Objective:To explore the impact of benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) on the risk of cardiovascular diseases (CVD) recurrence.Methods:This study is a prospective cohort study based on the China Health and Retirement Longitudinal Study (CHARLS) database. The inclusion criteria were participants who underwent the national baseline survey in 2011. The exclusion criteria were as follows: ① female participants; ② participants without BPH/LUTS information at baseline; ③ participants who had not experienced CVD at baseline. The basic characteristics of BPH/LUTS patients and non-BPH/LUTS patients was compared. The Cox proportional hazards model was used to analyze whether BPH/LUTS is a risk factor for CVD recurrence.Results:A total of 903 male patients with stroke or heart disease were finally included, among which there were 324 (36.9%) cases of BPH/LUTS and 579 (64.1%) cases without BPH/LUTS. Patients with BPH/LUTS had a higher proportion of comorbidities such as hypertension [186 cases (57.4%) vs. 165 cases (28.5%), P=0.014], dyslipidemia [100 cases (31.2%) vs. 104 cases (18.2%), P<0.001], diabetes [55 cases (17.2%) vs. 57 cases (9.8%), P=0.002], chronic kidney disease [71 cases (22.2%) vs. 56 cases (9.8%), P<0.001], and chronic lung disease [87 cases (26.9%) vs. 117 cases (20.3%), P=0.029] compared to those without BPH/LUTS. During the 7-year follow-up, there were 341 (37.8%) cases of CVD recurrence, including 319 (35.3%) cases of heart disease recurrence and 38 (4.2%) cases of stroke recurrence. In the multifactorial adjusted Cox regression model, BPH/LUTS was a risk factor for CVD recurrence ( HR=1.41, 95% CI 1.12-1.77, P=0.003) and heart disease recurrence ( HR=1.40, 95% CI 1.10-1.77, P=0.005), while BPH/LUTS was not a risk factor for stroke recurrence ( HR=2.05, 95% CI 0.97-4.32, P=0.058). When stratified by age, in the population aged ≤65 years, BPH/LUTS was a risk factor for CVD ( HR=1.43, 95% CI 1.07-1.91, P=0.002) and heart disease recurrence ( HR=1.40, 95% CI 1.03-1.90, P=0.006), but not for stroke recurrence ( HR=2.16, 95% CI 0.98-6.09, P=0.053). In patients aged >65 years, BPH/LUTS was not a risk factor for CVD ( P=0.110), heart disease ( P=0.096), or stroke recurrence ( P=0.830). Conclusions:BPH/LUTS is closely related to an increased risk of CVD recurrence, especially for CVD patients aged ≤65 years old. Therefore, for elderly male CVD patients aged ≤65 years, preventing and actively treating BPH/LUTS may have significant implications.

Objective:To explore the impact of benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) on the risk of cardiovascular diseases (CVD) recurrence.Methods:This study is a prospective cohort study based on the China Health and Retirement Longitudinal Study (CHARLS) database. The inclusion criteria were participants who underwent the national baseline survey in 2011. The exclusion criteria were as follows: ① female participants; ② participants without BPH/LUTS information at baseline; ③ participants who had not experienced CVD at baseline. The basic characteristics of BPH/LUTS patients and non-BPH/LUTS patients was compared. The Cox proportional hazards model was used to analyze whether BPH/LUTS is a risk factor for CVD recurrence.Results:A total of 903 male patients with stroke or heart disease were finally included, among which there were 324 (36.9%) cases of BPH/LUTS and 579 (64.1%) cases without BPH/LUTS. Patients with BPH/LUTS had a higher proportion of comorbidities such as hypertension [186 cases (57.4%) vs. 165 cases (28.5%), P=0.014], dyslipidemia [100 cases (31.2%) vs. 104 cases (18.2%), P<0.001], diabetes [55 cases (17.2%) vs. 57 cases (9.8%), P=0.002], chronic kidney disease [71 cases (22.2%) vs. 56 cases (9.8%), P<0.001], and chronic lung disease [87 cases (26.9%) vs. 117 cases (20.3%), P=0.029] compared to those without BPH/LUTS. During the 7-year follow-up, there were 341 (37.8%) cases of CVD recurrence, including 319 (35.3%) cases of heart disease recurrence and 38 (4.2%) cases of stroke recurrence. In the multifactorial adjusted Cox regression model, BPH/LUTS was a risk factor for CVD recurrence ( HR=1.41, 95% CI 1.12-1.77, P=0.003) and heart disease recurrence ( HR=1.40, 95% CI 1.10-1.77, P=0.005), while BPH/LUTS was not a risk factor for stroke recurrence ( HR=2.05, 95% CI 0.97-4.32, P=0.058). When stratified by age, in the population aged ≤65 years, BPH/LUTS was a risk factor for CVD ( HR=1.43, 95% CI 1.07-1.91, P=0.002) and heart disease recurrence ( HR=1.40, 95% CI 1.03-1.90, P=0.006), but not for stroke recurrence ( HR=2.16, 95% CI 0.98-6.09, P=0.053). In patients aged >65 years, BPH/LUTS was not a risk factor for CVD ( P=0.110), heart disease ( P=0.096), or stroke recurrence ( P=0.830). Conclusions:BPH/LUTS is closely related to an increased risk of CVD recurrence, especially for CVD patients aged ≤65 years old. Therefore, for elderly male CVD patients aged ≤65 years, preventing and actively treating BPH/LUTS may have significant implications.

Objective:To explore the changes of left atrial volume and function in patients with early diabetic nephropathy by four-dimensional auto left atrial quantification (4D Auto LAQ).Methods:Forty patients with early diabetic nephropathy (early diabetic nephropathy group), 40 patients with type 2 diabetes (diabetes group) in Henan Provincial People′s Hospital from March 2020 to April 2021 were selected, and 36 healthy volunteers (control group) were collected during the same period. The parameters of conventional echocardiography were measured, and the four-dimensional volume probe was used to obtain the complete left atrial volume image in 5 cardiac cycles. The 4D Auto LAQ software on the EchoPAC workstation was used for analysis to obtain the left atrial volume and strain indicators: left atrial (LA) maximum volume (LAVmax), left atrial minimum volume (LAVmin), pre-systolic volume (LAVpreA), left atrial volume index (LAVImax), left atrial emptying volume (LAEV), left atrial emptying fraction (LAEF), and long axis and circumferential strains in left atrial reserve phase, pipeline phase and systolic phase (LASr, LASr-c; LAScd, LAScd-c; LASct, LASct-c). The differences of these parameters among 3 groups were analyzed.Results:There were no significant differences in interventricular septum end-diastolic thickness(IVSd), left ventricular posterior wall end-diastolic thickness(LVPWd), left ventricular end-diastolic dimension(LVIDd), left ventricular ejection fraction(LVEF), and E/A (ration of early to late diastolic peak flow velocity of mitral orifice) among 3 groups (all P>0.05), and left atrial diameter(LAD), relative wall thickness(RWT), and E/e′ (ration of early diastolic peak flow velocity of mitral orifice to early diastolic velocity of lateral mitral annulus) among 3 groups were significantly different (all P<0.05). Further pairwise comparison results showed that LAD was only significantly different between the early diabetic nephropathy group and control group ( P=0.001 2), and the differences in RWT and E/e′ were statistically significant among 3 groups (all P<0.05). There were no significant differences in LAEV, LAScd-c, and LASct-c among 3 groups (all P>0.05), and LAVmin, LAVmax, LAVpreA, LAVImax, LAEF, LASr, LAScd, LASct, and LASr-c among the 3 groups were significantly different (all P<0.05). The pairwise comparison showed that, compared with the control group and the diabetes group, LAVmin, AVpreA, and LAVImax in the early diabetic nephropathy group were increased, and LAEF, LAScd, LASct, and LASr-c were decreased (all P<0.05). Compared with the control group, LAVmax, LAVImax and LASct in the diabetes group were increased, and LAEF, LAScd, and LASr-c were decreased (all P<0.05). Conclusions:4D Auto LAQ technology can quantitatively evaluate the changes in left atrium volume and function in patients with early diabetic nephropathy. Patients with early diabetic nephropathy have an increase in left atrium volume and a decrease in strain value.

Objective:To study the changes of left atrial volume and function in patients with acute myocardial infarction (AMI) by three-dimensional echocardiography (3DE) and magnetic resonance imaging (MRI).Methods:Thirty-one patients with AMI in Henan People′s Hospital from March to October 2020 were selected as AMI group and 30 healthy subjects were selected as control group.The left atrial maximum volume (LAVmax), minimum volume (LAVmin), presystolic volume (LAVpre), volume index(LAVI), emptying volume (LAEV), ejection fraction (LAEF), long axis and circumferential strain (LASr, LASr-c; LAScd, LAScd-c; LASct, LASct-c) were measured by two-dimensional echocardiography (2DE), 3DE left atrial automatic quantitative technique and CMR.The differences of left atrial indices between two groups and among 2DE, 3DE left atrial automatic quantitative and CMR techniques were compared. Pearson correlation coefficient and Bland-Altman analysis were used to compare 2DE, 3DE left atrial automatic quantitative and CMR. Intra-observer and inter-observer repeatability of 2DE, 3DE left atrial automatic quantitative technique and CMR were evaluated by intra-group correlation coefficient (ICC).Results:①Compared with the control group: LAVmax, LAVmin, LAVpre, LAVI, LASct and LASct-c by 3DE left atrial automatic quantitative increased, while LAEV, LAEF, LASr, LASr-c, LAScd and LAScd-c by 3DE left atrial automatic quantitative technique decreased in AMI group (all P<0.05). ②LAVmax, LAVmin, LAVpre, LASr, LAScd, LASct measured by 3DE left atrial automatic quantitative were more strongly related to CMR than that measured by 2DE(all P<0.05). Compared with CMR, 2DE underestimated LAVmax, LAVmin, LAVpre, LASr, LAScd, LASct by (8.01±4.01)ml, (9.03±4.15)ml, (7.26±2.09 )ml, (7.26±1.23)%, (5.02±1.08)%, (6.24±0.43)%(all P<0.05); 3DE left atrial automatic quantitative technique underestimated LAVmax, LAVmin, LAVpre, LASr, LAScd, LASct by (1.67±0.62)ml, (1.95±0.90)ml, (2.52±0.76)ml, (1.97±0.59)%, (2.03±0.39)%, (1.02±0.30)% (all P>0.05); The time-consuming of 2DE and 3DE left atrial automatic quantitative technique was reduced, and the time-consuming of 3DE left atrial automatic quantitative technique was less than 2DE [(12.18±3.24)s vs (73.34±10.37)s]. ③The reproducibility of 2DE, 3DE left atrial automatic quantitative technique and CMR measurement within and between observers were good. Conclusions:3DE left atrial automatic quantitative technique can effectively evaluate the changes of left atrial volume and function in patients with AMI. Compared with 2DE and CMR, it is simple, rapid, accurate and repeatable, which provides a new and effective method for clinical study of cardiovascular diseases.

Objective:The evaluate left ventricular myocardial work in maintenance hemodialysis (MHD) patients by non-invasive left ventricular pressure strain curve.Methods:Forty-eight patients undergoing maintenance hemodialysis were selected as the MHD group, and 33 healthy subjects were selected as the control group from Apr to Oct 2019 in Henan Provincial People′s Hospital. The differences of general clinical data, basic parameters of two-dimensional ultrasound including left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter (LVDs), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), stroke volume (SV), diastolic interventricular septal thickness (IVSd), left ventricular diastolic posterior wall thickness (LVPWd), left ventricular diastolic mass (LVDm), left ventricular systolic mass (LVSm), late diastolic tissue velocity (a′), early diastolic peak velocity/early diastolic tissue velocity (E/e′), A peak and cardiac output (CO), peak strain dispersion (PSD), and global work index (GWI), global work efficiency (GWE), global constructive work (GCW), global wasted work (GWW) and global long-axis strain (GLS) between two groups were compared, and the correlation between myocardial work parameters and conventional cardiac parameters was analyzed.Results:①In terms of comparison, LVDd, LVDs, LVEDV, LVESV, SV, IVSd, LVPWd, LVDm, LVSm, systolic blood pressure (SBP), diastolic blood pressure (DBP), a′, E/e′. A peak and CO of the MHD group were greater than those in the control group (all P<0.05), and e′ of the MHD group was lower ( P<0.05). ②In terms of comparison, PSD and GWW of the MHD group were greater than those of the control group (all P<0.05), while GLS and GWE of the MHD group was lower (all P<0.05). There were no statistically significant differences in GCW and GWI between two groups(all P>0.05). ③GWI was positively correlated with SBP, DBP and left ventricular ejection fraction (LVEF)( r1=0.442, P1=0.030; r2=0.477, P2=0.019; r3=0.431, P3=0.040), and negatively correlated with GLS and LVDs( r1=-0.576, P1=0.003; r2=-0.404, P2=0.050). GWW was positively correlated with GLS and PSD( r1=0.584, P1=0.003; r2=0.564, P2=0.004). GWE was positively correlated with LVEF( r=0.424, P=0.044), and negatively correlated with LVEDV, LVESV, PSD, GLS and LVDm( r1=-0.444, P1=0.034; r2=-0.490, P2=0.018; r3=-0.721, P3<0.001; r4=-0.738, P4<0.001; r5=-0.442, P5=0.035). GCW was positively correlated with LVEF and DBP( r1=0.494, P1=0.017; r2=0431, P2=0.035), and negatively correlated with GLS and LVDs( r1=-0.630, P1=0.001; r2=-0.419, P2=0.042). Conclusions:The non-invasive left ventricular pressure-strain curve combines blood pressure and strain. Compared with the GLS, it can accurately assess left ventricular myocardial work in maintenance hemodialysis patients and predict potential left ventricular function changes in maintenance hemodialysis patients.

Objective:To explore the association between nighttime sleep duration and semen quality.Methods:By using a cross-sectional study, 3357 men were investigated by questionnaire for nighttime sleep duration, the time of falling asleep and falling asleep duration in the Reproductive Center of Shenzhen People's Hospital from August 2017 to August 2018. Semen quality parameters were obtained by computer-aided semen analysis system (CASA). Multiple linear regression was used to analyze the relationship between nighttime sleep duration and semen quality parameters. According to age and body mass index (BMI) stratification, the relationship between nighttime sleep duration and semen quality parameters was further discussed.Results:Compared with males with nighttime sleep duration between 6-8 h, the sperm progressive motility and total motility were 49.15% and 59.49%, respectively, which were significantly lower in the males with nighttime sleep duration≥8 h after adjusting for age, BMI, abstinence time, exercise, drinking and smoking, with regression coefficients, β=-3.16, 95% confidence interval ( CI)=-5.77--0.55 and β=-3.22, 95% CI=-5.93--0.51, respectively. Compared with the shortest duration of falling asleep group (<10 min), the increase of falling asleep duration was related to the decrease of sperm progressive motility ( P=0.045). The total sperm motility of falling asleep duration between 31-60 min group was also significantly lower than that of the shortest falling asleep duration group （ β=-3.80, 95% CI=-6.54--1.06, P=0.007）. Further stratification analysis showed that among the subjects aged 35 to 39 years, the sperm progressive motility of men with nighttime sleep duration less than 6 h was lower than that of 6-8 h group ( β=-4.01, 95% CI=-7.84-0.18, P=0.04). And among the subjects aged more than 40 years, the total sperm number of the men who slept ≥8 h at night was lower than that of the men with nighttime sleep duration between 6-8 h （percentage changes: -47.84%, 95% CI=-72.29%--2.19%, P=0.04）. The progressive and total sperm motility of men with BMI≥24 kg/m 2 and nighttime sleep duration ≥8 h were lower than those with BMI≥24 kg/m 2 in 6-8 h nighttime sleep duration group, and the corresponding regression coefficients were β=-5.75, 95% CI=-10.40--1.10, P=0.02 and β=-6.85, 95% CI=-11.69--2.00, P=0.01. Conclusion:In men ≥40 years old or BMI≥24 kg/m 2, the nighttime sleep duration ≥8 h were associated with the decreased sperm progressive motility and total motility.

Objective:To explore the association between nighttime sleep duration and semen quality.Methods:By using a cross-sectional study, 3357 men were investigated by questionnaire for nighttime sleep duration, the time of falling asleep and falling asleep duration in the Reproductive Center of Shenzhen People's Hospital from August 2017 to August 2018. Semen quality parameters were obtained by computer-aided semen analysis system (CASA). Multiple linear regression was used to analyze the relationship between nighttime sleep duration and semen quality parameters. According to age and body mass index (BMI) stratification, the relationship between nighttime sleep duration and semen quality parameters was further discussed.Results:Compared with males with nighttime sleep duration between 6-8 h, the sperm progressive motility and total motility were 49.15% and 59.49%, respectively, which were significantly lower in the males with nighttime sleep duration≥8 h after adjusting for age, BMI, abstinence time, exercise, drinking and smoking, with regression coefficients, β=-3.16, 95% confidence interval ( CI)=-5.77--0.55 and β=-3.22, 95% CI=-5.93--0.51, respectively. Compared with the shortest duration of falling asleep group (<10 min), the increase of falling asleep duration was related to the decrease of sperm progressive motility ( P=0.045). The total sperm motility of falling asleep duration between 31-60 min group was also significantly lower than that of the shortest falling asleep duration group （ β=-3.80, 95% CI=-6.54--1.06, P=0.007）. Further stratification analysis showed that among the subjects aged 35 to 39 years, the sperm progressive motility of men with nighttime sleep duration less than 6 h was lower than that of 6-8 h group ( β=-4.01, 95% CI=-7.84-0.18, P=0.04). And among the subjects aged more than 40 years, the total sperm number of the men who slept ≥8 h at night was lower than that of the men with nighttime sleep duration between 6-8 h （percentage changes: -47.84%, 95% CI=-72.29%--2.19%, P=0.04）. The progressive and total sperm motility of men with BMI≥24 kg/m 2 and nighttime sleep duration ≥8 h were lower than those with BMI≥24 kg/m 2 in 6-8 h nighttime sleep duration group, and the corresponding regression coefficients were β=-5.75, 95% CI=-10.40--1.10, P=0.02 and β=-6.85, 95% CI=-11.69--2.00, P=0.01. Conclusion:In men ≥40 years old or BMI≥24 kg/m 2, the nighttime sleep duration ≥8 h were associated with the decreased sperm progressive motility and total motility.

Objective: To understand the occupational external exposure dose among radiation workers in a first-class hospital at Grade 3 of Suzhou, and to provide reference for radiological protection. Methods: The individual dose of 1156 radiation workers in the hospital from 2010 to 2017 were detected, the annual collective effective dose and per capita annual effective dose were analyzed for different years, different occupations (diagnostic radiology, radiotherapy, nuclear medicine, interventional radiology) , gender, and age. Results: From 2010 to 2017, the total annual collective effective dose was 351.40 person·mSv, the per capita annual dose was 0.30 mSv/a, and radiation workers whose annual effective dose was less than 1 mSv accounted for 94.98%. There were 5 interventional radiology workers and 1 nuclear medicine worker with annual effective dose between 2 and 4 mSv. There was no worker with annual effective dose over 4 mSv. The per capita annual effective dose of nuclear medicine workers was the highest (0.40 mSv/a) . The per capita annual effective dose was not significantly different between radiation workers with different genders and ages (P>0.05) . Conclusion Most of radiation workers have low individual dose level in the hospital. It is important to focus on nuclear medicine workers and interventional radiology workers.

Objective To investigate the application value of three-dimensional shear wave elastography( 3D-SWE) in diagnosis of malignant and benign breast masses . Methods Sixty-seven patients with total 96 masses diagnosed by ultrasound and verified with surgical pathological analysis were selected . The masses were divided into benign group ( 54 masses ) and malignant group ( 42 masses ) . The quantitative diagnosis was performed using two-dimensional shear wave elastography ( 2D-SWE) and 3D-SWE to evaluate the hardness of the masses . Receiver operating characteristic ( ROC ) curves of 2D-SWE and 3D-SWE were drawn to calculate the sensibility and specificity in diagnosis of breast masses . The qualitative diagnosis was performed according to the elastic color image classification to classify the elastic images of the lesions into type Ⅰ - Ⅳ . Results The quantitative diagnosis:① There were significant differences in Emean ,Emax and SD on planes of 2D-SWE and three orthogonal planes of 3D-SWE between the two groups ( P <0 .05) ;② There was no significant difference in Emean ,Emax and SD of two groups between 2D-SWE and 3D-SWE ( P > 0 .05) ;③ Emean ,Emax and SD on planes of 2D-SWE and three orthogonal planes of 3D- SWE both exhibited high diagnostic performance . However , there was no significant difference in Emean ,Emax and SD between 2D-SWE and 3D-SWE ( P >0 .05) . The qualitative diagnosis of elastic color mode:type Ⅰ and type Ⅱ account for most planes of 2D-SWE and three orthogonal planes of 3D-SWE in benign masses ,while type Ⅲ and type Ⅳ account for most in malignant masses . Among the malignant group ,type Ⅲ on the 3D-SWE coronal planes was significantly more than other three types ( P < 0 .05) .Conclusions For quantitative diagnosis ,2D-SWE and 3D-SWE are both beneficial to differentiate benign from malignant masses ,but there is no difference in diagnostic efficacy ;for qualitative diagnosis ,3D-SWE can provide more diagnostic information than 2D-SWE ,especially on the coronal planes of 3D-SWE .