Objective To explore the effect of physical exercise on semen quality in order to provide basic data and theoretical basis for the improvement of male reproductive health.Methods A cross-sectional study was conducted on 1 059 males who visited the Reproductive Medicine Center of Shandong Maternal and Child Health Hospital for medical treatment and physical examination during July 2022 and April 2023.Their demographic data and physical exercise data were surveyed with questionnaires.Total sperm count,sperm concentration,total sperm motility,forward movement and normal sperm morphology were analyzed with computer aided analysis.Logistic regression model and multiple linear regression model were applied to analyze the effects of physical exercise on semen quality.Results After adjustment for confounding factors such as age,body mass index,alcohol consumption and smoking,logistic regression analysis showed that the risk of abnormal semen quality was increased in patients with moderate and heavy exercise intensity(OR=2.103,OR=2.229).Compared with the participants with physical exercise ≤10 min per session,those with＞20 min per session had a lower risk of abnormal semen quality(OR=0.357,0.256,0.289 for exercise time for＞20～30,＞30～60,＞60 min,respectively).There was no statistical significance between physical exercise frequency and semen quality(P＞0.05).The participants having exercise well were at a lower risk for abnormal semen quality(OR=0.711).Multiple linear regression analysis revealed that the frequency of physical exercise was an influencing factor of sperm concentration(β=7.474,95％CI:4.800～10.149,P＜0.05);the time of physical exercise per session was an influencing factor for total sperm count(β=20.632,95％CI:7.634～33.629);the intensity of physical exercise(β=-1.461,95％CI:-2.392～-0.530)and time of physical exercise per session(β=2.608,95％CI:1.404～3.812,P＜0.05)were influencing factors for percentage of forward motility sperm(P＜0.05);and physical exercise intensity(β=-1.934,95％CI:-3.238～-0.630),time of physical exercise per session(β=4.211,95％CI:2.525～5.897)and frequency of physical exercise(β=-2.008,95％CI:-3.480～-0.536)were influencing factors of total sperm motility(P＜0.05).Conclusion Physical exercise may affect semen quality,greater intensity of physical exercise may be a risk factor for abnormal semen quality,and longer physical exercise time may be related to improving semen quality.Therefore,proper physical exercise can help improve semen quality.

Objective:To explore the feasibility of circulating tumor cell (CTC) dual-antibody enrichment and dual-antibody detection for epithelial-mesenchymal phenotypes in patients with hepatocellular carcinoma (HCC), and investigate the clinical diagnostic value of CTC typing in evaluating postoperative recurrence and prognosis of HCC.Methods:Of 89 HCC patients who underwent surgical treatment in Zhejiang Jinhua Guangfu Tumor Hospital from March 2020 to January 2024 were enrolled into this study, including 73 males and 16 females, aged (64.4±9.5) years old. The peripheral blood samples of patients were collected before operation. Epithelial CTC, mesenchymal CTC and hybrid epithelial-mesenchymal CTC in blood samples of patients with HCC were enriched and detected by EpCAM/CSV double capture antibodies and PanCK/CSV double detection antibodies. Kaplan-Meier analysis was employed to assess recurrence-free survival (RFS) and overall survival (OS) rates. Univariate and multivariate Cox regression were used to analyze the effects of different types of CTC on postoperative RFS and OS.Results:The detection rates of total CTC, epithelial CTC, mesenchymal CTC and hybrid epithelial-mesenchymal CTC were 92.1% (82/89), 64.0% (57/89), 62.9% (56/89) and 55.1% (49/89), respectively. Multivariate Cox regression analysis showed that HCC patients with more mesenchymal CTC ( HR=2.408, 95% CI: 1.580-3.668) and hybrid epithelial-mesenchymal CTC ( HR=1.840, 95% CI: 1.004-3.371) in peripheral blood had higher postoperative recurrence risk (both P<0.05). Univariate Cox regression showed patients with more total CTC ( HR=1.426, 95% CI: 1.040-1.954, P=0.028) was associated with survival. Conclusion:The technique of epithelial-mesenchymal phenotypes analysis of circulating tumor cells based on dual-antibody capture and dual-antibody detection is feasible. The number of mesenchymal CTC and hybrid epithelial-mesenchymal CTC before operation is the influencing factor of postoperative recurrence in patients with hepatocellular carcinoma.

Objective:To collect data on urinary flow rate in the elderly female population across the country and to analyze the range of reference values.Methods:This study enrolled 333 subjects from July 2020 to June 2022.The study implementation process was divided into two steps.In the first step, subjects completed an electronic questionnaire, which included basic information about the subject, a short form for urinary incontinence, and a scoring form for the symptoms of overactive bladder syndrome.In the second step, the staff introduced the use of a mobile uroflowmetric device and distributed the instrument and materials.Uroflow rate data were automatically uploaded to a cloud database via the mobile phone.Subsequently, two or more physicians specializing in urinary control performed Uroflow rate-qualifying screenings and conducted statistical analyses.Results:A total of 333 subjects were enrolled in the study, and the researchers collected 1375 qualified urine flow rate records using a mobile urine flow rate instrument.The age of the subjects ranged from 60 to 84 years, with a mean age of 69 years.The reference ranges for urinary flow rate were found to be 24.8-26.2 s, with a mean urinary flow rate of 12.2-12.9 ml/s, a maximum urinary flow rate of 22.2-23.4 ml/s, and a time to peak of 8.5-9.7 s. The study observed a tendency for both maximal and mean urinary flow rates to decrease in older women as their age increased(Pearson correlation coefficient: -0.1, P<0.001). Conclusions:The uroflow rate of older women decreases with aging.Specifically, the average uroflow rate of women over 80 years old is lower than that of other age groups.This study aims to establish normal uroflow parameters for uroflowmetry in healthy older women in China.

In order to reduce bone resorption after tooth extraction and achieve the necessary soft and hard tissue augmentation, it is very important to adequately manage the tooth extraction site. Alveolar ridge preservation (ARP) before implantation helps to obtain predictable and satisfactory bone augmentation results. In this paper, the characteristics, histological studies, clinical applications and therapeutic effects of osteoconductive alternative materials in ARP are introduced, and related references are provided for their application in ARP.

Objective: To observe the effects of electroacupuncture (EA) pretreatment on M1 polarization of alveolar macrophages (AMs) in rats with acute lung injury (ALI) induced by lipopolysaccharide (LPS), and to explore the potential protective mechanism of EA.Methods: Forty Sprague-Dawley rats were randomly divided into a normal group, a model group, and three groups of EA pretreatment [including a Chize (LU5) group, a Zusanli (ST36) group and a Chize (LU5) plus Zusanli (ST36) group], with eight rats in each group. The model rats of ALI were established by instilling LPS [2 mg/(kg·bw)] into the trachea of rats for 3 h. The rats in each EA pretreatment group were pretreated with EA for 30 min per day at the corresponding bilateral acupoints 6 d before instilling LPS. Three hours after modeling, the pulmonary function of the rats was tested, and the lung tissue was taken to calculate the ratio of lung wet weight to dry weight (W/D). The pathological lung changes and the injury score were observed by hematoxylin-eosin staining. The contents of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and myeloperoxidase (MPO) in rat's bronchoalveolar lavage fluid (BALF) were detected by enzyme-linked immunosorbent assay. The mRNA and protein expression levels of M1 macrophage markers clusters of differentiation 86 (CD86), inducible nitric oxide synthase (iNOS), and its signaling pathway factor Toll-like receptor (TLR) 4, and nuclear factor-κB (NF-κB) p65 in the alveoli were detected by fluorescence quantitative polymerase chain reaction and Western blot, respectively. Results: After being induced by LPS, the pulmonary function of the model rats showed that the forced expiratory volume in 0.1 s (FEV0.1), forced expiratory volume in 0.3 s (FEV0.3), and their respective ratios of FEV to forced vital capacity (FVC) (including FEV0.1/FVC and FEV0.3/FVC) were significantly decreased (P<0.01), while the W/D of lung tissue was increased (P<0.01). The score of lung injury was significantly higher (P<0.01). The contents of TNF-α, IL-1β, and MPO in the BALF and the mRNA and protein expression levels of CD86, iNOS, TLR4, and NF-κB p65 in the lung tissue were significantly increased (P<0.01). After EA pretreatment, the FEV0.1, FEV0.3, FEV0.1/FVC, and FEV0.3/FVC were significantly increased, the lung injury score decreased significantly, and the contents of TNF-α, IL-1β, and MPO in the BALF and the expression levels of CD86, iNOS, TLR4, and NF-κB p65 mRNAs and proteins in the alveoli decreased significantly (P<0.05 or P<0.01). Compared with the other two single acupoint groups, the contents of TNF-α, IL-1β, and MPO in the BALF and the expression levels of CD86, iNOS, TLR4, and NF-κB p65 mRNAs in the alveoli in the Chize (LU5) plus Zusanli (ST36) group were significantly lower (P<0.01). Conclusion: EA pretreatment at Chize (LU5) and Zusanli (ST36) can inhibit inflammation and reduce pulmonary injury in ALI rats induced by LPS. The effect of the combination of Chize (LU5) and Zusanli (ST36) is better than that of using these two acupoints separately, and its mechanism may be related to the inhibition of AMs' M1 polarization by down-regulation TLR4/NF-κB signaling pathway.

The development of efficient molecular imaging probes with high specificity, high sensitivity, and low toxicity is the core in promoting the development of cancer molecular imaging technology. Natural expressed purified protein-based nanocage with self-assembling ability to form intrinsically cavity structure has been widely used to prepare various molecular imaging probes of cancer for its ideal physical properties, excellent biological compatibility, exceptional biodegradability as well as diverse engineering strategies. This paper focuses on the research progress of natural protein-based nanocage from the following aspects: various types of protein-based nanocages of different origins and compositions, cargos loading mechanisms, functionalization strategies, and their recent advances in cancer molecular imaging.

Objective:To explore the effect of de-escalation thinking in the triage of critically ill children in the Department of Pediatrics.Methods:From January 2018 to January 2020, we selected a total of 486 critically ill pediatric patients admitted to Zhumadian Central Hospital in Henan Province. According to the random number table, the children were simply randomly divided into control group and observation group, each with 243 cases. Control group carried out traditional routine triage, and observation group conducted de-escalation thinking for pre-examination and triage. We observed the differences in the triage accuracy, satisfaction of the children and their parents and the quality of the triage between the two groups of children.Results:The scores of the disease classification and triage accuracy, total satisfaction, service attitude, treatment timeliness, health guidance as well as safety of children in observation group were higher than those in control group, and the differences were all statistically significant ( P<0.05) . Conclusions:De-escalation thinking has a high accuracy rate in the triage of critically ill children in the Department of Pediatrics, which can improve the treatment effect, reduce the adverse results of the rescue, and improve the satisfaction of the children and their family members.

Objective:To evaluate the effect of different doses of cisatracurium on the monitoring of motor-evoked potentials (MEPs) in the patients undergoing intracranial aneurysm clipping.Methods:Eighty patients of both sexes, aged 18-64 yr, with body mass index <30 kg/m 2, of American Society of Anesthesiologists physical statusⅠor Ⅱ, with Hunt-Hess grade 0-Ⅱ, undergoing intracranial aneurysm clipping under general anesthesia, were divided into 4 groups ( n=20 each) using a random number table method: conventional group (group R) and different doses of cis-atracurium groups (Cis 1-3 groups). After anesthesia induction, muscle relaxation was monitored, and train-of-four (TOF) stimulation (frequency 2 Hz, wave width 0.2 ms, interval 15 s) was applied to the ulnar nerve of forearm, and the TOF ratio was recorded as the baseline value (T 1). MEPs were assessed with a nerve electrophysiology monitor after induction of anesthesia.In Cis 1-3 groups, cis-atracurium 0.625, 0.833 and 1.000 μg·kg -1·min -1 were intravenously infused, while the equal volume of normal saline was given instead in group R when TOF ratio returned to the baseline value and MEPs could be effectively elicited.At T 1, immediately after dural incision (T 2), immediately after aneurysm occlusion (T 3) and immediately after dural closure (T 4), the TOF ratio, effective elicitation of intraoperative MEPs, and occurrence of intraoperative cardiovascular events, recovery of spontaneous breathing and body movement were recorded. Results:Compared with group R, no significant change was found in TOF ratio at each time point in group Cis 1 ( P>0.05), and TOF ratio was significantly decreased at T 2-4 in group Cis 2 and at T 2-4 in group Cis 3 ( P<0.05). Compared with group Cis 1, TOF ratio was significantly decreased at T 3, 4 in group Cis 2 and at T 2-4 in group Cis 3 ( P<0.05). The effective elicitation rate of MEPs was 100% in the four groups.There was no significant difference in the incidence of intraoperative cardiovascular events, recovery of spontaneous breathing and body movement among the four groups ( P>0.05). Conclusion:Continuous intravenous infusion of cis-atracurium 0.833-1.000 μg·kg -1·min -1 can maintain a certain degree of muscle relaxation without affecting MEP monitoring in the patients undergoing intracranial aneurysm clipping.

In order to search for new antiplatelet agents with higher potency, a series of tetramethylpyrazine ( TMP) /chalcone hybrids ( 2-26) were synthesized and evaluated based on the principle of bioisostere and hybrid-ization. They exerted inhibitory activity against adenosine diphosphate ( ADP )-induced and arachidonic acid ( AA)-induced platelet aggregation to varied extent. Among them, compound 8 was the most potent with IC50 of 0. 14 mmol/L on ADP-induced platelet aggregation ( 9. 1 folds of TMP and 10. 5 folds of chalcone ) and 0. 09 mmol/L on AA-induced platelet aggregation ( 8. 8 folds of TMP and 10. 0 folds of chalcone) , which was superior to clinically used anti-platelet drug aspirin ( ASP, IC50 =0. 15 mmol/L) .

Sepsis should be defined as life-threatening organ dysfunction caused by a dys-regulated host response to infection. Continuous renal replacement therapy (CRRT) is one of the methods for the clinical treatment of sepsis. For patients undergoing CRRT, rational antimicrobial therapy is very important for the control of patient's infection. However, during CRRT, there is no clear guideline for the dose adjustment of antibiotics. In this paper, we analyzed the effect of CRRT combined with antibiotics on sepsis treatment in China and abroad, and discussed its effect on antibiotic clearance, and provided reference for clinical work.