To investigate the impact of preoperative serum follicle-stimulating hormone (FSH) levels on the probability of testicular sperm retrieval, we conducted a study of nonobstructive azoospermic (NOA) men with different testicular volumes (TVs) who underwent microdissection testicular sperm extraction (micro-TESE). A total of 177 NOA patients undergoing micro-TESE for the first time from April 2019 to November 2022 in Shenzhen Zhongshan Obstetrics and Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital, Shenzhen, China) were retrospectively reviewed. The subjects were divided into four groups based on average TV quartiles. Serum hormone levels in each TV group were compared between positive and negative sperm retrieval subgroups. Overall sperm retrieval rate was 57.6%. FSH levels (median [interquartile range]) were higher in the positive sperm retrieval subgroup compared with the negative outcome subgroup when average TV was <5 ml (first quartile [Q1: TV <3 ml]: 43.32 [17.92] IU l -1 vs 32.95 [18.56] IU l -1 , P = 0.048; second quartile [Q2: 3 ml ≤ TV <5 ml]: 31.31 [15.37] IU l -1 vs 25.59 [18.40] IU l -1 , P = 0.042). Elevated serum FSH levels were associated with successful micro-TESE sperm retrieval in NOA men whose average TVs were <5 ml (adjusted odds ratio [OR]: 1.06 per unit increase; 95% confidence interval [CI]: 1.01-1.11; P = 0.011). In men with TVs ≥5 ml, larger TVs were associated with lower odds of sperm retrieval (adjusted OR: 0.84 per 1 ml increase; 95% CI: 0.71-0.98; P = 0.029). In conclusion, elevated serum FSH levels were associated with positive sperm retrieval in micro-TESE in NOA men with TVs <5 ml. In men with TV ≥5 ml, increases in average TVs were associated with lower odds of sperm retrieval.
Humans ; Male ; Azoospermia/surgery* ; Sperm Retrieval/statistics & numerical data* ; Adult ; Follicle Stimulating Hormone/blood* ; Retrospective Studies ; Testis/pathology* ; Microdissection ; Organ Size

A 12-year-old boy was admitted with symptoms of cough and fever lasting over a month, accompanied by weight loss 2 kg. Prior anti-infective treatments proved ineffective in alleviating the symptoms. Chest imaging revealed diffuse interstitial pulmonary edema in the right lung with obstructed lymphatic drainage. Combined with histopathological examinations, the diagnosis was confirmed as lung cancer with pulmonary lymphangitic carcinomatosis. The patient underwent chemotherapy with docetaxel and carboplatin, yet the disease progressively worsened, resulting in death three months after diagnosis. This case highlights lung cancer should not be overlooked in patients with persistent respiratory symptoms of unknown etiology. Early imaging examinations, along with necessary pathological evaluations, are crucial for timely detection and diagnosis. The presence of pulmonary lymphangitic carcinomatosis often indicates an advanced-stage of cancer, associated with a poor prognosis.
Humans ; Male ; Lung Neoplasms/complications* ; Child ; Carcinoma/drug therapy*

BACKGROUND: Hypertension is associated with an increased risk of calcific aortic valve stenosis (CAVS). However, the directionality of causation between blood pressure traits and aortic stenosis is unclear, as is the benefit of antihypertensive drugs for CAVS. METHODS: Using genome-wide association studies (GWAS) summary statistics, we performed bidirectional two-sample univariable mendelian randomization (UVMR) to assess the causal associations of systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) with CAVS. Multivariable mendelian randomization (MVMR) was conducted to evaluate the direct effect of hypertension on CAVS, adjusting for confounders. Drug target mendelian randomization (MR) and summary-level MR (SMR) were used to estimate the effects of 12 classes of antihypertensive drugs and their target genes on CAVS risk. Inverse variance weighting was the primary MR method, with sensitivity analyses to validate results. RESULTS: UVMR showed SBP, DBP, and PP have causal effects on CAVS, with no significant reverse causality. MVMR confirmed the causality between hypertension and CAVS after adjusting for confounders. Drug-target MR analyses indicated that calcium channel blockers (CCBs), loop diuretics, and thiazide diuretics via SBP lowering exerted protective effects on CAVS risk. SMR analysis showed that the CCBs target gene CACNA2D2 and ARBs target gene AGTR1 were positively associated with CAVS risk, while diuretics target genes SLC12A5 and SLC12A1 were negatively associated with aortic stenosis risk. CONCLUSIONS Hypertension has a causal relationship with CAVS. Managing SBP in hypertensive patients with CCBs may prevent CAVS. ARBs might exert protective effects on CAVS independent of blood pressure reduction. The relationship between diuretics and CAVS is complex, with opposite effects through different mechanisms.

OBJECTIVE: To explore the effects and mechanism of Chinese medicine Liujunzi Decoction (LJZD) on regulating microbial flora in mice with asthma flora disorder. METHODS: Thirty BALB/c female mice were divided into control, model, LJZD [3.5 g/(kg•d), by gavage], dexamethasone [DXMS, 0.7 mg/(kg•d), intraperitoneal injection], and Clostridium butyricum [CB, 230 mg/(kg•d), by gavage] groups according to a random number table, 6 mice in each group. The asthma flora disorder mice model was induced with ovalbumin (OVA). Lung and gut lesions were analyzed by hematoxylin-eosin (HE) and periodic acid-Schiff (PAS) stainings. The secretory immunoglobulin A (sIgA) protein expression in lung and gut tissues was detected by Western blot. Flow cytometry was used to detect the relative counts of GATA binding protein 3 (GATA3)/type 2 innate lymphoid cells (ILC2) in lung and gut. The levels of inflammatory factors in lung and gut tissues were detected by enzyme-linked immunosorbent assay (ELISA). Chao1 and Shannon index were used to compare microbial abundance and diversity in alveolar lavage fluid and cecal contents. The similarity or difference in the composition of mice microbial communities was analyzed through cluster analysis. The serum short-chain fatty acids (SCFAs) content was detected by ultra performance liquid chromatograph mass spectrometer (LC-MS)/MS. RESULTS: The asthma flora disorder model mice showed obvious asthma-related symptoms, but LJZD treatment effectively alleviated these symptoms. LJZD restored alveolar wall thickening, airway inflammatory cell infiltration, gut tissue structure destruction, and inflammatory cell infiltration in asthma flora disorder mice. LJZD downregulated the sIgA protein expression in mice (P<0.05). Moreover, LJZD decreased the activation of GATA3/ILC2s in lung and gut tissue (P<0.01), and reduced the levels of interleukin (IL)-5, IL-33, IL-25, IL-9 and IL-13 (P<0.01). LJZD treatment returned the abundance of microbial species and the microbial community structure of alveolar lavage fluid and cecal content in asthma flora disorder mice to the normal state. The SCFAs content and body metabolism were also improved. CONCLUSION LJZD exerted anti-asthmatic effects by improving the microbial balance of lung-gut axis and affecting systemic metabolism, consequently regulating the GATA3/ILC2s axis to impact the lung inflammatory response.
Animals ; Asthma/pathology* ; GATA3 Transcription Factor/metabolism* ; Drugs, Chinese Herbal/therapeutic use* ; Gastrointestinal Microbiome/drug effects* ; Mice, Inbred BALB C ; Female ; Lung/drug effects* ; Homeostasis/drug effects* ; Inflammation/pathology* ; Lymphocytes/drug effects* ; Mice

The pathogenesis of cardiovascular diseases (CVD) is complex, and dynamic imbalances in protein acylation modification are significantly associated with the development of CVD. In recent years, most studies on exercise-regulated protein acylation modifications to improve cardiovascular function have focused on acetylation and lactylation. Protein acylation modifications are usually affected by exercise intensity. High-intensity exercise directly affects oxidative stress and cellular energy supply, such as changes in ATP and NAD⁺ levels; moderate-intensity exercise is often accompanied by improvements in aerobic metabolism, such as fatty acid β-oxidation and TCA cycle, which modulate mitochondrial biogenesis. The above processes may affect the acylation status of relevant regulatory enzymes and functional proteins, thereby altering their function and activity and triggering signaling cascades to adapt to exercise’s metabolic demands and stresses. Exercise regulates the levels of acylation modifications of H3K9, H3K14, H3K18, and H3K23, which are involved in regulating the transcriptional expression of genes involved in oxidative stress, glycolysis, inflammation, and hypertrophic response by altering chromatin structure and function. Exercise can regulate the acylation modification of non-histone-specific sites in the cardiovascular system involved in mitochondrial function, glycolipid metabolism, fibrosis, protein synthesis, and other biological processes, and participates in the regulation of protein activity and function by altering the stability, localization, and interaction of proteins, and ultimately works together to achieve the improvement of cardiovascular phenotypes and biological functions. Exercise affects acyl donor concentration, acyltransferase, and deacetylase expression and activity by influencing acyl donor concentration, acyltransferase, and deacetylase. Exercise regulates the abundance of acyl donors such as acetyl coenzyme A, propionyl coenzyme A, butyryl coenzyme A, succinyl coenzyme A, and lactoyl coenzyme A by promoting glucose and lipid metabolism and improving intestinal bacterial flora, which in turn affects protein acylation modification, accelerates oxidative decarboxylation of pyruvic acid in the body, and activates the energy-sensing molecule, adenosine monophosphate-activated protein kinase (AMPK), to improve cardiovascular function. Exercise may affect protein acylation modifications in the cardiovascular system by regulating the activity and expression of adenoviral E1A binding protein of 300 kDa (p300)/cyclic adenosine monophosphate response element-binding protein (CBP), general control nonderepressible 5-related N-acetyltransferases (GNAT), and alanyl-transfer t-RNA synthetase (AARS), which in turn improves cardiovascular function. The relationship between exercise and cardiovascular deacetylases has attracted much attention, with SIRT1 and SIRT3 of the silence information regulator (SIRT) family of proteins being the most studied. Exercise may exert transient or long-term stable cardiovascular protective benefits by promoting the enzymatic activity and expression of SIRT1, SIRT3, and HDAC2, inhibiting the enzymatic activity and expression of HDAC4, and mediating the deacylation of metabolic regulation-related enzymes, cytokines, and molecules of signaling pathways. This review introduces the role of protein acylation modification on CVD and the effect of exercise-mediated protein acylation modification on CVD. Based on the existing studies, it analyzes the possible mechanisms of exercise-regulated protein acylation modification to improve CVD from the perspectives of acylation modification donors, acyltransferases, and deacetylases. Deciphering the regulation of cardiovascular protein acylation and modification by exercise and exploring the essential clues to improve cardiovascular disease can enrich the theoretical basis for exercise to promote cardiovascular health. However, it is also significant for developing new cardiovascular disease prevention and treatment targets.

The Hazardous Drug Exposure Management: Information for Healthcare Settings (2023 Edition) released by the National Institute for Occupational Safety and Health (NIOSH) of US provided detailed protection recommendations for medical personnel to mitigate the risks of occupational exposure to hazardous drugs. This study reviewed the literature in terms of hazard identification, occupational exposure assessment, risk assessment, risk management planning, and waste and spill control. It also explored the precautions for each step of hazardous drug handling, aiming to raise medical personnel's awareness of hazardous drug protection and improve their self-protection skills. The findings provided valuable references for medical institutions to develop hazardous drug disposal plans and reduce employees' exposure to hazardous drugs and occupational injuries.

Spinal cord injury(SCI)is a structural and functional disruption of the spinal cord caused by various factors,leading to neurological dysfunction.As a common central nervous system disorder in clinical practice,SCI poses significant risks to human life and health.Its pathological mechanism is exceedingly complex,involving multiple pathological processes.Given the irreversibility of primary injury,targeting secondary injury has gradually become the main direction for the clinical treatment of SCI in recent years.Recent studies have highlighted the crucial role of blood-spinal cord barrier damage and microvascular dysfunction in the progression of secondary injury following SCI.Therefore,investigating the pathological mechanisms of microcirculation and exploring targeted therapies could provide valuable insights for clinical SCI treatment.This paper aims to provide an objective review of the role of microcirculation in SCI,identify the critical regulators of microvascular function,and summarize strategies for treating SCI by targeting microcirculation.The findings of this study may offer novel references for the clinical management of SCI.

Spinal cord injury(SCI)is a central nervous system disease with high morbidity and disability rates,bringing serious economic and psychological burdens to families and society worldwide.AMP-activated protein kinase(AMPK)is an important sensor in the energy metabolism process in living organisms,which plays a central role in maintaining energy balance.It is currently considered a key target for the prevention and treatment of multiple diseases.Studies have shown that AMPK signaling can regulate autophagy,neuroinflammation,oxidative stress,mitochondrial function and other processes after SCI,thus affecting the pathological process of SCI.This review summarizes the research progress on AMPK signaling pathway involved in the regulation of SCI,in order to provide new ideas for the treatment and drug development of SCI.

As early mobilization of patients in the intensive care unit(ICU)is increasingly recognized as a key measure for improving patient prognosis and reducing complications,related research is increasing.However,conventional early mobilization methods are often limited by factors such as patient condition,nursing resources,and environmental factors,making it difficult to achieve optimal results.In recent years,virtual reality(VR)technology,owing to its unique immersion and interactive features,has emerged as a focus of research in the field of ICU patient rehabilitation.This review summarizes the advances in the application of VR technology in the early mobilization of ICU patients,focusing on its advantages over traditional methods,specific implementation approaches,clinical outcomes,and challenges encountered during application.By synthesizing existing evidence,this review aims to provide valuable references for clinical practice and to explore future directions for VR technology in ICU rehabilitation,with the goal of promoting its widespread application in the early mobilization of critically ill patients.

Objective To investigate the effects of estrogen signaling on T-cell recruitment and polarization in acutely injured skeletal muscle.Methods One hundred C57BL/6 male mice,one hundred and eighty C57BL/6 female mice were selected.Twenty-five female mice were ovariectomized(OVX)and 10 male mice were taken as the sham-operated(sham).Then,cardiotoxin(CTX)induced tibialis anterior(TA)injury for preparing mice myoinjury model.Subcutaneous injection of 17β-estradiol(E2)or estrogen receptor antagonist 4-hydroxytamoxifen(4-OHT)was performed.A total of 140 mice(70 males and 70 females)were divided into four group including:PBS-male,CTX-male,PBS-female,and CTX-female.Serum estradiol(E2)levels were measured by ELISA,and muscle injury models were validated via HE staining.Subsequently,20 male and 20 female mice were selected for immunofluorescence(IF)and Real-time PCR to assess estrogen receptors(ER)expression in injured muscle tissue.Further,10 male and 40 female mice were allocated into five experimental groups,including CTX,CTX+E2,CTX+4-OHT,CTX+OVX,CTX+sham.HE staining and IF were performed to evaluate inflammatory infiltration in the injured muscle.Additionally,50 female mice were divided into CTX and CTX+OVX groups,and IF combined with flow cytometry were used to analyze T-cell phenotypes and muscle fiber regeneration in the injured muscle.Results In vivo,serum E2 and myofiber ERβ increased post-injury in mice of both sexes,significantly higher in females.Compared to the control group,E2 alleviated inflammation,OVX exacerbated inflammation,increased CD4+T-cell infiltration,elevated T helper 1 cell(Th1)response,decreased regulatory T cells(Tregs),impaired regeneration.In vitro,IFN-γ/LPS significantly upregulated ERβ in myotubes.Conclusion Estrogen signaling critically regulates muscle inflammation.Estrogen deficiency(OVX)delays repair of skeletal muscle by promoting Th1 response and suppressing Tregs function.