In recent years, the incidence of infertility has been steadily increasing. Obesity, recognized as a chronic inflammatory condition, can not only lead to various chronic diseases such as hypertension and diabetes, but also adversely affects female reproductive health,including rare ovulation, anovulation, menstrual irregularities, and even infertility. The reproductive outcomes of overweight/obese women are not optimistic even among people undergoing assisted reproductive technology (ART).However, the mechanisms of overweight and obesity on ART outcomes remain poorly understood. This review aims to summarize current evidence on the impact of overweight and obesity on ART outcomes in women and explore the potential mechanisms.

In recent years, the incidence of infertility has been steadily increasing. Obesity, recognized as a chronic inflammatory condition, can not only lead to various chronic diseases such as hypertension and diabetes, but also adversely affects female reproductive health,including rare ovulation, anovulation, menstrual irregularities, and even infertility. The reproductive outcomes of overweight/obese women are not optimistic even among people undergoing assisted reproductive technology (ART).However, the mechanisms of overweight and obesity on ART outcomes remain poorly understood. This review aims to summarize current evidence on the impact of overweight and obesity on ART outcomes in women and explore the potential mechanisms.

Purpose: Male overweight and obesity could affect sperm quality and reproductive health. However, the impact of body mass index (BMI) on assisted reproductive technology (ART) outcomes in oligospermia and/or asthenospermia patients is yet lacking. This study aims to assess the impact of paternal BMI on ART and neonatal outcomes among oligozoospermia and/or asthenospermia patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Materials and Methods: In this study, 2,075 couples undergoing their first fresh embryo transfer between January 2015 and June 2022 were recruited. Following the World Health Organization’s (WHO’s) categories, couples were stratified into three cohorts based on paternal BMI: normal weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2), and obese (≥30.0 kg/m2). Modified Poisson regression models were used to assess the associations of paternal BMI with fertilization, in vitro embryonic development, and pregnancy outcomes. Logistic regression models were performed to investigate the associations of paternal BMI with pregnancy loss and neonatal outcomes. Furthermore, stratified analyses were performed based on fertilization methods, male infertility cause, and maternal BMI. Results: Higher paternal BMI is associated with a lower likelihood of achieving normal fertilized (p-trend=0.002), Day 3 transferable (p-trend=0.007), and high-quality embryos (p-trend=0.046) in IVF cycles, rather than in ICSI cycles. Paternal BMI of oligospermia or asthenospermia was negatively correlated with day 3 transferable (p-trend=0.013 and 0.030) and high-quality embryos (p-trend=0.024 and 0.027). Moreover, for neonatal outcomes, paternal BMI was positively associated with macrosomia (p-trend=0.019), large for gestational age (LGA) (p-trend=0.031), and very LGA (p-trend=0.045). Conclusions Our data suggested that higher paternal BMI was associated with fetal overgrowth, reduced fertilization, and embryonic development potential. Among males with oligospermia and/or asthenospermia, the impact of overweight and obesity on the choice of fertilization method and the long-term effects on their offspring need to be further investigated.

Periodontitis is a chronic inflammatory disease initiated by biofilm microorganisms and mediated by host immune imbalance.Uncontrolled periodontal infections are the leading cause of tooth loss in adults.Thrombotic diseases can lead to partial or complete obstruction of blood flow in the circulatory system,manifesting as organ or tissue ischemia and necrosis in patients with arterial thrombosis,and local edema,pain and circulatory instability in patients with venous thrombosis,which may lead to mortality or fatality in severe case.Recent studies found that periodontitis might enhance thrombosis through bacterial transmission or systemic inflammation by affecting platelet-immune cell interactions,as well as the coagulation,and periodontal therapy could have a prophylactic effect on patients with thrombotic diseases.In this review,we summarized clinical findings on the association between periodontitis and thrombotic diseases and discussed several novel prothrombotic periodontitis-related agents,and presented a perspective to emphasize the necessity of oral health management for people at high risk of thrombosis.

Periodontitis is a chronic inflammatory disease initiated by biofilm microorganisms and mediated by host immune imbalance.Uncontrolled periodontal infections are the leading cause of tooth loss in adults.Thrombotic diseases can lead to partial or complete obstruction of blood flow in the circulatory system,manifesting as organ or tissue ischemia and necrosis in patients with arterial thrombosis,and local edema,pain and circulatory instability in patients with venous thrombosis,which may lead to mortality or fatality in severe case.Recent studies found that periodontitis might enhance thrombosis through bacterial transmission or systemic inflammation by affecting platelet-immune cell interactions,as well as the coagulation,and periodontal therapy could have a prophylactic effect on patients with thrombotic diseases.In this review,we summarized clinical findings on the association between periodontitis and thrombotic diseases and discussed several novel prothrombotic periodontitis-related agents,and presented a perspective to emphasize the necessity of oral health management for people at high risk of thrombosis.

The European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines showed us venous thrombosis management in January 2022. In terms of iliac vein diseases, it retained some guiding views, upgraded some guiding views, and added some new views compared with the version 2015. It has good guidance and reference significance for medical staff and patients. The part of the guidelines about iliac vein disease is worth our interpretation.

Background::Endovascular abdominal aortic aneurysm repair (EVAR) is the major treatment for abdominal aortic aneurysm (AAA); however, EVAR still carries a considerable risk of acute kidney injury (AKI). The present study aimed to investigate the risk factors for AKI after elective EVAR procedures.Methods::This was a retrospective observational study. Eligible patients who underwent EVAR from September 2011 to March 2019 in West China Hospital were included. The primary outcome was the occurrence of AKI within two days after EVAR, which was defined by the Kidney Disease Improving Global Outcomes Clinical Practice Guideline. Demographics, comorbidities, medications, laboratory tests, anatomical parameters of AAA, and relative operative details were collected as variables. Univariable and multivariable logistic regression analyses were applied to identify the risk factors among variables, and covariate interactions were further assessed.Results::A total of 679 eligible patients were included. The incidence of postoperative AKI was 8.2% (56/679) in the whole cohort, and it was associated with a lower 5-year survival rate (63.5% vs. 80.9%; χ2 = 4.10; P = 0.043). The multivariable logistic regression showed that chronic kidney disease (OR, 5.06; 95% CI: 1.43-17.95; P = 0.012), angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) (OR, 2.60; 95% CI: 1.17-5.76; P = 0.019), and short neck (OR, 2.85; 95% CI: 1.08-7.52; P = 0.035) were independent risk factors for postoperative AKI. In the covariate interaction analysis, the effect of ACEIs/ARBs use on postoperative AKI was similar across all subgroups ( P > 0.05), thereby suggesting a robust effect of ACEIs/ARBs use in all patients undergoing elective endovascular abdominal aortic aneurysm repair. Conclusions::Postoperative AKI was associated with lower survival rate, and the use of ACEIs/ARBs was the only adjustable independent risk factor. Clinicians should consider withdrawing ACEIs/ARBs in high-risk patients undergoing elective endovascular abdominal aortic aneurysm repair to prevent postoperative AKI.

3D printing technology has been widely applied in the field of clinical education in vascular surgery due to the advantage of 100% reduction of objects. Vascular surgeons with different levels benefit from 3D printing application in anatomy structure, operation plan, skill training with simulator. At present, the application of 3D printing model in vascular surgery is still in the initial stage with some limitations. This paper reviews the application, limitations, and prospects of 3D printing model in clinical teaching of vascular surgery.

Objective To explore the clinical application of subxyphoid approach thoracoscopic surgery in thymoma resection. Methods The clinical data of 15 cases of mediastinal tumors receiving subxyphoid approach video-assisted thoracoscopic surgery from June 2015 to May 2017 were analyzed retrospectively.Among these cases,there were 6 male cases and 9 female cases, and the average age was(48.5 ±5.4)years old.There were 6 cases of thymoma with myasthenia gravis,including 5 cases of ocular myasthenia gravis and 1 case of mild systemic myasthenia gravis. Results All the 15 cases of operations were performed successfully without conversion to open surgery.The average operation time was(95 ±15)min, and average bleeding was(50 ±10)ml.The average hospital time was(4.2 ±1.5)days, and average thoracic cavity drainage time was(1.5 ±1.0)days.No postoperative complications occurred.Pathological reports showed that type A thymoma in 8 cases,type AB thymoma in 5 cases,type B1 thymoma in 1 case,and type B2 thymoma in 1 case.The mean follow-up time of all the 15 cases was(6.5 ±2.5)months, and no thymoma recurrence was seen.According to the Monden standard,muscle weakness symptoms disappeared in 5 cases and improved in 1 case in the 6 cases with myasthenia gravis. Conclusion Subxyphoid approach thoracoscopic thymoma resection is safe and feasible.

Objective To evaluate 3D printing abdominal aortic aneurysm model in analysis of clinical teaching effect for standardized resident doctors in vascular surgery department. Methods 48 resi-dents in vascular surgery department in our hospital from December 2016 to September 2017 were seleeected and randomly divided into control group and the experimental group. The traditional vascular surgical anatomy atlas, ultrasound, CT abdominal blood vessel 3D reconstruction, digital subtraction, video and so on were used by 24 residents in the control group, while in the experimental group, on the basis of the traditional teaching, abdominal aortic aneurysm model of 3D printing, true aortic coated stent delivery system were increased. After the teaching, the theory of evaluation (abdominal vascular anatomical features, morphological characteristics and classification of AAA, measurement of various parameters and key points of operation in the EVAR) and satisfaction questionnaire were adopted to evaluate the effect of two kinds of teaching methods. SPSS 19.0 was used to conduct t test on two groups of physician evaluation data. Results The results of theoretical assessment showed that there was no significant difference between the control group and the experimental group in the abdominal vascular anatomical features, the morphological features and the classification of the experimental group (P>0.05) in the examination of the common AAA cases and the complicated AAA cases. However, the experimental group was higher than the control group in the mea-surement of the parameters of EVAR, and the score of the operation points and the total score, and the difference was statistically significant (t=2.283, t=2.263, P<0.05). The results of the questionnaire showed that the students' satisfaction scores on the teaching satisfaction of the normal and complex AAA cases were better than those of the control group, and the difference was statistically significant (P<0.05). Conclusion The 3D printing model can increase the understanding and mastery of the anatomy and treat-ment of abdominal aortic aneurysm and improve its learning enthusiasm for vascular surgery. We should make full use of the advantages of 3D printing technology on the basis of retaining the advantages of tradi-tional teaching methods and means, and further enhance the teaching effect.