Volume 98 ·  Issue 46 ·  2018

Testicular torsion is a rare scrotal emergency, and the complications are very serious, often leading to orchiectomy. It is reported in literature that the cumulative testicular loss rate is 31.9~41.9%^[1]。 Misdiagnosis will directly lead to delayed treatment and orchiectomy. Patients with testicular loss due to misdiagnosis usually prevail in medical lawsuits, and such litigation cases rarely mention the details. This paper analyzes the medical litigation cases caused by testicular torsion, analyzes the root causes of these problems from multiple angles, and explores the influencing factors of testicular torsion litigation cases, hoping to improve the ability to identify and deal with testicular torsion, help the parties identify and avoid the occurrence of adverse events, and improve the medical safety of patients.

Azoospermia is the most serious male infertility, which refers to the complete absence of sperm in the ejaculated semen, accounting for about 5% to 20% of male infertility patients^[1]。 The diagnosis of azoospermia must have ≥2 semen specimens, more than 2 weeks apart, and no sperm was found before and after semen centrifugation^[2]。 Azoospermia does not refer to the absence of sperm production in the testicles, but rather emphasizes the absence of sperm in the semen^[3]。

To discuss the efficacy and safety of subinguinal microsurgical varicocelectomy in the treatment of non-obstructive azoospermia (NOA) with varicocele.

The clinical data of 141 patients with NOA and varicocele who underwent subinguinal microsurgical varicocelectomy from March 2015 to June 2017 in Shanghai General Hospital was collected.One hundred and ten patients suffered from varicocele on the left side, 1 on the right side, and the rest (30 cases) were bilateral varicocele. Grade Ⅰ varicocele were found on 7 sides (the right and left side was count respectively), grade Ⅱ on 121 sides, and grade Ⅲ on 43 sides. Sperm analysis, pregnancy rate and complications were recorded after at least 6 months since operation.

Eleven cases were lost during the follow-up. Eighteen of the remaining 130 NOA patients processed successful sperm retrieval in post-operative semen analysis (18/130, 13.8%). Six couples(6/130, 4.6%) succeeded in natural pregnancy. Five couples (5/130, 3.8%)underwent successful pregnancy following with intracytoplasmic sperm injection(ICSI). Twenty-six out of the remaining 112 patients underwent the micro dissection testicular sperm extraction (micro-TESE), and 4 patients got a successful sperm retrieval (4/26, 15.4%). Among them, 2 couples had successful pregnancy with ICSI. Totally 2 cases of postoperative infection of incision were found.

Microsurgical varicocelectomy had a beneficial effect on sperm quality of patients suffered from NOA with varicocele to some extent, even leading to unassisted pregnancy or avoiding micro-TESE before ICSI. Microsurgical varicocelectomy could be applied in the treatment of NOA with varicocele.

To analyze the factors affecting the patency rate of microsurgical single-stitch longitudinal intussusception vasoepididymostomy and to explore the possible causes of failure.

The clinical data of 87 patients with epididymal obstructive azoospermia who underwent microsurgical vasoepididymostomy from January 2015 to February 2018 in the First Affiliated Hospital of Fujian Medical University were analyzed retrospectively. We observed the patency rate postoperatively and evaluated several factors that possibly related to the patency rates. Preoperative examinations included peripheral blood chromosomes, Y chromosome microdeletions, sex hormones, seminal plasma, etc. After admission, microsurgical single-stitch longitudinal intussusception vasoepididymostomy was performed. During the follow-up, the semen was evaluated to assess the patency rate and the time to patency.

The patient′s age ranged from 21 to 42 years and the mean age was(25±3) years. Infertility lasted for 1-8 years and the mean infertility time was(2.2±1.1) years. The longitudinal intussusception vasoepididymostomy was successfully completed in 80 patients , 5 cases gave up the anastomosis surgery because of multiple segment obstruction of the vas deferens, complete obstruction of the epididymis or testicular obstruction. Two cases underwent crossed vasovasostomy( sperm was present in the ejaculate in 1 case postoperatively). Of all the patients, 72 were successfully followed up. The follow-up time was 3-29 months, with an average of (12.0±1.7)months. Excluding 3 cases of follow-up time less than 12 months who still had no sperm in the ejaculate, 69 patients′ data were in cluded in the final statistics, of which 50 cases with return of sperm in the ejaculate, the overall patency rate was 72.5%(50/69), concentration of sperm was 0.1-137.2 million/ml, and the mean concentration was(29±21) million/ml; with the progressive motile sperm rate ranging from 0-57.9%, the mean rate was(29.9±21.1)%. The patency rates of motile sperm and immobile sperm found in epididymal fluid during surgery were 82.2%(37/45) and 54.2%(13/24), respectively. The patency rate of bilateral and unilateral anastomoses was 77.6%(45/58) and 45.5%(5/11), respectively; the patency rate of caput anastomosis was 47.8%(11/23), and 84.8%(39/46) for corpus or caudal anastomosis. 17 patients achieved natural pregnancy postoperatively, the rate was 34.0%(17/50).

The therapeutic effect of microsurgical single-stitch longitudinal intussusception vasoepididymostomy is satisfactory. The motile spermatozoa in epididymal fluid, bilateral surgery and corpus or caudal anastomosis can improve the patency rate postoperatively.

To analyze the effect of insufficient intake of vitamin D (VD) on sperm quality and male fertility and to discuss the mechanism of the effect.

VD deficiency mice were fed with VD-deficient diet and light-sheltered. The sperm motility, morphology, ultrastructure, testicular pathology, sex hormones and fertility of normal and VD-deficient mice were analyzed to investigate the effects of VD deficiency on male reproduction.

Compared with the normal group, the mice with VD deficiency had lower sperm concentration[(128±53) ×10⁶/ml vs( 58±15) ×10⁶/ml, P<0.05], less sperm in the epididymis, slightly less mature spermatozoa.The serum testosterone[(328±65 )nmol/L vs(255±58 )nmol/L]and estradiol levels[(60±115) pmol/L vs(384±104) pmol/L]were significantly lower (P<0.05), and the FSH[(296±177)ng/L vs(219±105 )ng/L]and LH[(393±129) ng/L vs(364±108) ng/L]levels were significantly higher (P<0.05). The other tests did not show any significant difference (P>0.05).

The impact of insufficient intake of VD on sperm quality is not prominent, the specific impact of VD on male reproductive needs to be further studied.

To investigate the expression of factor that binds to inducer of short transcripts-1 of HIV (FBI-1)in breast cancer pre- and pro-neoadjuvant chemotherapy and explore the relationship between FBI-1 expression and treatment efficacy.

We collected 50 patients with breast cancer who received neoadjuvant chemotherapy before operation in the Affiliated Tumor Hospital of Guangxi Medical University from January, 2010 to December, 2014. The expression of FBI-1 in breast cancer tissues pre- and pro-neoadjuvant chemotherapy was detected by immunohistochemical staining. We compared the level of FBI-1 expression pre- and pro-neoadjuvant chemotherapy, and tried to explore its relationship with patient and tumor characteristics and treatment efficacy.

(1) The rate of upregulated expression of FBI-1 in breast cancer tissues was 70% (35/50). The upregulated expression of FBI-1 was related to the higher clinical stage and trend of lymph node metastasis (P<0.05), whereas not related to the age and expression of ER, PR, Ki-67, and Her-2(P>0.05); (2) the setting of FBI-1 lower expression pre-neoadjuvant chemotherapy had superior treatment outcome than the high expression setting based on either clinical assessment (86.7% vs 51.4%,P=0.027) or pathological assessment(80.0% vs 28.6%, P=0.001); (3) the rate of upregulated FBI-1 expression was significantly decreased post-neoadjuvant chemotherapy(70.0% vs 38.0%, P=0.004), with FBI-1 expression of 22 patients downregulated (62.9%); (4) the expression of FBI-1 in responded setting was significantly decreased than that in the non-responded setting based on either clinical (77.4% vs 26.3%, P=0.001) or pathological (72.7% vs 39.3%, P=0.024) assessment. The downregulation of FBI-1 was correlated to either clinical efficacy (r=0.440, P<0.01) or pathological efficacy (r=0.491, P<0.05) of neoadjuvant chemotherapy.

In breast cancer patients receiving neoadjuvant chemotherapy, the upregulated expression of FBI-1 in breast cancer lesion is associated with clinical stage and lymph node metastasis. The neoadjuvant chemotherapy can significantly reduce the expression of FBI-1. The upregulated expression of FBI-1 may be predictive of resistance to chemotherapeutic drugs, and has predictive value for the efficacy of neoadjuvant chemotherapy in breast cancer patients.

To investigate the effects of berberine on urine albumin/creatine ratio (UACR) and serum cystatin C (Cys C) in patients with type 2 diabetes mellitus (T2DM).

A total of 114 T2DM inpatients or outpatients, including 46 males and 68 females aged (55±14) years between January 2015 and January 2016 were randomly divided into two groups: the control group (n=57) only with hypoglycemic agents, and the intervention group (n=57) with berberine (0.4 g, 3 times a day) on the basis of treatment from the control group. Both groups were treated and followed up for six months. All the clinical and biochemical parameters were routinely evaluated before and after treatment. And the safety of berberine was assessed.

After the treatment, the improvement of glycosylated hemoglobin (HbA1c), blood urea nitrogen (BUN), systolic pressure (SP), high sensitive C-reactive protein (hs-CRP), rythrocyte sedimentation rate (ESR), estimated glomerular filtration rate (eGFR) in the intervention group were significantly better than those in the control group (all P<0.05), as well as the UACR[47(26, 120) mg/g vs 103(42, 267) mg/g,P<0.001]and serum Cys C[(0.83±0.30) mg/L vs (0.98±0.25) mg/L,P=0.031]. However, there was no statistically significant difference of UACR and Cys C between before and after treatment in the control group (all P>0.05). Compared to the control group, the patients in the intervention group had lesser UACR[47(26, 120) mg/g vs 68(28, 158) mg/g,P=0.039], and lower serum Cys C[(0.83±0.30) mg/L vs (0.96±0.30)mg/L, P=0.041]. Berberine had no obvious adverse effects. Multiple linear regression analysis revealed that the berberine administration was independently associated with the reduction of UACR (β=-0.051,P=0.041) and Cys C (β=-0.068,P=0.033) in T2DM patients.

Berberine improves diabetic kidney disease by reducing UACR and serum Cys C in T2DM patients, and it was safe.

To explore the factors associated with glycemic control in children and adolescents with type 1 diabetes mellitus (T1DM) treated with continuous subcutaneous insulin infusion (CSII).

Subjects were enrolled from the Guangdong Type 1 Diabetes Translational Medicine Study between June 2011 and August 2017. Patients with T1DM aged less than 18 years and treated with CSII for at least 6 months were included. Demographic data and clinical information on self-monitoring of blood glucose (SMBG), glycosylated hemoglobin (HbA1c) and insulin treatment were collected. Participants were categorized based on HbA1c levels as sufficient control group (HbA1c<7.5% ) and insufficient control group ( HbA1c≥7.5%). A multivariate logistic regression model was used to examine the factors associated with glycemic control.

A total of 142 participants (76 females, 66 males) with a median age of 13.0 (9.9, 15.0) years and a median disease duration of 3.0 (1.6, 5.0) years were enrolled. HbA1c was (8.2±2.0)% and 41.55%(59/142) of patients achieved the target for HbA1c. The frequency of SMBG was 5.0 (2.0, 8.0) and 3.0 (1.0, 4.0) tests per day (P<0.001), and the frequency of hypoglycemia was 2.0 (0.8, 4.0) and 1.0 (0, 2.0) times per week (P=0.003) in sufficient control group and insufficient control group, respectively. Sufficient glycemic control (HbA1c <7.5%) was associated with the frequency of SMBG ( OR=1.238, 95% CI: 1.088-1.409, P=0.001).

A higher frequency of SMBG is one of the key factors to achieve sufficient glycemic control among children and adolescents with T1DM treated with CSII.

To evaluate the feasibility and safety of supraglottic tracheal tube ventilation by comparing with modified laryngeal mask airway ventilation during painless fiberbronchoscopy.

This was a prospective study. Twenty-eight patients undergoing painless fiberbronchoscopy in Hangzhou First People′s Hospital were randomly divided into 2 groups(n=14): supraglottic tracheal tube ventilation(group A) and modified laryngeal mask airway(group B). MAP, HR, SpO₂, P_ETCO₂ and BIS were recorded after entering the operating room(T₀), after anesthesia induction(T₁), immediately after inserting laryngeal mask airway or tracheal tube(T₂), fiberbronchoscopy inserting(T₃), at the end of the operation(T₄), and at the recovery of patients′ consciousness(T₅). The arterial carbon dioxide partial pressure(PaCO₂), the time spent in successful positioning of the tube, the endoscope indwelling duration, operative time, tube drawing time, patients′ awakening time, satisfaction of operators, adverse events during anesthesia, the numbers of bucking or body moving were also recorded.The dose of propofol and remifentanil were also statisticed.

P_ETCO₂ in group A at T₀, T₁, T₂, T₃, T₄, T₅ were (36.9±4.1), (36.3±4.7), (38.1±5.6), (40.4±4.0), (48.8±7.7), (45.3±7.6) mmHg, P_ETCO₂ in group B were (38.6±4.4), (37.8±5.6), (37.8±5.4), (37.4±6.7), (43.3±12.2), (43.5±8.0) mmHg, at the end of operation, the P_ETCO₂ at T₄ and T₅ were significantly higher than at T₀ in group A and group B (F=14.582, 12.651, all P<0.05). The PaCO₂ in group A was (62.0±4.7) mmHg , which was significantly higher than group B at the end of operation[(51.9±4.2) mmHg, t=2.432, P<0.05]. The time spent successfully positioning the insertion in group A and group B were (17.6±7.5), (29.8±13.6)s, the endoscope indwelling duration were(0.8±0.1), (1.4±0.3)min, and the operation time were(32.3±4.3), (46.8±4.8)min, there were significantly difference between group A and group B(t=2.670, 2.214, 2.166, all P<0.05). There were no significantly difference of the numbers of bucking or body moving , the satisfaction of operators and patients, and adverse events (allP>0.05).

Supraglottic tracheal tube ventilation for painless fiberbronchoscopy is a safe and effective procedure.

To investigate effects of two anesthesia methods on the first night sleep quality in middle-aged and elderly patients after surgery.

This was a prospective study conducted from November 2017 to March 2018. Sixty patients, aged 50-70, undergoing elective surgery for unilateral lower extremity varicose vein at Ningbo No.2 Hospital, with American Society of Anesthesiologists (ASA) grade Ⅰ or Ⅱ, were enrolled and randomly allocated to two groups (n=30), general anesthesia group and spinal anesthesia group. On the first day before surgery, the patient′s general data were collected and the Pittsburgh sleep quality index (PSQI) was used to assess the patient′s sleep status in the past month. The postoperative mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO₂) in the ward were recorded with a multi-function monitor on first night after surgery. The total sleep time and arousal time were obtained by bispectral index (BIS) monitoring from 20: 00 (the first day) to 6: 00 (the second day). Athens Insomnia Scale (AIS) was recorded at 18: 00 at the second day after surgery.

There was no significant difference in general data and PSQI scale scores between the two groups of patients (all P>0.05). And there were no significant differences in MAP, HR, SpO₂ and BIS every 2 hours between the two groups from 20: 00 (the first day) to 6: 00 (the second day)(all P>0.05). Compared with the general anesthesia group, the first night of total sleep time in the spinal anesthesia group was significantly shorter[(357.2±83.4)min vs (275.1±64.8)min,t=-9.635, P<0.05], while the rate of wakefulness, total sleep time, overall sleep quality, daytime mood and daytime physical function were significantly higher[(25.9%, 22.2%, 25.9%, 18.5%和18.5%) vs (51.7%, 51.7%, 55.2%, 48.3%和44.8%), χ²=3.901, 5.192, 4.941, 5.523 and 4.437, all P<0.05], and the cases of postoperative urinary retention and lower limb discomfort were significantly higher[(8 and 6) vs (1 and 0), allP<0.05].

Both anesthesia methods can be safely and effectively applied to middle-aged and elderly patients with lower extremity varicose veins surgery, but patients with general anesthesia show fewer adverse reactions on the first night after surgery and have better sleep quality.

To investigate the effects of dexmedetomidine on perioperative stress and postoperative pain in patients with radical resection of esophageal cancer under combined thoracoscope and laparoscope.

In this prospective study, one hundred patients undergoing radical resection of esophageal cancer in Affiliated Cancer Hospital of Zhengzhou University from January 2016 to October 2017, were randomly divided into control group (group C) and dexmedetomidine group (group D), n=50. All patients were anaesthetized (induced and maintained) with intravenous target-controlled infusion(TCl) of propofol and remifentanil, and intermittent intravenous injection of cisatracuriumbesylate. Bispectral index(BIS) was used to monitor the depth of anesthesia and maintained between 45-60 during operation.All patients received sufentanil (0.3 μg/kg) 30 min before the end of the operation and then received intravenous analgesia pump for postoperative patient controlled analgesia(PCA). Patients in group D received intravenous infusion of dexmedetomidine(1 μg/kg) 20 min before anesthesia induction, followed by intravenous pumping of dexmedetomidine(0.2 μg·kg ^-1·h^-1) intraoperatively.Postoperative intravenous patient-controlled analgesia(PCA) was performed in all patients, with background doses of sufentanil 0.04 μg· kg ^-1·h^-1 for patients in group C, and sufentanil 0.025 μg·kg ^-1·h^-1 plus dexmedetomidine 0.1 μg· kg ^-1·h^-1 for patients in group D. The operation time, liquid input and output during operation, the number of PCA pressings after operation were recorded. At these time points: T₀(the day before operation), T₁(immediate before anesthesia induction), T₂(1 h after emergence), T₃(24 h after operation), T₄(3 d after operation), T₅(7 d after operation), T₆(one month after operation), T₇(3 months after operation) and T₈(6 month after operation) , venous blood samples of patients were collected for detection of epinephrine, norepinephrine and corticosterone. The pain visual analogue scale(VSA) was used to assess pain levels in patients at T₂, T₃, T₄, T₅, T₆, T₇, T₈.

The age, sex ratio, body mass index (BMI) and ASA grading ratio in two groups were not significantly different(all P>0.05). There were no Significant differences in operation time, liquid input and blood output between group C and group D(allP>0.05). Within 24 h after operation, the sufentanil consumption in group D[(35.86±8.65)μg]was significantly less than that in group C[(59.53±15.26) μg,t=7.061, P<0.05], and the number of PCA pressing in group D(2.15±1.38) was obviously less than that in group C(5.85±2.16,t=4.971, P<0.05). Compared with group C, serum norepinephrines in group D was significantly less (t=13.276, 16.027, 14.319, 12.771, 12.296, respectively; all P<0.05) at T₁, T₂, T₃, T₄, T₅.And there were no difference between these two groups at T₀, T₆, T₇, T₈(all P>0.05). Serum epinephrine in group D were significantly lower than them in group C at T₂, T₃, T₄, T₅ (t=6.153, 8.774, 9.127, 8.409, respectively; all P<0.05), but there were no difference between these two groups at T₀, T₁, T₆, T₇, T₈(all P>0.05). Serum corticosterone in group D were sharply less than them in group C at T₂, T₃, T₄, T₅ (t=16.364, 15.306, 12.153, 12.592, respectively; all P<0.05), but at T₀, T₁, T₆, T₇, T₈, there were no difference between these two groups (all P>0.05). Compared with group C, the number of patients with postoperative pain(VAS score≥4) in group D was obviously less at T₆, T₇, T₈(10 vs 20, 4 vs 12, 3 vs 10; χ ²=4.762, 4.762, 4.332, respectively; all P<0.05).

Perioperative application of dexmedetomidine can effectively decrease the perioperative stress response, obviously cut down the perioperative opioid consumption, and prevent the transition from postoperative acute pain to chronic pain in patients with radical resection of esophageal cancer under combined thoracoscope and laparoscope.

To conduct an epidemiological investigation and analysis of an outbreak of mycoplasma pneumonia in adults.

The first case was a 23-year-old male came from the Third Military Medical University, who served as an intern in the Fuzhou General Hospital of PLA and presented on July 16, 2015 with a history of low-grade fever, dizziness, fatigue and chest tightness. Chest CT revealed pulmonary nodules shadow. It was found that other 11 individuals who had been in close contact with the first patient also had similar pulmonary nodules shadow after chest CT examination. Immediately, the health and epidemic prevention department of the ministry of health of Nanjing Military Command and the disease prevention and control center of the Nanjing Military Command received a phone call from Fuzhou General Hospital of PLA. Upon arrival, the prevention and control team conducted a series of epidemiological investigations and on-site prevention, control and disposal of the event, and conducted chest CT screening for other 289 students and staff who volunteered to be examined living in the same area. After the patients with similar pulmonary nodules shadow were screened out, mycoplasma antibody titer detection and chest CT re-scanning were performed for compliance patients.

There were 301 students living in the dormitories (Building A and B) of the student living area, and they were screened by chest CT, and it was found that 27 of them had pulmonary nodules shadow, including single pulmonary nodules shadow (48.1%, 13 out of 27) and multiple pulmonary nodules shadow (51.9%, 14 out of 27). And halo sign was observed in 25 of 27 patients (92.6%). The majority of the 27 patients were asymptomatic, only 2 patients got cough, a few of them had systemic symptoms such as fever, dizziness, fatigue. The positive rate of pulmonary nodules shadow was 32.8% (22/67) in building A (poor environmental hygiene), 2.14% (5/234) in building B, and the total incidence rate was 8.97%. Four-fold increase in the mycoplasma pneumoniae (MP) antibody titer in the paired sera was observed in first 12 patients. Measures such as disinfection, isolation and sanitation were taken to control the spread of the epidemic. There was no serious and death cases on the basis of active treatment on the affected patients.

The outbreak of mycoplasma pneumoniae pneumonia often occur in crowded places. And the clinical and imaging features of mycoplasma pneumoniae pneumonia are atypical. Standard epidemiological intervention should be adopted for the sudden onset of respiratory diseases with unknown causes.

In the past ten or two years, andrology has developed rapidly, and new testing items have been continuously introduced into the clinic, and have become routine testing items. However, some of these tests have obvious defects, but they are still widely used by clinical and scientific researchers. For example, the sperm DNA fragmentation index (DFI), which reflects sperm DNA damage, has been developed by a large number of andrology laboratories since its introduction into the clinic in 2002; The detection of semen elastase, which reflects recessive infection of male reproductive tract, has been gradually developed as a kit for routine clinical detection since it was reported in 1980s; Prostatosomal leakage protein (PSEP) reported in 2014 rapidly entered clinical routine testing without extensive clinical validation. These testing items have several common characteristics: (1) the clinical charges are high, up to several hundred yuan; (2) Since the promotion into clinical routine testing, although some clinicians suspect that the results are inconsistent with the clinical manifestations of patients, they have been silently used in clinical use; (3) Whether these indicators are used in clinical or scientific research, almost the same detection method comes from the same original literature, and no one seems to have ever doubted it. There may be two fundamental reasons for this phenomenon: driven by interests, high charges will inevitably bring high returns, and its clinical significance is not important; Some medical staff who have doubted these test items think that since reagent manufacturers have provided kits, they must have undergone strict verification. Coupled with a large number of repeated literature reports, they feel powerless to refute them.

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE), is a common complication of hospitalized patients, and it is also the main cause of increased medical expenses and prolonged hospital stay^[1]。 Because of its insidious onset and non-specific symptoms, it has the characteristics of high morbidity, high mortality, high missed diagnosis rate and high misdiagnosis rate. It is an important cause of unexpected death and perioperative death of hospitalized patients. VTE is considered to be the most common preventable cause of hospital-related death and disability in low, middle and high-income countries^[2]。 Therefore, VTE prophylaxis is essential for hospitalized patients.

Bronchial asthma (abbreviated as asthma) is a chronic airway inflammatory disease caused by genetic and environmental factors, and its incidence is on the rise in China^[1]。 Around 30 million people in China suffer from asthma, and less than 30% of them reach asthma control^[2]Well below the long-term asthma management goals set out by the Global Asthma Initiative (GINA). Poor asthma control can lead to increased hospitalization and emergency department visits, affecting patients' study and work, and increasing medical expenditure^[3]It imposes a huge economic burden on individuals and society. The effect of asthma treatment is closely related to patient compliance, and improving patient compliance is an important measure to improve asthma control. The following are four aspects: compliance of asthma patients and its influence on disease control, methods of judging patient compliance, influencing factors of compliance of asthma patients and strategies to improve patient compliance.

Resveratrol is a polyhydric phenol antitoxin synthesized by plants to resist microbial infection. It is widely found in grapes, red wine, peanuts and other plants^[1]。 Studies have shown that resveratrol has many beneficial biological effects, such as anti-cancer, antioxidant and anti-inflammatory, cardiovascular protection, etc^[2]。 The effects of resveratrol on the reproductive function of male mammals have also been extensively studied. This paper summarizes the effects of resveratrol on the gonad function of male mammals, hoping to provide reference for the application of resveratrol in improving the reproductive function of male mammals, especially humans.

Cardiovascular disease has always been one of the main diseases that threaten human health. It is still an urgent problem in the field of cardiovascular to explore its pathogenesis and factors affecting its prognosis, and develop effective prevention and treatment measures. Myocardial ischemia-reperfusion injury (MIRI) is one of the causes of cardiac dysfunction after reperfusion and open heart surgery in different types of angina pectoris and myocardial infarction (MI); Cardiomyocyte regeneration, survival and endothelial microvascular regeneration are crucial to the prognosis of cardiovascular disease and the improvement of cardiac function; Moreover, the final outcome of cardiovascular diseases such as coronary heart disease, cardiomyopathy and valvular heart disease is a decrease in the number of cardiomyocytes with complete diastolic function, and heart failure occurs after myocardial fibrosis and cardiac remodeling. It is of great significance to prevent or delay this process. Studies have shown that different stress factors, exosomes can release different microRNAs (miRs), which regulate the occurrence and development of MIRI, myocardial regeneration and survival, microvascular genesis, myocardial fibrosis and cardiac remodeling. This article focuses on the research progress of exosome-derived miRs in the pathogenesis of cardiovascular diseases.

The common causes of primary liver cancer (HCC) are viral hepatitis, ethanol, aflatoxin or algal chemotoxins, autoimmune liver disease, etc. In recent years, Budd-Chiari syndrome (BCS) combined with HCC has been reported frequently in the literature, which shows that BCS is also one of the causes of HCC^[1]。 Of course, BCS is associated with high risk factors for HCC, such as age, sex, smoking, etc^[2]But after all, BCS is a disease that obstructs the liver outflow tract, which will cause cell damage caused by hypoxia in the local microenvironment of the liver. Persistent liver damage will cause local sustained inflammatory reaction, leading to liver fibrosis and cirrhosis, and eventually developing into HCC. By summarizing the microenvironment of liver hypoxia caused by BCS in recent years, the possible molecular mechanisms related to HCC caused by liver hypoxia in this disease were further explored.