Background/Aims: Non-alcoholic fatty liver disease (NAFLD) is closely associated with metabolic dysfunction. Among the multiple factors, genetic variation acts as important modifiers. Klotho, an enzyme encoded by the klotho (KL) gene in human, has been implicated in the pathogenesis of metabolic dysfunctions. However, the impact of variants in KL on NAFLD risk remains poorly understood. The aim of this study was to investigate the impact of KL rs495392 C>A polymorphism on the histological severity of NAFLD. Methods: We evaluated the impact of the KL rs495392 polymorphism on liver histology in 531 Chinese with NAFLD and replicated that in the population-based Rotterdam Study cohort. The interactions between the rs495392, vitamin D, and patatin-like phospholipase domain containing 3 (PNPLA3) rs738409 polymorphism were also analyzed. Results: Carriage of the rs495392 A allele had a protective effect on steatosis severity (odds ratio [OR], 0.61; 95% confidence interval [CI], 0.42–0.89; P=0.010) in Chinese patients. After adjustment for potential confounders, the A allele remained significant with a protective effect (OR, 0.66; 95% CI, 0.45–0.98; P=0.040). The effect on hepatic steatosis was confirmed in the Rotterdam Study cohort. Additional analysis showed the association between serum vitamin D levels and NAFLD specifically in rs495392 A allele carriers, but not in non-carriers. Moreover, we found that the rs495392 A allele attenuated the detrimental impact of PNPLA3 rs738409 G allele on the risk of severe hepatic steatosis. Conclusions The KL rs495392 polymorphism has a protective effect against hepatic steatosis in patients with NAFLD.

We aimed to confirm the predictive ability of the presence of intraductal carcinoma of the prostate (IDC-P) for prognosis and the associations between IDC-P and clinicopathological parameters. Studies were identified in PubMed, Cochrane Library, EMBASE, Web of Science, and SCOPUS up to December 1, 2019. Hazard ratios (HRs) for survival data and odds ratios for clinicopathological data with 95% confidence intervals (CIs) were extracted. Heterogeneity was evaluated by the I

Objective:To Compare and analyze the gut microbiota and biochemical indexes between patients with acute traumatic complete spinal cord injury and healthy subjects. Methods:From May, 2017 to May, 2018, a total of 44 patients with acute traumatic complete spinal cord injury (patient group) and 33 healthy controls (control group) were included. The clinical data and fresh blood, urine and fecal samples of the two groups were collected. The V3-V4 region of 16S rRNA gene was sequenced and analyzed. Results:The abundance of gut microbiota was higher in the patient group than in the control group, and the structural composition was different. Compared with the control group, the expression of Bacteroidetes decreased (P < 0.05), and the expression of Actinobacteria, Proteobacteria, Synergistetes, Saccharibacteria and Cyanobacteria increased in the patient group (P < 0.05). The serum glucose, low density lipoprotein, triglyceride and total cholesterol were significantly higher in the patient group than in the control group (P < 0 05). There was a significant correlation between these elevated markers and intestinal microbial community structure (P < 0.05). Conclusion:There is gut microbiota dysbiosis in patients with acute traumatic complete spinal cord injury, and the changes of the microbiota are related to the elevation of some serum biomarkers.

ObjectiveTo investigate the value of micro- dissection testicular sperm extraction (micro-TESE) in the treatment of non-obstructive azoospermia (NOA) in patients with the history of secondary testicular injury.

METHODSTotally, 121 NOA patients with the history of secondary testicular injury underwent micro-TESE in our hospital from September 2014 to December 2017. We analyzed the correlation of the sperm retrieval rate with the causes of testicular injury and compared the outcomes of the ICSI cycles with the sperm retrieved from the NOA males by micro-TESE (the micro-TESE group) and those with the sperm ejaculated from severe oligospermia patients (sperm concentration <1×10⁶/ml, the ejaculate group). Comparisons were also made between the two groups in the female age, two-pronucleus (2PN) fertilization rate, transferrable embryos on day 3 (D3), D3 high- quality embryos, D14 blood HCG positive rate, embryo implantation rate, and clinical pregnancy rate.

RESULTSTesticular sperm were successfully retrieved by micro-TESE in 86.0% of the patients (104/121), of whom 98.4% had the history of orchitis, 75.5% had been treated surgically for cryptorchidism, and 63.6% had received chemo- or radiotherapy. No statistically significant differences were observed between the micro-TESE and ejaculate groups in the 2PN fertilization rate (59.4% vs 69.3%, P > 0.05), D14 blood HCG positive rate (44.6% vs 57.9%, P > 0.05), embryo implantation rate (31.8 %% vs 32.6%, P > 0.05) and clinical pregnancy rate (41.5% vs 48.7%, P > 0.05). However, the rate D3 transferrable embryos was significantly lower in the micro-TESE than in the ejaculate group (40.5% vs 52.2%,P < 0.05), and so was that of D3 high-quality embryos (32.5% vs 42.1%, P < 0.05).

CONCLUSIONSMicro-TESE can be applied as the first choice for NOA patients with the history of secondary testicular injury, but more effective strategies are to be explored for the improvement of ICSI outcomes with the sperm retrieved by micro- TESE.

The issues of disordering production and non-standard pesticide application are common in the production of Chinese herbal medicines. Aimed to above problems, research groups built the pollution-free and precision cultivation system of medicinal plants. This system mainly included the precise site selection of medicinal plants based on the GIS technology, modern omics-assisted breeding, metagenomics guiding the soil complex improvement, and the precise field management based on rational application of fertilizer and comprehensive control of disease. At present, the production and distribution of medicinal plants were performed in the many poor counties of the whole nation. The breeding platform of resistant varieties was built, and certificates of new and well-bred varieties were received, in the base of genetic backgrounds of the original species of medicinal plants. The disease incidences were declined after application of these resistant varieties. Additionally, chemical pesticide consumption of medicinal plants (such as Panax ginseng, P. notoginseng, Salvia miltiorrhiza, P. quinquefolium, Schisandra chinensis, Platycodon grandiflorum and P. grandiflorus etc.) reduced by 20%-80% based on the genetic testing technologies of plant diseases and insect pests and safety evaluation of pollution-free pesticides. The application of pollution-free and precision cultivation system of Chinese herbal medicines achieve significantly social, economic and ecological benefits.

Objective To investigate the clinical features of patients with acute ST-segment elevation myocardial infarction (STEMI) comorbid with diabetes mellitus (DM) and to analyze the prognosis within 12 months after primary percutaneous coronary intervention (pre-PCI). Methods A total of 375 STEMI patients were divided into the diabetes group (n=140) and the normal blood glucose group(n=235) according to whether they met the diagnostic criteria of DH. The clinical data,characteristics of coronary artery lesions,type of stent implant,rate of coronary slow flow or no-reflow after pre-PCI, and the prognosis within 12 months after PCI of the two groups were investigated.Results Patient in the diabetes group presented with higher mean age ,higher comorbid rates of hypertension , hyperlipidemia and heart function of Killip class Ш and above than patients in the normal blood glucose group (all P<0.05). patients in the diabetes group had higher rates of slow reflow /no-reflow after PCI(12.9% vs.5.5%,P=0.013),higher percentages of 3-ressel disease(40.7% vs. 28.9%,P=0.019)and lef t main lesions(13.6% vs. 7.2%,P=0.044). The in-hospital mortality rates(6.4% vs.1.7%,P=0.020),revascularization rates within 12 months(7.9% vs.0.9%,P=0.001)and incidence of heart failure(7.9% vs. 2.6%,P=0.017)were all higher in the diabetes group. Conclusions STEMI patients comorbid with DM were relatively older, had higher comorbidities of hypertension,hyperlipidemia, three-vessel disease, left main coronary lesions and higher mortality during hospitalization. No significant increase in cardiac death and recurrent myocardial infarction were deserved during the follow-up period. These patients may benefit more from early intervention.

Objective To retrospectively analyze the features and related factors of deep venous thrombosis(DVT)in patients with traumatic paraplegia during early rehabilitation. Methods Inpatients of our hospital from June,2014 to June,2017 were included and patients with traumatic paraplegia during early rehabilitation were analyzed.The clinical information,lower limbs deep vein ultrasonic testing and laboratory examination were collected to analyze features and related factors of DVT. Results A total of 269 patients with traumatic paraplegia during early rehabilitation were analyzed and 62 patients had DVT in lower limbs(23.0%),in which 50 patients had an isolated distal DVT and 28 cases occurred in bilateral lower limbs(45.2%).No patients younger than 14 had DVT in lower limbs(n=31).Logistic regression analysis showed that increased D-dimer (OR=1.348, 95% CI 1.193~1.525), advanced age (OR=3.450, 95% CI 1.372~8.674),male(OR=2.872,95% CI 1.095~7.533)and diabetes(OR=5.319,95% CI 1.094~25.872)were indepen-dent related factors for DVT. Conclusion The incidence of DVT in lower limbs of traumatic paraplegia patients during early rehabilitation is high. DVT develops mainly distally to the popliteal vein and bilaterally of lower limbs. Prepubertal children have a low incidence of DVT.Increased D-dimer,advanced age,male and diabetes are independent related factors for DVT.

Acute spinal cord injury(ASCI)can be divided into primary injury and secondary injury.Spinal cord edema is important for the development of secondary injury after ASCI.Spinal cord edema can be mainly divided into cytotoxic edema and angioedema.The application of dehydrating agents in the treatment of acute spinal cord injury is obvious.This article de-scribed the application of mannitol,hypertonic saline,glycerol fructose,furosemide,human serum albumin,resveratrol and other dehydrating agents in the treatment of ASCI.

Neurogenic bowel dysfunction is one of the most common complications of spinal cord injury.It can cause abdominal distension,constipation,fecal incontinence,difficult defecation,prolonged defecation and other symptoms.At present, neurogenic bowel dysfunction is mainly evaluated through general condition,physical examination,experimental exami-nation,professional scales and intestinal microbiota,etc.

Objective To study the dynamic changes of the intestinal function of neurogenic bowel dysfunction rats caused by spi-nal cord injury using X-ray radiography. Methods Twenty-four female Sprague-Dawley rats were divided into control group (n=12) and spinal cord injury group (n=12). The T10spinal cord injury model was established using aneurysm clip (70 grams calibration force) for 60 seconds. The control group exposed the dura only. X-ray Barium was used to observe the dynamic changes of in-testinal function, and HE staining was used to observe the pathology of the colon before and four weeks after modeling. Results Compared with the control group, gastric emptying and intestinal transit function significantly reduced in the spinal cord injury group (P<0.05). Conclusion The spinal cord injury model can be successfully duplicated with aneurysm clip in rats; neurogenic bowel dysfunction occurs after spinal cord injury, gastric emptying and intestinal transit function are weakened.