Safety and efficacy of traditional Chinese medicine,Qiaoshao formula,combined with dapoxetine in the treatment of premature ejaculation: An open-label,real-life,retrospective multicentre study in Chinese men

To evaluate the safety and efficacy of Chinese medicine, Qiaoshao formula combined with dapoxetine was used for the treatment of premature ejaculation in a real-life setting. Nine hundred and five males diagnosed with premature ejaculation were reviewed in this retrospective cohort study. We divided the patients into two groups: dapoxetine alone and Qiaoshao formula combined with dapoxetine according to actual interventions provided to patients in clinics. The perceived intravaginal ejaculation latency time and the premature ejaculation profile measures markedly improved in both groups. However, in men with severe premature ejaculation (baseline perceived intravaginal ejaculation latency time <1 min) and those with baseline age ≤30 years, the perceived intravaginal ejaculation latency time was slightly but significantly longer with combined therapy than with dapoxetine alone (p < .05). Therefore, combined therapy involving the Qiaoshao formula and dapoxetine proved to safe as well as effective for treating premature ejaculation while prolonging the perceived intravaginal ejaculation latency time, which significantly improved the overall satisfaction of the patient and likely that of the couple.     

Effect of Wuzi Yanzong Pills on Sertoli cells and blood–testis barrier in heat-stressed rats based on Akt signalling pathway

The blood–testis barrier (BTB) of Sertoli cells (SCs) is an important biological barrier that maintains spermatogenesis and provides a favourable microenvironment for spermatogenesis. However, heat stress can directly damage the BTB structural proteins of testicular SCs, leading to dyszoospermia. Wuzi Yanzong Pills (WYP) is a traditional Chinese medicine formula used to treat male reproductive diseases. However, whether WYP could ameliorate heat stress injury in primary SCs extracted from rat testes and BTB proteins remains unknown. Here, treatment with WYP (low, medium and high dose) increased the SC viability and the proliferation of cell antigen Ki67 significantly. Additionally, it promoted SC maturation, which presented in the form of increased androgen receptors (ARs) and decreased cytokeratin 18 (CK-18) in three WYP dose groups. WYP upregulated BTB proteins such as zonula occludens 1 (ZO-1) and occludin across all WYP groups and decreased phosphorylated Akt (p-Akt) in the middle and high-dose groups; however, ZO-1 and occludin recovery were reduced with the presence of Akt inhibitor in WYP groups. WYP improved SC viability and proliferation, and ameliorated dedifferentiation and BTB-proteins damaged by heat stress via Akt signalling. The findings present theoretical support for the effects of WYP in the management of dyszoospermia and male infertility.     

Digoxin reduces the incidence of prostate cancer but increases the cancer-specific mortality: A systematic review and pooled analysis

Digoxin, a commonly used drug for congestive heart failure and cardiac arrhythmias, has been reported to exert cytotoxic and apoptosis-inducing effects on prostate cancer (PCa) cells. In this study, we aimed to perform a pooled analysis to summarise all the evidence related to the effects of digoxin on PCa development. Four electronic databases were systematically searched to filter the eligible studies. The hazard ratio (HR) with its 95% confidence interval (CI) was calculated. This study was registered on PROSPERO (ID: CRD42021226885). Ten clinical studies with a total of 108,444 participants (15,835 individuals were digoxin users) were included. The pooled result from 6 included studies demonstrated that digoxin usage was correlated with a significant decrease in PCa risk (adjusted RR = 0.892, 95% CI: 0.799–0.997, p = .044) when compared with the nonusers. Synthetic result of 4 eligible studies revealed that digoxin significantly correlated with higher prostate cancer-specific mortality than the controls (adjusted HR = 1.142, 95% CI: 1.005–1.297). No statistical heterogeneity was detected during this analysis (all I² < 50%, p > .1). Our study confirmed a preventive effect of digoxin usage for the risk of PCa in men. However, digoxin use was associated with a significantly elevated risk of prostate cancer-specific mortality. This finding needs more well-designed studies to better interpret the causality.     

Investigating the effects of walnut ointment on non-healing burn wounds

Effective treatments for non-healing burn wounds are an unmet need for 95% of burn sufferers. Approaches currently available to treat non-healing burn wounds are not satisfactory due to undesirable side-effects or expense. The anti-oxidation and antibacterial activities of walnuts are recommended for treating chronic diseases. Walnut ointment has been developed and successfully applied to treat non-healing burn wounds in our hospital for decades. We report herein a detailed retrospective case review examining patients’ response to the walnut ointment. The walnut ointment has shortened healing time of non-healing burn wounds and improved clinical outcomes. In order to investigate the mechanism of action, walnut ointment has been applied on wounds of porcine full-thickness burn wound models. Histological and immunohistochemical analysis indicated our walnut ointment supports wound healing through promoting keratinocyte proliferation and differentiation. Taken together, we recommend the walnut ointment offers an effective and economical treatment for patients presenting with non-healing burn wounds.     

Supratentorial pediatric cortical ependymomas: a comprehensive retrospective study

Neurosurgical Review - Pediatric cortical ependymomas (CEs) are rare; the clinical features and optimal treatment remain ill-defined. We aimed to clarify the clinical characteristics and outcome of...     

Has Removal From the Inpatient-Only List Increased Complications After Outpatient Total Knee Arthroplasty?

BackgroundOn 1/1/2018, the Centers for Medicare and Medicaid Services removed total knee arthroplasty (TKA) from the Inpatient-Only (IPO) list. This change allowed expansion of outpatient TKA, potentially to include older, more frail patients at greater risk for perioperative complications. The purpose of this study was to evaluate the impact of removing TKA from the IPO list on early complications.MethodsPatients undergoing TKA in the National Surgical Quality Improvement Program database were identified using CPT code 27447. Only cases with length of stay of zero days were included. Rates of 30-day complications, readmissions, and reoperation were compared before and after TKA was removed from the IPO list (2015-2017 vs 2018). The analysis was performed both with and without propensity score matching.Results212,313 patients underwent TKA during the study period. 2466 (1.5%) were outpatient TKA in 2015-2017 and 3189 (5.6%) in 2018. After propensity matching, there were 2458 patients in each cohort. Rates of total 30-day complications were significantly lower in 2018 (3.7%) than the years TKA remained on the IPO (4.5%, P = .04). Similarly, rates of any reoperation decreased from 1.2% during 2015-2017 to 0.6% in 2018 (P = .03). There were no significant changes in rates of readmission (2.5% vs 2.2%, P = .5) or wound complications (0.8% vs 0.8%, P = 1.0).ConclusionRemoval of TKA from the IPO list did not result in an increase in complications or readmissions. These data suggest, despite the regulatory change, surgeons have continued to exercise sound judgment as to what patients can safely undergo outpatient TKA.     

居家模拟培训对老年髋关节置换患者康复效果的影响

目的探讨开展居家模拟培训提高老年髋关节置换患者康复的效果。方法按住院时间将老年髋关节置换患者162例分为对照组80例和观察组82例,对照组采取骨科常规护理方式进行康复指导,观察组在常规护理基础上由高级责任护士实施全程居家生活与出行路径的模拟培训。于入院时、术后1个月、3个月、6个月评价两组Harris髋关节功能评分与Barthel指数。结果观察组Harris髋关节功能评分及Barthel指数评分显著高于对照组(均P<0.01)。结论开展居家模拟培训有利于促进老年髋关节置换术后患者康复,提高日常生活能力。     

基于关键指标监测的双闭环管理在急诊预检分诊中的应用

目的 探讨基于关键指标监测的急诊预检分诊双闭环管理的效果.方法 2019年1～6月对急诊患者实施常规预检分诊管理;2019年7～12月实施急诊预检分诊活动与监管双闭环管理,包括动态评估、规范处理、实时监控、持续改进,并利用信息化平台实现关键指标监测.结果 2个时间段分别收集4 550例、4 670例患者资料.实施双闭环管理后,初次分诊准确率、目标响应时间达标率及急诊分诊满意度显著高于常规管理,候诊不良事件发生率显著低于常规管理(P＜0.05,P＜0.01);双闭环管理后分诊信息采集完整、二次分诊落实、二次分诊准确度3项关键指标落实率逐步提升.结论 双闭环管理联合关键指标监测,可有效提高急诊预检分诊质量与效率,提升患者满意度,保障急诊患者安全.     

全麻气管插管患者术后咽喉疼痛预防最佳证据总结

目的 总结全麻气管插管患者术后咽喉疼痛预防的最佳证据,为预防术后咽喉疼痛提供循证依据.方法 运用循证护理的方法,检索相关数据库建库至2020年8月针对围手术期咽喉疼痛预防的临床决策、推荐实践、最佳实践信息册、指南、证据总结、系统评价、专家共识.结果 共纳入18篇文献,从咽喉疼痛评估、插管策略、预防药物、套囊管理、拔管管理方面总结20条最佳证据.结论 临床医护人员可通过最佳证据的临床转化及应用来减少全麻气管插管患者术后咽喉疼痛发生率和严重程度,促进患者康复.