Asthenospermia is one of the important causes of male infertility,and its etiology and pathogenesis are complex.Traditional Chinese medicine(TCM)offers unique advantages in treating this disease.The"kidney deficiency and toxic-stasis"theory reveals the dynamic relationship between kidney essence deficiency and the interaction of toxic-stasis in disease pathogenesis,which can be applied clinically to guide the differentiation and treatment of asthenospermia.The formation of asthenospermia is closely related to the deficiency of kidney essence and the blockage of toxic stasis.The kidney essence is the source of reproductive essence.If the kidney essence is depleted for a long time and the kidney essence is deficient,the essence chamber cannot be enriched,resulting in spermatozoa dysfunction and poor spermatozoa mobility.The poison stasis interferes with the spermatozoa and turns into spermatotoxin,which directly harms spermatozoa fertility and leads to the decrease of spermatozoa mobility.Tongjing Jiedu Formula takes tonifying kidney to supply essence,diuresis and detoxification,activating blood circulation and removing blood stasis as the treatment principle,focusing on tonifying kidney to fill essence and nourishing healthy qi to restore the nourishing effect of kidney essence,and also emphasizes clearing heat and detoxification,activating blood circulation and removing blood stasis,promoting diuresis and dredging collaterals to remove poisonous damp-heat and static blood and harmonize blood and vessel,improving spermatogenic environment and improving sperm vitality to help men have children.This article analyzes the application of Tongjing Jiedu Formula in treating asthenospermia from the perspective of"kidney deficiency and toxic stasis",aiming to provid new ideas and methods for the explanation of the pathogenesis of the disease and TCM treatment.

Asthenospermia is one of the important causes of male infertility,and its etiology and pathogenesis are complex.Traditional Chinese medicine(TCM)offers unique advantages in treating this disease.The"kidney deficiency and toxic-stasis"theory reveals the dynamic relationship between kidney essence deficiency and the interaction of toxic-stasis in disease pathogenesis,which can be applied clinically to guide the differentiation and treatment of asthenospermia.The formation of asthenospermia is closely related to the deficiency of kidney essence and the blockage of toxic stasis.The kidney essence is the source of reproductive essence.If the kidney essence is depleted for a long time and the kidney essence is deficient,the essence chamber cannot be enriched,resulting in spermatozoa dysfunction and poor spermatozoa mobility.The poison stasis interferes with the spermatozoa and turns into spermatotoxin,which directly harms spermatozoa fertility and leads to the decrease of spermatozoa mobility.Tongjing Jiedu Formula takes tonifying kidney to supply essence,diuresis and detoxification,activating blood circulation and removing blood stasis as the treatment principle,focusing on tonifying kidney to fill essence and nourishing healthy qi to restore the nourishing effect of kidney essence,and also emphasizes clearing heat and detoxification,activating blood circulation and removing blood stasis,promoting diuresis and dredging collaterals to remove poisonous damp-heat and static blood and harmonize blood and vessel,improving spermatogenic environment and improving sperm vitality to help men have children.This article analyzes the application of Tongjing Jiedu Formula in treating asthenospermia from the perspective of"kidney deficiency and toxic stasis",aiming to provid new ideas and methods for the explanation of the pathogenesis of the disease and TCM treatment.

Knee adduction moment(KAM)is a key biomechanical index in knee joint biomechanics research,which is closely related to the occurrence and development of knee osteoarthritis(KOA).Therefore,understanding the factors influencing KAM is important for the diagnosis and treatment of KOA diseases.This review summarizes the factors that may affect KAM based on relevant research.

Parathyromegaly refers to chronic enlargement of the parathyroid glands caused by multiple etiological factors. Pathological conditions, such as hyperparathyroidism, parathyroid hyperfunction, parathyroid adenoma, parathyroid cysts, and parathyroid carcinoma may all lead to parathyromegaly. Notably, calcium intake insufficiency and/or vitamin D insufficiency (CVI), which is the predominant etiology of parathyromegaly, now has been recognized as a global public health challenge. Chronic CVI induces negative calcium balance and relative low serum calcium level, stimulating compensatory parathyroid hyperplasia and enlargement. This progression triggers parathyroid hyperfunction and secondary hyperparathyroidism, resulting in bone mass loss, height reduction, kyphosis, osteoporosis, pathological fractures, metastatic vascular calcification and systemic abnormal calcium migration and calcinosis (such as urolithiasis). During the early stages of parathyromegaly, the condition remains preventable and treatable; However, delayed intervention may lead to irreversible tertiary hyperparathyroidism. CVI-associated parathyromegaly exhibits high prevalence and heterogeneous clinical manifestations, representing a critically underrecognized clinical entity. This article will systematically discuss the etiology, pathological characteristics, clinical consequences, and prevention and control strategies for CVI-related parathyromegaly.

Patients with initially diagnosed breast cancer and uncontrolled hyperthyroidism are at high risk of perioperative thyroid crisis. This article reports two cases of early-stage breast cancer initially diagnosed concurrently with uncontrolled primary hyperthyroidism. In Case 1, the patient received neoadjuvant chemotherapy to control breast cancer progression while concurrently taking antithyroid drugs to manage hyperthyroidism. Hyperthyroidism was controlled during chemotherapy, and the patient successfully underwent surgery after neoadjuvant chemotherapy. Case 2 involved recurrent primary hyperthyroidism with leukopenia after antithyroid drug therapy. Since leukopenia is a relative contraindication for antithyroid drugs, the patient underwent radioactive iodine therapy (iodine-131) and endocrine therapy for one month before proceeding with breast cancer surgery. Through a literature review, this article analyzes preoperative management strategies for uncontrolled hyperthyroidism in initially diagnosed breast cancer patients, emphasizing the importance of normalizing thyroid function to prevent thyroid crisis and reduce perioperative risks.

Objective:To explore the application effect of a multidisciplinary full-process chain nursing program based on the online-to-offline (OTO) model for patients with Parkinson′s disease and providing theoretical basis for medical staff to guide patients' rehabilitation.Methods:A randomized controlled trial was conducted, and 80 patients with Parkinson′s disease who visited the Neurology Department of Qilu Hospital, Shandong University (Qingdao) from January to December 2023 were selected using convenience sampling. Patients were divided into an intervention group and a control group using random number table method, with 40 patients in each group. The control group received routine nursing interventions, while the intervention group received a multidisciplinary full-process chain nursing program based on the OTO model in addition to routine care. The quality of life, rehabilitation training outcomes, psychological status, and nursing satisfaction of the two groups were compared.Results:In the intervention group, there were 23 males and 17 females, with an age of (65.46 ± 3.04) years; in the control group, there were 24 males and 16 females, with an age of (65.02 ± 3.42) years. After intervention, the scores for quality of life, rehabilitation training outcomes, Hamilton Anxiety Rating Scale, and Hamilton Depression Rating Scale in the intervention group were (163.57 ± 18.56), (44.18 ± 4.57), (6.27 ± 1.05) and (6.18 ± 1.05) respectively, while those in the control group were (139.42 ± 14.26), (37.54 ± 4.80), (11.53 ± 2.24) and (10.48 ± 2.22) respectively. There were statistically significant differences between the two groups ( t values were from 6.34 to 13.45, all P<0.05). Patient satisfaction was 97.50% (39/40) in the intervention group and 77.50% (31/40) in the control group, with a statistically significant difference ( χ2=7.31, P<0.05). Conclusions:Implementing a multidisciplinary full-process chain nursing program based on the OTO model for patients with Parkinson′s disease yields significant rehabilitation effects, improves negative emotions and quality of life, and is worthy of promotion in clinical practice.

Parathyromegaly refers to chronic enlargement of the parathyroid glands caused by multiple etiological factors. Pathological conditions, such as hyperparathyroidism, parathyroid hyperfunction, parathyroid adenoma, parathyroid cysts, and parathyroid carcinoma may all lead to parathyromegaly. Notably, calcium intake insufficiency and/or vitamin D insufficiency (CVI), which is the predominant etiology of parathyromegaly, now has been recognized as a global public health challenge. Chronic CVI induces negative calcium balance and relative low serum calcium level, stimulating compensatory parathyroid hyperplasia and enlargement. This progression triggers parathyroid hyperfunction and secondary hyperparathyroidism, resulting in bone mass loss, height reduction, kyphosis, osteoporosis, pathological fractures, metastatic vascular calcification and systemic abnormal calcium migration and calcinosis (such as urolithiasis). During the early stages of parathyromegaly, the condition remains preventable and treatable; However, delayed intervention may lead to irreversible tertiary hyperparathyroidism. CVI-associated parathyromegaly exhibits high prevalence and heterogeneous clinical manifestations, representing a critically underrecognized clinical entity. This article will systematically discuss the etiology, pathological characteristics, clinical consequences, and prevention and control strategies for CVI-related parathyromegaly.

Patients with initially diagnosed breast cancer and uncontrolled hyperthyroidism are at high risk of perioperative thyroid crisis. This article reports two cases of early-stage breast cancer initially diagnosed concurrently with uncontrolled primary hyperthyroidism. In Case 1, the patient received neoadjuvant chemotherapy to control breast cancer progression while concurrently taking antithyroid drugs to manage hyperthyroidism. Hyperthyroidism was controlled during chemotherapy, and the patient successfully underwent surgery after neoadjuvant chemotherapy. Case 2 involved recurrent primary hyperthyroidism with leukopenia after antithyroid drug therapy. Since leukopenia is a relative contraindication for antithyroid drugs, the patient underwent radioactive iodine therapy (iodine-131) and endocrine therapy for one month before proceeding with breast cancer surgery. Through a literature review, this article analyzes preoperative management strategies for uncontrolled hyperthyroidism in initially diagnosed breast cancer patients, emphasizing the importance of normalizing thyroid function to prevent thyroid crisis and reduce perioperative risks.

A 20-year old female patient diagnosed with right distal tibial giant cell tumor underwent a surgery of resection of distal tibial giant cell tumor, residual cavity liquid nitrogen and electrocauterization inactivation and local arthroplasty on March 17, 2023. Preoperatively a life-size distal tibia model was 3D printed using polylactic acid (PLA) material based on the CT data of patient's distal tibia. Tumor resection was simulated on the model, preserving the surrounding normal bone and articular cartilage unaffected by the tumor. The residual cavity was filled with bone cement and the distal tibial articular surface was shaped using the talar articular surface as a template. The 3D CT data of bone cement was collected and reconstructed. The irregular bone and cartilage defect data were trimmed to form a regular arc shape, which was used as the data for fabricating local arthroplasty prosthesis. The local arthroplasty prosthesis composed of a titanium base and a VE polyethylene liner was 3D printed. During the operation, the test models of titanium alloy base and VE polyethylene liner were used to test the matching degree with the bone and cartilage defect. Minor adjustments were made by removing a portion of the lateral wall of the residual cavity and modifying the base height to achieve proper alignment of the distal tibial articular surface with the talar surface. After confirming a satisfactory fit, the local arthroplasty prosthesis was implanted. Intraoperative fluoroscopic confirmed accurate placement of the prosthesis, good anatomical match with the defect, and restoration of the joint line. The postoperative follow-up was conducted at 2, 4, 12, 20, 48, 72 and 92 weeks. Wound healing was closely monitored, along with radiologic assessment for prosthesis bone ingrowth and local tumor recurrence. Functional evaluations were performed using the AOFAS and Kofoed scoring systems. Postoperatively, the patient experienced plantar numbness and sensory disturbance, which gradually resolved after three weeks. Assisted ambulation began at two weeks postoperatively, and the patient resumed a normal gait by 12 weeks. The Mayo ankle arthroplasty evaluation criteria at postoperative at 48 weeks were excellent. The AOFAS score and Kofoed score were 97 points and 94 points respectively, indicating excellent functional outcomes. Postoperative X-ray indicated that no bone ingrowth was observed at 2 weeks and 4 weeks after the operation, minor ingrowth at 12 weeks postoperatively, significant bone ingrowth at 20 weeks, and complete osseointegration by 48 to 64 weeks. Postoperative CT imaging at 92 weeks confirmed full prosthesis osseointegration, while MRI at 72 weeks showed no evidence of tumor recurrence.

The shortage of donor organs is the primary factor limiting the availability of liver transplantation (LT) and is a leading cause of death among patients on the waiting list. The reuse of liver allografts, while rare, represents a significant and unconventional donor resource, offering a promising strategy to expand the donor pool. This approach has been documented in international literature, demonstrating favorable surgical outcomes and long-term follow-up results. Here, we report the first case of liver allograft reuse in the Liver Transplantation Center, Department of General Surgery, Huashan Hospital, Fudan University. In this case, the first recipient underwent orthotopic LT for acute liver failure and hepatic encephalopathy. However, their condition deteriorated on the seventh postoperative day, culminating in brain death. Following evaluation and maintenance, the liver allograft was successfully re-transplanted into a second recipient, who had undergone LT six days earlier but experienced acute hepatic artery embolism leading to rapid liver function deterioration. The second recipient's liver function recovered smoothly after surgery, and they were discharged on the 28th postoperative day. This case highlights the significant value of liver allograft reuse in expanding the donor pool and providing life-saving options for critically ill patients requiring urgent LT.