The hemodynamic characteristics of venous reflux are associated with infertility in patients with varicocele; however, an effective method for quantifying the structural distribution of the reflux is lacking. This study aimed to predict surgical outcomes using a new software for venous reflux quantification. This was a retrospective cohort study of a consecutive series of 105 patients (age range: 22-44 years) between July 2017 and September 2019. Venous reflux of the varicocele was obtained using the Valsalva maneuver during scrotal Doppler ultrasonography before microsurgical varicocelectomy. Using this software, the colored reflux signals were segmented, and the gray scale of the color pixels representing the reflux velocity was comprehensively quantified into the mean reflux velocity of the green layer (MRVG) and the reflux velocity standard deviation of the green layer (RVSDG). Spontaneous pregnancy and changes from baseline in the semen parameters were assessed during a 12-month follow-up period. Data were analyzed using logistic regression analysis. An association of the high MRVG group with impaired progressive motility (odds ratio [OR] = 2.868, 95% confidence interval [CI]: 1.133-7.265) and impaired sperm concentration (OR = 2.943, 95% CI: 1.196-7.239) was found during multivariate analysis. High MRVG (OR = 2.680, 95% CI: 1.086-6.614) and high RVSDG (OR = 2.508, 95% CI: 1.030-6.111) were found to be independent predictors of failure to achieve pregnancy following microsurgical repair. In summary, intense venous reflux is an independent predictor of impaired progressive motility, sperm concentration, and pregnancy outcomes after microsurgical varicocelectomy.
Pregnancy ; Female ; Humans ; Male ; Young Adult ; Adult ; Varicocele/surgery* ; Retrospective Studies ; Semen ; Veins/surgery* ; Sperm Count ; Infertility, Male/surgery* ; Microsurgery/methods* ; Sperm Motility

To compare the pancreatic proteomics and autophagy between Rehmanniae Radix-and Rehmanniae Radix Praeparata-treated mice with type 2 diabetes mellitus(T2DM). The T2DM mouse model was established by high-fat diet coupled with streptozotocin(STZ, intraperitoneal injection, 100 mg·kg~(-1), once a day for three consecutive days). The mice were then randomly assigned into a control group, low-(5 g·kg~(-1)) and high-dose(15 g·kg~(-1)) Rehmanniae Radix groups, low-(150 mg·kg~(-1)) and high-dose(300 mg·kg~(-1)) catalpol groups, low-(5 g·kg~(-1)) and high-dose(15 g·kg~(-1)) Rehmanniae Radix Praeparata groups, low-(150 mg·kg~(-1)) and high-dose(300 mg·kg~(-1)) 5-hydroxymethyl furfuraldehyde(5-HMF) groups, and a metformin(250 mg·kg~(-1)) group. In addition, a normal group was also set and each group included 8 mice. The pancreas was collected after four weeks of administration and proteomics tools were employed to study the effects of Rehmanniae Radix and Rehmanniae Radix Praeparata on protein expression in the pancreas of T2DM mice. The expression levels of proteins involved in autophagy, inflammation, and oxidative stress response in the pancreatic tissues of T2DM mice were determined by western blotting, immunohistochemical assay, and transmission electron microscopy. The results showed that the differential proteins between the model group and Rehmanniae Radix/Rehmanniae Radix Prae-parata group were enriched in 7 KEGG pathways, such as autophagy-animal, which indicated that the 7 pathways may be associated with T2DM. Compared with the control group, drug administration significantly up-regulated the expression levels of beclin1 and phosphorylated mammalian target of rapamycin(p-mTOR)/mTOR and down-regulated those of the inflammation indicators, Toll-like receptor-4(TLR4) and Nod-like receptor protein 3(NLRP3), in the pancreas of T2DM mice, and Rehmanniae Radix showed better performance. In addition, the expression levels of inducible nitric oxide synthase(iNOS), nuclear factor erythroid 2-related factor 2(Nrf2), and heine oxygenase-1(HO-1) in the pancreas of T2DM mice were down-regulated after drug administration, and Rehmanniae Radix Praeparata demonstrated better performance. The results indicate that both Rehmanniae Radix and Rehmanniae Radix Praeparata can alleviate the inflammatory symptoms, reduce oxidative stress response, and increase the autophagy level in the pancreas of T2DM mice, while they exert the effect on different autophagy pathways.
Mice ; Animals ; Diabetes Mellitus, Type 2/genetics* ; Streptozocin/pharmacology* ; Diet, High-Fat/adverse effects* ; Proteomics ; Inflammation ; TOR Serine-Threonine Kinases ; Autophagy ; Mammals

To explore the efficacy and value of personalized surgical schemes in the repair of maxillary sinus perforation and maxillary sinus fistula based on the size of the maxillary sinus perforation and maxillary sinus fistula. A total of 28 patients with maxillary sinus perforation and maxillary sinus fistula who were admitted to the Department of Oral and Maxillofacial Surgery, Stomatology Hospital of Kunming Medical University from July 2017 to May 2020 were included to conduct a prospective case clinical study. After the inflammation in the maxillary sinus was controlled, a proper surgical repair method was selected according to the size of the perforation and fistula based on the double-layer closure technique. The diameter of the perforation and fistula was measured with the assistance of cone-beam CT. After that, the platelet rich fibrin (PRF) repair was performed on the perforation and fistula with 3 mm≤diameter<7 mm in size in 14 patients. The PRF repair and buccal flap repair were performed on the perforation and fistula with 7 mm ≤diameter<15 mm in size in 7 patients. The adjacent buccal pad repair, palatine flap repair, and buccal flap repair were performed on the perforation and fistula with 15 mm≤ diameter<25 mm in size in 4 patients. The nasolabial axial flap repair and nasolabial free flap repair were performed on the perforation and fistula with a diameter ≥25 mm in size in 3 patients. The medical follow-up was conducted in all patients in the 1st, 2nd, and 4th week after surgery, with an overall success rate reaching 96.4% (27/28) after the initial intervention. The relapse of disease occurred in one patient (4.6%) with diabetes and a smoking history in the 2nd week after surgery. Identifying a proper surgical repair method according to the size of the oral and maxillary sinus perforation and maxillary sinus fistula based on the double-layer closure technique can improve the one-time cure rate in these patients under the premise that the inflammation in the maxillary sinus can be controlled.
Fistula/surgery* ; Humans ; Inflammation ; Maxilla ; Maxillary Sinus/surgery* ; Oroantral Fistula/surgery*

BACKGROUND: Andersson lesions (ALs) are not uncommon in ankylosing spondylitis (AS). Plain radiography (PR) is widely used for the diagnosis of ALs. However, in our practice, there were some ALs in AS patients that could not be detected on plain radiographs. This study aimed to propose the concept of occult ALs and evaluate the prevalence and radiographic characteristics of the occult ALs in AS patients. METHODS: A total of 496 consecutive AS patients were admitted in the Affiliated Drum Tower Hospital, Medical School of Nanjing University between April 2003 and November 2019 and they were retrospectively reviewed. The AS patients with ALs who met the following criteria were included for the investigation of occult ALs: (1) with pre-operative plain radiographs of the whole-spine and (2) availability of pre-operative computed tomography (CT) and/or magnetic resonance imaging (MRI) of the whole-spine. The occult ALs were defined as the ALs which were undetectable on plain radiographs but could be detected by CT and/or MRI. The extensive ALs involved the whole discovertebral junction or manifested as destructive lesions throughout the vertebral body. Independent-samples t test was used to compare the age between the patients with only occult ALs and those with only detectable ALs. Chi-square or Fisher exact test was applied to compare the types, distribution, and radiographic characteristics between detectable and occult ALs as appropriate. RESULTS: Ninety-two AS patients with a mean age of 44.4 ± 10.1 years were included for the investigation of occult ALs. Twenty-three patients had occult ALs and the incidence was 25% (23/92). Fifteen extensive ALs were occult, and the proportion of extensive ALs was significantly higher in detectable ALs (97% vs. 44%, χ2 = 43.66, P < 0.001). As assessed by PR, the proportions of osteolytic destruction with reactive sclerosis (0 vs. 100%, χ2 = 111.00, P < 0.001), angular kyphosis of the affected discovertebral units or vertebral body (0 vs. 22%, χ2 = 8.86, P = 0.003), formation of an osseous bridge at the intervertebral space adjacent to ALs caused by the ossification of the anterior longitudinal ligament (38% vs. 86%, χ2 = 25.91, P < 0.001), and an abnormal height of the affected intervertebral space were all significantly lower in occult ALs (9% vs. 84%, χ2 = 60.41, P < 0.001). CONCLUSIONS Occult ALs presented with more subtle radiographic changes. Occult ALs should not be neglected, especially in the case of extensive occult ALs, because the stability of the spine might be severely impaired by these lesions.
Adult ; Humans ; Kyphosis/diagnostic imaging* ; Magnetic Resonance Imaging ; Middle Aged ; Radiography ; Retrospective Studies ; Spine/diagnostic imaging* ; Spondylitis, Ankylosing/diagnostic imaging*

OBJECTIVE: To investigate the clinical significance of bone marrow microvessel density(MVD) and angiogenesis related factors in multipic myeloma(MM). METHODS: Twenty cases of MM and 20 cases of simple fracture were selected and enrolled in MM group and control group respectively. The clinical data and results of laboratorial tests were collected; the bone marrow MVD of patients was detected by using the modified plastic-embedded pathologic sections of bone marrow tissue and histochemistry staining, the expression levels of amgiogenesis-related factors including VEGF, TNF-α, HGF, TGF-α, TGF-β1, bFGF, Ang-Ⅰ, Ang-Ⅱ in bone marrow supernatant were detected by ELISA; the mRNA expression levels of above-mentioned cytokines in bone marrow mononuclear cells were detected by real time-PCR; the pearson correlation analysis was used to analyze the correlation of MVD with VEGF, HGF and bFGF levels. RESULTS: The MVD in MM group was significantly higher than that in control group (P＜0.001); the mRNA expression of VEGF, TGF-α, TGF-β1 and HGF in bone marrow mononuclear cells of MM group was higher than that of control group(P＜0.001); the levels of VEGF, HGF, bFGF and THF-α in bone marrow supernatant of MM group were higher than those in control group(P＜0.05), moreover, the MVD positively correlated with levels of VEGF, HGF and bFGF in bone marrow(r=0.488, 0.472 and 0.457). CONCLUSION The MVD and levels vessel-related factors in bone marrow supernatant of MM patients increase, among which the levels of VEGF and HGF in bone marrow supernatant are consistant with those mRNA expression level in bone marrow mononuclear cells, moreover, the MVD possitively cerrelates with levels of VEGF, HGF and bFGF in bone marrow supernatant, suggesting that the changes of bone marrow microenvironment vassel-related factors play an important role in angiogenesis and pathogenesis of multiple myeloma.
Bone Marrow ; Bone Marrow Cells ; Humans ; Microvessels ; Multiple Myeloma ; Neovascularization, Pathologic ; Tumor Microenvironment

OBJECTIVE: To compare the sagittal morphological features of the spine and pelvis between L₅S₁ dysplastic spondylolisthesis and isthmus spondylolisthesis in adolescent. METHODS: Retrospective analysis of 24 cases of adolescent L₅S₁ spondylolisthesis with complete imaging data from May 2002 to December 2016. Those included 8 males and 16 females, aged from 10 to 18 years old with an average of (13.4±2.0) years. Among them, 9 cases were diagnosed as dysplastic spondylolisthesis (dysplasia group) and 15 cases isthmic spondylolisthesis (ischemic group). Radiographic parameters including slippage distance, slippage degree, slippage angle, sagittal vertical axis(SVA), thoracic kyphosis(TK), lumbar lordosis(LL), L₅ incidence(L₅I), pelvic incidence(PI), pelvic tilt(PT), sacral slope(SS), sagittal pelvic thickness(SPT), lumbosacral angle (LSA), sacral table angle (STA) were measured on the spinal lateral X-ray of the standing position. Independent-samples t-test was used in the comparison of each variable between two groups. <0.05 was considered statistically significant. RESULTS: There were no significant differences in slippage distance, slippage rate, slippage angle between two groups. In dysplasia group, SVA, L₅I, PT, SPT were (37.0±48.4) mm, (57.0±14.8)°, (42.3±15.4)°, (56.1±21.2) mm, respectively, and (-11.0±22.2) mm, (31.7±19.3) °, ( 15.5±10.2)°, (31.4±19.1) mm in ischemic group; and the differences between the two groups were significant(<0.05). In ischemic group, SS, LSA, STA were (44.1±12.6)°, (103.9±21.7)°, (92.7±9.9)°, respectively, and (25.9±20.2) °, (75.4±16.4) °, (75.4±9.7) ° in dysplasia group; and the differences between the two groups were significant(<0.05). There was no significant difference in TK, LL between two groups(>0.05). CONCLUSIONS Significant different from isthmic spondylolisthesis, adolescents with dysplastic spondylolisthesis present a different spino-pelvic sagittal alignment, characterized with trunk forward leaning and pelvic retroversion. In case of sagittal imbalance, early surgical intervention is required to restore a balanced spino-pelvic alignment.
Adolescent ; Child ; Female ; Humans ; Lumbar Vertebrae ; Male ; Pelvis ; Postural Balance ; Radiography ; Retrospective Studies ; Spine ; Spondylolisthesis ; surgery

Outbreaks of hand-foot-mouth disease (HFMD) have occurred many times and caused serious health burden in China since 2008.Application of modem information technology to prediction and early response can be helpful for efficient HFMD prevention and control.A seasonal auto-regressive integrated moving average (ARIMA) model for time series analysis was designed in this study.Eighty-four-month (from January 2009 to December 2015) retrospective data obtained from the Chinese Information System for Disease Prevention and Control were subjected to ARIMA modeling.The coefficient of determination (R2),normalized Bayesian Information Criterion (BIC) and Q-test P value were used to evaluate the goodness-of-fit of constructed models.Subsequently,the best-fitted ARIMA model was applied to predict the expected incidence of HFMD from January 2016 to December 2016.The best-fitted seasonal ARIMA model was identified as (1,0,1)(0,1,1)12,with the largest coefficient of determination (R2=0.743) and lowest normalized BIC (BIC=3.645) value.The residuals of the model also showed non-significant autocorrelations (PBox-Ljung (Q)=0.299).The predictions by the optimum ARIMA model adequately captured the pattern in the data and exhibited two peaks of activity over the forecast interval,including a major peak during April to June,and again a light peak for September to November.The ARIMA model proposed in this study can forecast HFMD incidence trend effectively,which could provide useful support for future HFMD prevention and control in the study area.Besides,further observations should be added continually into the modeling data set,and parameters of the models should be adjusted accordingly.

This study was purposed to investigate the expression of Btk and NFκB in acute myeloid leukemia (AML) cells and its significance. Bone marrow mononuclear cell specimens were taken from 14 AML patients who were in new diagnosis and complete remission respectively, the expressions of Btk and NFκB at mRNA and protein levels were detected by RT-PCR and Western blot, respectively. The results showed that Btk and NFκB expressed in all the samples at RNA and protein levels. At protein level, Btk and NFκB expressions were higher in the cells from newly diagnosed AML patients than that in the cells from patients in complete remission stage (P < 0.05). It is concluded that Btk and NFκB may play an important role in the development and progression of AML, they may be used as potential therapeutic targets of AML and used in predicting the prognosis.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Leukemia, Myeloid, Acute ; genetics ; pathology ; Male ; Middle Aged ; NF-kappa B ; genetics ; Prognosis ; Protein-Tyrosine Kinases ; genetics ; RNA, Messenger ; genetics ; Young Adult

OBJECTIVETo analyze the cancer incidence and mortality of Henan province in 2009.

METHODSOn basis of the criteria of data quality from the National Central Cancer Registry (NCCR), data from 6 registries in Henan province were evaluated, covering 6 061 564 people, accounting for 6.45% of the total population in Henan in 2009. There were 3 104 991 people of males, and 2 956 573 people of females. The incidence, mortality, 10 most common cancers, constitution and cumulative rate (0-74 years old) were then calculated. The age-standardized rate was calculated and adjusted by the Chinese standard population in 1982 as well as the Segi's world standard population.

RESULTSThere were 12 091 new diagnosed cancer and 8040 death cases registered in Henan province in 2009. The rate of pathological diagnosis was 68.2% (8246/12 901) and only 1.75% (2116/12 901) had death certificates. The ratio of mortality and incidence was 0.66 (8040/12 091). The incidence rate was 199.47/100 000 (12 091/6 061 564) in total, and it was 216.36/100 000(6718/3 104 991) in males and 181.73/100 000(5373/2 956 573) among females. The standardized incidence by Chinese population was 126.50/100 000 and it was 166.08/100 000 by world's population. The cumulative rate was 19.95% between 0 and 74 years old. The incidence was the highest in Linzhou city, whose standardized incidence was 156.87/100 000 by Chinese population and the incidence was the lowest in Shenqiu city, whose standardized incidence was 104.82/100 000 by Chinese population. The morphology verified cases accounted for 68.2% (8246/12 091), death certification cases only accounted for 1.75% (2116/12 091), and mortality to incidence ratio was 0.66 (8040/12 091). The crude incidence in cancer registration areas of Henan province was 199.47/10 000 (12 091/6 061 564), 216.36/10 000(6718/3 104 991) for males, 181.73/10 000 (5373/2 956 573) for females, age-standardized incidence rates by Chinese standard population and by world standard population were 126.50/10 000 and 166.08/10 000 with cumulative incidence rate (0-74 age years old) of 19.95%. The crude mortality in cancer registration areas of Henan province was 132.64/100 000 (8040/6 061 564), separately 160.58/100 000 (4986/3 104 991) for males and 103.30/10 000 (3054/2 956 573) for females. The age-standardized mortality rates by Chinese standard population and by world's standard population were 78.41/10 000 and 107.49/10 000. The cumulative mortality rate (0-74 age years old) was 12.18%. The mortality rate was the highest in Linzhou city, whose standardized rate was 93.35/100 000 by Chinese population, and the lowest mortality rate was in Yuzhou city, whose standardized rate was 67.95/100 000. The most common cancers were lung cancer, esophageal cancer, gastric cancer, liver cancer, breast cancer, rectum cancer, brain nervous system cancer, colon cancer, cervical cancer and uterus cancer, all of which accounted for 82.23% (9943/12 091) of the registered cancers.Lung cancer, esophageal cancer, gastric cancer, liver cancer, breast cancer, rectum cancer, brain nervous system cancer, pancreas cancer, colon cancer and gallbladder carcinoma were the major causes for the death, accounting for 86.30% (6938/8040) of all cancer deaths.

CONCLUSIONBoth incidence and mortality of cancer in Henan province were lower than the level in China, prevention and control should be implemented based on practical situation.

Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Neoplasms ; epidemiology ; mortality ; Registries ; Sex Distribution ; Survival Rate ; Young Adult

OBJECTIVETo analyze the trends in mortality of esophageal cancer and explore the effects of age, period and cohort on esophageal cancer mortality rate in Linzhou city in 1986 - 2010, and predict the mortality of esophageal cancer in 2016 - 2020.

METHODSAll of the esophageal cancer-attributed deaths in 1986 - 2010 were drawn from the database in Center of Cancer and Vita Statistics in Henan Province. The numbers of the death cases and population were tabulated into 5-year age groups and 5-year period groups for each sex and linked each other. The age-adjusted mortality rates were calculated by direct standardization to the Chinese population structure in 1982. Intrinsic estimator model (IE model)was used to perform the age-period-cohort analysis and estimate the corresponding parameters. Age effect, period effect and cohort effect on esophageal cancer mortality rate was plotted separately. The mortality of esophageal cancer during 2016 - 2020 was predicted according to the parameters by that model.

RESULTSA total of 15432 cases died from esophageal cancer in Linzhou city in1986 - 2010. The overall crude mortality rate was 63.89 per 100, 000. Among men, the age-adjusted mortality rate was 109.66 per 100, 000 during 1986-1990 and decreased to 60.59 per 100, 000 during 2006 - 2010. For women, the age-adjusted mortality rate decreased from 74.72 per 100, 000 to 39.05 per 100, 000 at the same two calendar periods. The IE model showed that age effect was remarkable, the period effect was stable and the cohort effect decreased greatly. The predicted mortality of over 30-years old population during 2016 - 2020 is 1501 for men and 1083 for women. Compared with 2006 - 2010 period the mortality will be decreased by 6.71% and 11.08%, respectively.

CONCLUSIONSThe mortality rate of esophageal cancer in Linzhou city shows a decreasing trend during the period of 1986 - 2010. This trend is mainly attributed to the cohort effect. The predicted mortality in the future will decrease continually.

Adult ; Age Distribution ; Aged ; Aged, 80 and over ; China ; epidemiology ; Cohort Studies ; Esophageal Neoplasms ; mortality ; Female ; Humans ; Male ; Middle Aged ; Mortality ; trends