Objective To investigate the perioperative changes in serum interleukin 6 (IL-6) levels in elderly male patients with intertrochanteric fractures, and provide evidence for inflammatory control in this patient population. Methods The clinical data of 40 male patients aged more than 60 years with intertrochanteric fractures who met the selection criteria between January 2021 and December 2022 were retrospectively analyzed, including 25 non-osteoporosis patients (T value>?2.5, group A) and 15 osteoporosis patients (T value≤?2.5, group B). In addition, 40 healthy men aged more than 60 years old were included as controls (group C) according to the age matching rule. There was no significant difference in age, smoking history, drinking history, body mass index, complications (hypertension and diabetes), alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine, and total protein among the 3 groups (P>0.05). Serum samples were collected from group C subjects and from groups A and B patients preoperatively and on postoperative days 1, 3, 5, and 7. IL-6 levels were measured using ELISA assay. Pearson correlation analysis was used to assess the relationship between IL-6 levels and T values at various time points in groups A and B. Postoperative complications during hospitalization and 1-year mortality rates were recorded for groups A and B. Results Preoperative IL-6 levels were significantly higher in groups A and B than in group C (P<0.05), with group B being significantly higher than group A (P<0.05). In groups A and B, IL-6 levels increased significantly on postoperative day 1 compared to preoperative levels and then gradually decreased, approaching preoperative levels by postoperative day 7. IL-6 levels in group B were significantly higher than those in group A at all postoperative time points (P<0.05). Correlation analysis showed that IL-6 levels were negatively correlated with T values at all perioperative time points in all patients from groups A and B (P<0.05). Complications occurred in 4 patients (16.0%) in group A, including 2 cases of pulmonary infection, 1 case of urinary tract infection, and 1 case of heart failure, and in 3 patients (20.0%) in group B, including 2 cases of pulmonary infection and 1 case of gastrointestinal bleeding. There was no significant difference in the incidence of complications between the two groups (χ2=0.104, P=0.747). There were 2 cases (8.0%) and 4 cases (26.7%) died within 1 year after operation in groups A and B, respectively, and there was no significant difference in 1-year mortality rates between the two groups (χ2=2.562, P=0.109). Conclusion Serum IL-6 levels significantly increase in the early postoperative period in elderly male patients with intertrochanteric fractures, especially in those with osteoporosis. Monitoring the inflammatory state and promptly controlling the inflammatory response during the perioperative period, may reduce complications and improve postoperative survival in this patient population.
Objective To systematically review the willingness to use pre-exposure prophylaxis (PrEP) and its influencing factors among men who have sex with men (MSM) in China. Methods We conducted a comprehensive search on various databases, including China National Knowledge Infrastructure, VIP database, Wanfang data, China Biomedical Literature Service System, PubMed, Web of Science, Cochrane Library, and Embase, covering the period from database inception to September 6th, 2023. We focused on studies that publicly reported data on the willingness to use PrEP and its influencing factors among MSM in China. The quality of included studies was assessed using the quality evaluation criteria recommended by the Agency for Healthcare Research and Quality. RevMan 5.3 software and Stata 13.1 software were used to perform meta-analysis for the willingness to use PrEP and its influencing factors among MSM in China. Results A total of 24 cross-sectional studies with 19 influencing factors and a sample size of 16499 participants were included in the review. The results revealed a PrEP usage intention rate of 60.4% [95% confidence interval (CI) (51.8%, 68.9%)] among the MSM population in China. Factors such as awareness of PrEP [odds ratio (OR)=5.26, 95%CI (1.33, 20.82)], having heard of PrEP [OR=1.84, 95%CI (1.28, 2.64)], age<25 years [OR=1.92, 95%CI (1.34, 2.77)], being a student [OR=1.92, 95%CI (1.17, 3.16)], monthly income of 1000-3000 yuan [OR=1.36, 95%CI (1.12, 1.65)], history of human immunodeficiency virus (HIV) testing [OR=2.05, 95%CI (1.53, 2.74)], history of sexually transmitted infections [OR=1.75, 95%CI (1.27, 2.40)], seeking sexual partners online [OR=1.38, 95%CI (1.19, 1.59)], openness about sexual orientation [OR=1.90, 95%CI (1.27, 2.84)], having a non-local household registration [OR=1.66, 95%CI (1.37, 2.02)], and recommending PrEP to friends [OR=20.14, 95%CI (2.59, 156.91)] were identified as promoting factors for the willingness to use PrEP. Conversely, a homosexual orientation [OR=0.67, 95%CI (0.52, 0.85)] was identified as a barrier to the willingness to use PrEP. Conclusions Chinese MSM have a low intention to use PrEP, and there are many factors affecting the intention to use PrEP in MSM. In the future HIV prevention and control work, measures such as strengthening education and publicity of PrEP, providing a certain degree of support for PrEP costs, strengthening health education on campus, strengthening community organizations and support networks should be taken to promote the willingness of MSM to use PrEP.
ObjectiveTo summarize the research progress of the cause, treatment, and other aspects in male breast cancer (MBC).
MethodsThrough reading the related literatures, relevant literatures of MBC were reviewed.
ResultsFamily history, BRCA1/2 mutation, the imbalance of level of estrogen and androgen, and other factors were risk factors of the MBC. Sentinel lymph node biopsy (SLNB) was feasible in the MBC. Radiotherapy could control local recurrence of MBC, and chemotherapy may be beneficial for long-term survival rate of MBC. The endocrine therapy principle for MBC was not exact as female breast cancer (FBC).
ConclusionsMBC has many risk factors. Radiotherapy, chemotherapy, and endocrine therapy are benefit to MBC patients, but it still needs to be confirmed by many high-quality clinical researches of large sample.
Objective To study the effectiveness, safety and tolerance of testosterone undecanoate （TU） in improving exhaustion and quality of life （QOL） of the elderly male patients with chronic disease in advanced stage. Methods Using a simple randomized controlled trial design, eighty patients were randomized into two groups. The treatment group took routine therapy and TU and the control group with routine therapy alone. Results 1. Baseline characteristics in both groups were similar. 2. The PADAM grade decreased, and the QOL scale increased in the treatment group （P〈0.05 ）. 3. Serum total testosterone in the treatment group rose, upper arm circumference and right hand grip improved （P〈0.05 ）. 4. There were no significant differences in adverse effects between both groups. Conclusions TU can improve the clinical health status in the elderly male patients with chronic disease in advanced stage and increase serum testosterone level, there is a satisfactory tolerances and few adverse reactions.
The sonographic features of male breast lesions, which underwent ultrasound examination in our hospital for the past 10 years, were retrospectively analyzed. Sonographic features of these lesions were standardized as BI-RADS image lexicon. The differences in ultrasonic malignant signs were assessed between the benign and the malignant diseases. Between the two groups, incomplete boundary was statistically different. The specificity was above 95% within the two groups in terms of speculated margin, echogenic halo, calcification, axillary lymphadenopathy, thickening of skin and eccentric of mass to the nipple. High-frequency sonographic examination has a high level of differential diagnosis for male breast lesions.
Objective To investigate the relationship between skin/pectoral muscle invasion and the prognosis of male breast cancer. Methods Clinical data and follow-up information of 79 male breast cancer patients who received treatment between September 2008 to April 2020 in West China Hospital were retrospectively reviewed, to analyze the clinicopathological features of male breast cancer and prognostic value of skin/pectoral muscle invasion. Results Among 79 male breast cancer patients, a total of 23 patients (29.1%) were with skin/pectoral muscle invasion at diagnosis. All the patients were followed up, with a median follow-up period of 63.3 months (1.0–204.5 months). Within follow-up period, 8 patients (10.1%) suffered from relapse, 19 patients (24.7%, 19/77) suffered from metastasis, and 4 patients (5.1%) died. Multivariate Cox proportional risk regression model suggested that patients with skin/pectoral muscle invaded had poor disease free survival [RR=4.48, 95%CI (1.08, 18.52), P=0.038]. Conclusions Skinor pectoral muscle invasion might be a valuable prognostic factor for male breast cancer patients. However, limited by sample size, the conclusion should be proved by further high-level studies.
ObjectiveTo investigate the effectiveness of clitoroplasty of reserving the clitoris dorsal neurovascular bundle and the ventral complete urethral plate for genital virilization in girls with congenital adrenal hyperplasia (CAH).
MethodsBetween June 2000 and October 2015, 27 girls with genital virilization were treated with clitoroplasty of reserving the clitoris dorsal neurovascular bundle and the ventral complete urethral plate. The chromosomal karyotype was 46, XX in all patients, whose age ranged from 3 to 11 years (mean, 3.9 years). According to Parder's virilization scale, 5 cases were classified as stage Ⅱ, 18 cases as stage Ⅲ, and 4 cases as stage Ⅳ. The hormone tests showed decreased cortisol level and increased testosterone and 17-hydroxyprogesterone levels. They were diagnosed with non-salt-wasting CAH.
ResultsAll of the patients underwent clitoroplasty successfully. The mean operation time was 74 minutes (range, 58-95 minutes). Incision healed primarily. The patients were followed up 6 months to 10 years (median, 19 months). The external genitalia had good appearance, without necrosis of flap and the glans clitoris, abnormal sensation of the glans clitoris, or clitorism recurrence. Five girls had breast development and normal menstrual cycle during adolescence, and 1 patient who was followed up for 10 years gave birth to a son.
ConclusionClitoroplasty of reserving the clitoris dorsal neurovascular bundle and the ventral complete urethral plate is a relatively ideal method for treating genital virilization in girls. It has less complications, good aesthetic and functional results. There are satisfactory outcomes when combining with the endocrine treatment.
