Testicular histology based on testicular biopsy is an important factor for determining appropriate testicular sperm extraction surgery and predicting sperm retrieval outcomes in patients with azoospermia. Therefore, we developed a deep learning (DL) model to establish the associations between testicular grayscale ultrasound images and testicular histology. We retrospectively included two-dimensional testicular grayscale ultrasound from patients with azoospermia (353 men with 4357 images between July 2017 and December 2021 in The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China) to develop a DL model. We obtained testicular histology during conventional testicular sperm extraction. Our DL model was trained based on ultrasound images or fusion data (ultrasound images fused with the corresponding testicular volume) to distinguish spermatozoa presence in pathology (SPP) and spermatozoa absence in pathology (SAP) and to classify maturation arrest (MA) and Sertoli cell-only syndrome (SCOS) in patients with SAP. Areas under the receiver operating characteristic curve (AUCs), accuracy, sensitivity, and specificity were used to analyze model performance. DL based on images achieved an AUC of 0.922 (95% confidence interval [CI]: 0.908-0.935), a sensitivity of 80.9%, a specificity of 84.6%, and an accuracy of 83.5% in predicting SPP (including normal spermatogenesis and hypospermatogenesis) and SAP (including MA and SCOS). In the identification of SCOS and MA, DL on fusion data yielded better diagnostic performance with an AUC of 0.979 (95% CI: 0.969-0.989), a sensitivity of 89.7%, a specificity of 97.1%, and an accuracy of 92.1%. Our study provides a noninvasive method to predict testicular histology for patients with azoospermia, which would avoid unnecessary testicular biopsy.
Humans ; Male ; Azoospermia/diagnostic imaging* ; Deep Learning ; Testis/pathology* ; Retrospective Studies ; Adult ; Ultrasonography/methods* ; Sperm Retrieval ; Sertoli Cell-Only Syndrome/diagnostic imaging*

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

The main active compound, 3,4-dihydroxyacetophenone(3,4-DHAP), in the leaves of Ilex pubescens var. glaber, exhibits various pharmacological activities, including vasodilation and heart protection. Currently, natural extraction and chemical synthesis are the primary methods for obtaining 3,4-DHAP, but both approaches have inherent challenges. To address these problems, this study explored the whole-cell bioconversion of 1-(4-hydroxyphenol)-ethanol to 3,4-DHAP using recombinant Escherichia coli, cultivated in a green, cost-effective medium at room temperature and atmospheric pressure. Firstly, this study successfully constructed recombinant E. coli S1, which contained only the HpaBC gene, and recombinant E. coli S3, which contained both the Hped and HpaBC genes. The ability of S1 and S3 to synthesize 3,4-DHAP from their respective substrates was then evaluated through whole-cell bioconversion. Based on these results, the effects of four factors, i.e., substrate concentration, IPTG concentration, induction temperature, and transformation temperature, on the whole-cell bioconversion yield of S3 were investigated using an orthogonal experiment. The results showed that the factors influenced the yield in the following order: transformation temperature > induction temperature > IPTG concentration > substrate concentration. The optimal conditions were found to be a transformation temperature of 35 ℃, IPTG concentration of 0.1 mmol·L~(-1), induction temperature of 25 ℃, and substrate concentration of 10 mmol·L~(-1). Finally, the effect of transformation time on the yield of 3,4-DHAP was further examined under the optimal conditions. The results indicated that as the transformation time increased, the yield of 3,4-DHAP steadily increased. The highest yield of 260 mg·L~(-1) with a productivity of 17% was achieved after 72 hours of transformation. In conclusion, this study successfully achieved the whole-cell bioconversion of 1-(4-hydroxyphenol)-ethanol to 3,4-DHAP using recombinant E. coli for the first time, laying the groundwork for further optimization and development of the biosynthesis of 3,4-DHAP.
Escherichia coli/genetics* ; Acetophenones/chemistry* ; Ethanol/chemistry* ; Drugs, Chinese Herbal/chemistry* ; Biotransformation

Objective The aim of the study is to reveal the polymorphisms of Eustrongylides spp.in Monopterus albus.Methods A total of five Eustrongylides spp.collected from five M.albus in the Yongzhou area were sampled to amplify ribosomal ITS sequence by PCR in vitro,then sequenced after extracting the DNA templates of Eustrongylides.The phylogenetic tree based on the ITS sequence was also constructed to explore the evolutionary history of Eustrongylides.Results The length of the ITS sequence of the five Eustrongylides spp.is approximately 933 bp,and the genetic differences between the isolates are 0.00％-0.90％and the genetic inheritance differences with other nematodes are 15.5％-18.20％,maintaining a certain genetic distance from other families.Conclusions The ITS sequence of Eustrongylides spp.in M.albus will be used as a genetic marker for the molecular identification of Eustrongylides spp.and will provide a basis for the prevention and control of Eustrongylides spp.in the future.

AIM To explore the clinical effects of Jinfukang Oral Liquid combined with thymosin α1 on patients with non-small cell lung cancer due to Dual Deficiency of Qi and Yin.METHODS Seventy-five patients were randomly assigned into thymosin α1 group(15 cases)for 4-week administration,Jinfukang Oral Liquid group(30 cases)for 4-week administration,and combination group(30 cases)for 4-week administration.The changes in TCM clinical syndrome effects,immunity indices(CD3+T,Th,CTL,total NK,CD56dim CD16+NK,NKT,Treg,MDSC),lethality/inhibition ratios(CTL/Treg,total NK/Treg,NKT/Treg,CTL/MDSC,total NK/MDSC,NKT/MDSC)and FACT-L scores were detected.RESULTS The Jinfukang Oral Liquid group and combination group demonstrated higher total effective rates than the thymosin α1 group(P＜0.05).After the treatment,the Jinfukang Oral Liquid group and combination group displayed increased NKT(P＜0.05)and decreased MDSC(P＜0.05),which were more obvious than those in the thymosin α1 group(P＜0.05),and higher NKT was observable in the Jinfukang Oral Liquid group(P＜0.05);the Jinfukang Oral Liquid group and combination group displayed increased lethality/inhibition ratios(P＜0.05),among which NKT/Treg,CTL/MDSC,total NK/MDSC,NKT/MDSC were higher than those in the thymosin α1 group(P＜0.05),and higher CTL/MDSC,NKT/MDSC were observable in the Jinfukang Oral Liquid group(P＜0.05);the Jinfukang Oral Liquid group(except for physiological status,society and family status)and combination group(except for society and family status)displayed increased FACT-L scores(P＜0.05).CONCLUSION For the patients with non-small cell lung cancer due to Dual Deficiency of Qi and Yin,Jinfukang Oral Liquid single use or combined with thymosin α1 can enhance peripheral blood immune surveillance,inhibit immune escape,restore the balanced state of tumor immune responses,and improve TCM syndromes and life quality.

Objective:To investigate the application effect of diltiazem hydrochloride combined with sacubitril valsartan on chronic heart failure after coronary intervention(PCI).Methods:A prospective study was conducted.The cases were included from May 2020 to May 2023.After the inclusion and exclusion criteria were deleted,a total of 88 patients with chronic heart failure after PCI met the research requirements.They were divided into two groups with the same number of cases,namely 44 cases in each group.The control group received oral treatment with sacubitril and valsartan,while the observation group received additional treatment with diltiazem hydrochloride on top of the control group.Compare the clinical efficacy,changes in cardiac function related indicators and exercise endurance before and after treatment between two groups,and conduct a 1-year follow-up of all patients to record the incidence of cardiovascular adverse events during the follow-up period.Finally,compare the changes in quality of life before and after treatment between the two groups of patients.Results:The total effective rate of the observation group was 93.18％,which was higher than the control group's 77.27％(P＜0.05);After treatment,the changes of cardiac function related indexes and exercise tolerance were compared.It was found that the N-terminal B-type natriuretic peptide(NT proBNP)(45.14±6.34)pg/mL,LVEDD(51.66±3.04)mm and LVESD(32.63±4.45)mm in the observation group were lower than those in the control group,while the left ventricular ejection fraction(LVEF)(55.57±4.25)％and 6MWT(514.62±34.42)m in the observation group were higher than those in the control group(P＜0.05);During the 1-year follow-up,no death occurred in the two groups.The incidence of cardiovascular adverse events in the observation group was 4.55％,much lower than 20.45％in the control group(P＜0.05);After treatment,the scores of emotion,body,others and MLHFQ in the observation group(13.53±2.21,14.25±2.63,20.35±4.52,48.13±5.25)were lower than those in the control group(P＜0.05).Conclusion:The combination of Diltiazem Hydrochloride and Sacubitril Valsartan has significant therapeutic effects on patients with chronic heart failure after PCI.It can improve patients' cardiac function and exercise endurance,reduce the incidence of cardiovascular adverse events,and improve their quality of life.

AIM To explore the clinical effects of Jinfukang Oral Liquid combined with thymosin α1 on patients with non-small cell lung cancer due to Dual Deficiency of Qi and Yin.METHODS Seventy-five patients were randomly assigned into thymosin α1 group(15 cases)for 4-week administration,Jinfukang Oral Liquid group(30 cases)for 4-week administration,and combination group(30 cases)for 4-week administration.The changes in TCM clinical syndrome effects,immunity indices(CD3+T,Th,CTL,total NK,CD56dim CD16+NK,NKT,Treg,MDSC),lethality/inhibition ratios(CTL/Treg,total NK/Treg,NKT/Treg,CTL/MDSC,total NK/MDSC,NKT/MDSC)and FACT-L scores were detected.RESULTS The Jinfukang Oral Liquid group and combination group demonstrated higher total effective rates than the thymosin α1 group(P＜0.05).After the treatment,the Jinfukang Oral Liquid group and combination group displayed increased NKT(P＜0.05)and decreased MDSC(P＜0.05),which were more obvious than those in the thymosin α1 group(P＜0.05),and higher NKT was observable in the Jinfukang Oral Liquid group(P＜0.05);the Jinfukang Oral Liquid group and combination group displayed increased lethality/inhibition ratios(P＜0.05),among which NKT/Treg,CTL/MDSC,total NK/MDSC,NKT/MDSC were higher than those in the thymosin α1 group(P＜0.05),and higher CTL/MDSC,NKT/MDSC were observable in the Jinfukang Oral Liquid group(P＜0.05);the Jinfukang Oral Liquid group(except for physiological status,society and family status)and combination group(except for society and family status)displayed increased FACT-L scores(P＜0.05).CONCLUSION For the patients with non-small cell lung cancer due to Dual Deficiency of Qi and Yin,Jinfukang Oral Liquid single use or combined with thymosin α1 can enhance peripheral blood immune surveillance,inhibit immune escape,restore the balanced state of tumor immune responses,and improve TCM syndromes and life quality.

Objective:To investigate the application effect of diltiazem hydrochloride combined with sacubitril valsartan on chronic heart failure after coronary intervention(PCI).Methods:A prospective study was conducted.The cases were included from May 2020 to May 2023.After the inclusion and exclusion criteria were deleted,a total of 88 patients with chronic heart failure after PCI met the research requirements.They were divided into two groups with the same number of cases,namely 44 cases in each group.The control group received oral treatment with sacubitril and valsartan,while the observation group received additional treatment with diltiazem hydrochloride on top of the control group.Compare the clinical efficacy,changes in cardiac function related indicators and exercise endurance before and after treatment between two groups,and conduct a 1-year follow-up of all patients to record the incidence of cardiovascular adverse events during the follow-up period.Finally,compare the changes in quality of life before and after treatment between the two groups of patients.Results:The total effective rate of the observation group was 93.18％,which was higher than the control group's 77.27％(P＜0.05);After treatment,the changes of cardiac function related indexes and exercise tolerance were compared.It was found that the N-terminal B-type natriuretic peptide(NT proBNP)(45.14±6.34)pg/mL,LVEDD(51.66±3.04)mm and LVESD(32.63±4.45)mm in the observation group were lower than those in the control group,while the left ventricular ejection fraction(LVEF)(55.57±4.25)％and 6MWT(514.62±34.42)m in the observation group were higher than those in the control group(P＜0.05);During the 1-year follow-up,no death occurred in the two groups.The incidence of cardiovascular adverse events in the observation group was 4.55％,much lower than 20.45％in the control group(P＜0.05);After treatment,the scores of emotion,body,others and MLHFQ in the observation group(13.53±2.21,14.25±2.63,20.35±4.52,48.13±5.25)were lower than those in the control group(P＜0.05).Conclusion:The combination of Diltiazem Hydrochloride and Sacubitril Valsartan has significant therapeutic effects on patients with chronic heart failure after PCI.It can improve patients' cardiac function and exercise endurance,reduce the incidence of cardiovascular adverse events,and improve their quality of life.

Objective To investigate the nutritional status of children with Crohn's Disease (CD) at diagnosis and its association with clinical characteristics. Methods A retrospective analysis was performed for the clinical data and nutritional status of 118 children with CD who were admitted to Beijing Children's Hospital,Capital Medical University,from January 2016 to January 2024. A multivariate logistic regression analysis was used to investigate the risk factors for malnutrition. Results A total of 118 children with CD were included,among whom there were 68 boys (57.6％) and 50 girls (42.4％),with a mean age of (11±4) years. Clinical symptoms mainly included recurrent abdominal pain (73.7％,87/118),diarrhea (37.3％,44/118),and hematochezia (32.2％,38/118),and 63.6％ (75/118) of the children had weight loss at diagnosis. The incidence rate of malnutrition was 63.6％ (75/118),and the children with moderate or severe malnutrition accounted for 67％ (50/75). There were 50 children (42.4％) with emaciation,8 (6.8％) with growth retardation,and 9 (7.6％) with overweight or obesity. Measurement of nutritional indices showed a reduction in serum albumin in 83 children (70.3％),anemia in 74 children (62.7％),and a reduction in 25 hydroxyvitamin D in 15 children (60％,15/25). The children with malnutrition had significantly higher disease activity,proportion of children with intestinal stenosis,and erythrocyte sedimentation rate and a significant reduction in serum albumin (P<0.05). The multivariate logistic regression analysis showed that intestinal stenosis was an independent risk factor for malnutrition in children with CD (OR=4.416,P<0.05). Conclusions There is a high incidence rate of malnutrition in children with CD at diagnosis,which is associated with disease activity and disease behavior. The nutritional status of children with CD should be closely monitored.

OBJECTIVE: To explore the role of the CMTM2 gene in regulating testicular spermatogenesis in the mouse model of experimental autoimmune orchitis (EAO). METHODS: We constructed an EAO model in CMTM2 knockout and wild-type (WT) mice, studied the immunological reproductive phenotype and examined the number, morphology and activity of the sperm generated in the CMTM2 knockout mice. We assessed the infiltration of macrophages and lymphocytes in the testis tissue sections and Leydig cells, and determined the expression levels of CMTM2 in the homozygous knockout (KO), heterozygous and WT mice by RT-PCR, Western blot and Northern blot. RESULTS: Statistically significant differences were observed in the long testicular axis and the number of sperm generated between the KO and WT mice after reaching adulthood (P<0.05). The total numbers of macrophages and lymphocytes were markedly increased, while sperm motility and the percentage of morphologically normal sperm remarkably decreased in the testis of the KO mouse model compared with those in the WT mouse model of EAO. CONCLUSION The CMTM2 gene, as a regulator of spermatogenesis, is highly expressed in adult male mice and plays an important role in the maintenance of spermatogenesis. Moreover, decreased expression products of the CMTM2 gene may weaken spermatogenesis under chronic inflammation conditions.
Animals ; Male ; Mice ; Orchitis/genetics* ; Spermatogenesis/genetics* ; Disease Models, Animal ; Testis/metabolism* ; Autoimmune Diseases/genetics* ; Mice, Knockout ; MARVEL Domain-Containing Proteins/genetics*