Chronic epididymitis (CE) is a long-standing inflammatory condition of the epididymis caused by unresolved acute infections, chronic infections, medication use, or other factors. Clinically, it is characterized by persistent dull pain or a dragging sensation in one or both sides of the scrotum. The disease course typically exceeds three months and is marked by insidious onset and recurrent episodes. Current studies suggest that CE may disrupt the epididymal microenvironment through multiple pathological processes, including local inflammatory responses, oxidative stress, fibrotic remodeling, and autophagy. These alterations impair sperm maturation, transport, and capacitation, thereby contributing to male reproductive dysfunction and infertility. This review summarizes the major etiologies and pathophysiological characteristics of CE and its impact on male reproductive function. It focuses on the roles of inflammatory cytokines and related signaling pathways, oxidative stress mechanisms, and fibrotic progression in the pathogenesis of CE. Moreover, it explores targeted therapeutic strategies based on these mechanisms, aiming to provide a theoretical basis for identifying key molecular targets and signaling pathways involved in CE-induced male reproductive impairment.

Objective:To investigate the structural changes in the spinal cord in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) and their relationship with clinical disability.Methods:This study was cross-sectional. A retrospective analysis of clinical and imaging data from 124 patients with MS (MS group), 101 patients with aquaporin-4 antibody-positive NMOSD (NMOSD group), and 110 healthy controls (HC group) from seven medical centers were conducted from January 2018 to October 2021. All subjects underwent 3D T 1WI, and the upper cervical spinal cord cross-sectional area (MUCCA) was segmented and measured. All patients completed the expanded disability status scale (EDSS) assessments at baseline and during follow-up, as well as the baseline 25-foot walk test (T25FW) and the nine-hole peg test (NHPT). Patients were classified into EDSS progression and non-progression groups based on follow-up EDSS scores. Comparisons of MUCCA among the three groups were conducted using analysis of covariance, controlling for age and sex as covariates. Pairwise comparisons between groups were performed using the HSD test. Univariate linear regression and logistic models were employed to identify candidate predictors of baseline clinical disability status or EDSS progression in the MS and NMOSD groups. L1 regularized multivariable linear regression analysis was used to determine independent predictors of baseline clinical disability status or EDSS progression. Independent predictors were then combined to establish a logistic regression model, and the model′s performance in predicting EDSS progression was evaluated using receiver operating characteristic analysis and the area under the curve (AUC). Results:A total of 144 patients completed follow-up EDSS assessments, with a follow-up duration of 3.30 (1.10, 6.42) years, including 82 patients in the MS group and 62 patients in the NMOSD group. Controlling for sex and age as covariates, the overall difference in MUCCA among the MS, NMOSD, and HC groups was statistically significant ( P=0.001). The MUCCA in the MS group was lower than that in the HC group, with a significant difference ( t=-2.54, P=0.007); the MUCCA in the NMOSD group was also lower than that in the HC group, with a significant difference ( t=-2.80, P=0.002). However, the difference in MUCCA between the MS and NMOSD groups was not statistically significant ( t=-0.40, P=0.882). In the MS group, MUCCA was an independent predictor of baseline EDSS score (β=-0.03), baseline T25FW score (β=-0.09), and baseline NHPT score (β=-0.30). In the NMOSD group, MUCCA (β=-0.08), age (β=0.06), and baseline EDSS score (β=-0.43) were independent predictors of EDSS progression, and the logistic regression model incorporating these three factors predicted EDSS progression with an AUC of 0.82. Conclusions:Significant spinal cord atrophy occurs in patients with both MS and NMOSD. Atrophy of the upper cervical spinal cord can predict the degree of disability in MS patients and the progression of clinical disability in NMOSD patients.

Chronic epididymitis (CE) is a long-standing inflammatory condition of the epididymis caused by unresolved acute infections, chronic infections, medication use, or other factors. Clinically, it is characterized by persistent dull pain or a dragging sensation in one or both sides of the scrotum. The disease course typically exceeds three months and is marked by insidious onset and recurrent episodes. Current studies suggest that CE may disrupt the epididymal microenvironment through multiple pathological processes, including local inflammatory responses, oxidative stress, fibrotic remodeling, and autophagy. These alterations impair sperm maturation, transport, and capacitation, thereby contributing to male reproductive dysfunction and infertility. This review summarizes the major etiologies and pathophysiological characteristics of CE and its impact on male reproductive function. It focuses on the roles of inflammatory cytokines and related signaling pathways, oxidative stress mechanisms, and fibrotic progression in the pathogenesis of CE. Moreover, it explores targeted therapeutic strategies based on these mechanisms, aiming to provide a theoretical basis for identifying key molecular targets and signaling pathways involved in CE-induced male reproductive impairment.

Objective:To investigate the structural changes in the spinal cord in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) and their relationship with clinical disability.Methods:This study was cross-sectional. A retrospective analysis of clinical and imaging data from 124 patients with MS (MS group), 101 patients with aquaporin-4 antibody-positive NMOSD (NMOSD group), and 110 healthy controls (HC group) from seven medical centers were conducted from January 2018 to October 2021. All subjects underwent 3D T 1WI, and the upper cervical spinal cord cross-sectional area (MUCCA) was segmented and measured. All patients completed the expanded disability status scale (EDSS) assessments at baseline and during follow-up, as well as the baseline 25-foot walk test (T25FW) and the nine-hole peg test (NHPT). Patients were classified into EDSS progression and non-progression groups based on follow-up EDSS scores. Comparisons of MUCCA among the three groups were conducted using analysis of covariance, controlling for age and sex as covariates. Pairwise comparisons between groups were performed using the HSD test. Univariate linear regression and logistic models were employed to identify candidate predictors of baseline clinical disability status or EDSS progression in the MS and NMOSD groups. L1 regularized multivariable linear regression analysis was used to determine independent predictors of baseline clinical disability status or EDSS progression. Independent predictors were then combined to establish a logistic regression model, and the model′s performance in predicting EDSS progression was evaluated using receiver operating characteristic analysis and the area under the curve (AUC). Results:A total of 144 patients completed follow-up EDSS assessments, with a follow-up duration of 3.30 (1.10, 6.42) years, including 82 patients in the MS group and 62 patients in the NMOSD group. Controlling for sex and age as covariates, the overall difference in MUCCA among the MS, NMOSD, and HC groups was statistically significant ( P=0.001). The MUCCA in the MS group was lower than that in the HC group, with a significant difference ( t=-2.54, P=0.007); the MUCCA in the NMOSD group was also lower than that in the HC group, with a significant difference ( t=-2.80, P=0.002). However, the difference in MUCCA between the MS and NMOSD groups was not statistically significant ( t=-0.40, P=0.882). In the MS group, MUCCA was an independent predictor of baseline EDSS score (β=-0.03), baseline T25FW score (β=-0.09), and baseline NHPT score (β=-0.30). In the NMOSD group, MUCCA (β=-0.08), age (β=0.06), and baseline EDSS score (β=-0.43) were independent predictors of EDSS progression, and the logistic regression model incorporating these three factors predicted EDSS progression with an AUC of 0.82. Conclusions:Significant spinal cord atrophy occurs in patients with both MS and NMOSD. Atrophy of the upper cervical spinal cord can predict the degree of disability in MS patients and the progression of clinical disability in NMOSD patients.

Objective:To comprehensively search, evaluate and summarize the relevant evidence of early ambulation in patients with total knee arthroplasty (TKA), so as to provide evidence-based basis for the nursing practice of early ambulation in patients with TKA.Methods:Clinical decisions, best practice manuals, guidelines, systematic reviews, expert consensus and evidence summaries for early postoperative ambulation of TKA patients were searched by computer on PubMed, Web of Science, BMJ Best Practice, Cochrane Library, UpToDate, OVID, CINAHL, Embase, Joanna Briggs Institute (JBI) Centre for Evidence-based Health Care, Physiotherapy Evidence Database, China National Knowledge Infrastructure, WanFang Data, VIP, China Biology Medicine disc, Guidelines International Network, National Guideline Clearinghouse, National Institute for Health and Care Excellence, Canadian Medical Association Clinical Practice Guideline, Scottish Intercollegiate Guidelines Network, American Academy of Orthopaedic Surgeons and American Association of Hip and Knee Surgeons. The retrieval time was from the establishment of the databases to March 31, 2023. Four nursing graduate students trained in evidence-based nursing systems independently evaluated the quality of the included literature and divided the evidence levels according to the JBI Evidence Pre Grading System (2014 edition) .Results:A total of 15 articles were included, including four clinical decision papers, three guidelines, six expert consensus papers, one evidence summary and one systematic review. According to the judgment of professionals, 23 pieces of best evidence were formed from seven aspects, including the director of ambulation, evaluation before ambulation, ambulation planning, ambulation timing, ambulation content, ambulation evaluation and health education.Conclusions:The best evidence of early postoperative ambulation of patients with TKA summarized in this study is scientific and practical, which can provide evidence-based basis for clinical nursing work.

Aged ; Humans ; Non-alcoholic Fatty Liver Disease/etiology* ; China/epidemiology*

Pulmonary hypertension (PH) is an extremely malignant pulmonary vascular disease of unknown etiology. ADAR1 is an RNA editing enzyme that converts adenosine in RNA to inosine, thereby affecting RNA expression. However, the role of ADAR1 in PH development remains unclear. In the present study, we investigated the biological role and molecular mechanism of ADAR1 in PH pulmonary vascular remodeling. Overexpression of ADAR1 aggravated PH progression and promoted the proliferation of pulmonary artery smooth muscle cells (PASMCs). Conversely, inhibition of ADAR1 produced opposite effects. High-throughput whole transcriptome sequencing showed that ADAR1 was an important regulator of circRNAs in PH. CircCDK17 level was significantly lowered in the serum of PH patients. The effects of ADAR1 on cell cycle progression and proliferation were mediated by circCDK17. ADAR1 affects the stability of circCDK17 by mediating A-to-I modification at the A5 and A293 sites of circCDK17 to prevent it from m1A modification. We demonstrate for the first time that ADAR1 contributes to the PH development, at least partially, through m1A modification of circCDK17 and the subsequent PASMCs proliferation. Our study provides a novel therapeutic strategy for treatment of PH and the evidence for circCDK17 as a potential novel marker for the diagnosis of this disease.

Objective:The iodine excretion of adult individuals was calculated by two creatinine correction methods of urinary iodine, and the significance and value of the methods to measure individual iodine nutrition levels were assessed to provide a reference basis for further epidemiological investigation and study of iodine deficiency disorders.Methods:Healthy adults aged 18 - 59 years from Fujian Province were recruited and their 24 h urine, fasting urine, and morning spot urine (8:00 - 12:30) were collected and the corresponding urinary iodine and creatinine concentrations were measured. The estimated 24 h urinary iodine excretion was calculated using two different creatinine correction and creatinine estimation formulas were compared with the measured 24 h urinary iodine excretion.Results:There were no significant differences in measured 24 h urinary iodine excretion value, estimated 24 h urinary iodine excretion value 1 of fasting urine and morning spot urine, and estimated 24 h urinary iodine excretion 2 of fasting urine and morning spot urine between genders (μg/d: 195.5 vs 190.9, 190.0 vs 181.7, 160.2 vs 144.2, 174.8 vs 179.2, 148.3 vs 131.5); there were no significant differences in measured 24 h urinary iodine excretion and fasting urinary estimated 24 h urinary iodine excretion 1, estimated 24 h urinary iodine excretion 2 ( P > 0.05), and there were significant differences in measured 24 h urinary iodine excretion and morning spot urinary estimated 24 h urinary iodine excretion 1, estimated 24 h urinary iodine excretion 2 ( P < 0.01). And there were significant linear correlations between measured 24 h urinary iodine excretion and estimated 24 h urinary iodine excretion 1 of fasting urine and morning spot urine, estimated 24 h urinary iodine excretion 2 of fasting urine and morning spot urine ( r = 0.772, 0.266, 0.828, 0.391, P < 0.01). Conclusions:It is feasible to estimate 24 h urinary iodine excretion in adults with creatinine-corrected fasting urinary iodine concentration. Creatinine-corrected fasting urinary iodine concentration can be used as an individual iodine nutrition level evaluation index, but whether it is applicable to children and pregnant women remains to be further studied.

Objective To evaluate the efficacy and safety of Willis covered stent in the treatment of traumatic carotid cavernous fistulae (tCCF).Methods The imaging and clinical data of 7 patients with tCCF treated with Willis covered stent in Shanghai Punan Hospital from November 2015 to June 2018 were analyzed retrospectively.Results Seven Willis covered stent were used in 7 patients.Immediately after stent release,angiography showed that the fistulae completely disappeared in 6 cases.One patient had a small amount of endoleak,and there was still a small amount of endoleaks after balloon dilatation.It was not further treated.There were no operative complications.During 3-12 months follow-up,no new neurological deficits were found in all patients.Angiographic follow-up of 2 patients showed that the fistulae completely disappeared without recurrence.The internal carotid arteries were patent,no in-stent stenosis and stent displacement.Conclusions Wills covered stent can be used as a treatment for tCCF.Its efficacy is satisfactory and the safety is good.

There are many noise signals in original laser induced breakdown spectroscopy (LIBS) spectra.To explore the effect of spectral pretreatment on LIBS information by different filter methods, the LIBS spectra of Pb-polluted cabbage in wavelength range of 400.45-410.98 nm was investigated and preprocessed by adjacent averaging, Savitzky-Golay (S-G) and fast Fourier transformation (FFT).Then partial least square (PLS) model was established for evaluating the spectral treatment effect.The result showed that the root mean square error of prediction (RMSEP) and average relative error of S-G method were 0.26 and 3.7%, suggesting a superior smoothing effect than other methods.Experimental results indicated that an appropriate filtering method could help to improve the spectral quality and raise the precision of model checkout.