Objective To discuss the curative effect of interventional embolization using vascular plug together with spring coil in treating varicocele.Methods A total of 15 patients with varicocele,who were admitted to authors'hospital between March 2022 and October 2022 to receive treatment,were enrolled in this study.Interventional embolization therapy by using vascular plug together with spring coil via the left elbow vein access or via the femoral vein access was carried out in all the 15 patients.The instant surgical success rate,complications,time spent for operation,average hospital stay,and postoperative clinical efficacy were recorded and analyzed.Results Successful interventional embolization using vascular plug together with spring coil was accomplished in all the 15 patients,and no complications occurred during the perioperative period.The time spent for operation was(19±12)min,and the average hospital stay was 2.3 days.The patients were followed up for one month,the degree of the scrotal varices was obviously improved,and the swelling feeling of the perineum was significantly reduced.Conclusion For the treatment of varicocele,the interventional embolization using vascular plug together with spring coil carries certain advantages,such as reliable curative effect,easy to operate,patient being more comfortable,fast recovery,and less complications.Therefore,this technique is a therapeutic approach worth further investigation.(J Intervent Radiol,2024,32:73-76)

Objective: To examine the short-term curative effect with minimally invasive right infra-axillary thoracotomy for transaortic modified Morrow procedure. Methods: The clinical data of 60 patients who underwent video-assisted thoracoscopic transaortic modified Morrow procedure from August 2021 to August 2022 at Department of Cardiovascular Surgery, Zhejiang Provincial People's Hospital were retrospectively analyzed. There were 31 males and 29 females, with the age (M (IQR)) of 54.0(22.3) years (range: 15 to 71 years). The echocardiography confirmed the diagnosis of moderate mitral regurgitation in 30 patients, and severe mitral regurgitation in 13 patients. Systolic anterior motion (SAM) was present preoperatively in 54 patients. All 60 patients underwent transaortic modified Morrow procedure through a right infra-axillary thoracotomy using femorofemoral cardiopulmonary bypass. Surgical procedures mainly included transverse aortic incision, exposure of left ventricular outflow tract (LVOT), septal myectomy, and correction of the abnormal mitral valve and subvalvular structures. Results: All 60 patients underwent the programmatic procedures successfully without conversion to full sternotomy. The cardiopulmonary bypass time was (142.0±32.1) minutes (range: 89 to 240 minutes), while the cross-clamp time was (95.0±23.5) minutes (range: 50 to 162 minutes). The patients had a postoperative peak LVOT gradient of 7.0 (5.0) mmHg (range: 0 to 38 mmHg) (1 mmHg=0.133 kPa). A total of 57 patients were extubated on the operating table. The drainage volume in the first 24 h was (175.9±57.0) ml (range: 60 to 327 ml). The length of intensive care unit stay was 21.0 (5.8)h (range: 8 to 120 h) and postoperative hospital stay was 8 (5) days (range: 5 to 19 days). The postoperative septal thickness was 11 (2) mm (range: 8 to 14 mm). All patients had no iatrogenic ventricular septal perforation or postoperative residual SAM. The patients were followed up for 4 (9) months (range: 1 to 15 months), and none of them needed cardiac surgery again due to valve dysfunction or increased peak LVOT gradient during follow-up. Conclusion: Using a video-assisted thoracoscopic transaortic modified Morrow procedure through a right infra-axillary minithoracotomy can provide good visualization of the LVOT and hypertrophic ventricular septum, ensure optimal exposure of the mitral valve in the presence of complex mitral subvalvular structures, so that allows satisfactory short-term surgical results.
Male ; Female ; Humans ; Mitral Valve Insufficiency/surgery* ; Thoracotomy ; Retrospective Studies ; Cardiomyopathy, Hypertrophic/surgery* ; Ventricular Septum/surgery* ; Treatment Outcome ; Minimally Invasive Surgical Procedures/methods*

Patients with congenital unilateral absence of the vas deferens (CUAVD) manifest diverse symptoms from normospermia to azoospermia. Treatment for CUAVD patients with obstructive azoospermia (OA) is complicated, and there is a lack of relevant reports. In this study, we describe the clinical features and evaluate the treatments and outcomes of CUAVD patients with OA. From December 2015 to December 2020, 33 patients were diagnosed as CUAVD with OA in Shanghai General Hospital (Shanghai, China). Patient information, ultrasound findings, semen analysis, hormone profiles, and treatment information were collected, and the clinical outcomes were evaluated. Of 33 patients, 29 patients were retrospectively analyzed. Vasoepididymostomy (VE) or cross VE was performed in 12 patients, the patency rate was 41.7% (5/12), and natural pregnancy was achieved in one of the patients. The other 17 patients underwent testicular sperm extraction as the distal vas deferens (contralateral side) was obstructed. These findings showed that VE or cross VE remains an alternative treatment for CUAVD patients with OA, even with a relatively low rate of patency and natural pregnancy.
Pregnancy ; Female ; Humans ; Male ; Vas Deferens/abnormalities* ; Azoospermia/surgery* ; Epididymis/surgery* ; Retrospective Studies ; Tertiary Care Centers ; China ; Semen

Taking lipophagy as the breakthrough point, we explored the mechanism of Zexie Decoction(ZXD) in improving lipid metabolism in the hepatocyte model induced by palmitic acid(PA) and in the animal model induced by high-fat diet(HFD) on the basis of protein kinase B(Akt)/transcription factor EB(TFEB) signaling pathway. Co-localization was carried out for the microtubule-associated protein light chain 3(LC3) plasmid labeled with green fluorescent protein(GFP) and lipid droplets(LDs), and immunofluorescence co-localization for liver LC3 of HFD mice and perilipin 2(PLIN2). The results showed that ZXD up-regulated the expression of LC3, reduced lipid accumulation in hepatocytes, and increased the co-localization of LC3 and LDs, thereby activating lipo-phagy. Western blot results confirmed that ZXD increased autophagy-related protein LC3Ⅱ/LC3Ⅰ transformation ratio and lysosome-associated membrane protein 2(LAMP2) in vivo and in vitro and promoted the degradation of sequestosome-1(SQSTM1/p62)(P<0.05). The results above jointly explained that ZXD regulated lipophagy. Furthermore, ZXD activated TFEB expression(P<0.05) and reversed the PA-and HFD-induced decrease of TFEB nuclear localization in hepatocytes(P<0.05). Meanwhile, ZXD activated liver TFEB to up-regulate the expression of the targets Lamp2, Lc3 B, Bcl2, and Atg5(P<0.05). Additionally, ZXD down-regulated the protein level of p-Akt upstream of TFEB in vivo and in vitro. In conclusion, ZXD may promote lipophagy by regulating the Akt/TFEB pathway.
Animals ; Mice ; Autophagy/drug effects* ; Hepatocytes/metabolism* ; Microtubule-Associated Proteins/metabolism* ; Proto-Oncogene Proteins c-akt/metabolism* ; Signal Transduction ; Drugs, Chinese Herbal/pharmacology*

OBJECTIVE: To explore the protective effect and the underlying mechanism of Hu-Lu-Ba-Wan (, HLBW) on the testis of diabetic rats. METHODS: Twenty-four male Wistar rats (160-180 g) were randomly divided into 3 groups according to a random number table, including a control group (n=8), diabetic group (n=8), and HLBW group (n=8). Diabetic rat model was established by high-fat-diet administration and single intravenous injection of streptozotocin (26 mg/kg). Then HLBW granule was administrated for 12 weeks. Fasting blood glucose and insulin levels as well as serum total testosterone level and testicular testosterone content were examined. Oxidative stress markers in both serum and testis were tested. Meanwhile, testicular morphology was observed under hematoxylin and eosin (HE) and the ultrastructure of Leydig cell was observed by electron microscope. The superoxide anion level was detected by DHE, and TUNEL-positive cells of testis was evaluated by TUNEL assay. The gene and protein expression of protein kinase C (PKCα), phosphorylated PKCα (P-PKCα) and P47phox in testicular tissues were determined by quantitative RT-PCR analysis and Western bolt analysis. RESULTS: Compared with the diabetic group, HLBW treatment significantly reduced the fasting glucose levels and increased the levels of fasting insulin and testosterone in serum (P<0.01). HLBW administration also reduced the levels of reactive oxygen species (ROS) in plasma and alleviated the damage of oxidative stress in the testis of diabetic rats. Additionally, HLBW down-regulated the protein and mRNA levels of PKCα, P-PKCα and P47phox in testicular tissues. CONCLUSION HLBW may attenuate the oxidative stress in the testis of diabetic rats via PKCα /NAPDH oxidase signaling pathway.

As compulsory standards in occupational health, the diagnostic criteria for occupational diseases are the main basis for the diagnosis of occupational diseases. According to the Occupation Disease Classification and Catalogue in China, there are currently 13 kinds of legal occupational radiation diseases in China. There are 14 supporting diagnostic criteria, including the GBZ 104-2017 Diagnosis of Acute Radiation Sickness from Occupational External Exposure, GBZ 99-2002 Diagnostic Criteria for Subacute Radiation Sickness from External Exposure, GBZ 105-2017 Diagnosis of Chronic Radiation Sickness from Occupational External Exposure, GBZ 96-2011 Diagnostic Criteria for Radiation Sickness from Internal Exposure, GBZ 106-2020 Diagnosis for Occupational Radiation Diseases of Skin, GBZ 97-2017 Judgment Standard for Occupational Radiogenic Neoplasms, GBZ 100-2010 Diagnostic Criteria for External Radiation Bone Injury, GBZ 101-2020 Diagnosis for Occupational Radiation Thyroid Disease, GBZ 107-2015 Diagnosis for Occupational Radiation Induced Gonad Disease, GBZ 102-2007 Diagnostic Criteria of Combined Radiation-blast Injury, GBZ 103-2007 Diagnostic Criteria of Combined Radiation-burn Injury, GBZ 95-2014 Diagnostic Criteria for Occupational Radiation Cataract, GBZ 108-2002 Diagnostic Criteria for Acute Uranium Intoxication and GBZ 112-2017 General Guideline for Diagnosis of Occupational Radiation Diseases. Compared with previous criteria, some of the new criteria changed a lot in terms of diagnostic conditions, included diseases, dose threshold and calculation methods for etiological probability. The science and practicability improved continually, which is conducive to standardize the diagnosis of occupational radiation diseases.

Objective:To analyze the epidemiological characteristics of hepatitis B （HB） in Huzhou from 2004 to 2017 in order to provide theoretical basis for the prevention of HB. Methods:Descriptive epidemiologic methods were used to analyze the data of HB cases in Huzhou city， 2004-2017. Results:A total of 16 685 HB cases were reported in Huzhou from 2004 to 2017. The average annual incidence of HB was 41.58/10⁵. Incidence tended to decrease （χ²=5 094.667， P<0.01）. The incidence of HB among males was higher than that among females （χ²=2 619.143，P<0.01）， and the incidence rate among males and females both tended to decrease （male： χ²= 3 408.813， P<0.01；female： χ²=1 716.388， P<0.01）. Of the reported case of HB， 83.0% involved individuals between 20 and 60 years of age. Most of the patients were farmers， accounting for 52.41% of the total cases. The top three districts reporting high case numbers were Changxing （4 584 cases （27.47%））， Wuxing （4 356 cases （26.11%））， Anji （3 192 cases（19.13%））， while the top county/district of the annual incidence was Changxing （50.10/10⁵）. Conclusion:Incidence of HB kept decreasing between 2004 and 2017 in Huzhou. Adults are the key population vulnerable to HB virus. To further reduce the incidence of HB， it is necessary to strengthen the prevention of HB and HB vaccination rate among high-risk groups.

Objective:To reveal the dynamic changes of flavonoids secondary metabolites and relevant genes expressions in the process of germination of tartary buckwheat seeds by investigating the content of catechins，epicatechins，rutin，and quercetin，and the expressions of their relevant genes in tartary buckwheat sprouts and seedlings，in order to provide scientific basis for the selection of high-quality, high-nutrition tartary buckwheat sprouts.Method:Contents of catechin，epicatechin，rutin，and quercetin in tartary buckwheat sprouts and seedlings were detected by UPLC-ESI-QQQ-MS，and the expression levels of genes relating to flavonoids synthesis in tartary buckwheat sprouts and seedlings were detected by real-time quantitative PCR.Result:There were differences between tartary buckwheat sprouts and seedlings in the relative contents of catechin，epicatechin，rutin and quercetin，as well as the expressions of relevant genes in the synthesis pathway, including FtPAL，FtC4H，Ft4CL，FtCHS，FtCHI，FtF3H，FtF3'H，FtFLS，FtDFR，FtLAR，FtANS，FtANR. The contents of flavonoids and the expressions of relevant genes in tartary buckwheat sprouts were higher than those in tartary buckwheat seedlings.Conclusion:The higher accumulation of secondary metabolites and flavonoids in tartary buckwheat sprouts may be related to tartary buckwheat seeds' resistance to the external environment in the initial growth stage of germination. From the perspective of application，there are more flavonoids in tartary buckwheat sprouts than in tartary buckwheat seedlings, indicating that tartary buckwheat sprouts have a higher nutritional value.