The impact of access to sanitary toilets on rural adult residents' health: Evidence from the China family panel survey.

Toilet sanitation is related to public health and environmental protection. In the context of the toilet revolution in rural China, an ordered probit regression analysis was conducted to evaluate the impact of access to sanitary toilets on rural residents' health. Using data from the China Family Panel Study (CFPS) in 2014, we found that access to sanitary toilets in rural households significantly improved residents' health, and this finding remained robust across a series of checks. Meanwhile, results of the mechanism analysis showed that preventing feces from contaminating water sources was an important mechanism behind the positive effects of sanitary toilet use on health. We also found that the impact of access to sanitary toilets was more pronounced among female, middle-aged, and low-income people. Toilet revolution plays an important role in ensuring residents' health and protecting water sources, thereby underscoring the need for governments in developing countries to invest in sanitary toilets. In addition, the existing policies and sanitation programs in China need to be improved to promote public health.

Spatial distribution, regional differences, and dynamic evolution of the medical and health services supply in China.

The imbalance of medical and health services supply (MHSS) is a significant public health concern as regional economic development disparities widen in China. Based on the provincial panel data of medical and health services, this paper constructed an evaluation index system and used the two-stage nested entropy method to measure the MHSS level of 31 provinces in China from 2005 to 2020. Then we used the standard deviation ellipse, Dagum Gini coefficient, ß convergence model, kernel density estimation and Markov chain to investigate the spatial distribution, regional differences, and dynamic evolution of MHSS. According to the results of these analysis, the conclusions are drawn as follows: (1) In general, the MHSS level in China showed a significant up-ward trend from 2005 to 2020. However, the MHSS level among different provinces showed a non-equilibrium characteristic. (2) Regional comparison shows that the eastern region had the highest level, and the central region had the lowest level. The eastern and central regions presented polarization, while the western region showed unremarkable gradient effect. (3) During the period, the overall regional differences, intra-regional differences, and inter-regional differences of MHSS level all showed convergence. (4) The economic development, urbanization rate, fiscal self-sufficiency rate, and foreign direct investment had significant impacts on the convergence. (5) The provinces with high levels had the positive spillover effect. The findings of this paper provide theoretical supports for optimizing the allocation of health resources and improving the equity of MHSS.

Clinical Efficacy of Intersphincteric Resection for Low Rectal Cancer Compared With Abdominoperineal Resection: A Single-Center Retrospective Study.

BACKGROUND: In recent years, intersphincteric resection (ISR) has been increasingly used to replace abdominoperineal resection (APR) in the surgical treatment of ultra-low rectal cancer. AIM: This study was to compare the clinical efficacy of ISR and APR. METHODS: Between 2012 and 2018, 74 consecutive patients with ultra-low rectal cancer underwent ISR or APR in our medical center. A retrospective comparison of these 2 procedures was performed. RESULTS: A total of 43 patients underwent ISR and 31 underwent APR were included in the study. No significant differences were found between 2 groups in gender, age, BMI, and ASA score. Intersphincteric resection group showed shorter operative time (P = .02) and less blood loss (P = .001). Hospital stays, time to soft diet, and postoperative 30-day complications were not significantly different between the 2 groups. R0 resection achieved 100% in both the groups. As for the long-term outcomes, the survival and recurrence rate were similar between 2 groups. Moreover, the LARS and Wexner score showed that the postoperative anal function after ISR were satisfactory. CONCLUSION: This study suggested that ISR was feasible and safe for selected patients with ultra-low rectal cancer, with clinically superior outcomes in select patients (small tumors/further from the anal verge) and similar oncological outcomes to APR, and the anal functional outcomes after ISR were acceptable.

[Expression of COX10 in human non-obstructive azoospermia testes].

OBJECTIVE: To evaluate the expression of COX10 mRNA in the testes of non-obstructive azoospermia patients and normal men. METHODS: A cDNA microarray containing COX10 and some other genes as RBM and EIF1AY was used to identify the differential gene expression profiles in the normal and azoospermic testes. The cDNA probes were prepared by labeling mRNA from azoospermic and normal testis tissues with Cy5-dUTP and Cy3-dUTP respectively through reverse transcription. The mixed cDNA probes were then hybridized with cDNA microarray. Later the fluorescent signals were scanned and the values of Cy5-dUTP and Cy3-dUTP on each spot were calculated and analyzed. After that an ISH was employed to detect the expression of COX10 mRNA in 10 fertile and 39 non-obstructive azoospermic testes, and the expression levels were compared to evaluate the significance. RESULTS: We obtained 128 differentially expressed genes that might be related with azoospermia, among which 56 were up-regulated and 72 down-regulated, with the expression of COX10 significantly decreased. In situ hybridization confirmed that the mRNA expression of COX10 was stronger in the spermatogenic cells of the normal fertile than the azoospermic testes. CONCLUSION: COX10 may play a certain role in the development and progression of azoospermia. The technique of cDNA microarray can be applied to further studies of screening non-obstructive azoospermia associated genes.

In vitro and in vivo inhibitory effect evaluation of cyclooxygenase-2 inhibitors, antisense cyclooxygenase-2 cDNA, and their combination on the growth of human bladder cancer cells.

Overexpression of cyclooxygenase (COX)-2 is associated with the progression of various malignancies, but the contribution of COX-2 expression, bioactivity or their cooperation to bladder cancer growth calls for further clarification. In this study, we investigated the inhibitory effect of COX-2 inhibitors, antisense COX-2 nucleotide, and their combination on the growth of bladder cancer cells (5637, 5637-P and 5637-AS). Suppression of either COX-2 expression or activity caused reduced cell proliferation, enhanced cell numbers in G(1) phase, and increased apoptosis; the joint suppression of COX-2 expression and bioactivity enhanced the degree of cell growth inhibition. COX-2 antisense-expressing 5637-AS tumors showed a 41.42+/-3.08% growth inhibition as compared with 5637 controls. Oral administration of indomethacin (3mg/kg) or celecoxib (15 mg/kg) caused tumor growth inhibition by 31.5+/-14.87% or 83.17+/-1.17%, respectively. When COX-2 antisense cDNA and COX-2 inhibitor celecoxib were combined, the tumor growth inhibition rate was further increased up to 88.78+/-3.10%. These results provide evidence that celecoxib has potential therapeutic effect on bladder cancer, and the joint use of COX-2 antisense cDNA with celecoxib may improve their individual therapeutic effect, especially significantly increase the growth inhibitory effect of COX-2 antisense cDNA.

[Clinical investigation of renal angiomyolipoma].

OBJECTIVE: To study the diagnosis and management of renal angiomyolipoma (RAML), and to identify risk factors affecting spontaneous angiomyolipoma rupture. METHODS: The data of 68 patients with RAML from 1989 to 2002 were retrospectively reviewed. These patients were divided in two groups on the basis of tumor size, 35 patients in group A ( 4 cm). RESULTS: Seven patients were identified by image-guided percutaneous biopsy, and no major complications was noted. Sixteen patients with RAML were examined with angiography and 9 of 16 patients had got spontaneous rupture. 41.2% of patients were symptomatic, 4 cases (11.4%) in group A and 24 (72.7%) cases in group B (P < 0.01). There were significant differences in mean tumor size (11.6 cm +/- 5.1 cm vs 5.3 cm +/- 2.9 cm, P < 0.01) and mean aneurysm size (13.6 mm +/- 5.8 mm vs 2.6 mm +/- 3.0 mm, P < 0.01) between 9 cases of the ruptured tumor and 59 cases of unruptured tumor, 9 cases of the ruptured and 7 cases of unruptured tumor with angiography, respectively. Treatment consisted of conservative observation in 10 patients (no radiographic changes during the follow-up of 2 - 7 years); partial nephrectomy in 14 patients, tumor enucleation in 30 patients, total nephrectomy in 14 and posterior laparoscopic nephrectomy in 3 (no recurrence and complication correlation to operation during the follow-up of 2 - 144 months). CONCLUSIONS: It is an important role that percutaneous biopsy guided by ultrasonography or computerized tomography performs in managing suspicious and/or indeterminate RAML. A higher probability of rupture is related to tumor and/or aneurysms size. Nephron-sparing surgery is the first choice for surgical treatment of RAML.

Expression and significance of Rap1A in testes of azoospermic subjects.

AIM: To evaluate the Rap1A mRNA expression and its significance in the testes of normal and azoospermic subjects. METHODS: A cDNA microarray that contained Rap1A and some other genes such as RBM, EIF1AY was used to identify the differential gene expression profiles between the normal and azoospermic testes. cDNA probes were prepared by labeling mRNA from azoospermic and normal testicular tissues through reverse transcription with Cy5-dUTP and Cy3-dUTP, respectively. The mixed cDNA probes were then hybridized with cDNA microarray (each containing 4096 unique human cDNA sequences). The fluorescent signals were scanned and the values of Cy5-dUTP and Cy3-dUTP on each spot were analyzed and calculated. In situ hybridization was employed to detect the expression of Rap1A in the testes of 10 fertile and 39 azoospermic subjects. RESULTS: One hundred and twenty-eight differentially expressed genes were found to be possibly related to azoospermia, of which 56 were up-regulated and 72, down-regulated genes. The mRNA expression of Rap1A in the spermatogenic cells of azoospermic was stronger than that in those of the fertile testes. CONCLUSION: Rap1A may play certain roles in the development of azoospermia.

[Diagnosis and treatment of seminal vesicle cyst].

OBJECTIVES: To deepen the understanding of patients with seminal vesicle cyst for correct diagnosis and treatment. METHODS: Sixteen patients with seminal vesicle cysts were treated in the period of January 1980-May 2002. Their symptoms, diagnostic results, treatment and outcomes were analyzed retrospectively. The mean age of these patients at diagnosis was 31 years (range 19 - 43). Two patients were associated with ipsilateral renal agenesis. Symptoms included hematospermia in 12 (75%) patients, urinary frequency in 8 (50%), hematuria after ejaculation in 6 (27.5%), perineal malaise in 6 (27.5%), infertility in 3 (13.7%), pain after ejaculation in 3 (13.7%), scrotal pain in 2 (12.5%) and dysuria in 1 (6.3%). Cyst was palpable in 81.3% patients on digital rectal examination. All patients underwent intravenous urography and cystoscopy. Others received ultrasonography, CT scanning, MRI, and vasovesiculography. The size of masses ranged from 3.8 cm x 3.0 cm x 2.6 cm to 9.6 cm x 5.2 cm x 5.0 cm. Final open surgery consisted of vesiculectomy (4 patients) and partial vesiculectomy (12). RESULTS: Postoperative course was uneventful except in 1 patient with epididymitis. All patients were free of symptoms after open surgery. CONCLUSIONS: Seminal vesicle cysts are rare but should be considered in men with hematospermia and otherwise inexplicable bladder irritation symptoms, perineal discomfort or other genitourinary complaints of unknown etiology. Diagnosis consists of digital rectal examination, transrectal and abdominal ultrasonography, CT scan or MRI. Vesiculectomy and partial vesiculectomy give excellent results.

[A study of aspermia-related genes by genchips and analysis of the RAP1A gene].

OBJECTIVE: To study the differential gene expression profiles between the normal and aspermia human testes by genechips. METHODS: Probes were prepared from mRNA extracted from both normal and aspermia testes and employed on Biostar H-40s genechips to detect the differential gene expression profiles. A distinctly up-regulated gene RAP1A was analyzed by bibliogrphic retrieval. RESULTS: Six hundred and twenty-three differential expressed genes were found, among which the distinctly up-regulated gene RAP1A was closely related to human sperm regulation. CONCLUSIONS: Screening the differential gene expression profiles between the normal and aspermia human testes by genechips can be used in the study of aspermia-related genes.

[The relationships of PSA, FPSAR, clinical and pathological stage in patients with prostate cancer].

OBJECTIVES: To investigate the relationship between clinical and pathological stage, serum prostate specific antigen (PSA) concentration and free-to-total PSA ratio (FPSAR) in patients with prostate cancer. METHODS: Clinical and pathological stage were determined on the basis of pathological examination and clinic material in 42 prostate cancer patients treated by prostatectomy. PSA and FPSAR were measured before the operation. Spearman rank correlation was applied to evaluate the relationship between clinical and pathological stage, serum PSA concentration and FPSAR. RESULTS: Serum PSA concentration was significantly positively correlated with pathological stage(P < 0.05) but not correlated with clinical stage (P > 0.05) in prostate cancer patients. FPSAR was significantly correlated with pathological stage and negatively correlated with clinical stage in prostate cancer patients (P < 0.05). CONCLUSIONS: FPSAR is a more powerful predictor of clinical stage, pathological stage and prognosis than PSA.

Diagnosis and treatment of renal trauma in 298 patients.

OBJECTIVE: To investigate the diagnosis and treatment of renal trauma. METHODS: Retrospective analysis of 298 patients with renal trauma was carried out. Among them, 272 (91.3%) had blunt renal injuries and 26 (8.7%) had penetrating injuries; 123 (41.3%) had multiple complicated intraabdominal injuries and 56 (18.8%) had concomitant shock. Normal-dose-IVU examination was used in 39 patients and double-dose-IVU in 44 patients, ultrasonography in 109 patients, and CT in 45 patients. Conservative and supportive therapy was done in 193 patients (64.8%) and operation in 105 patients (35.2%). RESULTS: The positive rate was 48.7% by the normal-dose-I VU examination and 90.9% by double-dose-IVU, 78.8% by ultrasonography, and 95.6% by CT. One hundred and eighty-three patients were cured by conservative therapy and 101 by operation. Fourteen patients died. CONCLUSIONS: B-ultrasound can be conveniently used for primary assessment of renal injuries, while CT shows rapid, accurate and proper condition of a renal trauma patient. The treatment depends on the severity of the injury. The conservative therapy is employed in most cases which present slight or moderate injury and no evident massive bleeding. Severe injury requires surgical exploration. The operative approach is by using a transabdominal incision, which makes it relatively easy to explore intraabdominal organs and control the injured kidney. It is also very important to control shock and prevent other severe complications in the early stage of the treatment.