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.     

Expression of brain-derived neurotrophic factor in rapid ejaculator rats: A further study

Limited evidence has indicated that brain-derived neurotrophic factor (BDNF) may be involved in the neurobiology of premature ejaculation (PE). This study aimed to investigate BDNF levels in the central and peripheral nervous systems of a rapid ejaculation model. Eighteen male rats were selected and classified as ‘sluggish’, ‘normal’ and ‘rapid’ ejaculators on the basis of ejaculation frequency during copulatory behavioural tests. BDNF levels in specific brain regions, spinal cord and serum were determined by enzyme-linked immunosorbent assay (ELISA). Consistent with the results in PE patients, the concentration of serum BDNF decreased significantly from the sluggish rats to normal and rapid rats. Besides, in both brain regions and spinal cord, the sluggish group had the highest BDNF levels, while the rapid group had the lowest BDNF levels. Regression analyses of the expression of BDNF presented positive correlations between serum and brain (r = 0.958, p < .001), and between serum and spinal cord (r = 0.967, p < .001) respectively. Our findings suggested insufficient BDNF in the nervous system and serum may lead to rapid ejaculation. The current study adds to the evidence that BDNF is involved in the regulation of ejaculation.     

Bibliometric Analysis of the Top-Cited Articles on Unicompartmental Knee Arthroplasty

BackgroundUnicompartmental knee arthroplasty (UKA) has been proven to be an effective surgical technique for unilateral compartment osteoarthritis. The purpose of this study is to identify and analyze the top 100 cited articles in the field of UKA research.MethodsPublications on UKA from 1980 to 2020 in the Web of Science database were retrieved. The characteristics of the top 100 cited articles were analyzed, including information of publications and citations, level of evidence, and research interests.ResultsThe number of publications and citations increased over time. The majority of the highly cited articles were from the Nuffield Orthopedic Centre (Oxford, England) and the Brigham and Women’s Hospital (Boston, USA). Long-term outcome of UKA and comparison between UKA and TKA gathered most research interests. The most frequently occurring keywords were “survival” and “revision.” Since 2012, “life quality” and “robotics” have been used. There was no level I evidence, and most studies provided level IV evidence.ConclusionThere was a rising trend in publications and citations in the field of UKA research, the majority of them were from a few centers, and were low-level evidence. Most studies focused on the long-term outcomes of UKA; in recent years, patient satisfaction and navigation surgery have become new research trends.     

Sandwich联合案例教学法在神经内科临床实习中的应用

目的 探讨Sandwich联合以案例为基础的教学法在神经内科临床实习中的应用效果,为进一步优化教学方法提供参考.方法 以98名神经内科实习护理本科生为对象,按照实习病区分为对照组与观察组各49名.对照组采用传统教学法进行教学,观察组在对照组基础上采用Sandwich联合以案例为基础的教学法.出科前比较两组理论考试成绩及对教学方法的评价.结果 观察组理论考试成绩及教学满意评分显著高于对照组(P＜0.05,P＜0.01).结论 Sandwich联合以案例为基础的教学法可有促进学生对理论知识的掌握,提高教学效果.     

Systematic review of outcomes and meta-analysis of risk factors for prognosis after liver resection for hepatocellular carcinoma without cirrhosis

Long-term overall survival (OS) after liver resection for non-cirrhotic hepatocellular carcinoma (NCHCC) has been reported recently. The aim of this study was to review outcomes systematically and analyze risk factors for survival after surgical resection for HCC without cirrhosis. A literature search was performed of the PubMed and Embase databases for papers published between January 1995 and October 2012, which focused on hepatic resection for HCC without underlying cirrhosis. Cochrane systematic review methodology was used for this review. Outcomes were OS, operative mortality and disease-free survival (DFS). Pooled hazard ratios (HR) were calculated using the random effects model for parameters considered as potential prognostic factors. Totally, 26 retrospective case series were eligible for inclusion. The 1-, 3- and 5-year OS rate after surgical resection of NCHCC ranged from 62% to 100%, 46.3%–78.0%, and 30%–64%, respectively. The corresponding DFS rates ranged from 48.7% to 84%, 31.0%–66.0%, and 24.0%–58.0%, respectively. Five variables were related to poor survival: multiple tumors (HR 1.68, 95%CI 1.25–2.11); larger tumor size (HR 2.66, 95%CI 1.69–3.63); non-clear resection margin (R0 resection) (HR 3.52, 95%CI 1.63–5.42); poor tumor stage (HR 2.61, 95%CI 1.64–3.58); and invasion of the lymphatic vessels (HR 4.85, 95%CI 2.67–7.02). In sum, hepatic resection provides excellent OS rates for patients with NCHCC, and results have tended to improve recently. Risk factors for poor prognosis comprise multiple tumors, lager tumor size, non-R0 resection and invasion of the lymphatic vessels.     

Mid‐ to Long‐Term Outcomes of Cementless Modular,Fluted, Tapered Stem for Massive Femoral Bone Loss in Revision Total Hip Arthroplasty

ObjectiveTo evaluate mid‐ to long‐term results of revision total hip arthroplasty for massive femoral bone loss using a cementless modular, fluted, tapered stem.MethodsThis is a retrospective study performed at a single hospital. During the period of January 2007 to January 2015, 33 patients (34 hips) underwent primary revision surgery with cementless modular, fluted, tapered stems due to femoral bone loss. Sixteen men and 17 women were included in the study, with an average age of 63.9 ± 11.7 years (range, 27 to 88 years). Operative data including operative duration, length of incision, drainage volume and duration, blood loss and transfusion, cases of bone graft and extended trochanteric osteotomy were recorded. Clinical evaluation was performed using Harris hip score (HHS), visual analogue scale (VAS), and patients'' satisfaction. Radiographic data including femoral stem fixation, subsidence, integrin of allograft bone, and leg length discrepancy were assessed. Complications and survivorship were evaluated using Kaplan–Meier survival rate.ResultsThe mean follow‐up was 9.1 ± 2.5 years (range, 5–13 years). The Harris hip score was 43.6 ± 11.5 preoperatively and maintained at 86.5 ± 6.6 at the time of latest follow‐up (P < 0. 05). The X‐ray showed bone ingrowth fixation in 30 hips (88%), fibrous stable fixation in three hips (9%), and instability in one hip (3%). The average stem subsidence was 3.9 ± 2.2 mm (range, 1 to 10 mm). The mean difference in leg length in our study was 3.3 ± 2.7 mm (range, 0 to 10 mm), and the leg length discrepancy in 28 (82%) patients was within 5 mm. No case of junction fracture was observed. Seven (21%) intraoperative fractures occurred in our study. Three (9%) cases with infection were observed after revision. Six (18%) patients had lower limb vein thrombosis. The survivorship of prostheses with re‐revision for any reason was 95% (95% CI, 12.0 to 13.0) at the 10‐year follow‐up. Three (9%) re‐revisions were needed, including one for aseptic loosening, one for dislocation, and one for infection.ConclusionThe mid‐ to long‐term results of revision total hip arthroplasty with the cementless modular, fluted, tapered stems are encouraging for massive femoral bone loss.     

Association of angiotensin Ⅱ type 1 receptor gene polymorphism with essential hypertension

Objective To determine whether the polymorphism A1166C in the angiotensin Ⅱ type 1 receptor (AT1R) gene is associated with essential hypertension.Methods A case-control study was carried out using 125 hypertensive and 103 normotensive subjects. The A→C variant at position 1166 (A1166C) of t he AT1R gene was identified by polymerase chain reaction (PCR) and PCR/ restriction fragment length polymorphism (PCR/RFLP) analysis. The digestion products were separated on 2% agarose gels and visualized with ethid ium bromide under ultraviolet ray.Results The differences in C1166 allele frequency and in the AC genotype dist ribution of the AT1R gene between the hypertensive and normotensive groups were statistically significant (C allele: 0.092 vs 0.034, χ(2) =6.1 86, P&lt;0.05; AC genotype: 0.184 vs 0.068, χ(2) =6.654, P&lt;0.05).Conclusion The AC genotype is associated with essential hypertension, and the C a llele may be a marker for predisposition to hypertension in Chinese H an population.     

微电极记录技术在立体定向手术治疗帕金森病中的应用

目的：提高立体定向手术的定位精确度。方法：32例帕金森患者均采用CT定位。通过微电极描述和记录苍白球腹后内侧部（Gpi)及丘脑腹外侧核（Vim)的电生理信号。从而pi和Vim核的电生理靶点。结果：电生理靶点坐标与原始CT靶点坐标的更换率为64%。总有效率为90%,无永久性并发症,结论：微电极记录技术的应用提高了手术治疗帕金森病的效果。降低了手术并发症。     

急诊冠状动脉内支架植入治疗急性心肌梗死——围术期死亡和近期预后的研究

为评价急性心肌梗死(AMI)患者急诊经皮冠状动脉腔内成形(PTCA)和冠状动脉内支架植入围术期死亡和近期预后的影响因素,通过对74例行急诊冠状动脉内支架植入的AMI,术后6个月内的临床随访和冠状动脉造影随访,进行多因素相关回归分析。结果表明,多支病变患者的糖尿病、高血压和高血脂的合并比例明显高于单支病变患者;总围术期内死亡率为5.4％,剔除合并心源性休克患者后,死亡率为1.4％;12例75岁以上的患者中,2例死于心源性休克,1例死于心脏破裂,5例心源性休克患者死亡3例;术中非致命性合并症的发生率在单支和多支病变组之间差异无显著性(P>0.05);多元回归分析表明血流动力学状态和患者的年龄是决定AMI患者围术期死亡的独立相关因素;多支病变患者术后6个月内心脏事件发生率明显高于单支病变组;术前和术后6个月内的患者左心室射血分数(LVEF)明显改善;而且单支和多支病变组之间术后6个月时的LVEF之间无显著性差异。     

《伤寒杂病论》合方运用探讨

重点阐述了《伤寒杂病论》所创合方的这一方剂变化的特殊形式及其运用。并对合方的源流,涵义,组方原则,作用及意义进行了探讨。认为合方虽源于《内经》,但成形于《伤寒杂病论》。合方具有单方所不具备的优势和疗效,如治疗面广,作用性强,产生新疗效,调整作用功能等。