The adverse effects of obesity on male reproductive function are mainly manifested as the abnormal development of the reproductive system, decrease of testosterone level, decline of sperm quality, and impact on the health of offspring, while its regulatory mechanism is far from being clarified. This paper expounds the influence of obesity on the male reproductive system in the aspects of population epidemiology and animal experiments, presents an overview on the action mechanisms of obesity from the perspectives of the hypothalamus-pituitary-testis axis, blood-testis barrier, inflammatory reaction, oxidative stress, testicular germ cell apoptosis, and impact of paternal obesity on the health of offspring, aiming to shed some light on the clinical treatment and prevention of obesity-related male reproductive dysfunction.
Male ; Obesity/physiopathology* ; Humans ; Animals ; Hypothalamo-Hypophyseal System ; Testis/physiopathology* ; Oxidative Stress ; Infertility, Male/etiology* ; Reproduction ; Blood-Testis Barrier

Objective:To explore the safety key points of total pancreaticoduodenectomy in the era of vascular resection technology and the important factors affecting rapid postoperative recovery.Methods:The clinical data of 52 patients with pancreatic cancer who underwent total pancreaticoduodenectomy in Beijing Chaoyang Hospital Affiliated to Capital Medical University from November 2014 to September 2022 were retrospectively analyzed, including 34 males and 18 females, aged (62±9). The intraoperative situation, incidence of postoperative complication, postoperative blood glucose control and postoperative survival rate were analyzed.Results:All operations of the 52 patients were successfully completed, including 48 patients underwent total pancreaticoduodenectomy combined with portal vein resection and allograft vascular grafts via artery approach. The portal vein occlusion time was (20±5) min. The incidence of postoperative complications was 28.8% (15/52), including 2 cases of abnormal gastric empty, 2 cases of diarrhea, 2 cases of chylous fistula, 4 cases of abdominal infection, 1 case of gastrointestinal fistula, 3 cases of gastrointestinal bleeding, and 1 case of pulmonary infection. Subcutaneous short-acting insulin injection was used to control blood glucose in the early stage after surgery, short-acting insulin combined with long-acting insulin was used for subcutaneous injection before sleep for diet recovery. All patients did not experience uncontrolled hyperglycemia. The median survival time of 52 patients was 13 months, and the longest follow-up time was 38 months. There were 37 patients died of tumor recurrence, 4 patients died of cardiovascular and cerebrovascular accidents, and 1 patient died of pulmonary infection in the 42 died patients.Conclusions:Total pancreaticoduodenectomy via artery approach can improve the R 0 resection rate in pancreatic cancer patients with vascular invasion, the rate of postoperative complication and mortality has no significant increase. The postoperative blood sugar control is satisfactory and the quality of life is guaranteed.

The articles on alarm management of clinical medical equipment from January 2000 to January 2023 were collected with common databases in the world as search sources.CiteSpace software was used for trend drawing of annual publication distribution,author cooperation network mapping,country/institution cooperation network mapping and keyword knowledge mapping,and for analyzing related issues in depth.The annual publication of medical equipment alarm management research showed a fluctuating upward trend,the authors had good cooperative relationship with the organizations,the hotspots included ventilator,alarm and alarm fatigue in Chinese and alarm fatigue,intensive care unit and patient safety in English,and the research frontier involved in alarm fatigue,false alarm and alarm management.References were provided for conducting related research in China.

OBJECTIVE: To investigate the effect of tibial coronal curvature on the alignment of tibial prosthesis in patients undergoing total knee arthroplasty (TKA). METHODS: From July 2019 to April 2021, 100 patients with knee osteoarthritis were treated with total knee arthroplasty. Before operation, the full-length films of lower limbs were taken and the tibial bowing angle(TBA) was measured. TBA more than 2° was tibial bending, which was divided into tibial bending group and non bending group. There were 40 cases in tibial bending group, 9 males and 31 females, aged 56 to 84 years old with an average of (69.22±7.10) years. There were 60 cases in the non bending group, 19 males and 41 females, aged from 51 to 87 years old with an average of (70.80±7.21) years. The preoperative tibial length (TL) and medial proximal tibial angle (MPTA) were measured and compared between the two groups. The full-length X-rays of the lower limbs were taken again 3 days to 1 week after operation. The medial angle of the tibial component coronal aligement angle (TCCA) and the outilier rate of force line of the tibial prosthesis were measured and compared between the two groups. Pearson method was used to analyze the correlation between TCCA and age, TCCA and height, TCCA and weight, TCCA and BMI, TCCA and TBA, TCCA and TL, TCCA and MPTA; Spearman method was used to analyze the correlation between TCCA and gender, TCCA and Kellgren-Lawrence(K-L) grade. RESULTS: All 100 patients successfully completed the operation and obtained satisfactory full-length X-rays in standing position. There was no significant difference in TL, MPTA and TCCA between bending group and non bending group(P>0.05). The outilier rate of force line in tibial bending group was 22.5%, and that in non bending group was 6.67%, the difference was statistically significant(P<0.05). The correlation study found that TCCA was strongly correlated with TBA(r=-0.702, P<0.01), weakly correlated with MPTA(r=0.311, P<0.01), and had no correlation with other parameters(P>0.05). CONCLUSION In patients with knee osteoarthritis undergoing total knee arthroplasty, tibial bending will lead to poor force line of tibial prosthesis. During operation, attention should be paid to osteotomy of proximal tibial vertical tibial mechanical axis and correct installation of prosthesis to avoid poor alignment of prosthesis.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/adverse effects* ; Female ; Humans ; Knee Joint/surgery* ; Knee Prosthesis/adverse effects* ; Male ; Middle Aged ; Osteoarthritis, Knee/surgery* ; Retrospective Studies ; Tibia/surgery*

Objective:To investigate the clinical effect of early arthroscopic shoulder treatment of moderate full-thickness tear of the supraspinatus tendon.Methods:A retrospective case control study was conducted to analyze the clinical data of 43 patients with moderate full-thickness supraspinatus tendon tear admitted to First Affiliated Hospital of Xi 'an Jiaotong University from January 2018 to June 2020，including 17 males and 26 females，aged from 41 to 68 years［（55.9±8.2）years］. All patients had arthroscopic shoulder supraspinatus tendon suture and acromioplasty，including 22 patients underwent surgery within 1 month after persistent shoulder pain and motion limitation in early group and 21 patients between 1 month and 3 months in late group. The duration of operation and intraoperative blood loss were recorded. The visual analogue scale（VAS），American Shoulder and Elbow Society（ASES）score and Constant-Murley score were assessed before operation and at postoperative 3 weeks，6 weeks，3 months and 6 months. The complications were detected with 6 months after operation. Results:All patients were followed up for 6-7 months［（6.4±0.4）months］. There was no statistical significance in operation duration and intraoperative blood loss between the two groups（ P>0.05）. At 3 weeks，6 weeks，3 months and 6 months after operation，there showed significant decrease of VAS but significant increase of ASES and Constant-Murley scores compared to preoperation（ P<0.05）. At 3 weeks and 6 weeks after operation，the VAS in early group［（4.4±0.9）points，（3.7±0.8）points］was lower than that in late group［（5.5±1.0）points，（4.8±1.1）points］；while the ASES score［（49.1±4.6）points，（56.8±4.1）points］and Constant-Murley score［（54.1±4.8）points，（64.1±4.4）points］in early group were higher than those in late group［ASES score：（45.2±5.4）points，（50.3±5.4）points；Constant-Murley score：（50.5±3.3）points，（58.2±3.9）points］（ P<0.05）. At 3 months and 6 months after operation，the two groups showed no statistical significance in these scores. There were no postoperative complications such as infection or nerve injury in both group within 6 months. Conclusion:For moderate full-thickness tear of the supraspinatus tendon，arthroscopic shoulder surgery performed within 1 month after persistent shoulder pain and motion limitation can achieve better pain relief and faster functional rehabilitation in the short term compared with surgery performed 1-3 months later.

Objective:To improve the diagnostic criteria of suspected cases through investigating the epidemiological and clinical manifestations of confirmed cases of novel coronavirus infection in children.Methods:We retrospectively analyzed the epidemiological and clinical manifestations of six children with novel coronavirus infection diagnosed in Chongqing Three Gorges Central Hospital from February 3, 2020 to February 15, 2020.Compared with the diagnostic criteria of suspected cases, we summarized the problems encountering in the application of this standard in clinic and try to put forward suggestions for improvement.Results:Among the six confirmed cases: five males and one female; three from Hubei Province and three from Wanzhou; six cases of clustered onset of the family.Visiting nature: six cases of suspected case, six cases from community or outpatient screening.Three fever cases with/without respiratory symptoms, one of which had diarrhea; all children′s blood routine and lymphocyte counts were within the normal range; chest CT imagings of No.1 and No.5 case showed typical novel coronavirus pneumonia signs, and the other three patients had abnormalities without the characteristics of novel coronavirus pneumonia, and one case was normal.Comparison results: Only No.1 case fully met the diagnostic criteria, and the remaining cases did not meet the diagnostic criteria for early suspected cases.Conclusion:In order to improve the accuracy and practicality of the diagnosis of suspected cases in children, it is recommended to refine and standardize the diagnostic criteria for some suspected cases.

Objective: To improve the diagnostic criteria of suspected cases through investigating the epidemiological and clinical manifestations of confirmed cases of new-type coronavirus infection in children. Methods: We retrospective analyzed the epidemiological and clinical manifestations of 6 children with new coronavirus infection diagnosed in Chongqing Three Gorges Central Hospital from February 3, 2020 to February 15, 2020 . Compared with the diagnostic criteria of suspected cases,we summarized the problems encountered in the application of this standard in clinical work and try to put forward Suggestions for improvement. Results: Among the 6 children with confirmed cases: 5 males and 1 female; 3 from Hubei Province and 3 from Wanzhou ; 6 cases of clustered onset of the family; Visiting nature: 3 cases of suspected case income, 3 cases of community or outpatient screening . Three cases with fever and / or respiratory symptoms, one of which had symptoms of diarrhea; all children's blood routine and lymphocyte counts were within the normal range; chest CT imaging except for cases No. 1 and No. 5 were in line with typical new coronavirus pneumonia signs. In addition, the remaining 3 patients had abnormal imaging but did not have the characteristics of new coronavirus pneumonia, and 1 case was normal. Comparison results:Only case 1 of all cases fully met the diagnostic criteria, and the remaining cases did not meet the diagnostic criteria of early suspected cases. Conclusion In order to improve the accuracy and practicality of the diagnosis of suspected cases in children, it is recommended to refine and standardize the diagnostic criteria of some suspected cases.

OBJECTIVETo explore occurrence and risk factors of sarcopenia in patients with hip facture.

METHODSFrom May 2013 to January 2017, 187 patients with hip fractures were collected, including 99 males and 88 females aged from 50 to 95 years old with an average age of (77.40±10.58) years old. General conditions, appendicular skeletal muscle index (ASMI), total fat mass, bone mineral content (BMC), body mass index (BMI), grip strength, preoperative blood vitamin D (VITD), albumin, American Society of Anesthesiologists(ASA) classification and new mobility scores(NMS) were observed and analyzed. According to grip strength and ASMI, patients were divided into sarcopina group and non-sarcopina group, univariate and multivariate statistical methods were used to analyzed.

RESULTSNinty-nine patients(52.9%) were diagnosed as sarcopenia. Compared with non-sarcopenia group, occurrence of sarcopenia was associated with advanced age, high ASA, low total fat mass, low bone mineral content, low BMI, low albumin, and low NMS. Subsequent binary logistic regression analysis showed that advanced age (OR=1.804, =0.048), high ASA score (OR=3.052, =0.001), low fat content (OR=0.843, =0.006), low bone mineral salt(OR=0.203, =0.026) were risk factors of hip fracture patient with sarcopenia.

CONCLUSIONSOld age, high ASA score, low fat content, low bone mineral content may be related risk factors for sarcopenia in hip fracture patients.

OBJECTIVETo determine the association of sarcopenia with short-term postoperative function after hip replacement for femoral neck fractures.

METHODSA prospective study of 181 consecutive patients with femoral neck fractures who underwent hip replacement from May 2014 to January 2017 were performed, including 58 males and 123 females aging from 53 to 92 years old. The general conditions were collected before surgery, skeletal muscle index(ASMI), handgrip strength were measured. Clinical outcomes were followed up including postoperative complications, time of on-site, Harris score (postoperative 2 weeks, 3, 6 months), hospitalization costs, and hospital stay. According to handgrip strength and ASMI, the patients were divided into the sarcopina group and the non-sarcopina group; according to the Harris score at the 6-month follow-up, the patients were divided into good prognosis group and poor prognosis group. Univariate analysis and binary logistic regression analysis were used to investigate whether sarcopenia was a risk factor for poor postoperative hip joint surgery.

RESULTSAll patients were followed up at 2 weeks, 3 and 6 months, postoperative early complication included wound infection in 16 cases, thrombus of lower extremity veins in 14 cases, no dislocation, prosthetic loosening and prosthesis related infections occurred. Sarcopenia was present in 82 of 181 patients(45%), Compared with non-sarcopenic patients, sarcopenic patients had a higher risk of postoperative complications, longer postoperative hospital stay, more hospital costs and lower harris scores. In Binary logistic analysis revealed that sarcopenia(=0.08), hemiarthroplasty(<0.001), diabetes(=0.016) and infection(=0.018) were important predictors of unsatisfactory postoperative function.

CONCLUSIONSSarcopenia is an important predictor of poor postoperative prognosis in patients with femoral neck fractures after hip replacement. The treatment for sarcopenia maybe an important way to protect patients with femoral neck fractures from poor prognosis after hip replacement.

Objective To observe the efficacy of acupoint thread embedding in treating bronchial asthma in remission stage and how it controls the acute attack, the length of interval, and severity of symptoms during the attack. Method Thirty subjects were selected as the treatment group by using the random number table following the visiting sequence, to receive acupoint thread embedding plus Western medication; thirty cases in the control group were given Western medication alone, both for 3 months. The pulmonary function and eosinophil count were compared before and after the intervention, as well as the symptoms scores during the acute attack. Result There were significant differences in most parameters between the two groups (P<0.05). Conclusion Acupoint thread embedding can produce a positive effect in preventing and treating bronchial asthma in remission stage.