic profiles and related data of CWP patients were obtained. The differential metabolites related to the occurrence and development of CWP were screened by multiple statistical analysis; furthermore, we searched the Kyoto Encyclopedia of Genes and Genomes (KEGG) database for potential metabolic pathways involved in the progression. Results There was no significant difference in the general conditions of the subjects, such as weight, height, age, and length of service among the stage I group, the stage II group, the stage III group, and the control group (P˃0.05). When comparing the CWP stage I group with the control group, 48 differential metabolites were screened out, among which 14 were up-regulated and 34 were down-regulated. A total of 66 differential metabolites were screened out between the patients with CWP stage II and the controls, 14 up-regulated and 52 down-regulated differential metabolites. Compared with the control group, 63 differential metabolites were screened out in the patients with CWP stage III, including 11 up-regulated and 52 down-regulated differential metabolites. There were 36 differential metabolites that may be related to the occurrence of CWP, among which 11 differential metabolites were up-regulated, and 25 were down-regulated. Four significant differential metabolic pathways were identified through KEGG database query: linoleic acid metabolic pathway, alanine metabolic pathway, sphingolipid metabolic pathway, and glycerophospholipid metabolic pathway. Conclusion The metabolomic study of BALF show that there are 36 different metabolites in the occurrence and development of CWP, mainly associating with linoleic acid metabolism, alanine metabolism, sphingolipid metabolism, and glycerophospholipid metabolism pathways.
4.Changes in intestinal flora of coal workers' pneumoconiosis patients after tetrandrine intervention
Xiaolu LIU ; Baoping LI ; Fuhai SHEN ; Zhiping SUN ; Yongmei ZHAO ; Bowen HOU ; Lini GAO ; Qianqian LI ; Xinyu LI ; Chaoyi MA
Journal of Environmental and Occupational Medicine 2024;41(6):625-631
Background Pneumoconiosis is a widespread occupational disease in China at present. As a type of lung diseases, its pathological damage is mainly irreversible fibrotic changes in the lungs. Several studies have shown that the occurrence and development of lung diseases such as coal workers' pneumoconiosis are closely related to intestinal flora. Objective To observe intestinal flora of coal workers' pneumoconiosis patients based on the results of 16SrDNA high-throughput sequencing and evaluate the changes of intestinal flora after treatment with tetrandrine tablets. Methods A total of 80 patients with coal workers' pneumoconiosis attending the outpatient clinic of the Department of Occupational Diseases of the Emergency General Hospital from April to July 2022 were enrolled. All patients were treated with tetrandrine tablets for 4 weeks, with group A before the treatment of tetrandrine tablets and group B after the treatment. In the same period, 24 healthy controls (group C) were set up. Stool samples were collected before and after the treatment. Using 16SrDNA high-throughput sequencing, gene V3-V4 sequencing technology, and bioinformatic analysis platform, we evaluated the intestinal flora after treatment by groups. Results The dominant flora at the phylum level and genus level were the same across three groups. The relative abundances of phylum Bacteroidetes, Bifidobacterium, Bacteroides, and Facealibacterium in groups B and C were higher than those in group A, and the relative abundances of phy-lum Actinobacteria, genus Blautia, and genus Romboutsia in groups B and C were lower than those in group A (P<0.05). The relative abundances of genus Clostridium, genus Megamonas, and genus Lactobacillus in group C was lower than that in groups A and B (P<0.05). The alpha diversity analysis showed that the Chao1 index was higher in group A than in group C (P<0.01). Compared with group A, the Shannon index was higher in group B, and the increases of Simpson index were all statistically significant in stage I patients (P<0.05), but the differences in Chao1 index were not statistically significant (P>0.05). The differences in the values of Chao1 index, Shannon index, and Simpson index in stage Ⅱ and stage III patients were not statistically significant (P>0.05). The beta diversity analysis showed that the difference in flora structure between group A and group C was statistically significant (P<0.05); the differences in flora structure before and after treatment in the same stage patients were statistically significant (P<0.05). The partial least squares discriminant analysis (PLS-DA) showed that there were significant differences between group A and group C, and between group A and group B. The LEfSe analysis showed that the significant markers contributing to the differences were basically the same in stage I, stage Ⅱ, and stage Ⅲ after treatment, which were mainly phylum Bacteroidetes and its subordinate groups, class Negativicutes, or-der Selenomonas, and genus Facealibacterium. Conclusion There are differences in the distribution of flora between coal workers' pneumoconiosis patients and healthy individuals, and the structure and relative abundance of intestinal flora are changed and the number of beneficial flora is increased after treatment with tetrandrine tablets.
5.The clinical features of children with Kawasaki disease in PICU
Lini CHEN ; Lili LUO ; Deyuan LI ; Zhongqiang LIU ; Lina QIAO
Chinese Pediatric Emergency Medicine 2019;26(4):274-279
Objective To summarize the clinical characteristics of children with Kawasaki disease (KD) in pediatric intensive care unit(PICU). Methods Medical record of children with KD at PICU were collected. At the same time,29 cases of KD in PICU were 1∶3 matched by age,gender and the time admitted in hospital with those admitted in general pediatric department(control group). Results PICU patients had longer length of hospital stay,longer fever duration compared with control group. In addition,patients in PICU had higher neutrophil percentage,C reaction protein,creatinine,urea nitrogen,N ̄terminal natriuretic peptide and procalcitonin,but lower hemoglobin,blood platelet and albumin compared with the control group. What′s more,patients in PICU tended to find hemoglobin<100 g/L,platelet<150×109/L,albumin<30 g/L,abnor ̄mal in urine routine and echocardiographic and more likely to have fever longer than 10 days when used intra ̄venous immunoglobulin(IVIG) compared with control group. And PICU patients were more likely to require therapy with antibiotics,albumin,glucocorticoid and the second dose of IVIG. Some part of children in PICU group were treated with IVIG and glucocorticoid because of doubted severe infection before KD diagnosed,all patients in the control group used IVIG after the diagnosis. Conclusion Patients who admitted in PICU are severe and not typical in clinical manifestation. These patients are easily misdiagnosed as sepsis and more likely to be IVIG ̄refractory and have coronary artery damage. We still worry that somebody might be misdi ̄agnosed as sepsis,who are treated with IVIG and get better. Because they are not diagnosed as KD,these pa ̄tient would not followe up like KD,but have potential risk of cardiovascular disease and need more alarming.
6. Risk Factors of Functional Dyspepsia Patients With Anxiety
Chinese Journal of Gastroenterology 2019;24(5):289-292
Background: Patients with functional dyspepsia (FD) often complicated with anxiety. Recognizing effectively the risk factors of anxiety is helpful for the precise treatment with anti-anxiety drug, which can improve the prognosis of patients. Aims: To explore the clinical characteristics and risk factors of FD patients with anxiety. Methods: A total of 295 FD patients from June 2014 to September 2014 at the Second Xiangya Hospital of Central South University were enrolled. Hamilton Anxiety Rating Scale was used to evaluate the anxiety in FD patients. Risk factors of anxiety in FD patients were analyzed. Results: In this study, the incidence of anxiety was 8.1% (24/295) in FD patients. Univariate analysis showed that age, disease duration, marriage status, psychosis history and history of administration of psychotropic drugs were related to the anxiety in FD patients (P<0.05). Multivariate analysis showed that disease duration, marriage status and psychosis history were the risk factors for anxiety in FD patients (P<0.05). Conclusions: Long disease duration, incomplete marriage, and psychosis history are the risk factors for anxiety in FD patients, routine anxiety screening should be carried out in these patients.
7.Investigation of pregestational diabetes mellitus in 15 hospitals in Guangdong province
Haitian CHEN ; Songqing DENG ; Zhuyu LI ; Zilian WANG ; Jing LI ; Jiekun GAO ; Yonghong ZHONG ; Dongmei SUO ; Lini LU ; Shilei PAN ; Hongxia CHEN ; Yongyi CUI ; Jianhui FAN ; Jiying WEN ; Liruo ZHONG ; Fengzhen HAN ; Yunhui WANG ; Shujun HU ; Peipei LIU
Chinese Journal of Obstetrics and Gynecology 2017;52(7):436-442
Objective To investigate the morbidity, diagnostic profile and perinatal outcome of pregestational diabetes mellitus (PGDM) in 15 hospitals in Guangdong province. Methods A total of 41338 women delivered in the 15 hospitals during the 6 months,195 women with PGDM(PGDM group) and 195 women with normal glucose test result(control group)were recruited from these tertiary hospitals in Guangdong province from January 2016 to June 2016. The morbidity and diagnostic profile of PGDM were analyzed. The complications during pregnancy and perinatal outcomes were compared between the two groups. In the PGDM group, pregnancy outcomes were analyzed in women who used insulin treatment (n=91) and women who did not (n=104). Results (1)The incidence of PGDM was 0.472%(195/41338). Diabetes mellitus were diagnosed in 59 women (30.3%, 59/195) before pregnancy, and 136 women (69.7%,136/195) were diagnosed as PGDM after conceptions. Forty-six women (33.8%) were diagnosed by fasting glucose and glycohemoglobin (HbA1c) screening. (2) The maternal age, pre-pregnancy body mass index (BMI), prenatal BMI, percentage of family history of diabetes, incidence of macrosomia, concentration of low density lipoprotein were significantly higher in PGDM group than those in control group (all P<0.05). Women in PGDM group had significantly higher HbA1c concentration((6.3±1.3)% vs (5.2±0.4)%), fasting glucose [(6.3±2.3) vs (4.8±1.1) mmol/L], oral glucose tolerance test(OGTT)-1 h glucose((12.6±2.9) vs (7.1± 1.3) mmol/L)and OGTT-2 h glucose [(12.0±3.0) vs (6.4±1.0) mmol/L] than those in control group (P<0.01). (3)The morbidity of preterm births was significantly higher (11.3% vs 1.0%, P<0.01), and the gestational age at delivery in PGDM group was significantly smaller [(37.6±2.3) vs (39.2±1.2) weeks, P<0.01]. Cesarean delivery rate in the PGDM group (70.8% vs 29.7%) was significantly higher than the control group (P<0.01). There was significantly difference between PGDM group and control in the neonatal male/female ratio (98/97 vs 111/84, P=0.033). The neonatal birth weight in PGDM group was significantly higher((3159±700) vs (3451±423) g, P<0.01). And the incidence of neonatal hypoglycemia in the PGDM group was higher than the control group (7.7% vs 2.6%, P=0.036).(4)In the PGDM group, women who were treated with insulin had a smaller gestational age at delivery [(36.9±2.9) vs (37.9±2.5) weeks, P<0.01], and the neonates had a higher neonatal ICU(NICU)admission rate (24.2% vs 9.6% , P<0.01). Conclusions The morbidity of PGDM in the 15 hospitals in Guangdong province is 0.472%. The majority of PGDM was diagnosed during pregnancy; HbA1c and fasting glucose are reliable parameters for PGDM screening. Women with PGDM have obvious family history of diabetes and repeated pregnancy may accelerate the process of diabetes mellitus. Women with PGDM have higher risk for preterm delivery and neonatal hypoglycemia. Unsatisfied glucose control followed by insulin treatment may increase the need for NICU admission.
8.Risk factors of depression in patients with functional dyspepsia
Journal of Chinese Physician 2015;17(11):1662-1664,1668
Objective To explore the risk factors of depression in patients with functional dyspepsia.Methods From July 2014 to September 2014, a total of 295 patients was diagnosed of functional dyspepsia (FD).All of them were evaluated with the 17-item Hamilton Depression Rating Scale (HAMD-17).They were divided into two groups: FD with depression and FD without depression.Socio-demographic and clinical features were collected and analyzed.Logistic regression analysis was used to detect risk factors of depression in FD patients.Results In our studies, 20.0% (59/295) of FD patients were diagnosed as depression.Risk factors for depression were age, disease duration, and marriage in univariate analysis, and marriage and disease duration in multivariate analysis.FD patients with moderate to severe depression had a longer duration of disease and more sessions of gastroscopy than those with mild depression.Conclusions Prevalence of depression is higher in FD patients with incomplete marriage and long disease duration, routine depression screening should be carried out for these patients.
9.Characterization and immunoprotective effect of SjIrV1, a 66 kDa calcium-binding protein from Schistosoma japonicum.
Meimei WEI ; Yanian XIONG ; Yang HONG ; Lini HUANG ; Peipei MENG ; Dezhou AI ; Min ZHANG ; Zhiqiang FU ; Shengfa LIU ; Jiaojiao LIN
Chinese Journal of Biotechnology 2013;29(7):891-903
Calcium-binding protein is an indispensable protein which performs extensive and important functions in the growth of Schistosoma japonicum. Based on our primary study on tegument surface proteins of S. japonicun, a cDNA encoding a 66 kDa calcium-binding protein of S. japonicum (Chinese strain) was cloned, sequence analysis revealed that it was identical with that of SjIrV1 of Philippines strains S. japonicum. The expression of SjIrV1 were detected by Real-time PCR, using cDNA templates isolated from 7, 14, 21, 28, 35 and 42 days worms and the results revealed that the gene was expressed in all investigated stages, and the mRNA level of SjIrV1 is much higher in 42 d female worms than that in 42 d male worms. The cDNA containing the open reading frame of IrV1 was subcloned into a pET28a (+) vector and transformed into competent Escherichia coli BL21 for expression. The recombinant protein was purified using a Ni-NTA purification system, and confirmed by high performance liquid chromatography (RP-HPLC) and tandem mass spectrometry (MS/MS). Western blotting analysis showed that recombinant SjIrV1 (rSjIrV1) could be recognized by the S. japonicum infected mouse serum and the mouse serum specific to rSjIrV1, respectively. Immunofluorescence observation exhibited that SjIrV1 was mainly distributed on the tegument of the 35-day adult worms. ELISA test revealed that IgG, IgG1 and IgG2a antibodies are significantly increased in the serum of rSjIrV1 vaccinated mice. The study suggested that rSjIrV1 might play an important role in the development of S. japonicum.
Animals
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Antibodies, Helminth
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blood
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Calcium-Binding Proteins
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genetics
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metabolism
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Cloning, Molecular
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Escherichia coli
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metabolism
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Female
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Genetic Vectors
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Helminth Proteins
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genetics
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metabolism
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Male
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Mice
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Recombinant Proteins
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genetics
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metabolism
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Schistosoma japonicum
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genetics
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metabolism
10.The effect of metabolic syndrome on pathogenesis of benign prostate hyperplasia
Ying LIU ; Xiaobing QU ; Xianqin MENG ; Zhigao HU ; Xiaokun ZHAO ; Fang SHEN ; Lini DONG
Chinese Journal of Geriatrics 2011;30(11):909-913
ObjectiveTo explore the effect of metabolic syndrome (MS) on the occurrence and development of benign prostate hyperplasia (BPH).Methods 101 elderly BPH patients were divided into two groups:BPH (n = 45) and BPH with MS (n= 56)group.The effects of metabolic indexes,including body mass index (BMI),waist,high density lipoprotein cholesterol (HDL-C),fasting blood glucose (FBS) and insuline resistance index (H()MA-IR),on prostate volume(PV),prostate-specific antigen (PSA),international prostate symptom score (IPSS) and lower urinary tract symptoms (LUTS) were surveyed in BPH patients.Results BPH with MS group showed significantly higher values of PV (t = 3.22,P= 0.003)and longer course of LUTS (t= 2.02,P =0.046) than BPH group.The BPH patients with overweight and obesity had significantly higher levels of PV(49.44±26.83 ml and 51.7±22.2 ml,P=0.021 and 0.043) than BPH patients with normal weight (38.10 ± 10.64 ml).Additionally,BPH patients with abdominal obesity had significantly higher levels of PV than BPH patients without abdominal obesity(50.26±26.51 ml vs.38.99± 11.25ml,P=0.005).BPH patients with low HDL-C had significantly higher PV than BPH patients with normal HDL-C[(54.23±28.92)ml vs.(40.40± 14.87) ml,P=0.009].The values of PV,PSA in the BPH patients with elevated FBS were significantly higher than in BPH patients with normal FBS (t=3.17 and 2.4I,P= 0.035 and 0.013).BPH patients with insuline resistance (IR) had higher values of PV and longer courses of LUTS than BPH patients without IR (t= 3.43 and 3.58,P-0.001).The PV was positively correlated with BMI(r= 0.459.P= O.OOO),FINS (r= 0.42,P=O.OOI),HOMA-IR (r= 0.49,P= 0.003) and gatively correlated with HDL-C (r= 0.38,P-0.000)- Multiple linear stepwise regression analysis showed that PV was closely correlated with HOMA-IR.ConclusionsMS has evident effects on the occurrence and development of BPH.

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