Chitosan Nerve Grafts Incorporated with SKP-SC-EVs Induce Peripheral Nerve Regeneration

BACKGROUND@#Repair of long-distance peripheral nerve defects remains an important clinical problem. Nerve grafts incorporated with extracellular vesicles (EVs) from various cell types have been developed to bridge peripheral nerve defects. In our previous research, EVs obtained from skin-derived precursor Schwann cells (SKP-SC-EVs) were demonstrated to promote neurite outgrowth in cultured cells and facilitate nerve regeneration in animal studies. @*METHODS@#To further assess the functions of SKP-SC-EVs in nerve repair, we incorporated SKP-SC-EVs and Matrigel into chitosan nerve conduits (EV-NG) for repairing a 15-mm long-distance sciatic nerve defect in a rat model. Behavioral analysis, electrophysiological recording, histological investigation, molecular analysis, and morphometric assessment were carried out. @*RESULTS@#The results revealed EV-NG significantly improved motor and sensory function recovery compared with nerve conduits (NG) without EVs incorporation. The outgrowth and myelination of regenerated axons were improved, while the atrophy of target muscles induced by denervation was alleviated after EVs addition. @*CONCLUSION@#Our data indicated SKP-SC-EVs incorporation into nerve grafts represents a promising method for extended peripheral nerve damage repair.

Machine and deep learning-based clinical characteristics and laboratory markers for the prediction of sarcopenia / 中华医学杂志(英文版)

BACKGROUND@#Sarcopenia is an age-related progressive skeletal muscle disorder involving the loss of muscle mass or strength and physiological function. Efficient and precise AI algorithms may play a significant role in the diagnosis of sarcopenia. In this study, we aimed to develop a machine learning model for sarcopenia diagnosis using clinical characteristics and laboratory indicators of aging cohorts.@*METHODS@#We developed models of sarcopenia using the baseline data from the West China Health and Aging Trend (WCHAT) study. For external validation, we used the Xiamen Aging Trend (XMAT) cohort. We compared the support vector machine (SVM), random forest (RF), eXtreme Gradient Boosting (XGB), and Wide and Deep (W&D) models. The area under the receiver operating curve (AUC) and accuracy (ACC) were used to evaluate the diagnostic efficiency of the models.@*RESULTS@#The WCHAT cohort, which included a total of 4057 participants for the training and testing datasets, and the XMAT cohort, which consisted of 553 participants for the external validation dataset, were enrolled in this study. Among the four models, W&D had the best performance (AUC = 0.916 ± 0.006, ACC = 0.882 ± 0.006), followed by SVM (AUC =0.907 ± 0.004, ACC = 0.877 ± 0.006), XGB (AUC = 0.877 ± 0.005, ACC = 0.868 ± 0.005), and RF (AUC = 0.843 ± 0.031, ACC = 0.836 ± 0.024) in the training dataset. Meanwhile, in the testing dataset, the diagnostic efficiency of the models from large to small was W&D (AUC = 0.881, ACC = 0.862), XGB (AUC = 0.858, ACC = 0.861), RF (AUC = 0.843, ACC = 0.836), and SVM (AUC = 0.829, ACC = 0.857). In the external validation dataset, the performance of W&D (AUC = 0.970, ACC = 0.911) was the best among the four models, followed by RF (AUC = 0.830, ACC = 0.769), SVM (AUC = 0.766, ACC = 0.738), and XGB (AUC = 0.722, ACC = 0.749).@*CONCLUSIONS@#The W&D model not only had excellent diagnostic performance for sarcopenia but also showed good economic efficiency and timeliness. It could be widely used in primary health care institutions or developing areas with an aging population.@*TRIAL REGISTRATION@#Chictr.org, ChiCTR 1800018895.

An unconventional presentation of Hip Joint Trevor disease with the involvement of the whole capital femoral epiphysis: A case report and literature review.

Dysplasia epiphysealis hemimelica (DEH) or Trevor's disease is a rare, nonhereditary developmental disorder of skeleton affecting epiphysis and short bones of limbs and characterized by a benign overgrowth of the medial half of the epiphysis resembling osteochondroma. We herein report an unconventional presentation of Trevor's disease of the hip with the involvement of the whole epiphysis. Only a few cases of DEH with such unusual features were found in the literature. The aim of this case report is to spread the awareness among the doctors about an unusual case of DEH with the involvement of the whole capital femoral epiphysis which has been neglected for 10 years. We also discuss the natural history of the development of disease, challenges faced during the course of treatment, clinical results, and complications.

Research progress of anesthesia methods in prostate biopsy / 中华外科杂志

Prostate biopsy is the gold standard for the diagnosis of prostate cancer. In order to successfully and effectively complete the biopsy, clinicians should not only select the correct puncture method, but also pay attention to the pain control of patients undergoing puncture. It is necessary to select a reasonable anesthetic method for biopsy. The pain during biopsy comes from the skin, muscle and other structures in the puncture approach, and also comes from the prostate capsule. Therefore, the anesthesia emphasis of transperineal and transrectal biopsy approaches will also be different. The use of appropriate anesthesia is of great significance to improve the patient's cooperation and ensure the success rate of biopsy. With the continuous maturity of the technology and concept of prostate biopsy, a single anesthesia method has been unable to meet the actual anesthetic needs of biopsy, and the use of multi-site and multi-phase combined anesthesia for different sources of pain has become the mainstream anesthetic option.

Analysis on SARS‑CoV‑2 contamination in the environment exposure to the SARS‑CoV‑2 cases in Huangpu District of Shanghai in 2022 / 中国热带医学

@#Abstract: Objective　To analyze the detection of SARS‑CoV‑2 in household environment and public place environment of Huangpu District, and describe the feature of SARS‑CoV‑2 contamination in the environment exposure to the infected cases, so as to support the control strategies such as disinfection and health communication. Methods　The results of RT-PCR test for the environmental samples exposure to the cases infected by SARS‑CoV‑2 during February 1 to March 31 2022 in Huangpu District of Shanghai were collected as the research data. Pearson χ2 was used to test the significance of the differences between positive rates of SARS‑CoV‑2 contamination. Results　From February 1 to March 31, household environment samples had a higher positive rate (6.47%, 234/3 618) of SARS‑CoV‑2 contamination while the public place samples had a lower one (1.22%, 47/3 582) in Huangpu District of Shanghai (χ2=141.908, P<0.01). Among the household buildings, the lane houses of old style representing poorer living condition had the highest positive rates (8.31%, 96/1 155) of SARS‑CoV‑2 contamination while the apartments representing better living condition had the lowest (3.59%, 22/612) (F=5.25，P<0.05). Among the samples from household environment, samples regarding sewerage had the highest positive rates (13.30%,58/436) of SARS‑CoV‑2 contamination, while samples regarding the tool of cooking and sweeping had the lowest (3.10%,17/548) (F=9.84，P<0.01). Among the samples from public place environment, samples regarding entertainment tools had the highest positive rates (13.33%, 2/15) of SARS‑CoV‑2 contamination, while samples regarding the tool of cooking and sweeping had the lowest (0.62%, 4/646) (F=4.22，P<0.01). Conclusion　In the environment exposure to the SARS‑CoV‑2 infected cases, the disinfection, ventilation and cleaning should be intensified strictly. SARS‑CoV‑2's surviving in sewage environment should be evaluation dynamically. More health communication should be pushed to people of poorer living condition.

Comparison of short-time efficacy of anti-VEGF therapy or anti-inflammatory therapy on different types of macular edema secondary to retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the efficacy of anti-inflammatory treatment and anti-vascular endothelial growth factor(VEGF)treatment on different types of macular edema secondary to retinal vein occlusion(RVO-ME).<p>METHODS: The clinical data of RVO-ME patients who were treated in the Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University from 2019-06/2020-12 were retrospectively collected. A total of 108 cases(108 eyes)of RVO-ME patients were collected, including 52 cases(52 eyes)with cystoid macular edema(CME), 38 cases(38 eyes)with macular edema with serous retinal detachment(SRD), and 18 cases(18 eyes)with diffuse retinal thickening(DRT). Patients with various types of ME were further classified into anti-VEGF group and anti-inflammatory group. The observation metrics such as best corrected visual acuity(BCVA)and foveal thickness(CMT)before and 3mo after surgery were collected and compared in each group.<p>RESULTS: There was no difference in baseline data between the anti-VEGF group and the anti-inflammatory group in all types of ME patients(all P>0.05). Patients with CME in the anti-VEGF group in BCVA, CMT, and the sum of CME diameter after operation were different from that before operation(Z= -4.463, -4.541, -4.541, all P<0.001); the postoperative BCVA, CMT, and the sum of CME diameter in the anti-inflammatory group were significantly different from those before operation(Z= -3.743, -4.345, -4.372, all P<0.001); and there was no difference between the anti-VEGF group and the anti-inflammatory group in the postoperative CMT and the sum of CME diameter(Z= -1.017, -0.968, all P>0.05), but there was a difference in BCVA after operation in two groups(Z= -1.978, P<0.05). SRD patients in the anti-VEGF group had differences in postoperative BCVA, CMT, and SRD heights compared with preoperative ones(Z= -4.111, -4.198, -4.198, all P<0.01); the BCVA, CMT, and SRD height in the anti-inflammatory group after operation were different from those before operation(Z= -3.410, -3.408, -3.408, all P<0.05); and there was no difference in BCVA and CMT between the two groups after operation(Z= -0.857, -1.030, all P>0.05), but the postoperative SRD height in the anti-inflammatory group was significantly lower than that in the anti-VEGF group(Z= -2.117, P<0.05). DRT patients in the anti-VEGF group were significantly different in BCVA and CMT after operation compared with preoperative ones(Z= -2.207, -2.521, all P<0.05), and in the anti-inflammatory group after injection, BCVA and CMT were significantly different from preoperative ones(Z= -2.207, -2.521, all P<0.05). There were differences in BCVA and CMT after injection in the anti-inflammatory group compared with those before operation(Z= -2.207, -2.803, all P<0.05). There was no difference in postoperative BCVA and CMT between the two groups(Z= -0.359, -0.845, all P>0.05). <p>CONCLUSION: Anti-inflammatory and anti-VEGF treatments are effective for all kinds of ME in improving vision and reducing CMT. Anti-VEGF treatment is superior to anti-inflammatory treatment in improving BCVA of CME patients and is inferior to anti-inflammatory in decreasing SRD thickness of SRD patients.

Fecal Microbiota Transplantation Controls Progression of Experimental Autoimmune Hepatitis in Mice by Modulating the TFR/TFH Immune Imbalance and Intestinal Microbiota Composition.

Intestinal microbiota (IM) dysbiosis contributes to the development of autoimmune hepatitis (AIH). This study aimed to investigate the potential effect of fecal microbiota transplantation (FMT) in a murine model of experimental AIH (EAH), a condition more similar to that of AIH patients. Changes in the enteric microbiome were determined in AIH patients and EAH mice. Moreover, we established an experimental model of secondary EAH mice harboring dysbiosis (ABx) to analyze the effects of therapeutic FMT administration on follicular regulatory T (TFR) and helper T (TFH) cell imbalances and IM composition in vivo. Alterations of the IM composition and bacterial translocation occurred in AIH patients compared to nonalcoholic fatty liver disease patients and healthy controls (HCs). Therapeutic FMT significantly attenuated liver injury and bacterial translocation and improved the imbalance between splenic TFR cells and TFH cells in ABx EAH mice. Furthermore, therapeutic FMT also partially reversed the increasing trend in serum liver enzymes (ALT and AST) of CXCR5-/-EAH mice on the 28th day. Finally, therapeutic FMT could effectively restore antibiotic-induced IM dysbiosis in EAH mice. Taken together, our findings demonstrated that FMT was capable of controlling hepatitis progression in EAH mice, and the associated mechanism might be involved in the regulation of the TFR/TFH immune imbalance and the restoration of IM composition.

Student returnees from China's COVID-19 epicenter: Spatio-temporal movement and impact of tracing.

At the initial stage of COVID-19 outbreak, tracing returnees from Wuhan - the epicenter of the disease - is a major strategy in each province of China to contain its spread. However, scholars are yet to assess the impact of tracing on individuals. Drawing upon a large-scale survey with students from four major universities in Wuhan, we investigate individual experiences with tracing activities at government and community levels and the impacts on students' socio-psychological wellbeing. Findings indicate that tracing is likely to increase the risks of privacy infringement, verbal slur, and warning at residence; and students experience moderate-to-high levels of anxiety and fear. Improved public health measures are therefore necessary to balance the twin goals of containing disease and alleviating unintended consequences of tracing.

Clinical characteristics and early recognition of thrombotic microangiopathy in children with systemic lupus erythematosus / 中国小儿急救医学

Objective:To analyze the clinical characteristics of children diagnosed with systemic lupus erythematosus(SLE)complicated with thrombotic microangiopathy(TMA)for early recognition.Methods:We retrospectively reviewed the clinical records of 14 SLE patients with TMA hospitalized at Shanghai Children′s Medical Center, Shanghai Jiaotong University School of Medicine from December 2005 to October 2020.Results:The incidence of TMA was 5.65%(14/248)of the hospitalized patients with SLE and 7.87%(14/178)of the hospitalized patients with lupus nephritis.Four patients were boys while ten patients were girls.One boy was six years old and other 13 patients were from 11 to 18 years old.Their SLEDAI scores ranged from 14 to 31, and all of them were severe activity.Renal biopsy of 11 patients during TMA course all revealed lupus nephritis(type Ⅳ, n=8; type Ⅳ+ Ⅴ, n=3). These 14 SLE children were diagnosed with TMA within 3 days to 2 months after admission.At the beginning of the hospitalization, only six patients had both anemia and thrombocytopenia, while eight patients only had moderate anemia.All of the patients had obvious hypocomplementemia.Especially in the patients with first onset of SLE without treatment, their serum levels of C3 were less than 0.17 g/L and C4 were less than 0.07 g/L.Moreover, glomerular filtration rates of these patients were lower than that in normal range.The follow-up time were 0.2-11.3 years(median time was 2.6 years). After treatment, six patients obtained complete remission, and five patients obtained partial remission.One patient had sudden death during the 4th plasmapheresis, and the other two patients deteriorated. Conclusion:Children with SLE and TMA are mostly in severe disease activity, and renal pathology is type Ⅳ lupus nephritis.The SLE children with anemia should be paid special attention to the level of serum complement whether they have thrombocytopenia or not.If the level of serum complements decrease obviously, glomerular filtration rates should be monitored closely and schistocytes should be searched repeatedly in the blood smears of the peripheral blood to facilitate the early recognition of TMA.

The role of androgen in male sexual arousal / 中华男科学杂志

Sexual arousal is an important factor for the success of sexual behavior, and regulated by the central nervous system, its underlying mechanism is very complicated. Androgen is the most important endocrine hormone in men, which is deeply involved in the whole process of male sexual response, but how it regulates male sexual arousal has not been fully clarified and remains one of the hotspots in current andrological research. Therefore, this paper presents an overview of the advances in the studies of the related role and mechanism of androgen in male sexual arousal. In the central nervous system, androgen regulates the release of dopamine neurotransmitters by binding androgen receptors or metabolizing neurosteroids, thus activating the brain reward system. Besides, androgen regulates the neuronal plasticity and spinous process formation in the neural circuit of sexual arousal to ensure successful activation and conduction of the neural circuit. However, the specific regulating mechanism of sexual arousal remains to be further explored.

Endoscopic submucosal dissection of coexisting early esophageal carcinoma and leiomyoma: a case report and review of the literature.

The occurrence of early esophageal cancer located within an area of leiomyoma is extremely rare, and its clinical features and treatment methods have not been well described. We herein report the clinical characteristics, diagnosis, and treatment methods of early esophageal cancer that developed on top of a leiomyoma in the upper third of the esophagus in a 78-year-old woman. All tumor marker concentrations were normal. The leiomyoma was correctly diagnosed as a submucosal tumor by endoscopy and endoscopic ultrasonography. Endoscopic biopsy revealed esophageal squamous cell carcinoma. Both lesions were successfully treated by endoscopic submucosal dissection. The patient was followed up for 6 months without recurrence. Endoscopic submucosal dissection was a successful initial treatment method for esophageal carcinoma coexisting with esophageal leiomyoma in this case.

Progress in the diagnosis and treatment of connective tissue disease-associated interstitial lung disease in children / 国际儿科学杂志

There is a wide spectrum of rheumatic diseases which manifest in children′s connective tissue disease(CTD). Lung involvement is common within the spectrum of CTD.And interstitial lung disease (ILD) is among the most serious complications.The early diagnosis and treatment is vital to improve the prognosis.In this article, the mechanisms, subtypes, clinical manifestations and management of children′s CTD-ILD are reviewed.

Effect of low high-density lipoprotein levels on mortality of septic patients: A systematic review and meta-analysis of cohort studies / 世界急诊医学杂志（英文）

@#BACKGROUND: An increase in high-density lipoprotein (HDL) is well associated with a decreased cardiovascular risk, especially atherosclerosis. Recent studies suggest that lower levels of HDL may also be associated with an increased risk of sepsis and an increased rate of mortality in septic patients. However, this conclusion remains controversial. METHODS: MEDLINE, EMBASE, and CENTRAL databases were searched from inception to September 30, 2019. All studies were conducted to evaluate the correlation of lipoprotein levels and the risk and outcomes of sepsis in adult patients. The primary outcomes were the risk and mortality of sepsis. RESULTS: Seven studies comprising 791 patients were included. Lower levels of HDL had no marked relevance with the risk of sepsis (odds radio [OR] for each 1 mg/dL increase, 0.94; 95% CI 0.86–1.02; P=0.078), whereas lower HDL levels were related to an increased mortality rate in septic patients (OR for below about median HDL levels, 2.00; 95% CI 1.23–3.24; P=0.005). CONCLUSION: This meta-analysis did not reveal a significant association between lower HDL levels and an increase in the risk of sepsis, whereas it showed that lower HDL levels are associated with a higher mortality rate in septic adult patients. These findings suggest that HDL may be considered as a promising factor for the prevention and treatment of sepsis in the future.

Reseach on origin identification of commercially available Zaocys dhumnades / 中国中药杂志

Through market investigation, the adulteration of Zaocys dhumnades on markets was found out, and samples of authentic and adulterated Z. dhumnades on markets were collected. The origin and properties of the adulterated Z. dhumnades were studied in order to provide reference for the identification of Z. dhumnades. The counterfeit Z. dhumnades sold on markets were as follows: Ptyas korros, P. mucosus, Najanaja atra, Sinonatrix annularis, Dinodon septentrionalis, etc. It is found that there existed a obvious difference between the traits of the Z. dhumnades and counterfeits. Genuine Z. dhumnades with "sword ridge" "iron tail", strongly ribbed scales and other features, is the key point to identify the difference from adulterants.

Principles and methods for selecting membrane separation process of Chinese materia medica based on “green manufacturing” concept / 中草药

The Chinese materia medica pharmaceutical process route designed for green manufacturing, also known as “green design”, aims to minimize the resource consumption and environmental effect of the life cycle of products process, coordinate and optimize economic and environmental efficiency. With membrane technology at the core of the pharmaceutical separation process technology closely related to green manufacturing of drugs. The three major requirements and maturity of “environment, performance, and cost” and separation technology principle are the basic elements of the pharmaceutical separation process green design. The development and adoption of clean technology not only conforms to the “principle of precautionary superior to governance”, but also reduces the consumption of raw materials and energy, and at the same time improves the economic efficiency of the enterprises. It is the best way to protect the coordinated development of the ecological environment and economic construction. In this paper, taking the construction of “membrane and resin technology system integration” as an example, the specific implementation plan for the green design of Chinese materia medica pharmaceutical process is introduced, and the technical economical problems in the design of pharmaceutical separation process are analyzed and discussed.

Smart Data-Driven Optimization of Powered Prosthetic Ankles Using Surface Electromyography.

The advent of powered prosthetic ankles provided more balance and optimal energy expenditure to lower amputee gait. However, these types of systems require an extensive setup where the parameters of the ankle, such as the amount of positive power and the stiffness of the ankle, need to be setup. Currently, calibrations are performed by experts, who base the inputs on subjective observations and experience. In this study, a novel evidence-based tuning method was presented using multi-channel electromyogram data from the residual limb, and a model for muscle activity was built. Tuning using this model requires an exhaustive search over all the possible combinations of parameters, leading to computationally inefficient system. Various data-driven optimization methods were investigated and a modified Nelder⁻Mead algorithm using a Latin Hypercube Sampling method was introduced to tune the powered prosthetic. The results of the modified Nelder⁻Mead optimization were compared to the Exhaustive search, Genetic Algorithm, and conventional Nelder⁻Mead method, and the results showed the feasibility of using the presented method, to objectively calibrate the parameters in a time-efficient way using biological evidence.

Pharmacokinetics of levornidazole disodium phosphate in monkey / 药学学报

This study was carried out to investigate the pharmacokinetics/bioequivalence of levornidazole disodium phosphate by using stable isotope labeled drug, evaluated the pharmacokinetic profile and confirmed the prodrug characteristics of levornidazole disodium phosphate in monkey. Levornidazole (Drug A) and stable isotope 15N labeled levornidazole disodium phosphate (Drug B) were mixed with equal mole amount (experiment I); stable isotope 15N labeled levornidazole disodium phosphate (Drug B) and levornidazole disodium phosphate (Drug C) were mixed with equal mole amount, respectively. After giving the mixed drugs to the monkey, the concentration of 15N-levornidazole disodium phosphate, levornidazole disodium phosphate, 15N-levornidazole and levornidazole in plasma samples of pre-dosing and 24 h after administration were analyzed by a liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) method. Pharmacokinetic calculations were performed through non-compartmental analysis using WinNonlin software. Two-sided 90% confidence intervals (CI) were used to evaluate the bioequivalence of two drugs. The results showed that levornidazole disodium phosphate was metabolized to levornidazole rapidly after administration, the body exposure were increased with the dosage. The method of bioequivalence used in this study was different from the traditional two periods, crossover design. By using the method of this study, the effects of administration period, intra-individual variability, and sequence of administration on bioequivalence were avoided. The results of this study had successfully supported the pharmacokinetic and bioequivalence study of this drug in human using the same approach.

The optimal rule-out strategy for acute myocardial infarction in chest pain patients with normal hs-cTnT / 实用医学杂志

Objective The aim of this study was to evaluate the diagnostic value of rule-out strategy for acute myocardial infarction (AMI) in chest pain patients with normal high-sensitivity troponin T (hs-cTnT).Methods Adults presenting chest pain to the West China hospital of Sichuan university from January 2016 to January 2017 were enrolled.Clinical data including ECG and hs-cTnT concentration was obtained.The diagnostic value of three strategies were evaluated.The optimal rule-out strategy for AMI were finally established in chest pain patients.Results A total of 153 patients were enrolled.In patients with chest pain time less than 5 h,the first hscTnT level was less than 14 ng/L.The negative predictive value (NPV) of 0/3 h dynamic observation and 5 minus the time of chest pain were 100％.The NPV was 99.8％ to rule-out AMI directly using the first hs-cTnT level.Conclusions For patients with chest pain time less than 5 h,the first hs-cTnT level less than 14 ng/L,0/3 h dynamic observation and the strategy of 5 h minus chest pain time have the same diagnosis value for ruling out AMI alternatively.It was not suggested to use the first hs-cTnT level to rule out AMI .

Comparison of two kinds of induction therapy in childhood acute myeloid leukemia / 临床儿科杂志

Objective To compare the efficacy and safety of induction therapy in 3+7 protocol and 3+10 protocol in children with acute myeloid leukemia (AML). Methods Two protocols were carried out in our hospital during January 2010 to January 2015, namely 3+7 protocol(AML-06,A group) and 3+10 protocol (modified AML protocol, B group). A total of 56 cases aged from 1 year-old to 13 year-old were enrolled in A group with male to female ratio at 31:25. Five of them were classified as FAB M1, 25 as M2, 11 as M4, 10 as M5, 2 as M6 and 3 as M7. Another 44 cases aged from 1 year to 12 years were enrolled in B group with a male to female ratio at 26:18, and 17 cases were classified as FAB M2, 14 as M4, 9 as M5, 2 as M6, and 2 as M7. Efficacy and adverse events were compared between the two groups. Results The complete remission rate (CR) of B group was 70.4%, while CR in A group was 48.2%. Considering the CR, 3+10 protocol showed higher efficacy than 3+7 protocol (P< 0.05). The major adverse event was bone marrow suppression. Treatment-related mortality (TRD) in A group was 1.8%, which was lower than that in B group (2.3%). The overall survival rate in A group was 75.0%, which was lower than that in B group (86.4%, P< 0.05). Conclusions The induction therapy of 3+10 protocol and 3+7 protocol showed effectiveness for AML treatment. The 3+10 protocol showed a higher CR than 3+7 protocol with no TRD increase, indicating that the 3+10 protocol should be recommended for AML treatment in children.

Combined therapy of Compound Xuanju Capsules and traditional Chinese medicinal formula for infertility in male smokers / 中华男科学杂志

<p><b>Objective</b>To investigate the clinical effects of the combined therapy of Compound Xuanju Capsules (CXJC) and traditional Chinese medicinal formula on infertility in male smokers.</p><p><b>METHODS</b>A total of 176 male infertility patients were divided into a smoking and a non-smoking group and the former further divided into mild, moderate and heavy smokers according to the daily consumption of cigarettes and the length of smoking history. The patients were treated with CXJC combined with traditional Chinese medicinal formula for 3 four-week courses and the therapeutic results were evaluated by comparing the indicators of the traditional Chinese medicine (TCM) syndrome, routine semen parameters, sperm morphology, and sperm DNA fragmentation index (DFI) among different groups before and after treatment.</p><p><b>RESULTS</b>The baseline TCM syndrome scores were remarkably higher in the heavy smokers than in the non-smoking group (P < 0.05) but showed no statistically significant differences between the mild and moderate smokers (P > 0.05). The baseline percentage of sperm head defects and DFI were also markedly higher in the heavy and moderate smokers than in the non-smoking group (P < 0.05). Compared with the baseline, significant improvement was achieved after treatment in the TCM syndrome, routine semen parameters, sperm morphology and sperm DFI, especially in the heavy smokers in the percentages of grade a+b sperm (［17.12 ± 2.54］ vs ［30.15 ± 3.10］%, P < 0.05), morphologically normal sperm (［15.54 ± 1.98］ vs ［26.82 ± 3.52］%, P < 0.05), and head-defective sperm (［27.02 ± 2.14］ vs ［22.07 ± 1.52］%, P < 0.05).</p><p><b>CONCLUSIONS</b>Sperm quality is significantly decreased while the risk of infertility remarkably increased in moderate and heavy smokers. The combined therapy of CXJC and traditional Chinese medicinal formula can effectively improve semen quality, sperm morphology and sperm DFI in male smokers with infertility, though more evidence is to be collected from further studies.</p>