Surgical methods for varicocele remain controversial. This study intends to evaluate the efficacy and safety of different surgical approaches for treating varicocele through a network meta-analysis (NMA). PubMed, Embase, Cochrane, and Web of Science databases were thoroughly searched. In total, 13 randomized controlled trials (RCTs) and 24 cohort studies were included, covering 9 different surgical methods. Pairwise meta-analysis and NMA were performed by means of random-effects models, and interventions were ranked based on the surface under the cumulative ranking curve (SUCRA). According to the SUCRA, microsurgical subinguinal varicocelectomy (MSV; 91.6%), microsurgical retroperitoneal varicocelectomy (MRV; 78.2%), and microsurgical inguinal varicocelectomy (MIV; 76.7%) demonstrated the highest effectiveness in reducing postoperative recurrence rates. In this study, sclerotherapy embolization (SE; 87.2%), MSV (77.9%), and MIV (67.7%) showed the best results in lowering the risk of hydrocele occurrence. MIV (82.9%), MSV (75.9%), and coil embolization (CE; 58.7%) were notably effective in increasing sperm motility. Moreover, CE (76.7%), subinguinal approach varicocelectomy (SV; 69.2%), and SE (55.7%) were the most effective in increasing sperm count. SE (82.5%), transabdominal laparoscopic varicocelectomy (TLV; 76.5%), and MRV (52.7%) were superior in shortening the length of hospital stay. The incidence rates of adverse events for MRV (0), SE (3.3%), and MIV (4.1%) were notably low. Cluster analyses indicated that MSV was the most effective in the treatment of varicocele. Based on the existing evidence, MSV may represent the optimal choice for varicocele surgery. However, selecting clinical surgical strategies requires consideration of various factors, including patient needs, surgeon experience, and the learning curve.
Humans ; Male ; Embolization, Therapeutic/methods* ; Microsurgery/methods* ; Randomized Controlled Trials as Topic ; Sclerotherapy/methods* ; Treatment Outcome ; Urologic Surgical Procedures, Male/methods* ; Varicocele/surgery*

The anti-counterfeiting application of three-color fluorescent carbon dots(CDs)in high-quality inkjet printing was studied.Blue,green and red fluorescent CDs were synthesized by solvothermal method using three kinds of isomers of phenylenediamine as precursor,and ethanol-glycerol mixture as solvent.The morphology,composition,structure,and optical properties were characterized.Blue,green and red fluorescent inks were then prepared by diluting CDs with water.The dilution ratio,excitation light source and filtering method were also optimized.The optimal dilution ratio of blue,green and red fluorescent ink was 5,5 and 20,respectively.Under 365,415 and 450 nm light excitation,bright blue,green and red fluorescence from above inks could be observed by using a blue,green and red filter,respectively.These fluorescent inks were finally used for high-quality inkjet printing through monochrome printing mode and polychrome printing mode.In addition,the sensitivity and contrast of printing were quantitatively investigated.The series of three-color fluorescent inks possessed great prospects in ordinary and invisible fluorescent anti-counterfeiting application.

Objective To investigate the dosimetric differences in preoperative short-course volumetric modulated arc therapy(VMAT)for rectal cancer using different fluence smoothing(FS)levels in the Monaco Treatment Planning System(Monaco TPS).Methods Twenty rectal cancer patients who received preoperative neoadjuvant short-course VMAT at some hospital from September 2021 to December 2022 were retrospectively selected.Four groups of radiotherapy plans were formulated using the Monaco TPS for each case,which were classified into an off group,a low group,a medium group and a high group based on the FS levels.Then the four groups were compared in terms of the dosimetric parameters,monitor unit and number of the segments in the planning target volume(PTV)and organ at risk(OAR).Statistical analysis was performed using SPSS 27.0 software.Results All the four groups had the doses to the target volume meeting clinical requirements,which had no significant differences in the doses to 5％(D5％)and 95％(D95％)to the target volume and the maximum dose(Dmax),minimum dose(Dmin),mean dose(Dmean)and conformity index(all P＞0.05).Statistical differences were found between the homogeneity indexes of the four groups(P＜0.05),with the medium group behaving the best.The number of the segments rose while the mornitor units decreased siginificantly with the increase of FS levels,with the differences being statistically significant(P＜0.05).There were no significant differences between the V25,V20,V15 and V10 of the small intestine,the V25 and V20 of the bladder and the V15 and V10 of the left and right femur(all P＞0.05).Conclusion In preoperative short-course VMAT for rectal cancer,clinical requirements can be met with different FS levels in the Monaco TPS,and medium-level FS results in optimal overall dose distribution in terms of treatment planning.[Chinese Medical Equipment Journal,2025,46(5):48-53]

Objective:This study aims to explore the application effect of anticipatory risk intervention combined with health education under LEARNS mode in elderly patients with chronic heart failure(CHF).Methods:This randomized controlled enrolled 126 elderly CHF patients admitted in Panzhihua Central Hospital between January 2022 and February 2023.They were divided into control group(n=63)and intervention group(n=63).All patients received routine nursing care,patients in control group received additional health education under LEARNS mode,compared to those in intervention group receiving additional anticipatory risk intervention based on control group,both groups were intervened for 2 months.Physiological indexes,negative emotion,quality of life,sleep quality,disease perception&control and self-efficacy,as well as incidence of adverse events,were compared between two groups.Results:Compared with patients in control group after intervention,those in intervention group had signif-icant lower systolic blood pressure(SBP)[(119.84±8.60)mmHg vs.(129.49±9.24)mmHg],diastolic blood pressure(DBP)[(81.59±5.08)mmHg vs.(88.51±6.36)mmHg],N terminal pro brain natriuretic peptide(NT-proBNP)[(2604.46±204.80)ng/L vs.(3024.87±212.27)ng/L],scores of Self-Rating Anxiety Scale(SAS)[(55.90±2.43)points vs.(60.11±2.62)points],Self-Rating Depression Scale(SDS)[(57.03±2.56)points vs.(61.54±2.66)points],Minnesota Living with Heart Failure Questionnaire(MLHFQ)[(52.05±6.32)points vs.(60.46±7.10)points]and Pittsburgh Sleep Quality Index(PSQI)[(9.00±1.65)points vs.(11.05±1.96)points],and significant higher left ventricular ejection fraction(LVEF)[(51.83±7.28)％vs.(47.57±5.98)％],scores of Control Attitude Scale-Revised(CAS-R)[(35.59±2.97)points vs.(30.60±3.52)points]and Gen-eral Self-Efficacy Scale(GSES)[(36.98±4.21)points vs.(30.52±4.14)points](P＜0.001 all).Incidence of adverse events in intervention group was significantly lower than that of control group(3.17％vs.12.70％,P=0.048).Conclusion:Anticipatory risk intervention combined with health education under the LEARNS model could effectively improve the physiological indexes,quality of life and sleep,enhance disease perception and self-effica-cy,and reduce negative emotion and incidence of adverse events in elderly CHF patients.

Objective:To investigate the effect of medical community homogenization management(MCHM)on self-care ability,heart function,vascular endothelial function and quality of life in patients with chronic heart failure(CHF).Methods:This randomized controlled study enrolled 110 CHF patients admitted in Panzhihua Central Hos-pital between April 2021 and April 2023.They were divided into intervention group(n=55)and routine group(n=55).The control group received routine management,while intervention group received additional MCHM,both groups were intervened for 3 months.Self-care ability,heart function,vascular endothelial function,quality of life and incidence of adverse events were compared between two groups.Results:Compared with patients in control group,those in intervention group had significant higher total score of self-care of heart failure index(SCHFI)[(82.30±2.98)points vs.(59.46±3.19)points],stroke volume(SV)[(73.30±2.31)ml vs.(54.66±1.96)ml],left ventricular ejection fraction(LVEF)[(58.25±2.90)％ vs.(52.41±2.52)％],early diastolic peak flow velocity/late diastolic peak flow velocity(E/A)[(1.95±0.18)vs.(1.30±0.16)]and the level of nitric oxide(NO)[(106.70±4.44)μmol/L vs.(82.36±4.66)μmol/L](P＜0.001 all),and significant lower left ventricular end-diastolic diameter(LVEDd)[(49.79±1.58)mm vs.(56.49±2.17)mm],endothelin-1(ET-1)[(36.66±2.65)ng/L vs.(46.88±2.66)ng/L],Minnesota living with heart failure questionnaire(MLHFQ)total score[(36.12±3.23)points vs.(54.67±3.35)points](P＜0.001 all).Patients in intervention group had significant lower incidence of adverse events comparing to those in control group(7.27％ vs.25.45％,P=0.010).Conclu-sion:Medical community homogenization management could significantly improve self-care ability,heart func-tion,vascular endothelial function and quality of life with good safety in CHF patients.

Objective To investigate the dosimetric differences in preoperative short-course volumetric modulated arc therapy(VMAT)for rectal cancer using different fluence smoothing(FS)levels in the Monaco Treatment Planning System(Monaco TPS).Methods Twenty rectal cancer patients who received preoperative neoadjuvant short-course VMAT at some hospital from September 2021 to December 2022 were retrospectively selected.Four groups of radiotherapy plans were formulated using the Monaco TPS for each case,which were classified into an off group,a low group,a medium group and a high group based on the FS levels.Then the four groups were compared in terms of the dosimetric parameters,monitor unit and number of the segments in the planning target volume(PTV)and organ at risk(OAR).Statistical analysis was performed using SPSS 27.0 software.Results All the four groups had the doses to the target volume meeting clinical requirements,which had no significant differences in the doses to 5％(D5％)and 95％(D95％)to the target volume and the maximum dose(Dmax),minimum dose(Dmin),mean dose(Dmean)and conformity index(all P＞0.05).Statistical differences were found between the homogeneity indexes of the four groups(P＜0.05),with the medium group behaving the best.The number of the segments rose while the mornitor units decreased siginificantly with the increase of FS levels,with the differences being statistically significant(P＜0.05).There were no significant differences between the V25,V20,V15 and V10 of the small intestine,the V25 and V20 of the bladder and the V15 and V10 of the left and right femur(all P＞0.05).Conclusion In preoperative short-course VMAT for rectal cancer,clinical requirements can be met with different FS levels in the Monaco TPS,and medium-level FS results in optimal overall dose distribution in terms of treatment planning.[Chinese Medical Equipment Journal,2025,46(5):48-53]

Objective:To investigate the effect of medical community homogenization management(MCHM)on self-care ability,heart function,vascular endothelial function and quality of life in patients with chronic heart failure(CHF).Methods:This randomized controlled study enrolled 110 CHF patients admitted in Panzhihua Central Hos-pital between April 2021 and April 2023.They were divided into intervention group(n=55)and routine group(n=55).The control group received routine management,while intervention group received additional MCHM,both groups were intervened for 3 months.Self-care ability,heart function,vascular endothelial function,quality of life and incidence of adverse events were compared between two groups.Results:Compared with patients in control group,those in intervention group had significant higher total score of self-care of heart failure index(SCHFI)[(82.30±2.98)points vs.(59.46±3.19)points],stroke volume(SV)[(73.30±2.31)ml vs.(54.66±1.96)ml],left ventricular ejection fraction(LVEF)[(58.25±2.90)％ vs.(52.41±2.52)％],early diastolic peak flow velocity/late diastolic peak flow velocity(E/A)[(1.95±0.18)vs.(1.30±0.16)]and the level of nitric oxide(NO)[(106.70±4.44)μmol/L vs.(82.36±4.66)μmol/L](P＜0.001 all),and significant lower left ventricular end-diastolic diameter(LVEDd)[(49.79±1.58)mm vs.(56.49±2.17)mm],endothelin-1(ET-1)[(36.66±2.65)ng/L vs.(46.88±2.66)ng/L],Minnesota living with heart failure questionnaire(MLHFQ)total score[(36.12±3.23)points vs.(54.67±3.35)points](P＜0.001 all).Patients in intervention group had significant lower incidence of adverse events comparing to those in control group(7.27％ vs.25.45％,P=0.010).Conclu-sion:Medical community homogenization management could significantly improve self-care ability,heart func-tion,vascular endothelial function and quality of life with good safety in CHF patients.

Objective:This study aims to explore the application effect of anticipatory risk intervention combined with health education under LEARNS mode in elderly patients with chronic heart failure(CHF).Methods:This randomized controlled enrolled 126 elderly CHF patients admitted in Panzhihua Central Hospital between January 2022 and February 2023.They were divided into control group(n=63)and intervention group(n=63).All patients received routine nursing care,patients in control group received additional health education under LEARNS mode,compared to those in intervention group receiving additional anticipatory risk intervention based on control group,both groups were intervened for 2 months.Physiological indexes,negative emotion,quality of life,sleep quality,disease perception&control and self-efficacy,as well as incidence of adverse events,were compared between two groups.Results:Compared with patients in control group after intervention,those in intervention group had signif-icant lower systolic blood pressure(SBP)[(119.84±8.60)mmHg vs.(129.49±9.24)mmHg],diastolic blood pressure(DBP)[(81.59±5.08)mmHg vs.(88.51±6.36)mmHg],N terminal pro brain natriuretic peptide(NT-proBNP)[(2604.46±204.80)ng/L vs.(3024.87±212.27)ng/L],scores of Self-Rating Anxiety Scale(SAS)[(55.90±2.43)points vs.(60.11±2.62)points],Self-Rating Depression Scale(SDS)[(57.03±2.56)points vs.(61.54±2.66)points],Minnesota Living with Heart Failure Questionnaire(MLHFQ)[(52.05±6.32)points vs.(60.46±7.10)points]and Pittsburgh Sleep Quality Index(PSQI)[(9.00±1.65)points vs.(11.05±1.96)points],and significant higher left ventricular ejection fraction(LVEF)[(51.83±7.28)％vs.(47.57±5.98)％],scores of Control Attitude Scale-Revised(CAS-R)[(35.59±2.97)points vs.(30.60±3.52)points]and Gen-eral Self-Efficacy Scale(GSES)[(36.98±4.21)points vs.(30.52±4.14)points](P＜0.001 all).Incidence of adverse events in intervention group was significantly lower than that of control group(3.17％vs.12.70％,P=0.048).Conclusion:Anticipatory risk intervention combined with health education under the LEARNS model could effectively improve the physiological indexes,quality of life and sleep,enhance disease perception and self-effica-cy,and reduce negative emotion and incidence of adverse events in elderly CHF patients.

Background: Therapeutic interventions for diabetes are most effective when administered in the newly onset phase, yet determining the exact onset moment can be elusive in practice. Spontaneous autoimmune diabetes among NOD mice appears randomly between 12 and 32 weeks of age with an incidence range from 60 to 90%. Furthermore, the disease often progresses rapidly to severe diabetes within days, resulting in a very short window of newly onset phase, that poses significant challenge in early diagnosis. Conventionally, extensive blood glucose (BG) testing is typically required on large cohorts throughout several months to conduct prospective survey. We incorporated ultrasensitive urine glucose (UG) testing into an ordinary BG survey process, initially aiming to elucidate the lag period required for excessive glucose leaking from blood to urine during diabetes progression in the mouse model. Results: The observations unexpectedly revealed that small amounts of glucose detected in the urine often coincide with, sometimes even a couple days prior than elevated BG is diagnosed. Accordingly, we conducted the UG-based survey protocol in another cohort that was validated to accurately identified every individual near onset, who could then be confirmed by following few BG tests to fulfill the consecutive BG + criteria. This approach required fewer than 95 BG tests, compared to over 700 tests with traditional BG survey, to diagnose all the 37–38 diabetic mice out of total 60. The average BG level at diagnosis was slightly below 350 mg/dl, lower than the approximately 400 mg/dl observed with conventional BG monitoring. Conclusions We demonstrated a near perfect correlation between BG + and ultrasensitive UG + results in prospective survey with no lag period detected under twice weekly of testing frequency. This led to the refined protocol based on surveying with noninvasive UG testing, allowing for the early identification of newly onset diabetic mice with only a few BG tests required per mouse. This protocol significantly reduces the need for extensive blood sampling, lancet usage, labor, and animal distress, aligning with the 3Rs principle. It presents a convenient, accurate, and animal-friendly alternative for early diabetes diagnosis, facilitating research on diagnosis, pathogenesis, prevention, and treatment.

Objective To analyze the status and trend for the mortality and DALY rates of child growth failure (CGF) in children aged < 5 years in China from 1990 to 2019, so as to provide a scientific basis for CGF prevention and control. Methods The mortality and DALY rates of CGF in children aged < 5 years from 1990 to 2019 were obtained from GBD 2019. The changes of these indicators with the years in China , the United States, Japan, Russia, India and the global were compared and analyzed. Results In 2019, the mortality of child wasting, child stunting and child underweight in children aged < 5 years in China were 9.62/100 000, 1.23/100 000, and 1.29/100 000 respectively, the mortality rates were 867.50/100 000 , 129.23/100 000 , and 112.87/100 000 rescpectively, higher than those of the United States, Japan, and Russia, and far lower than those of India and the global. The disease burden of three types of CGF were all higher in males than females, and higher in children aged < 1 years than children aged 1-4 years. From 1990 to 2019, the mortality and DALY rates of CGF in children aged < 5 years in China decreased from 300.41/100 000 and 26 445.38/100 000 to 10.49/100 000 and 943.57/100 000, respectively. China had the largest drop rate compared with all analyzed countries. As for children aged < 5 years in China, the DALY rate of lower respiratory infection ranked first in all the diseases caused by CGF. Conclusion From 1990 to 2019, the disease burden of CGF in children aged < 5 years has shown a significant decrease in China , but it is still far behind the developed countries. In the future, more attention should be paid to the problems of child growth in hope of reducing the mortality and DALY rates of CGF.