New developments in the treatment of castration resistant prostate cancer

In the past 5 years, the treatment and understanding of metastatic castrate resistant prostate cancer （CRPC） have improved dramatically. Our understanding of the mechanisms of castration resistance has allowed for the development of new drugs to target prostate cancer, and our understanding of genetic mutations may give us new tools with which to more accurately diagnose and be able to predict the course of this heterogeneous disease. This article summarizes the recent advances in the understanding of the development of CRPC, as well as the new drugs and targets, which have evolved from this basic research.     

Semen analysis with regard to and functional aspects sperm number,sperm morphology

The new World Health Organization （WHO） Manual for Semen Analysis contains several improvements. One is that the 20 million spermatozoa per mL paradigm has been ousted in favour of proper calculations of lower reference limits for semen from men, whose partners had a time-to-pregnancy of 12 months or less. The recommendation to grade the progressive motility as described in the third and fourth editions of the WHO manual was not evidence-based, and WHO was therefore motivated to abandon it. However, the new recommendation is not evidence-based either, and it is difficult to understand the rational for the new assessment. It may have been a compromise to avoid returning to the rather robust system recommended in the first edition （1980）. The unconditional recommendation of the ＇Tygerberg strict criteria＇ is not evidence-based, and seems to be the result of an unfortunate bias in the composition of the Committee in favour of individuals known to support the ＇strict criteria＇ method. This recommendation will have negative effects on the develop- ment ofandrology as a scientific field. Given the importance of the WHO manual, it is unfortunate that the recommenda- tions for such important variables, as motility and morphology, lack evidence-based support.     

Prognosis model of trauma outcome for Chinese victims：a revision on ASCOT parameters and weight coefficients from native trauma database

Objective:ASCOT(a severity characterization of trauma)is available for prognosis of trauma patients because its combination of parameters as physiology, anatomy,traumas types and age,These parameters are appareled with regressive reight coefficients that developed from TOS(the major trauma outcome study)reflecting North America patients.To improve the accuracy of ASCOT for Chinces trauma cases a serial of new weight coefficients is revised based on Chinese trauma database.Methods:Eleven thousand two hundred and fiftyeight cases from West China Trauma Database were analyzed with multi-variation regression to estimate the new weight coefficients of ASCOT for Chinese injured victims.Ps(probability of survival)of Chinese trauma victims were calculated with ACOOT,applying the weight coefficients of MTOS as well as the Chinese new ones,to predict their clincal outcome.The difference of the predicated and the actual outcomes was analyzed ,and the advantages of new coefficients in prognosis outcome of Chinese trauma were compared with that of MTOS coefficients.Results:The new coefficients emphasized weights of age,GCS,penetrating cerebral and blunt abdominal injury,Indexes of the new weight coefficients increased in accuracy,disparity,sensitivity and specificity,and the misclassification was reduced,when compared with the indexes of MTOS‘s weight coefficients.Conclusions:The new weight coefficients of ASCOT are in enhanced performance to prognosis outcome of Chinese trauma victims.It suggests that the new weight coefficients of ASCOT be used in the Chinese trauma cases as the sample size and the goodness-to -fit of resource database of the native trauma patients.     

Infertility treatment, a matter of a lovely sperm？

Nowadays, the efficiency of the infertil-ity treatment is relatively low. One of the cues to counteract this problem relies on the optimum selection of spermatozoa. We developed a new method （sperm selection assay （SSA）） based on the chemical attrac-tion of spermatozoa that are at the best functional state. Additionally, the SSA leads spermatozoa to complete and/or acquire the competence to fertilize the egg. These effects are equally observed either in nor-mal or subfertile semen samples. Those cap-abilities of SSA may improve the success of current infertility treatment.     

Type 2 diabetes after gestational diabetes: The influence of changing diagnostic criteria

A previous diagnosis of gestational diabetes(GDM)carries a lifetime risk of progression to type 2 diabetes of up to 60%.Identification of those women at higher risk of progression to diabetes allows the timely introduction of measures to delay or prevent diabetes onset.However,there is a large degree of variability in the literature with regard to the proportion of women with a history of GDM who go on to develop diabetes.Heterogeneity between cohorts with regard to diagnostic criteria used,duration of follow-up,and the characteristics of the study population limit the ability to make meaningful comparisons across studies.As the new International Association for Diabetes in Pregnancy Study Group criteria are increasingly adopted worldwide,the prevalence of GDM is set to increase by two-to three-fold.Here,we review the literature to examine the evolution of diagnostic criteria for GDM,the implications of changing criteria on the proportion of women with previous GDM progressing to diabetes,and how the use of different diagnostic criteria may influence the development of appropriate follow-up strategies.     

Updates in penile prosthesis infections

Inflatable penile prostheses are an important tool in the treatment of medically refractory erectile dysfunction.One of the major complications associated with these prostheses is infections,which ultimately require device explanation and placement of a new device.Over the past several decades,significant work has been done to reduce infection rates and optimize treatment strategies to reduce patient morbidity.This article reviews the current state of knowledge surrounding penile prosthesis infections,with attention to the evidence for methods to prevent infection and best practices for device reimplantation.     

Inaugural Editorial

Chinese Journal of Plastic and Reconstructive Surgery(CJPRS)is China's first English-language journal for the mega-specialty of plastic surgery.During its one-year trial period,the journal has provided excellent reference to specialists who utilize or have interest in principles and techniques of plastic surgery.Its official publication marks a new era for exchange and cooperation between Chinese plastic surgeons and their international peers.In China,plastic surgery has a history of nearly 90 years.Early records about modern plastic surgeons can be traced back to the 1930s.As in western countries,plastic surgery as a specialty made a leap forward during World War II.From 1949 to 1961,four major plastic surgery centers were born to fulfil the increased patient demands.In the 1980s and 1990s when international exchange became active,new subspecialties,predominantly microsurgery and craniofacial surgery,arose to extend the boundaries of plastic surgery.     

Detecting subtle changes in sperm membranes in veterinary andrology

Thanks to the increasing use of flow cytometry in research in veterinary spermatology, many new membrane integrity assays have been developed over the past decade. These assays are important because of their superior ability to forecast fertility when compared with other tests, such as sperm motility. This major component of the sperm quality assessment has generated new investigations with the aim of developing tests that can detect membrane damage in a very early state. Using phospholipid transposition tests, early changes in membrane permeability and fluidity can be assessed in a large number of spermatozoa using fluorescent probes in combination with flow cytometry.     

带指掌侧静脉的指动脉逆行岛状皮瓣的临床应用

介绍一种新的指动脉逆行岛状皮瓣。１９９３年１０月～１９９６年１２月，采用指动脉逆行岛状皮瓣修复１３例１７指皮肤缺损，并对皮瓣带或不带指掌侧静脉进行了对比性研究。结果表明，本组１７块皮瓣均成活。在术后早期并发症中，不带指掌侧静脉皮瓣的静脉危象发生率为８７．５％（７／８），带指掌侧静脉的皮瓣仅为１１．１％（１／９）。认为，带指掌侧静脉的指动脉逆行岛状皮瓣，可明显减少该皮瓣静脉危象的发生，提高皮瓣成活率     

日本第一例成功的断指再植

日本第一例成功的断指再植由奈良县立医科大学骨科的小松重雄和玉井进医师完成。他们从1959年开始用狗做微小血管吻合研究，1965年7月27日，初次应用端端吻合显微外科技术，再植成活一例离断拇指，目前被西方医学界公认为第一例成功的断指再植。     

吻合浅静脉的邻指逆行指动脉Y-V血管蒂皮瓣的临床应用

目的 探讨吻合浅静脉的邻指逆行指动脉Y-V血管蒂皮瓣修复手指软组织缺损的方法及临床效果. 方法 2009年3月至2011年6月,利用吻合浅静脉的邻指逆行指动脉Y-V血管蒂皮瓣修复20例手指近指间关节以远软组织缺损,其中示指12例,中指8例,皮瓣面积最大4.5 cm×3.5 cm,最小3.5 cm ×2.5 cm,血管蒂长度平均4.0 cm,均吻合一支浅静脉,缝接指背神经14例,供区全厚皮片植皮.结果 20例皮瓣全部顺利成活,随访8 ～16个月,皮瓣外形及质地满意,缝接神经的两点辨别觉恢复至7～9 mm,未缝接神经的感觉恢复至S2～S3,供区外形及功能无明显影响. 结论 邻指逆行指动脉Y-V血管蒂皮瓣可形成较长的血管蒂,修复近指间关节以远软组织缺损,通过吻合浅静脉可明显减轻皮瓣的静脉回流压力,提高皮瓣的成活质量,术后疗效满意.     

Optimal digital redesign of cascaded analogue controllers

This paper presents a new, optimal digital redesign technique for finding an optimal cascaded digital controller from the given continuous-time counterpart by minimizing a quadratic performance index. The control gains can be obtained by solving a set of Lyapunov equations. The developed optimal cascaded digital controller enables the state and/or outputs of the digitally controlled closed-loop sampled-data system to optimally match those of the original continuous-time closed-loop system at any instant between sampling periods. The developed control law can be implemented using inexpensive and reliable digital electronics with a relatively long sampling period.     

Digital artery occlusion secondary to plastic shopping bag trauma

Upper limb digital arterial occlusion is uncommon. We present the case of a 47-year-old man with an ischaemic right middle finger (dominant hand) due to trauma from carrying a heavy plastic shopping bag. Duplex scanning revealed no proximal source of emboli. An angiogram demonstrated occlusions in the medial and lateral digital arteries of the middle digit at the level of the proximal phalanx. Treatment with heparin and warfarin resulted in complete resolution of symptoms.     

关节镜计算机数字视频技术的研究与临床应用

作者利用视频卡，将关节镜电视信号转变成数字信号，通过计算机实现对关节镜彩色静止图像和动态画面的采集，并以计算机文件的方式长期记录和储存。计算机图像分辨率高，色彩真实，容易复制，具有病历查询、彩照打印、数据库管理、通讯会诊等用途。计算机多媒体技术的应用为关节镜资料的记录和保存提供一个迅捷、准确、可行的方法。本技术能够弥补传统窥镜照相等技术的不足，亦可推广应用于其它内窥镜电视中。