Objective To analyze the influencing factors for poor prognosis in elderly patients with CHD and left ventricular dysfunction(LVD)treated by CABG,and to construct a logistic predic-tion model.Methods A total of 199 elderly CHD patients with LVD undergoing CABG in Zhu-jiang Hospital from April 2020 to April 2023 were retrospectively enrolled.After 1 year of follow-up,according to whether MACCE occurred after surgery,they were divided into MACCE group(24 cases)and non-MACCE group(175 cases).The clinical data were compared between the two groups.Multivariate logistic regression analysis was used to analyze the influencing factors for poor prognosis,and a logistic prediction model was constructed.Results The MACCE group had significantly larger proportions of hypertension,diabetes,chronic kidney disease,NYHA gradeⅢand multi-vessel disease,and smaller proportion of non-cardiopulmonary bypass than the non-MACCE group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that diabetes(OR=2.328,95％CI:1.469-3.690,P=0.000),NYH A grade(OR=2.181,95％CI:1.184-4.021,P=0.013),multi-vessel disease(OR=1.996,95％CI:1.187-3.355,P=0.009),and non-cardiopulmonary bypass(OR=0.660,95％CI:0.541-0.806,P=0.000)were independent influen-cing factors for poor prognosis in the patients after CABG.The AUC value of the constructed pre-diction model in predicting poor prognosis was 0.822(95％CI:0.721-0.923),with a sensitivity of 66.70％and a specificity of 80.60％.Conclusion Diabetes,NYHA grade,multi-vessel disease and non-cardiopulmonary bypass are independent influencing factors for poor prognosis in elderly CHD patients complicated with LVD after CABG.The constructed logistic prediction model has certain predictive value for poor prognosis in these elderly patients.

Objective To analyze the influencing factors for poor prognosis in elderly patients with CHD and left ventricular dysfunction(LVD)treated by CABG,and to construct a logistic predic-tion model.Methods A total of 199 elderly CHD patients with LVD undergoing CABG in Zhu-jiang Hospital from April 2020 to April 2023 were retrospectively enrolled.After 1 year of follow-up,according to whether MACCE occurred after surgery,they were divided into MACCE group(24 cases)and non-MACCE group(175 cases).The clinical data were compared between the two groups.Multivariate logistic regression analysis was used to analyze the influencing factors for poor prognosis,and a logistic prediction model was constructed.Results The MACCE group had significantly larger proportions of hypertension,diabetes,chronic kidney disease,NYHA gradeⅢand multi-vessel disease,and smaller proportion of non-cardiopulmonary bypass than the non-MACCE group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that diabetes(OR=2.328,95％CI:1.469-3.690,P=0.000),NYH A grade(OR=2.181,95％CI:1.184-4.021,P=0.013),multi-vessel disease(OR=1.996,95％CI:1.187-3.355,P=0.009),and non-cardiopulmonary bypass(OR=0.660,95％CI:0.541-0.806,P=0.000)were independent influen-cing factors for poor prognosis in the patients after CABG.The AUC value of the constructed pre-diction model in predicting poor prognosis was 0.822(95％CI:0.721-0.923),with a sensitivity of 66.70％and a specificity of 80.60％.Conclusion Diabetes,NYHA grade,multi-vessel disease and non-cardiopulmonary bypass are independent influencing factors for poor prognosis in elderly CHD patients complicated with LVD after CABG.The constructed logistic prediction model has certain predictive value for poor prognosis in these elderly patients.

Objective:To explore the method of fertility preservation in severe β-thalassemia prepubertal boys who cannot produce sperm before gonadotoxicity therapy.Methods:Three cases of severe β-thalassemia patients who were going to undergo hematopoietic stem cell transplantation (HSCT) were reported. They were received testis cryopreservation by slow-rate freezing. The necessity of fertility preservation in prepubertal boys and the methods of fertility persevation, testicular cryopreservation and the downstream techniques were stated.Results:Totally 31, 31, 20 pieces of testicular tissue were frozen by slow-rate freezing in three boys respectively and the freezing process went smoothly.Conclusion:The cryopreservation of testicular tissue can preserve the fertility of severe β-thalassemia prepuberty boys who will receive HSCT, leaving hope for offspring.

Objective:To explore the method of fertility preservation in severe β-thalassemia prepubertal boys who cannot produce sperm before gonadotoxicity therapy.Methods:Three cases of severe β-thalassemia patients who were going to undergo hematopoietic stem cell transplantation (HSCT) were reported. They were received testis cryopreservation by slow-rate freezing. The necessity of fertility preservation in prepubertal boys and the methods of fertility persevation, testicular cryopreservation and the downstream techniques were stated.Results:Totally 31, 31, 20 pieces of testicular tissue were frozen by slow-rate freezing in three boys respectively and the freezing process went smoothly.Conclusion:The cryopreservation of testicular tissue can preserve the fertility of severe β-thalassemia prepuberty boys who will receive HSCT, leaving hope for offspring.

Objective:To investigate the value of anti-Müllerian hormone (AMH) determination for estimating the sperm retrieval rate (SRR) of microdissection testicular sperm extraction (micro-TESE) in non-obstructive azoospermia (NOA) patients.Methods:This was a retrospective case-control study. Totally 502 NOA patients treated with micro-TESE in Reproductive Medicine Research Centre, the Sixth Affiliated Hospital, Sun Yat-sen University from September 2014 to May 2022 were involved in the investigation. Patients were divided into different groups according to their surgery outcome and seminiferous tubules appearance. Age, testis volume, serum AMH, follicle-stimulating hormone (FSH), testosterone level were compared between the different groups. According to the cause of NOA, they were divided into orchitis group (idiopathic or parotid), AZFc gene deletion group, cryptorchidism descending fixation group, Klinefelter's syndrome (KS) group and idiopathic NOA group. The differences of SRR and AMH level in NOA patients with different etiologies were compared.Results:Testicular sperms were successfully retrieved in 270 cases (SRR=53.8%). There were no statistical differences in age, testicular volume, FSH and testosterone levels between the patients who succeeded or failed to obtain sperm (all P>0.05). The patients who obtained sperms had lower serum AMH level than those without sperm [0.81(0.16, 3.26) μg/L vs. 1.37(0.21, 4.84) μg/L, P<0.001]. Patients with orchitis or AZFc deletion, cryptorchidism, KS, idiopathic azoospermia have different AMH levels [(0.15(0.01,0.41) μg/L, 5.71(3.57,8.26) μg/L, 2.29(1.36,3.81) μg/L, 0.15(0.05,0.39) μg/L, 2.46(0.75,5.49) μg/L, P<0.001]. Idiopathic azoospermia patients who obtained sperms also had lower testosterone and AMH levels but higher age than those without sperm [(35.2±8.9) years vs. (32.5±5.5) years, P=0.010; (3.1±1.4) μg/L vs. (3.7±2.1) μg/L, P=0.029; 1.63(0.35,3.84) μg/L vs. 3.00(1.20,6.68) μg/L, P=0.001]. There were no statistical differences in testicular volume and FSH level between the two groups (all P>0.05). Receiver operating characteristic (ROC) curve showed that cut-off of serum AMH for successful sperm retrieval of idiopathic azoospermia patients was determined to be 2.96, with a sensitivity of 0.710 and specificity of 0.523, area under the curve (AUC) was 0.649. In the cases presenting heterogeneous seminiferous tubules during micro-TESE had lower AMH level and higher SRR than those presenting homogeneous seminiferous tubules [0.55(0.12, 2.05) μg/L vs. 2.99(0.76, 6.11) μg/L, P<0.001; 75.9% (236/311) vs. 17.8% (34/191), P<0.001]. Conclusion:NOA patients with low AMH level would have more opportunity to present heterogeneous seminiferous tubules when micro-TESE was performed and had higher SRR, especially in the idiopathic NOA cases.

Objective:To investigate the value of anti-Müllerian hormone (AMH) determination for estimating the sperm retrieval rate (SRR) of microdissection testicular sperm extraction (micro-TESE) in non-obstructive azoospermia (NOA) patients.Methods:This was a retrospective case-control study. Totally 502 NOA patients treated with micro-TESE in Reproductive Medicine Research Centre, the Sixth Affiliated Hospital, Sun Yat-sen University from September 2014 to May 2022 were involved in the investigation. Patients were divided into different groups according to their surgery outcome and seminiferous tubules appearance. Age, testis volume, serum AMH, follicle-stimulating hormone (FSH), testosterone level were compared between the different groups. According to the cause of NOA, they were divided into orchitis group (idiopathic or parotid), AZFc gene deletion group, cryptorchidism descending fixation group, Klinefelter's syndrome (KS) group and idiopathic NOA group. The differences of SRR and AMH level in NOA patients with different etiologies were compared.Results:Testicular sperms were successfully retrieved in 270 cases (SRR=53.8%). There were no statistical differences in age, testicular volume, FSH and testosterone levels between the patients who succeeded or failed to obtain sperm (all P>0.05). The patients who obtained sperms had lower serum AMH level than those without sperm [0.81(0.16, 3.26) μg/L vs. 1.37(0.21, 4.84) μg/L, P<0.001]. Patients with orchitis or AZFc deletion, cryptorchidism, KS, idiopathic azoospermia have different AMH levels [(0.15(0.01,0.41) μg/L, 5.71(3.57,8.26) μg/L, 2.29(1.36,3.81) μg/L, 0.15(0.05,0.39) μg/L, 2.46(0.75,5.49) μg/L, P<0.001]. Idiopathic azoospermia patients who obtained sperms also had lower testosterone and AMH levels but higher age than those without sperm [(35.2±8.9) years vs. (32.5±5.5) years, P=0.010; (3.1±1.4) μg/L vs. (3.7±2.1) μg/L, P=0.029; 1.63(0.35,3.84) μg/L vs. 3.00(1.20,6.68) μg/L, P=0.001]. There were no statistical differences in testicular volume and FSH level between the two groups (all P>0.05). Receiver operating characteristic (ROC) curve showed that cut-off of serum AMH for successful sperm retrieval of idiopathic azoospermia patients was determined to be 2.96, with a sensitivity of 0.710 and specificity of 0.523, area under the curve (AUC) was 0.649. In the cases presenting heterogeneous seminiferous tubules during micro-TESE had lower AMH level and higher SRR than those presenting homogeneous seminiferous tubules [0.55(0.12, 2.05) μg/L vs. 2.99(0.76, 6.11) μg/L, P<0.001; 75.9% (236/311) vs. 17.8% (34/191), P<0.001]. Conclusion:NOA patients with low AMH level would have more opportunity to present heterogeneous seminiferous tubules when micro-TESE was performed and had higher SRR, especially in the idiopathic NOA cases.

Objective To improve the accuracy of diagnosis and differential diagnosis of nonossifying fibroma (NOF) by comparing with the image features of X-ray and CT and pathological characteristics,Methods The images of X-ray and CT of 28 patients underwent surgery and pathological confirmed NOF were studied retrospectively.Results NOF often occurred in the metaphysis of long bone or backbone with mild clinical symptoms.Eighteen lesions occurred in tibia,9 in femur and 1 in humerus.In 19 cortical cases,there was a single room or multiple rooms translucent zone in cortex or subcortex with dense surrounding.In 9 medullary cases,lesions as a single room or multiple rooms ranslucent zone with dense surrounding developed in the central area of the bone with thinning corex slightly bulg ed to periphery.Conclusion The images of NOF have some characteristic.X-ray and CT are very useful tools in diagnosis of NOF.Thin layer scanning and multiplanar reconstruction of multi-layers spiral CT can more clearly show the imaging features of NOF.

Objective To evaluate the diagnostic value of contrast-enhanced CT scans in diagnosis of traumatic splenic rupture. Methods The findings of unenhanced and contrast-enhanced CT scans of 34 cases with traumatic splenic rupture confirmed by operation were retrospectively reviewed. Results Of the 34 patients, the diagnoses of splenic rupture on unenhanced CT scans were certain in 23 patients and uncertain in 6 patients. No abnormalities were found in 5 patients(sensitivity 85.3%, specificity 67.6%). After intravenous administration of contrast material, all of the patients were diagnosed as splenic rupture(sensitivity 100%,specificity 100%).Conclusion Contrast-enhanced CT is important in diagnosis of traumatic splenic rupture and can obviously improve the diagnostic accuracy. It provides reliable information for clinical treatment.