OBJECTIVE: To explore and quantify the association of hot night exposure during the sperm development period (0-90 lag days) with semen quality. METHODS: A total of 6,640 male sperm donors from 6 human sperm banks in China during 2014-2020 were recruited in this multicenter study. Two indices (i.e., hot night excess [HNE] and hot night duration [HND]) were used to estimate the heat intensity and duration during nighttime. Linear mixed models were used to examine the association between hot nights and semen quality parameters. RESULTS: The exposure-response relationship revealed that HNE and HND during 0-90 days before semen collection had a significantly inverse association with sperm motility. Specifically, a 1 °C increase in HNE was associated with decreased sperm progressive motility of 0.0090 (95% confidence interval [ CI]: -0.0147, -0.0033) and decreased total motility of 0.0094 (95% CI: -0.0160, -0.0029). HND was significantly associated with reduced sperm progressive motility and total motility of 0.0021 (95% CI: -0.0040, -0.0003) and 0.0023 (95% CI: -0.0043, -0.0002), respectively. Consistent results were observed at different temperature thresholds on hot nights. CONCLUSION Our findings highlight the need to mitigate nocturnal heat exposure during spermatogenesis to maintain optimal semen quality.
Humans ; Male ; Semen Analysis ; Adult ; Sperm Motility ; Hot Temperature/adverse effects* ; China ; Middle Aged ; Spermatozoa/physiology* ; Young Adult

Osteoarthritis （OA） and stroke are common clinical diseases that reduce patients' quality of life and place a burden on families and society. Ruyi Zhenbaowan， a classic prescription in Tibetan medicine， have the functions of clearing heat， awakening the brain and opening orifices， relaxing tendons and promoting meridian circulation， and eliminating yellow water. Clinically， they are used to treat osteoarthritis， post-stroke sequelae， neuropathic pain， and other related conditions. Modern pharmacological studies have demonstrated their anti-inflammatory， analgesic， and nerve-repairing effects. However， current research remains insufficient regarding the appropriate indications， timing， and efficacy of this medicine in treating relevant diseases. To enhance clinicians' understanding of this medicine and promote its standardized and rational clinical use， a panel of national experts， including clinical specialists， Tibetan medicine practitioners， pharmacologists， and methodologists， formulated this consensus based on clinical experience and evidence-based practice. The Cochrane systematic review framework， the Grading of Recommendations Assessment， Development and Evaluation （GRADE） system， and the nominal group method were employed to generate seven graded recommendations and 19 consensus-based suggestions. These recommendations clearly define the key points in the clinical application of Ruyi Zhenbaowan， including therapeutic indications， dosage and administration， treatment duration， and medication safety. The consensus specifically addresses the clinical efficacy， appropriate timing of administration， dosage strategies， treatment cycles， and combination medication strategies for treating osteoarthritis and stroke and provides an overview of safety considerations. The aim is to provide standardized guidance for hospitals and healthcare institutions nationwide to ensure the rational application of Ruyi Zhenbaowan in the treatment of osteoarthritis and stroke， reduce medication-related risks， and further leverage its clinical advantages. This consensus has been approved and issued by the China Association of Chinese Medicine， with the standard number GS/CACM 369-2024.

OBJECTIVE: Investigating the clinical efficacy of treating dorsally displaced distal radial double-column Die-punch fractures using a dorsal approach external fixator combined with Kirschner wires. METHODS: Retrospectively analyzed the clinical data of 15 patients with distal radial double-column Die-punch fractures treated with an external fixator combined with Kirschner wire between July 2020 and January 2023. There were 10 males and 5 females;6 cases on the left side and 9 on the right;age ranged from 22 to 76 years old. Recorded the preoperative and the final follow-up Cooney wrist function scores for the patients. The fracture healing time, and occurrence of complications were recorded. RESULTS: All 15 patients were followed up ranged from 12 to 16 months post-operation. All fractures achieved bony union, healing time ranging form 8 to 16 weeks. Not a single patient exhibited complications such as surgical site infection, fracture redislocation, or tendon injury. All individuals had their Kirschner wires and external fixation devices removed six weeks post-operatively and commenced rehabilitative therapy for wrist articulation. The Cooney wrist function scores at preoperative and ranged from 5 to 45 scores, at the latest follow-up ranged from 65 to 100 scores. At the final follow-up, the results were assessed as excellent in 10 patients, good in 4 patients, and fair in 1 patient. CONCLUSION The clinical efficacy of treating distal radial double-column Die-punch fractures using a dorsal approach external fixator combined with Kirschner wires is satisfactory.
Humans ; Male ; Female ; Middle Aged ; Adult ; External Fixators ; Bone Wires ; Aged ; Retrospective Studies ; Radius Fractures/physiopathology* ; Young Adult ; Fracture Fixation/methods*

Radiation-induced esophageal injury (RIEI) is a frequent complication following radiotherapy for thoracic and head-neck malignancies, which may lead to severe sequelae including esophageal stricture and perforation, adversely affecting patients' quality of life and therapeutic outcomes. With advancements in radiotherapy techniques — particularly the adoption of unconventional fractionation regimens, concurrent chemoradiotherapy, and combined molecular targeted / immunotherapy — the incidence of RIEI has been increasing. In this review, recent advances in understanding the pathogenesis, clinical manifestations, risk factors, and management strategies for RIEI were comprehensively summarized. Current therapeutic approaches have evolved beyond conventional anti-inflammatory and nutritional support to include novel interventions such as targeted therapy, free radical scavengers, and microbiota modulation, etc. Future research should prioritize the development of optimized, individualized prevention and treatment protocols to mitigate RIEI risk and improve patient prognosis.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective:To investigate changes in psychological status before and after sequential therapy in patients with skin circulatory disorders following hyaluronic acid injection.Methods:A retrospective study was conducted on 17 female patients, with a mean age of 28-54 (39.5±1.2) years, admitted to the Fourth Medical Center of PLA General Hospital from December 2021 to July 2022. Patients received ultrasound-guided percutaneous arterial puncture or digital subtraction angiography (DSA) guided catheter intervention for hyaluronidase injection, alongside corticosteroid pulse therapy, diuretic administration, neurotrophic support, wound protection, and laser therapy. Psychological assessments, including the Minnesota multiphasic personality inventory (MMPI) and symptom check list-90 (SCL-90), were performed at admission and 30-45 days post-discharge. Changes in assessment scores and patient satisfaction were analyzed.Results:Two patients failed to complete all assessments, leaving 15 cases for final analysis. Affected anatomical regions included the nose/perinasal area (13 cases), temporal region (3 cases), lips (3 cases), and forehead (7 cases). MMPI scores for hypochondriasis, depression, hysteria, psychopathic deviation, paranoia, psychasthenia, and hypomania showed statistically significant reductions compared to baseline (all P<0.05). SCL-90 scores for somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism, and sleep/appetite disturbances also demonstrated significant decreases (all P<0.05). Among the 15 patients, 7 patients reported being very satisfied, 6 patients were satisfied, and 2 patients were moderately satisfied, with no dissatisfaction reported. Conclusion:Sequential therapy is associated with improved psychological outcomes in patients with skin circulatory disorders secondary to hyaluronic acid injection.

Objective:This study aims to construct a colorectal cancer(CRC)prognosis prediction model based on disulfide death associated long-chain non coding ribonucleic acids(DRLncRNAs),and to explore its potential application in predicting prognosis and guiding personalized treatment.Methods:The data for this study was sourced from the Cancer Genome Atlas(TCGA)database,which includes RNA sequencing data and detailed clinical information of CRC patients.Using co expression network analysis to screen DRLncRNAs.Preliminary screening of DRLncRNAs related to prognosis was conducted through univariate Cox regression analysis,followed by variable screening and dimensionality reduction using LASSO Cox regression analysis.Finally,key DRLncRNAs for constructing a prognostic risk model were identified through multivariate Cox regression analysis.Evaluate the predictive ability of prognostic risk models for survival in CRC patients through Kaplan Meier survival curve analysis.The accuracy of the model was analyzed using receiver operating characteristic(ROC)curves,and the ability of different gene expression profiles to distinguish risk stratification was evaluated using principal component analysis(PCA).Gene ontology(GO)and KEGG enrichment analysis were used to evaluate the enrichment of high and low expression gene sets in different risk groups.Results:Five key DRLncRNAs(AC068580.3,AL161729.4,ZEB1-AS1,AC073896.3,and SNHG16)were successfully screened.In the overall concentration,the area under the curve(AUC)of the model's 1-year,3-year,and 5-year survival predictions are 0.674,0.746,and 0.727,respectively;In the training set,the predicted AUC for 1-year,3-year,and 5-year survival were 0.669,0.762,and 0.756,respectively;In the test set,the predicted AUC for 1-year,3-year,and 5-year survival were 0.666,0.725,and 0.697,respectively.SNHG16 and AC073896.3 are protective factors,and high expression was associated with better prognosis;ZEB1-AS1,AC068580.3,and AL161729.4 were risk factors,and high expression indicates poor prognosis.The Kaplan Meier survival analysis results showed that there was a significant difference in survival between the high-risk and low-risk groups(P＜0.05),and the overall survival rate of the high-risk group was significantly lower(P＜0.05).The enrichment analysis results showed that the phosphatidylinositol mediated signal transduction,mitochondrial gene expression,and other biological processes related to 5 DRLncRNAs may be involved in the occurrence,development,and poor prognosis of CRC.The results of this study showed that a prognostic risk model based on five DRLncRNAs(AC068580.3,AL161729.4,ZEB1-AS1,AC073896.3,and SNHG16)was successfully established,which showed independent correlation with the overall survival status of CRC patients.In addition,the prognostic risk model constructed based on these 5 DRLncRNAs can effectively predict the prognosis of CRC patients.Conclusion:This study identified five DRLncRNAs,including AC068580.3,AL161729.4,ZEB1-AS1,AC073896.3,and SNHG16,that are associated with the prognosis of CRC patients.The prognostic risk model constructed based on these five DRLncRNAs has a high evaluation efficiency for the prognosis of CRC patients.

Objective:This study aims to construct a colorectal cancer(CRC)prognosis prediction model based on disulfide death associated long-chain non coding ribonucleic acids(DRLncRNAs),and to explore its potential application in predicting prognosis and guiding personalized treatment.Methods:The data for this study was sourced from the Cancer Genome Atlas(TCGA)database,which includes RNA sequencing data and detailed clinical information of CRC patients.Using co expression network analysis to screen DRLncRNAs.Preliminary screening of DRLncRNAs related to prognosis was conducted through univariate Cox regression analysis,followed by variable screening and dimensionality reduction using LASSO Cox regression analysis.Finally,key DRLncRNAs for constructing a prognostic risk model were identified through multivariate Cox regression analysis.Evaluate the predictive ability of prognostic risk models for survival in CRC patients through Kaplan Meier survival curve analysis.The accuracy of the model was analyzed using receiver operating characteristic(ROC)curves,and the ability of different gene expression profiles to distinguish risk stratification was evaluated using principal component analysis(PCA).Gene ontology(GO)and KEGG enrichment analysis were used to evaluate the enrichment of high and low expression gene sets in different risk groups.Results:Five key DRLncRNAs(AC068580.3,AL161729.4,ZEB1-AS1,AC073896.3,and SNHG16)were successfully screened.In the overall concentration,the area under the curve(AUC)of the model's 1-year,3-year,and 5-year survival predictions are 0.674,0.746,and 0.727,respectively;In the training set,the predicted AUC for 1-year,3-year,and 5-year survival were 0.669,0.762,and 0.756,respectively;In the test set,the predicted AUC for 1-year,3-year,and 5-year survival were 0.666,0.725,and 0.697,respectively.SNHG16 and AC073896.3 are protective factors,and high expression was associated with better prognosis;ZEB1-AS1,AC068580.3,and AL161729.4 were risk factors,and high expression indicates poor prognosis.The Kaplan Meier survival analysis results showed that there was a significant difference in survival between the high-risk and low-risk groups(P＜0.05),and the overall survival rate of the high-risk group was significantly lower(P＜0.05).The enrichment analysis results showed that the phosphatidylinositol mediated signal transduction,mitochondrial gene expression,and other biological processes related to 5 DRLncRNAs may be involved in the occurrence,development,and poor prognosis of CRC.The results of this study showed that a prognostic risk model based on five DRLncRNAs(AC068580.3,AL161729.4,ZEB1-AS1,AC073896.3,and SNHG16)was successfully established,which showed independent correlation with the overall survival status of CRC patients.In addition,the prognostic risk model constructed based on these 5 DRLncRNAs can effectively predict the prognosis of CRC patients.Conclusion:This study identified five DRLncRNAs,including AC068580.3,AL161729.4,ZEB1-AS1,AC073896.3,and SNHG16,that are associated with the prognosis of CRC patients.The prognostic risk model constructed based on these five DRLncRNAs has a high evaluation efficiency for the prognosis of CRC patients.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective:To investigate changes in psychological status before and after sequential therapy in patients with skin circulatory disorders following hyaluronic acid injection.Methods:A retrospective study was conducted on 17 female patients, with a mean age of 28-54 (39.5±1.2) years, admitted to the Fourth Medical Center of PLA General Hospital from December 2021 to July 2022. Patients received ultrasound-guided percutaneous arterial puncture or digital subtraction angiography (DSA) guided catheter intervention for hyaluronidase injection, alongside corticosteroid pulse therapy, diuretic administration, neurotrophic support, wound protection, and laser therapy. Psychological assessments, including the Minnesota multiphasic personality inventory (MMPI) and symptom check list-90 (SCL-90), were performed at admission and 30-45 days post-discharge. Changes in assessment scores and patient satisfaction were analyzed.Results:Two patients failed to complete all assessments, leaving 15 cases for final analysis. Affected anatomical regions included the nose/perinasal area (13 cases), temporal region (3 cases), lips (3 cases), and forehead (7 cases). MMPI scores for hypochondriasis, depression, hysteria, psychopathic deviation, paranoia, psychasthenia, and hypomania showed statistically significant reductions compared to baseline (all P<0.05). SCL-90 scores for somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism, and sleep/appetite disturbances also demonstrated significant decreases (all P<0.05). Among the 15 patients, 7 patients reported being very satisfied, 6 patients were satisfied, and 2 patients were moderately satisfied, with no dissatisfaction reported. Conclusion:Sequential therapy is associated with improved psychological outcomes in patients with skin circulatory disorders secondary to hyaluronic acid injection.