With the rapid development of tumor subjects and the advance of medical technology,tumor mortality is declining in spite of the increase in tumor incidence.The male survivors pay more and more attention to their prognosis to improve the quality of their life.In the meantime,whether they could produce their own offspring become the main concern of tumor patients with good prognosis.However,until now,male tumor patients,their relatives,different social sectors and even some of our health workers,havent noticed the importance of fertility preservation and long-term fertility desires of male patients with tumor which will lead to declined or even irreversible sterility induced by the lack of fertility preservation before anti-tumor therapy.It's an important way to do fertility counseling,learn the risk of their treatment plans and choose the appropriate technique of fertility preservation which will improve prognosis quality of life of male tumor patients.This article will review the effects of tumor and the treatment on male fertility,their subjective needs and concerns,main methods for fertility preservation and the domestic and foreign research present situation.

Background and Objectives: Stroke mimics are medical conditions producing stroke-like symptoms but eventually get diagnosed as non-stroke diseases. Epileptic seizure is a common type of stroke mimic. The purpose of this study is to investigate the application of emergency multimodal computed tomography (CT) in the diagnosis of epileptic seizure. Methods: We retrospectively reviewed the case group of patients with suspected stroke in the emergency stroke care service of the First Affiliated Hospital of Suzhou University from September 2017 to October 2019. We included those who underwent multimodal CT, including non-contrasted cranial CT, CT perfusion with CT angiography, and were ultimately diagnosed as epileptic seizures. Ten patients with acute anterior circulation ischemic stroke were assigned as controls. Results: A total of five cases met the inclusion criteria. Multimodal CT was completed within 2.25 to 3.50h from symptom onset. On CT perfusion, hyperperfusion was shown in four cases and slightly increased perfusion in one case with epileptic seizures. Cerebral blood flow and cerebral blood volume were significantly increased, while time to peak and mean transit time decreased in the regions of interest of the epileptic hemisphere when compared to either the non-affected hemisphere or the ischemic area in the control group (P<0.05). The abnormal perfusion areas did not follow vascular territory supply and CT angiography did not show vessel occlusion in the case group. Conclusion: Emergency multimodal CT could be used effectively to differentiate epileptic seizure from stroke.

As a common emotional and psychogenic disorder, anxiety disorder seriously threats the human physical and mental health. Ventral tegmental area (VTA) is the canter of the mesocortical limbic circuit, with extensive bidirectional connections to forebrain areas, and plays important role in regulating reward, motivation, cognition, and disgust. Besides, VTA is involved in anxiety regulation by forming functional connections with multiple brain regions and connecting external stimulus information and feedback output behaviours. This article briefly summarizes the different cell subsets of VTA and its involvement in anxiety-related neural circuits.

Objective:Three-dimensional reconstruction and finite element analysis were used to investigate the outcomes of different fixation methods on horizontal osteotomy genioplasty and to identify the fixation method with best biomechanics.Methods:The skull spiral CT data of a patient with chin deformity were collected. The mandible three-dimensional model and internal fixation devices were reconstructed by Mimics, Geomagic Studio, Solidworks and Ansys Workbench software. The surgical osteotomy and four internal fixation methods (simple H-shaped titanium plate; 3 lag screws; H-shaped titanium plate combined with bilateral straight titanium plates; H-shaped titanium plate combined with bilateral lag screws) were simulated. The difference of deformation and stress distribution in each fixation under the same load were tested by finite element analysis.Results:The results of H-shaped titanium plate combined with bilateral lag screws fixation were the most balanced, the overall displacement was minimal (0.033 2 mm), the stress concentration of fixation material and free bone was 59.79 MPa and 4.69 MPa, respectively, and the regional stress was small[comparison of the equivalent stress of fixation material between groups, except that it was similar to the three lag screw fixation methods ( P>0.05), it was significantly smaller than the other two fixation methods ( P<0.01); comparison of the equivalent stress of free bone segment between groups, except that it was similar to the simple H-shaped titanium plate fixation method ( P>0.05), it was significantly smaller than the other two fixation methods ( P<0.05)]. Conclusion:The method of H-shaped titanium plate combined with bilateral lag screws fixation in horizontal osteotomy genioplasty has small deformation, which is not easy to cause deformation and fracture of fixation materials, and has superior mechanical properties. It is an appropriate method for clinical application.

Objective:Three-dimensional reconstruction and finite element analysis were used to investigate the outcomes of different fixation methods on horizontal osteotomy genioplasty and to identify the fixation method with best biomechanics.Methods:The skull spiral CT data of a patient with chin deformity were collected. The mandible three-dimensional model and internal fixation devices were reconstructed by Mimics, Geomagic Studio, Solidworks and Ansys Workbench software. The surgical osteotomy and four internal fixation methods (simple H-shaped titanium plate; 3 lag screws; H-shaped titanium plate combined with bilateral straight titanium plates; H-shaped titanium plate combined with bilateral lag screws) were simulated. The difference of deformation and stress distribution in each fixation under the same load were tested by finite element analysis.Results:The results of H-shaped titanium plate combined with bilateral lag screws fixation were the most balanced, the overall displacement was minimal (0.033 2 mm), the stress concentration of fixation material and free bone was 59.79 MPa and 4.69 MPa, respectively, and the regional stress was small[comparison of the equivalent stress of fixation material between groups, except that it was similar to the three lag screw fixation methods ( P>0.05), it was significantly smaller than the other two fixation methods ( P<0.01); comparison of the equivalent stress of free bone segment between groups, except that it was similar to the simple H-shaped titanium plate fixation method ( P>0.05), it was significantly smaller than the other two fixation methods ( P<0.05)]. Conclusion:The method of H-shaped titanium plate combined with bilateral lag screws fixation in horizontal osteotomy genioplasty has small deformation, which is not easy to cause deformation and fracture of fixation materials, and has superior mechanical properties. It is an appropriate method for clinical application.

Objective:To systematically summarize and comparatively analyze the development, establishment and usage of oncology drugs speedy review approaches in China and in the United States between 2012 and 2021.Methods:Based on National Medical Products Administration (NMPA) and Food and Drug Administration (FDA) websites, the development and current status of the speedy review approaches were consulted and summarized. Approved oncology drugs in China and in the United States (87 in China, 118 in the United States) over the past decade were analyzed using chi-square test for group comparison.Results:Five speedy approaches have been established in China and in the United States, three of which are the same, priority review, conditional approval or accelerated approval and breakthrough therapy. The rest two are special review and approval, special examination and approval in China, and fast track and real-time oncology review in the United States. Compared to the United States, speedy review approaches in China set up late (1992 vs. 2005). The overall utilization rates of the oncology drugs speedy review approaches were similar between the China and United States (90.8% vs. 92.4%, P=0.800) in the previous 10 years, and priority review have highest utilization rates in both China and the United States without significant group difference (77.0% vs. 82.2%, P=0.381); relatively low utilization rates of conditional approval (31.0% vs. 44.9%, P=0.041) and breakthrough therapy (2.3% vs. 50.0%, P＜0.001) were seen in China. 52.9% of new drugs applied for special examination and approval in China and 40.7% of new drugs applied for fast track in the United States. Overall, the priority review both in China and the United States are stable, with a similar average annual utilization rate (84.8% vs. 83.7%); accelerated approval and breakthrough therapies in the United States fluctuate wildly, but the situation is tending towards stability in the last 3 years. Conclusions:Both China and the United States have established a relatively complete accelerated review system, with an overall utilization rate over 90%; China's accelerated review started late, although the overall utilization rate is close to that of the United States. The utilization rates of conditional approval and breakthrough therapy are still relatively low. Flexible usage of speedy review approaches, gaining regulatory recognition to use alternative endpoints, achieving real-time review and guidance are keys to accelerate new drug development in China.

Objective To explore the impact of prolonged sitting on lumbar disc degeneration using MRI T1ρ and T2 mapping.Methods A total of 25 taxi drivers(prolonged sitting group)and 24 age-matched non-prolonged sitting volunteers(control group)underwent routine lumbar MRI,T1ρ,and T2 mapping.The differences of T1ρ and T2 values for different Pfirrmann grades of anterior annulus fibrosus(AAF),nucleus pulposus(NP),and posterior annulus fibrosus(PAF)were analyzed using Variance analysis,Spearman correlation test,and receiver operating characteristic(ROC)curve was drawn,with independent t-tests was used for between-group com-parisons.Results Statistically significant differences were observed in T1ρ and T2 values for all Pfirrmann Ⅰ-Ⅱ grades NP and Pfirrmann Ⅱ-Ⅳgrades AAF,NP,and PAF in both groups(P＜0.05).Both T1ρ and T2 values were negatively correlated with Pfirrmann grades.The area under the curve(AUC)of T1ρ values for NP at each Pfirrmann grade were 0.928,0.987,and 0.968,respectively,while the AUC of T2 values for NP were 0.777,0.966,and 0.975,respectively.The T1ρ and T2 values of L4/L5 NP and L5/S1 AAF,NP,and PAF were lower in the prolonged sitting group compared to the control group(P＜0.05).Conclusion T1ρ is superior to T2 mapping in detecting lumbar disc degeneration.Prolonged sitting is more likely to cause degeneration of L4/L5 and L5/S1 inter-vertebral discs.

Objective:To systematically summarize and comparatively analyze the development, establishment and usage of oncology drugs speedy review approaches in China and in the United States between 2012 and 2021.Methods:Based on National Medical Products Administration (NMPA) and Food and Drug Administration (FDA) websites, the development and current status of the speedy review approaches were consulted and summarized. Approved oncology drugs in China and in the United States (87 in China, 118 in the United States) over the past decade were analyzed using chi-square test for group comparison.Results:Five speedy approaches have been established in China and in the United States, three of which are the same, priority review, conditional approval or accelerated approval and breakthrough therapy. The rest two are special review and approval, special examination and approval in China, and fast track and real-time oncology review in the United States. Compared to the United States, speedy review approaches in China set up late (1992 vs. 2005). The overall utilization rates of the oncology drugs speedy review approaches were similar between the China and United States (90.8% vs. 92.4%, P=0.800) in the previous 10 years, and priority review have highest utilization rates in both China and the United States without significant group difference (77.0% vs. 82.2%, P=0.381); relatively low utilization rates of conditional approval (31.0% vs. 44.9%, P=0.041) and breakthrough therapy (2.3% vs. 50.0%, P＜0.001) were seen in China. 52.9% of new drugs applied for special examination and approval in China and 40.7% of new drugs applied for fast track in the United States. Overall, the priority review both in China and the United States are stable, with a similar average annual utilization rate (84.8% vs. 83.7%); accelerated approval and breakthrough therapies in the United States fluctuate wildly, but the situation is tending towards stability in the last 3 years. Conclusions:Both China and the United States have established a relatively complete accelerated review system, with an overall utilization rate over 90%; China's accelerated review started late, although the overall utilization rate is close to that of the United States. The utilization rates of conditional approval and breakthrough therapy are still relatively low. Flexible usage of speedy review approaches, gaining regulatory recognition to use alternative endpoints, achieving real-time review and guidance are keys to accelerate new drug development in China.

Objective To develop an evidence-based practice program for ICU eye care and evaluate its application effect using Stetler model of research utilization.Methods The systematic search was carried out in domestic and foreign guid elines,systematic reviews,evidence summaries,expert consensuses on eye care for ICU patients.The quality of the included literature was evaluated and the evidence was summarized.The evidence based on expert advice,clinical context and stakeholder opinions was screened.According to Stetler model of research utilization,the evidence translation/application was formulated from 3 aspects,including method,level and type of evidence application,and the evidence translation was implemented using a stepwise trial design.Five ICUs in a tertiary hospital in Zhejiang Province were selected,and the order of enrollment of each ICU was determined by computer-generated random numbers from April to september,2022.In the first month,all ICUs were in pre-evidence-based practice period,and in the second month,an ICU was trained and entered the evidence-based practice period.Until the 6th month,all ICUs entered the evidence-based practice period.Then the rate of ocular symptoms and implementation rate of eye care measures were compared before and after EBP.Results A total of 1 540 patients were included.With regard to the implementation rate of eye care measures,the rate of lubricant use and suspected ocular infection management in patients at high risk for ocular complications in evidence-based practice period was significantly higher compared with pre-evidence-based practice period(P＜0.001),and no statistically significant difference was found in the rate of eyelid closure.The incidence of conjunctival exposure,subconjunctival hemorrhage,conjunctival congestion,and ocular discharge in non-neurology critical care patients decreased compared with pre-evidence-based practice period(P＜0.05),and the incidence of conjunctival edema and conjunctival congestion in NICU patients decreased compared with pre-evidence-based practice period as the intervention continued(P＜0.001).Conclusion Evidence-based practice in eye care for ICU patients using Stetler model of research utilization can standardize the practice of eye care for ICU patients and improve the quality of care.

Objective:To investigate regulatory effect and mechanism of protein kinase C(PKC)δ/θ-dual functional oxidase 1(Duox1)-reactive oxygen species(ROS)signaling pathway on human airway mucin(MUC)5AC,to provide a new target for treatment of high secretion of airway mucus.Methods:Human airway epithelial cells 16HBE were pretreated with PKC and its subunit PKCδ/θ inhibitor,Duox1 inhibitor or free radical scavenger DMTU,respectively,and then human neutrophil elastase(HNE)stimulation to establish an in vitro airway inflammatory cell model.Generation level of ROS in each group of cells was determined by kit,mRNA levels of Duox1 and MUC5AC were detected by real-time fluorescent quantitative PCR,influence of interfering factors of each group of cells on Duox1 protein level was determined by Western blot,and protein expression of MUC5AC in each group of cells was detected by ELISA and immunofluorescence.Results:Compared with control group,ROS production in HNE group was increased significantly,expressions of Duox1 and MUC5AC mRNA and protein were also increased(P<0.05).After administration of Duox1 inhibitors,free radical scavengers or PKC inhibitors and PKCδ/θ inhibitors,ROS production was significantly inhibited,Duox1 and MUC5AC mRNA and protein expressions were decreased(P<0.05),while after giving PKCα/β,ROS generation,Duox1 and MUC5AC mRNA and pro-tein expressions were not significantly changed compared with HNE group(P>0.05).Conclusion:HNE can mediate high expression of MUC5AC through PKCδ/θ-Duox1-ROS,which plays an important role in development of high secretion of airway mucus in vitro cell model experiment.