Objective:To examine the prevalence and trends of male urogenital system tumors in China from 1990 to 2019.Methods:The Global Burden of Disease Study 2019 database was used to analyze the incidence and mortality of male urogenital tumors among different age groups and years in China. Joinpoint 5.2.0 software was utilized to analyze the incidence and mortality trends of male urogenital tumors in China from 1990 to 2019. Standardized incidence and mortality rates of male urogenital system tumors in China, in the world and in different sociodemographic index (SDI) regions were compared.Results:In 2019, the rank of incidence of male urogenital system tumors in China from high to low was prostate cancer (21.17/100 000), bladder cancer (11.41/100 000), kidney cancer (5.87/100 000) and testicular cancer (2.37/100 000). The rank of mortality was consistent with the rank of incidence, which was prostate cancer (7.50/100 000), bladder cancer (4.35/100 000), kidney cancer (2.33/100 000) and testicular cancer (0.17/100 000). The ranks of incidence and mortality of male urogenital tumors in China in 1990 were the same as those in 2019. In 2019, prostate cancer cases began to appear in the 20-year-old age group, bladder cancer cases in the 15-year-old age group, while kidney cancer and testicular cancer cases began to emerge in the 1-4-year-old age group. Before the age of 55, the incidence and mortality rates of four types of tumors in the male urogenital system did not differ significantly. After the age of 55, the incidence and mortality rate of prostate cancer surpassed those of kidney cancer, bladder cancer and testicular cancer. The incidence rate of male urogenital tumors in 2019 was higher in all age groups than in 1990. From 1990 to 2019, the incidence, mortality and standardized incidence rates of prostate cancer, bladder cancer, kidney cancer and testicular cancer all showed increasing trends. The standardized mortality rate of kidney cancer showed an upward trend, while prostate cancer exhibited a downward trend. Compared with global averages, the standardized incidence and mortality rates of male urogenital system tumors in China were lower in 1990 and 2019. Compared with different SDI regions, the standardized incidence and mortality rates of male kidney cancer, testicular cancer and bladder cancer in China in 1990 and 2019 were similar to those in moderate and low SDI regions. The standardized incidence and mortality rates of prostate cancer in 1990 and 2019 were lower in China than in different SDI regions.Conclusion:In 1990 and 2019, the incidence and mortality ranks of male urogenital tumors in China are the same, with prostate cancer, bladder cancer, kidney cancer and testicular cancer in order from high to low. From 1990 to 2019, the incidence, mortality and standardized incidence rates of male urogenital system tumors in China show increasing trends. In 1990 and 2019, compared with the global average, the standardized incidence and mortality rates of male urogenital system tumors in China are lower.

Objective:To explore the clinical efficacy of periosteum-covered iliac crest autografts for treatment of severe osteochondral lesions of talus （OCLTs）.Methods:A retrospective case series study was used to analyze the clinical data of 26 patients with severe OCLTs treated at Zhejiang Armed Police Corps Hospital from January 2013 to October 2019. There were 21 males and 5 females，aged 17-49 years ［（36.3 ± 10.9）years］. All patients were treated using periosteum-covered iliac crest autografts. The visual analogue scale （VAS），American Orthopedic Foot and Ankle Society （AOFAS） ankle-hindfoot score and ankle joint range of motion （ROM） were assessed before operation，6 months after operation and at the last follow-up （≥ 12 months）. The area of talus injury with MRI at the same level was recorded before operation and at the last follow-up. The healing of talus and joint surface was detected with CT at the last follow-up. The healing of the incision and osteotomy site and complications were observed.Results:All patients were followed for 12 to 22 months［（15.1 ± 3.2）months］. The VAS was （2.4 ± 0.9）points and （1.7 ± 0.6）points at postoperative 6 months and at the last follow-up，significantly lower than the preoperative （5.4 ± 1.2）points （ P < 0.01）. Meanwhile，the VAS at the last follow-up was significantly lower than that at postoperative 6 months （ P < 0.01）. The AOFAS ankle-hindfoot score was （71.7 ± 7.8）points and （87.8 ± 6.2） points at postoperative 6 months and at the last follow-up，significantly lower than the preoperative （66.5 ± 7.5） points （ P < 0.01）. Meanwhile，the AOFAS ankle-hindfoot at the last follow-up was significantly lower than that at postoperative 6 months （ P < 0.01）. The ankle ROM was （58.4 ± 5.5）° and （70.0 ± 4.9）° at postoperative 6 months and at the last follow-up，significantly improved when compared to the preoperative （42.3 ± 8.1）° （ P < 0.01）. Meanwhile，the ankle ROM at the last follow-up was significantly improved when compared to that at postoperative 6 months （ P < 0.01）. The area of talus injury with MRI at the same level was 0.67（0.55，0.89）cm 2 at the last follow-up，significantly improved when compared to preoperative 2.64（1.98，3.68）cm 2 （ P < 0.01）. The transplantation had neither obvious defects nor joint surface steps based on CT findings. All surgical incisions were healed by first intention. There were no complications such as incision infection，skin necrosis，nonunion of osteotomy，malunion or severe ankle joint disorder except that 8 patients had residual local subchondral bone?marrow?edema-like?signal?and 2 patients showed delayed healing of medial malleolus osteotomy. Conclusion:For patients with severe OCLTs，periosteum-covered iliac crest autografts can effectively relieve ankle pain，improve ankle function，and reduce the area of injury.

Objective To investigate the immunomodulatory effect of mesenchymal stem cells (MSCs) and their role in prolonging allograft survival in rat heart transplantation. Methods Inbred Wistar rats were used as donors, and Fisher 344 as recipients. MSC were isolated from femur and tibia bone marrow of donors and cultured in vitro. Mixed lymphocyte reaction assays were performed to assess the immunosuppressive effects of different concentrations of MSC on allogeneic T cell proliferation. Cardiac allograft model was established and according to different intervention measures recipients were divided into two groups (MSC treatment group and control group) (n=8 in each group). In MSC treatment group, recipients were infused with 2×106 MSC via the tail vein at designated intervals (one week before operation, during operation and consecutive three days postoperation), while in control group, the recipients were treated with Ringer's solution at the same interval& At day 5 posttransplantation real-time PCR was used to detect the changes in the expression of Thl and Th2 cytokine genes in transplanted hearts. Results In vitro allogeneic T cell response was greatly suppressed by MSC in a dose-dependent manner. Real-time PCR revealed that IL-1β,IFN-γ, IL-4 and IL-10 were expressed in MSC treatment group, while IL-4 and IL-10 were not expressed in control group but with significantly higher expression of IL-1β and IFN-γ. As compared with control group, survival of MSC-treated allografts was markedly prolonged as compared with control group (mean survivaldays: 12.4±5.3 vs 6.4±2.0, P＜0.05). Conclusion Intravenous adrninistmtion of MSC can prolong the survival of transplanted heart possibly by induction of allograft tolerance through changing Th1/Th2 balance.

Objective To evaluate clinical and CT features of the 4 th lumbar vertebral spondylolisthesis (L 4DS ) as well as CT value in its diagnosis. Methods CT features of 36 cases of L 4DS were observed and interarticular distance (IAD) and facet joint angle (FJA) were measured and compared with control group.Results Patients with L 4DS mostly were over 40 years old. CT features included degenaration, spondylolisthesis and spinal canal stenosis. IAD and FJA were significantly narrowed. Conclusion CT axial scans combined with plain films,CTM and MPR clearly shows basic changes of L 4DS , providing useful details for clinical management. Narrow posterior vertebral part are important factors leading to L 4DS.