Spermatogenesis, the basis of male reproduction, is susceptible to internal and external environmental interferences that impair fertility. Heat-induced reproductive damage is one of the most important factors contributing to male infertility. The testes are located within the scrotum and need to be maintained 2-4 ℃ below the core body temperature, which is essential for normal spermatogenesis and sperm maturation. In the past 40 years, the global male sperm concentrations have consistently declined at an average annual rate of 1%-2%, accompanied by a sharp increase in the prevalence of sperm quality abnormalities such as oligozoospermia and azoospermia. In daily life, a variety of factors can elevate scrotal temperature, such as occupational exposure, lifestyle habits, and pathological conditions, resulting in varying degrees of reproductive injury. In this article, the effects of heat stress on male reproductive injury, the injury patterns associated with different hyperthermic modalities, as well as preventive and therapeutic treatments were described, aiming at a comprehensive and in-depth understanding of the mechanism underlying heat-induced reproductive injury, as well as providing theoretical guidance for the clinic prevention and therapy of male infertility.

Objective:To research on the application effect of the supply-processing-distribution (SPD) model based on risk perspective in the management of low-value medical consumables of clinical departments in hospital,so as to improve management efficiency of hospital for low-value medical consumables. Methods:Risk points in the management of low-value medical consumables were identified based on a risk perspective,and the SPD mode was adopted to conduct collaborative management for low-value medical consumables in the hospital. Low-value medical consumables were used in clinical departments of the Hospital of Chengdu University of Traditional Chinese Medicine from October 2021 to November 2023 were selected. According to random number table,885 medical consumables were used from October 2021 to October 2022 were managed by using the conventional management model,and another 885 medical consumables were used from November 2022 to November 2023 were managed by using the SPD model based on a risk perspective. The management effect scores,performance evaluation results,management efficiency,and incidence of adverse situations of low-value medical consumables were compared between the two management modes. Results:The average scores of occurring problems and operation cost of low-value medical consumables in the SPD model group were respectively (15.14±2.06) and (20.44±3.16),which were lower than those in the conventional management model group,with statistically significant differences (t=84.009,92.863,P<0.05). The average scores of delivery timeliness,work efficiency,standardization,traceability of consumables,waste recycling of consumables,delivery satisfaction,and demand forecasting were respectively (97.14±10.11),(95.25±10.85),(89.65±12.54),(88.25±9.14),(94.14±10.22),(88.14±9.22),and (95.84±10.33) in the SPD model group,which were higher than those in the conventional management model group,with statistically significant differences (t=78.169,77.874,75.326,68.557,35.288,25.422,102.959,P<0.05). The average issuance time and replenishment time of low-value medical consumables in the SPD model group were respectively (6.11±0.72) min and (12.58±2.35) h,which were shorter than those in the conventional management model group,with statistically significant differences (t=54.129,122.343,P<0.05). The issuance accuracy rate and proportion of saved amount of low-value medical consumables in the SPD model group were respectively 98.76％ and 3.16％,which were higher than those in the conventional management model group,with statistically significant differences (x2=159.178,5.618,P<0.05). The number of issuance error and the proportion of expired consumables,invalid consumables or damaged consumables in the SPD model group were respectively 1.24％ and 0.90％,which were lower than those in the conventional management model group,with statistically significant differences (x2=159.178,23.792,P<0.05). The average time consuming of daily and monthly of low-value medical consumables in the SPD model group were respectively (0.29±0.02) h and (1.14±0.25) h,which were shorter than those in the conventional management model group,and the average number of monthly inventory backlog and average circulation time in the SPD model group were respectively (33.19±4.25) and (26.14±3.18) d,which were lower than those in the conventional management model group,with statistically significant differences (t=412.428,122.343,114.555,39.848,P<0.05). The incidence rates of unregistered use,unskilled operation,failure to enter data into the computer,carelessness during shift handovers,and loss of consumables of low-value medical consumables in the SPD model group were respectively 6.21％,7.12％,2.03％,2.26％ and 1.92％,which were lower than those in the conventional management model group,with statistically significant differences (x2=28.882,15.225,22.824,12.683,16.893,P<0.05). Conclusion:The application of the SPD model based on a risk perspective in the management of low-value medical consumables in clinical departments of hospital can reduce operating costs of hospital,and increase procurement efficiency for them,and enhance the level of refined management for low-value medical consumables.

Objective:To explore the configurational factors influencing the professional commitment of Master of Nursing Specialist (MNS) students and identify effective paths to enhance their professional commitment.Methods:A convenience sample of MNS students from six hospitals in Jiangsu Province, Shanghai City, and Anhui Province was surveyed between December 2023 and October 2024. Data were collected using a general information questionnaire, the Nurses' Professional Commitment Scale (NPCS), the Connor-Davidson Resilience Scale (CD-RISC-10), the Multidimentional Perceived Social Support (MSPSS), and the Vocational Outcome Expectation Scale (VOE-R). Fuzzy-set Qualitative Comparative Analysis (fsQCA) was used to explore the configurational influences on professional commitment.Results:A total of 332 questionnaires were distributed, and 302 valid responses were obtained (effective response rate: 90.1%). The mean NPCS score among respondents was (89.30±22.42), indicating a upper-middle level of professional commitment. The fsQCA results revealed that the frequency of night shift rotation was a necessary condition affecting professional commitment. A total of three distinct configurations (paths) were identified that can enhance the professional commitment of MNS students.Conclusions:The professional commitment of MNS students is influenced by multiple interacting factors. It is recommended that hospitals, universities, and nursing educators develop targeted interventions based on these identified configurations to improve professional commitment.

Objective To search,evaluate and integrate the evidence on enteral nutrition management based on intra-abdominal pressure(IAP)in ICU patients so as to provide an evidence-based basis for a standardised clinical enteral nutrition management for ICU patients with abdominal hypertension.Methods According to the"6S"model,the systematic searches were conducted on CNKI,VIP,SinoMed,Wanfang,Cochrane Library,Medive,UpToDate,International Guidelines Collaboration,Scottish Intercollegiate Guidelines,PubMed,Ovid,Web of Science,Embase,NICE,American Society for Parenteral Enteral Nutrition,World Association for Parenteral Syndromes,European Society of Critical Care,European Society of Clinical Nutrition and Metabolism on the grading of enteral nutrition based on intra-abdominal pressure classification,including guidelines,clinical decision-making,expert consensus,systematic evaluations,summaries of evidence,and original studies closely related to the topic of this study,with a search timeframe up to 31st October 2023.Evidence was extracted and synthesised from the literature that met the quality criteria,taking into account clinical professional judgement.Results A total of 23 articles were retrieved,including four guidelines,one evidence summary,one systematic evaluation,four expert consensuses,six randomized controlled trials,one case-control study and six quasi-experimental studies.Through strict quality evaluation,evidence extraction and summarisation,seven themes with 28 pieces of best evidence were extracted,with IAP grading as the main topic.The themes included definition and grading of abdominal hypertension,IAP monitoring,assessment of target feeding volume,IAP grades I-IV.Conclusion This study summarises the best evidence on graded enteral nutrition management for ICU patients based on IAP.This evidence provides an effective scientific basis on clinical decision-making for ICU professionals.It aims to manage the enteral nutrition for ICU patients with intra-abdominal hypertension using a scientific nursing method,thereby improving the quality of nursing care.

Objective:To research on the application effect of the supply-processing-distribution (SPD) model based on risk perspective in the management of low-value medical consumables of clinical departments in hospital,so as to improve management efficiency of hospital for low-value medical consumables. Methods:Risk points in the management of low-value medical consumables were identified based on a risk perspective,and the SPD mode was adopted to conduct collaborative management for low-value medical consumables in the hospital. Low-value medical consumables were used in clinical departments of the Hospital of Chengdu University of Traditional Chinese Medicine from October 2021 to November 2023 were selected. According to random number table,885 medical consumables were used from October 2021 to October 2022 were managed by using the conventional management model,and another 885 medical consumables were used from November 2022 to November 2023 were managed by using the SPD model based on a risk perspective. The management effect scores,performance evaluation results,management efficiency,and incidence of adverse situations of low-value medical consumables were compared between the two management modes. Results:The average scores of occurring problems and operation cost of low-value medical consumables in the SPD model group were respectively (15.14±2.06) and (20.44±3.16),which were lower than those in the conventional management model group,with statistically significant differences (t=84.009,92.863,P<0.05). The average scores of delivery timeliness,work efficiency,standardization,traceability of consumables,waste recycling of consumables,delivery satisfaction,and demand forecasting were respectively (97.14±10.11),(95.25±10.85),(89.65±12.54),(88.25±9.14),(94.14±10.22),(88.14±9.22),and (95.84±10.33) in the SPD model group,which were higher than those in the conventional management model group,with statistically significant differences (t=78.169,77.874,75.326,68.557,35.288,25.422,102.959,P<0.05). The average issuance time and replenishment time of low-value medical consumables in the SPD model group were respectively (6.11±0.72) min and (12.58±2.35) h,which were shorter than those in the conventional management model group,with statistically significant differences (t=54.129,122.343,P<0.05). The issuance accuracy rate and proportion of saved amount of low-value medical consumables in the SPD model group were respectively 98.76％ and 3.16％,which were higher than those in the conventional management model group,with statistically significant differences (x2=159.178,5.618,P<0.05). The number of issuance error and the proportion of expired consumables,invalid consumables or damaged consumables in the SPD model group were respectively 1.24％ and 0.90％,which were lower than those in the conventional management model group,with statistically significant differences (x2=159.178,23.792,P<0.05). The average time consuming of daily and monthly of low-value medical consumables in the SPD model group were respectively (0.29±0.02) h and (1.14±0.25) h,which were shorter than those in the conventional management model group,and the average number of monthly inventory backlog and average circulation time in the SPD model group were respectively (33.19±4.25) and (26.14±3.18) d,which were lower than those in the conventional management model group,with statistically significant differences (t=412.428,122.343,114.555,39.848,P<0.05). The incidence rates of unregistered use,unskilled operation,failure to enter data into the computer,carelessness during shift handovers,and loss of consumables of low-value medical consumables in the SPD model group were respectively 6.21％,7.12％,2.03％,2.26％ and 1.92％,which were lower than those in the conventional management model group,with statistically significant differences (x2=28.882,15.225,22.824,12.683,16.893,P<0.05). Conclusion:The application of the SPD model based on a risk perspective in the management of low-value medical consumables in clinical departments of hospital can reduce operating costs of hospital,and increase procurement efficiency for them,and enhance the level of refined management for low-value medical consumables.

Objective:To explore the configurational factors influencing the professional commitment of Master of Nursing Specialist (MNS) students and identify effective paths to enhance their professional commitment.Methods:A convenience sample of MNS students from six hospitals in Jiangsu Province, Shanghai City, and Anhui Province was surveyed between December 2023 and October 2024. Data were collected using a general information questionnaire, the Nurses' Professional Commitment Scale (NPCS), the Connor-Davidson Resilience Scale (CD-RISC-10), the Multidimentional Perceived Social Support (MSPSS), and the Vocational Outcome Expectation Scale (VOE-R). Fuzzy-set Qualitative Comparative Analysis (fsQCA) was used to explore the configurational influences on professional commitment.Results:A total of 332 questionnaires were distributed, and 302 valid responses were obtained (effective response rate: 90.1%). The mean NPCS score among respondents was (89.30±22.42), indicating a upper-middle level of professional commitment. The fsQCA results revealed that the frequency of night shift rotation was a necessary condition affecting professional commitment. A total of three distinct configurations (paths) were identified that can enhance the professional commitment of MNS students.Conclusions:The professional commitment of MNS students is influenced by multiple interacting factors. It is recommended that hospitals, universities, and nursing educators develop targeted interventions based on these identified configurations to improve professional commitment.

Objective To discuss the correlation between free prostate specific antigen(fPSA),serum ferritin(SF),blood uric acid(SUA)levels and Gleason grading in patients with prostate cancer(PCa).Methods The clinical data of 61 patients with prostate biopsy treated in 411 Hospital of Shanghai University from January to December of 2023 were retrospectively analyzed.According to the results of puncture,the patients were divided into benign prostatic hyperpla-sia(BPH)group(31 cases)and PCa group(30 cases).The levels of fPSA,SF and SUA in patients and Gleason grade in biopsy cases were analyzed.The correlation between fPSA,SF and SUA levels and Gleason grade was analyzed by the method of Spearman.And the diagnostic efficacy of fPSA,SF and SUA levels on PCa was analyzed by receiver operating characteristic curve(ROC).Results The levels of fPSA,SF and SUA in PCa group were significantly higher than those in BPH group(P＜0.05).There were statistically significant differences in levels of fPSA SF and SUA in PCA patients with different Gleason grades(P＜0.05).With the specificity reaching 96.08％and sensitivity reaching 94.35％,the ar-ea under the curve(AUC)of the combined fPSA,SF and SUA levels in the diagnosis of PCa was 0.982,which was higher than that of the single fPSA,SF and SUA levels(P＜0.05).SF and SUA levels in PCa patients were positively correlated with Gleason grade(P＜0.05),while fPSA levels were not correlated with Gleason grade(P＞0.05).Conclusion The levels of SF and SUA in PCa patients are positively correlated with Gleason grade,which can be used as an important index to predict Gleason grade in PCa patients.

OBJECTIVE: Salt-processed Psoraleae Fructus (SPF) is widely used as a phytoestrogen-like agent in the treatment of osteoporosis. However, due to improper clinical use or misuse, resulting in liver damage. In this study, network pharmacology was employed to analyze the mechanism of cholestatic liver damage. An adeno-associated virus overexpressing SULT1E1 (rAAV8-SULT1E1) was constructed and the hepatotoxicity of SPF, psoralen, and isopsoralen was determined. METHODS: By utilizing three databases inclding TCMSP, TCMID, and BATMAN- TCM, the targets of the three databases were summarized, and a total of 45 psoralen compounds were included. Network pharmacology analysis was then performed. The adenoviral vectors were injected into the tail vein of C57BL6 mice to elucidate the role of SULT1E1 in SPF-induced cholestasis-mediated hepatotoxicity in vivo. SPF (10 g/kg), psoralen, and isopsoralen (50 mg/kg each) were intragastrically administered to mice for 30 d. B-ultrasound and samples were collected and examined for follow-up experiments. RESULTS: A total of 854 targets were predicted for 45 active components, with 151 cholestasis-mediated hepatotoxicity-related disease targets obtained for SPF. A total of 126 pathways were enriched based on KEGG pathway analysis, with the "estrogen signaling pathway" identified as one of the top 20 pathways. In terms of pathological hepatic changes, treated mice had visually swollen hepatocytes, dilated bile ducts, and elevated serum biochemical markers, which were more prominent in mice treated with isopsoralen than in those treated with other compounds. Notably, the overexpression of SULT1E1 could reverse liver damage in each treatment group. B-ultrasound was used to observe the size of the gallbladder in vivo. The size of the gallbladder was found to significantly increase on day 30 after treatment in the SPF-, psoralen-, and isopsoralen-treated groups, especially the SPF group. Compared with the expression levels in the negative control group (rAAV8-empty + con), the expression levels of FXR, Mrp2, Bsep, SULT1E1, SULT2A1, Ntcp, and Nrf2 decreased, whereas those of CYP7a1 and IL-6 increased in the SPF-, psoralen-, and isopsoralen-treated groups. CONCLUSION The overexpression of SULT1E1 could alleviate the decreased or increased expression of indicators, indicating that SULT1E1 is an important target gene for SPF-induced liver damage. The severity of liver damage was significantly lower in the rAAV8-SULT1E1 groups than in the rAAV8-empty groups.

Objective To search,evaluate and integrate the evidence on enteral nutrition management based on intra-abdominal pressure(IAP)in ICU patients so as to provide an evidence-based basis for a standardised clinical enteral nutrition management for ICU patients with abdominal hypertension.Methods According to the"6S"model,the systematic searches were conducted on CNKI,VIP,SinoMed,Wanfang,Cochrane Library,Medive,UpToDate,International Guidelines Collaboration,Scottish Intercollegiate Guidelines,PubMed,Ovid,Web of Science,Embase,NICE,American Society for Parenteral Enteral Nutrition,World Association for Parenteral Syndromes,European Society of Critical Care,European Society of Clinical Nutrition and Metabolism on the grading of enteral nutrition based on intra-abdominal pressure classification,including guidelines,clinical decision-making,expert consensus,systematic evaluations,summaries of evidence,and original studies closely related to the topic of this study,with a search timeframe up to 31st October 2023.Evidence was extracted and synthesised from the literature that met the quality criteria,taking into account clinical professional judgement.Results A total of 23 articles were retrieved,including four guidelines,one evidence summary,one systematic evaluation,four expert consensuses,six randomized controlled trials,one case-control study and six quasi-experimental studies.Through strict quality evaluation,evidence extraction and summarisation,seven themes with 28 pieces of best evidence were extracted,with IAP grading as the main topic.The themes included definition and grading of abdominal hypertension,IAP monitoring,assessment of target feeding volume,IAP grades I-IV.Conclusion This study summarises the best evidence on graded enteral nutrition management for ICU patients based on IAP.This evidence provides an effective scientific basis on clinical decision-making for ICU professionals.It aims to manage the enteral nutrition for ICU patients with intra-abdominal hypertension using a scientific nursing method,thereby improving the quality of nursing care.

This paper reports a case of a patient with sleep-related painful erections treated by acupuncture combined with abdominal vibration therapy. The main symptom was repeated painful penile erections during nighttime sleep. The syndrome was differentiated as "water failing to nourish wood" and "liver qi stagnation". Acupuncture was applied at Baihui (GV20), Sishencong (EX-HN1), Guanyuan (CV4), and bilateral Neiguan (PC6), Hegu (LI4), Taichong (LR3), Taixi (KI3), Guilai (ST29), Yongquan (KI1), Yanglingquan (GB34), and Sanyinjiao (SP6). The treatment was combined with abdominal vibration therapy. Treatment was given once daily, five times per week. After the first treatment, the severity and duration of nocturnal erection pain were reduced, and sleep quality was improved. After two weeks of treatment, nocturnal erection pain persisted but became tolerable, with significantly shortened duration.
Humans ; Male ; Acupuncture Points ; Acupuncture Therapy ; Erectile Dysfunction/physiopathology* ; Penile Erection ; Sleep