Category: Statistics

Zhonghua Nan Ke Xue. 2024 Dec;30(12):1081-1085.

ABSTRACT

OBJECTIVE: To investigate the clinicopathological features and prognosis of urinary bladder urothelial carcinoma (UBUC) with incidental prostate cancer (IPCa).

METHODS: We retrospectively analyzed the clinicopathological features of 65 cases of UBUC and 38 cases of UBUC + IPCa after radical cystoprostatectomy (RCP) from January 2017 to February 2020. We compared their expressions of the immunohistochemical markers androgen receptor (AR) and (human epidermal growth factor receptor 2,HER2) between the two groups of patients, and analyzed their clinicopathological characteristics by chi-square test and their survival rates using the Kaplan-Meier method and log-rank test.

RESULTS: The detection rate of UBUC + IPCa was 16.5%, and that of clinically significant IPCa was 39.5%, with preoperative PSA≥4 μg/L in 23.7% of the patients. Compared with the patients with UBUC, most of the UBUC + IPCa cases had no smoking history (73.8% vs 92.1%, P = 0.024), and fewer had histological variants (43.1% vs 10.5%, P = 0.003). The incidence rate of vascular invasion was significantly higher in the UBUC than in the UBUC + IPCa group (49.2% vs 21.1%, P = 0.005), and so was the rate of advanced cases (67.7% vs 31.6%, P<0.001). In comparison with the patients of the UBUC group, those of the UBUC + IPCa group showed remarkably higher expressions of AR (9.2% vs 31.6%, P = 0.004) and HER2 (43.1% vs 71.1%, P = 0.006). The mean overall survival time was longer in the UBUC + IPCa than in the UBUC group (48.8 mo ［95% CI: 2.5－42.6 mo］ vs 39.9 mo ［95% CI: 2.8－34.5 mo］), but with no statistically significant difference between the two groups (P = 0.608).

CONCLUSION: Standardized sampling of prostate samples after RCP helps to improve the detection rate of IPCa. Preoperative level of PSA is not a good predictor of IPCa. Few patients with UBUC + IPCa have a history of cigarette smoking, and the predominant histological type of the malignancy is high-grade invasive urothelial carcinoma, which is not significantly different from UBUC in prognosis. The expressions of HER2 and AR are significantly higher in UBUC + IPCa than in UBUC, suggesting that UBUC + IPCa may benefit from HER2- and AR-targeted therapy.

PMID:40783917

Environ Geochem Health. 2025 Aug 10;47(9):369. doi: 10.1007/s10653-025-02685-5.

ABSTRACT

The combined impact of high iodine and high fluoride exposure has garnered increased attention. To determine whether exposure to high levels of fluoride and iodine in water has adverse effects on children’s teeth. In this study, 582 children aged 8 to 12 from rural Jiangsu, China, were divided into three groups based on the concentrations of iodine and fluoride in their drinking water: a high fluoride and high iodine group (HFHI), a high fluoride group (HF), and a control group (CONTROL). We employed the ion-selective electrode method to measure fluoride levels in urine samples and used inductively coupled plasma mass spectrometry to assess urinary iodine (UI) levels. The prevalence and severity of dental fluorosis (DF) were determined using Dean’s Index in accordance with WHO criteria. A logistic regression model was used to analyze factors related to dental fluorosis. The urinary fluoride (UF) regression coefficients were compared using the Z-test to assess their influence. The results indicate that the prevalence of DF was 52.5, 33.5, and 4.1% in the HFHI, HF, and CONTROL groups, respectively. There were statistically significant differences in both the prevalence and severity of DF among the groups (P < 0.001 for both). The dental fluorosis indexes (DFI) were calculated as 1.2, 0.7, and 0.1 for the HFHI, HF, and CONTROL groups, respectively. UF levels were positively associated with DF in the HFHI and HF groups, with adjusted odds ratios (OR) of 5.30 and 3.12, respectively. The Z-test results showed statistically significant differences (HFHI vs. CONTROL, P < 0.001; HF vs. CONTROL, P = 0.048; HFHI vs. HF, P < 0.001). UF levels > 1.4 mg/L and UI > 300 μg/L demonstrated a significant interaction in the HFHI group (OR = 9.62, 95% CI 2.70-18.36, P < 0.001) and Overall (OR = 9.15, 95% CI 2.71-16.58, P < 0.001). Simultaneous exposure to high iodine and high fluoride in water adversely impacts the incidence of DF in school-age children. It is recommended that monitoring of UI levels in children from high fluoride regions be enhanced.

PMID:40783901 | DOI:10.1007/s10653-025-02685-5

Eur J Orthop Surg Traumatol. 2025 Aug 10;35(1):343. doi: 10.1007/s00590-025-04460-9.

ABSTRACT

INTRODUCTION: There is limited evidence to guide treatment strategies for native and periprosthetic distal femoral nonunions. The aim was to determine factors associated with failure of distal femoral nonunion repair.

METHODS: All adult patients undergoing operative repair for a distal femoral nonunion from 2004 to 2023 at two Level 1 Trauma Centers with ≥ 6 months follow-up were identified. The primary outcome was additional nonunion surgery. Univariate logistic regression was performed to determine associations of patient, initial fracture, nonunion, and treatment characteristics with additional nonunion surgery.

RESULTS: Eighty-six patients (median age 63 years, 63% female) were included. Definitive fixation was most often a non-augmented lateral locking plate (LLP, 52%), 95-degree-blade-plate (BP, 29%), or augmented LLP (15%). Augmented fixation was defined as the addition of a medial or endosteal plate or intramedullary nail. Fourteen patients (16%) required additional nonunion surgery. In univariate logistic regression analysis, initial high-energy injuries (OR: 4.18, p = 0.044), increasing number of previous surgeries (OR: 1.94, p = 0.007), and treatment with retention of previous implants (OR: 5.25, p = 0.010) or bone morphogenetic protein use (OR: 5.82, p = 0.005) were associated with increased odds of additional nonunion surgery; whereas treatment with BP constructs (vs. non-augmented LLPs, OR: 0.11, p = 0.044) reduced odds. Rates of additional nonunion surgery were 12/45 (27%) for non-augmented LLP, 1/13 (7.7%) for augmented LLP, and 1/25 (4.0%) for BP constructs. When excluding patients treated with retention of previous implants, rates were 7/35 (20%) for non-augmented LLP, 0/8 (0%) for augmented LLP, and 1/25 (4%) for BP constructs. There were differences across constructs, including for rates of initial intra-articular fractures (49% vs. 0% vs. 13%), and use of autograft (51% vs. 62% vs. 16%) and bone morphogenetic protein (44% vs. 31% vs. 8.0%).

CONCLUSIONS: Approximately 1 in 6 patients required additional nonunion surgery. In unadjusted analyses, initial high-energy injuries and more prior surgeries were associated with increased odds for additional nonunion surgery, suggesting that the severity of the initial injury is associated with subsequent nonunion treatment outcomes. The current study findings suggest that distal femoral nonunion repair should be based on revision fixation using augmented lateral locking plate (dual-plate or nail-plate) or blade plate constructs. However, these findings are based on unadjusted comparisons. Larger studies with sufficient power to correct or stratify for confounding are needed to further define optimal treatment.

PMID:40783877 | DOI:10.1007/s00590-025-04460-9

Zhonghua Nan Ke Xue. 2024 Nov;30(11):1019-1024.

ABSTRACT

OBJECTIVE: This study aims to evaluate the clinical efficacy and safety of Dibai Yijing Formula (DYF) in the treatment of male infertility with essence deficiency in the kidney and damp-heat in the essence chamber (Abbreviation: kidney deficiency and damp-heat type).

METHODS: This study employed a randomized, controlled clinical trial design, recruiting 72 male patients with infertility due to kidney deficiency and damp-heat type. Patients were randomly assigned to an treatment group (36 patients) and a control group (36 patients) using a random number table. The control group received oral Clomiphene Citrate Capsules (50 mg, twice daily), while the treatment group received oral DYF (one dose daily, 200 ml each time, 30 minutes after breakfast and dinner). Both groups underwent a 12-week treatment period. After treatment, sperm concentration (SC), percentage of progressively motile sperms (PR), total sperm motility ［PR + percentage of non-progressively motile sperms (NP)］, and semen volume (SV) were compared between the two groups before and after treatment. Additionally, the total score of Traditional Chinese Medicine (TCM) syndrome score and sperm DNA fragmentation index (DFI) and pregnancy outcomes of the patients’ spouses were compared between the two groups.

RESULTS: Three patients dropped out from the treatment group and four from the control group. There were no statistically significant differences in semen parameters between the two groups ( P>0.05). After treatment，the patients in the treatment group showed significant difference in the percentage of SC (［19.42±5.30］×10⁶/ml vs ［10.75±2.41］×10⁶/ml）, PR(［27.72±6.62］% vs ［20.04±4.10］%）, PR+NP(［49.86±10.68］ % vs (33.74±5.58) %］, DFI(［12.33±3.43］ % vs ［15.06±3.98］ %） and TCM symtom score(［7.45±1.82］ vs ［13.85±1.91］）, and the difference was statistically significant (P<0.05). The patients in the control group showed significant difference in the percentage of SC(［19.56±5.24］×10⁶/ml vs ［11.31±2.08］×10⁶/ml ） and TCM symptom score (［12.81±1.86］ vs ［14.06±1.64］）. But no significant changes were observed in the PR (［21.75±5.93］ % vs ［20.05±4.67］ %）, PR+NP (［34.23±7.15］ % vs ［32.35±4.09］ %）, SV (［3.19±1.08］ ml vs ［3.12±1.13］ ml）, and DFI (［15.11±4.76］ % vs ［15.51±4.35］ %）were not statistically significant （P > 0.05). Improvements in PR, PR+NP, TCM symptom score and DFI in the treatment group were better than those in the control group after treatment (P < 0.05); the differences in SC and SV and spousal pregnancy in the treatment group were not statistically significant compared with those in the control group (P > 0.05). No serious adverse events occurred in both groups during the treatment period.

CONCLUSION: The treatment of male infertility with DYF is effective and safe.

PMID:40783872

Zhonghua Nan Ke Xue. 2024 Nov;30(11):1015-1018.

ABSTRACT

OBJECTIVE: To investigate the clinical application value of liquid wound dressing in circumcision.

METHODS: This retrospective study included 200 cases of redundant prepuce or phimosis undergoing circumcision in the Affiliated Hospital of Nanjing University of Chinese Medicine between August 2021 and December 2022. We divided the patients into two groups of an equal number to receive wound care with liquid wound dressing (the observation group) and iodine gauze dressing (the control group), respectively. We compared the operation time, postoperative bleeding, edema, infection, incision exudation and scarring, and pain scores during dressing change at 4, 24 and 72 hours after surgery. Results： No statistically significant differences were observed between the observation and control groups in the operation time (［16.22 ± 3.15］ vs ［17.01 ± 3.37］ min, P > 0.05) or postoperative bleeding (12 vs 14 cases, P > 0.05). The patients in the observation group, compared with the controls, showed significantly lower incidences of postoperative edema (9 vs 23 cases), infection (6 vs 17 cases), incision exudation (7 vs 21 cases) and scarring (5 vs 14 cases), and lower pain scores during dressing change at 4 hours (6.71 ± 1.02 vs 7.04 ± 0.92), 24 hours (5.38 ± 1.45 vs 5.87 ± 1.35) and 72 hours after surgery (3.65 ± 1.53 vs 4.26 ± 1.63) (all P < 0.05). Conclusion： For postoperative wound care of the patients undergoing circumcision, liquid wound dressing can evidently reduce postoperative pain, incision bleeding, edema, infection and scarring, and therefore deserves clinical promotion.

PMID:40783871

Zhonghua Nan Ke Xue. 2024 Nov;30(11):1002-1008.

ABSTRACT

OBJECTIVE: To compare the recanalization rate of 2-suture longitudinal intussusception vasoepididymostomy (LIVE) with that of 4-suture end-to-side vasoepididymostomy (ESVE).

METHODS: This retrospective case-control study included 127 cases of obstructive azoospermia (OA) treated by LIVE (n = 87) or ESVE (n = 40) in our Center of Reproductive Medicine from October 2013 to July 2024. We analyzed the clinical data and compared the age, testis volume, level of serum follicle-stimulating hormone (FSH), operation time and postoperative recanalization rate between the two groups.

RESULTS: Spermatozoa were observed in 90 (70.9%) of the 127 cases after surgery. There were no statistical differences in age, testis volume and FSH between the two groups of patients (all P > 0. 05), and nor were there any serious surgical complications. The operation time was significantly longer in the ESVE than in the LIVE group (22.0 ［20.0－25.8］ vs 17.0 ［15.0－23.0］ min, P < 0.05), while the postoperative recanalization rate remarkably higher in the former than in the latter group （85.0% vs 64.4%, P < 0.05）. Vasoepididymostomy was performed at the caput epididymis in 11 cases, with a higher recanalization rate in the ESVE than in the LIVE group (50.0% ［1/2］ vs 33.3% ［3/9］).

CONCLUSION: ESVE achieved a higher postoperative recanalization rate than LIVE in the treatment of OA, but its advantages need further investigation.

PMID:40783869

Zhonghua Nan Ke Xue. 2024 Nov;30(11):994-1001.

ABSTRACT

OBJECTIVE: To investigate the effect of spouse smoking cessation (SSC) on the pregnancy outcome of the patients with polycystic ovary syndrome (PCOS) based on a secondary analysis of the results of a large randomized clinical trial.

METHODS: Based on the inclusion and exclusion criteria, this secondary analysis included 861 female participants in the Trial of Acupuncture Combined with Clomiphene for PCOS from 2011 to 2015. According to the smoking status of their husbands, we divided the subjects into a smoking group (n = 345), a non-smoking group (n =387), and a smoking cessation group (n =129), collected their general demographics, anthropometric indexes, laboratory results and pregnancy outcomes, compared them among the three groups, and analyzed the relationship of SSC with the pregnancy outcomes of the PCOS patients.

RESULTS: The levels of total testosterone (T) and low-density lipoprotein cholesterol (LDL-C) in the smoking cessation group were similar to those in the non-smoking group, but significantly lower than those in the smoking group (P= 0.014 and P= 0.011). The contents of fasting insulin, total cholesterol, and apolipoprotein B exhibited statistically significant differences among the three groups (P= 0.029, P= 0.018 and P= 0.024), dramatically lower in the smoking cessation and non-smoking groups than in the smoking group, but similar between the former two. The ovulation rate of the smoking cessation group was similar to that of the non-smoking group, remarkably higher than that of the smoking group (P= 0.038). No statistically significant differences were observed in other indicators among the three groups (P > 0.05). Multivariate logistic regression analysis showed that SSC during pregnancy preparation was a protective factor for ovulation in the PCOS patients (OR = 1.74, 95% CI: 1.04－2.92, P= 0.035).

CONCLUSION: SSC can improve androgen and glucolipid metabolisms of infertile patients with PCOS, and thereby significantly increase the ovulation rate. It is of positive significance to encourage SSC clinically for improving the pregnancy outcomes of infertile women with PCOS.

PMID:40783868

Zhonghua Nan Ke Xue. 2024 Nov;30(11):987-993.

ABSTRACT

OBJECTIVE: To investigate the factors influencing the hospitalization expenses of PCa patients and provide some evidence for effectively reducing the direct economic burden of disease caused by laparoscopic radical prostatectomy (LRP).

METHODS: The author obtained the hospitalization data on 893 cases of PCa treated by LRP in a top tertiary hospital in Wuhan between January 1, 2019 and June 30, 2024. A database was constructed using the Stata 18.0 software, the Mann-Whitney U and Kruskal-Wallis H tests performed using the SPSS 27.0 and R 4.4.1 softwares, and the influencing factors for the hospitalization expenses of the patients analyzed by multiple linear regression, quantile regression, and random forest algorithm.

RESULTS: Out-of-pocket payment accounted for 64.40% of the total hospitalization costs, averaging ￥60 794.9, with the per capita treatment cost (￥20 631.6), drug cost (￥15 046.2) and consumable cost (￥12 469.6) as the top 3 items of expenditure, accounting for 33.94%, 24.75% and 20.51%, respectively. The results of multiple linear regression analysis showed that the number of hospital days (β = 0.027), the number of comorbidities (β = 0.008), the mode of admission (with the outpatient department as reference, the emergency department ［β = 0.128］ and transfer from other institutions ［β = 0.251］), and the mode of surgery (with LRP ［β = 0.157］ as reference) all had statistically significant impacts on the sub-per capita hospitalization costs (P < 0.05). Quantile regression analysis revealed dramatic influence of the number of hospital days and surgical mode in different quantiles (P < 0.001), and random forest regression analysis showed the two influencing factors ranking the top two in terms of importance.

CONCLUSION: PCa patients bear a heavy burden of hospitalization costs. The composition of the costs needs to be optimized, and efforts should be made to reduce the hospitalization expenses of the PCa patients by promoting the inclusion of medical consumables in medical insurance, facilitating the development of drugs and domestication of surgical robots, and reasonably shortening the hospital stay of the patients.

PMID:40783867

J Drug Target. 2025 Aug 10:1-36. doi: 10.1080/1061186X.2025.2546477. Online ahead of print.

ABSTRACT

Autoimmune diseases represent a heterogeneous group of disorders characterized by immune system dysregulation, wherein aberrant responses to self-antigens result in cellular and tissue damage. According to statistics, there are over 80 different types of autoimmune diseases worldwide, among which psoriasis and rheumatoid arthritis (RA) are relatively common. Current therapeutic strategies emphasize long-term management to mitigate symptoms and retard disease progression. Conventional approaches, including systemic administration of oral medications, injectables, and biologics, are frequently limited by adverse effects that compromise patient adherence. In contrast, the use of microneedle (MN) technology as a minimally invasive transdermal delivery platform has emerged as a promising alternative, offering distinct advantages such as painless self-administration, enhanced patient compliance, localized delivery to disease-specific sites (e.g., skin lesions in psoriasis, inflamed joints in RA), and improved bioavailability of immunomodulatory agents while minimizing systemic toxicity. This review systematically examines MN classification, immunomodulatory mechanisms, and therapeutic efficacy in autoimmune disease management, while also providing a critical assessment of MN biosafety and clinical translation challenges in autoimmune patients. Furthermore, it highlights recent advancements in MN technology for prevalent autoimmune disorders, with the goal of informing future innovation and accelerating clinical translation.

PMID:40783860 | DOI:10.1080/1061186X.2025.2546477

Zhonghua Nan Ke Xue. 2024 Oct;30(10):910-914.

ABSTRACT

OBJECTIVE: To explore the application of modified scrotoscopic surgery (MSS) in the treatment of testicular hydrocele.

METHODS: We selected 45 cases of testicular hydrocele for this study, 22 treated by traditional scrotoscopic surgery (TSS) and the other 23 by MSS, which was performed with a pin-shaped electrode bent inward at an angle of 60° instead of a circular electrode used in TSS. We recorded the general clinical data, operation time, incision length, intraoperative injury, incision infection, scrotal edema, postoperative hospital stay and postoperative Visual Analogue Scale (VAS) scores of the patients and compared them between the two groups.

RESULTS: There was no statistically significant difference in the general clinical data between the two groups (P > 0.05). Compared with the patients of the TSS group, those of the MSS group showed significantly shorter operative time (［32.86 ± 3.80］ vs ［26.13 ± 2.81］ min, P<0.05), incision length (［14.09 ± 2.23］ vs ［8.73 ± 1.48］ mm, P<0.05) and postoperative hospital stay (［4.36 ± 1.05］ vs ［2.00 ± 0.90］ d, P<0.05), and achieved remarkably lower VAS scores on postoperative days 1 (4.41 ± 1.05 vs 3.09 ± 0.79, P<0.05), 2 (3.36 ± 1.05 vs 2.78 ± 1.13, P<0.05), 3 (2.65 ± 0.72 vs 1.74 ± 0.86, P<0.05) and 7 (1.91 ± 0.81 vs 1.04 ± 0.82, P<0.05). At 3 and 7 days after surgery, scrotal edema was markedly milder in the MSS than in the TSS group (P<0.05). No testicular or epididymal damage, or wound infection occurred in either of the two groups.

CONCLUSION: MSS is safe and effective in the treatment of testicular hydrocele, superior to TSS for its advantages of shorter operation time, smaller surgical incision, less postoperative pain and milder scrotal edema.

PMID:40783855