Intramedullary nailing for irreducible spiral subtrochanteric fractures: A comparison of cerclage and non-cerclage wiring.

PURPOSE: Intramedullary nailing is the preferred internal fixation technique for the treatment of subtrochanteric fractures because of its biomechanical advantages. However, no definitive conclusion has been reached regarding whether combined cable cerclage is required during intramedullary nailing treatment. This study was performed to compare the clinical effects of intramedullary nailing with cerclage and non-cerclage wiring in the treatment of irreducible spiral subtrochanteric fractures. METHODS: Patients with subtrochanteric fractures admitted to our center from January 2013 to December 2021 were retrospectively analyzed. The patients were enrolled in the case-control study according to the inclusion and exclusion criteria and divided into the non-cerclage group and the cerclage group. The patients' clinical data, including the operative time, intraoperative blood loss, hospital stay, reoperation rate, fracture union time, and Harris hip score, were compared between these 2 groups. Categorical variables were compared using Chi-square or Fisher's exact test. Continuous variables with normal distribution were presented as mean ± standard deviation and analyzed with Student's t-test. Non-normally distributed variables were expressed as median (Q1, Q3) and assessed using the Mann-Whitney test. A p value < 0.05 was considered significant. RESULTS: In total, 69 patients were included in the study (35 patients in the non-cerclage group and 34 patients in the cerclage group). The baseline data of the 2 groups were comparable. There were no significant difference in the length of hospital stay (z = -0.391, p = 0.696), operative time (z = -1.289, p = 0.197), or intraoperative blood loss (z = -1.321, p = 0.186). However, compared with non-cerclage group, the fracture union time was shorter (z = -5.587, p < 0.001), the rate of nonunion was lower (χ2 = 6.030, p = 0.03), the anatomical reduction rate was higher (χ2 = 5.449, p = 0.03), and the Harris hip score was higher (z = -2.99, p = 0.003) in the cerclage group, all with statistically significant differences. CONCLUSIONS: Intramedullary nailing combined with cable cerclage wiring is a safe and reliable technique for the treatment of irreducible subtrochanteric fractures. This technique can improve the reduction effect, increase the stability of fracture fixation, shorten the fracture union time, reduce the occurrence of nonunion, and contribute to the recovery of hip joint function.

High-Capacity Spatial Structured Light for Robust and Accurate Reconstruction.

Spatial structured light (SL) can achieve three-dimensional measurements with a single shot. As an important branch in the field of dynamic reconstruction, its accuracy, robustness, and density are of vital importance. Currently, there is a wide performance gap of spatial SL between dense reconstruction (but less accurate, e.g., speckle-based SL) and accurate reconstruction (but often sparser, e.g., shape-coded SL). The central problem lies in the coding strategy and the designed coding features. This paper aims to improve the density and quantity of reconstructed point clouds by spatial SL whilst also maintaining a high accuracy. Firstly, a new pseudo-2D pattern generation strategy was developed, which can improve the coding capacity of shape-coded SL greatly. Then, to extract the dense feature points robustly and accurately, an end-to-end corner detection method based on deep learning was developed. Finally, the pseudo-2D pattern was decoded with the aid of the epipolar constraint. Experimental results validated the effectiveness of the proposed system.

Melatonin ameliorates paclitaxel-induced mice spermatogenesis and fertility defects.

Chemotherapeutic drug of paclitaxel (PTX) has been shown to cause reproductive toxicity thus affecting male fertility, but its underlying molecular basis is unclear. Melatonin (MLT) can mitigate the reproductive damage caused by certain chemotherapy drugs. In this study, we aimed to identify impact of PTX on the main biological processes and protective effect of MLT on reproductive damage caused by PTX. Mice exposed to PTX mainly impaired spermatogenesis, such as decreased sperm counts, reduced sperm motility and increased abnormal sperm. Decreased expressions of germ cell proliferation-associated protein PCNA and meiosis-related protein SYCP3 induced by PTX were determined by Western blot, while MLT ameliorated this effect and increased the expressions of PCNA, SYCP3, DMC1, STRA8 and fertility-related protein of HSPA2, resulting in significantly improved spermatogenesis and sperm quality levels. In vitro fertilization experiment showed that PTX significantly decreased blastocyst formation rates, which can be improved by MLT administration, but not two-cell development rates. Taken together, this work demonstrated PTX can adversely affect germ cell proliferation and meiosis, which ultimately influence sperm quality and male fertility, and highlighted the protective ability of MLT on ameliorating the side effects of PTX, especially on sperm quality. The results provide information to further the study on the molecular mechanism of PTX's effects on male reproduction and the protective mechanism of MLT.

Expressions of HSPA1L and HSPA9 are associated with poor sperm quality of low-motility spermatozoa in fertile men.

Human semen is a heterogeneous group containing a portion of low-motility sperm, which may determine the sperm quality evaluation. Abnormally expressed proteins in low-motility spermatozoa will be the candidates for sperm biology research. By comparing proteomes of high- or low-motility spermatozoa from the same semen of normal fertile men, 21 differentially expressed proteins were identified. Proteins with molecular chaperone function were significantly over-represented, of which HSPA1L and HSPA9 significantly decreased in low-motility sperm. Compared with young adult testes with normal spermatogenesis, HSPA1L and HSPA9 had decreased expressions in elderly testis characterised with poor spermatogenesis, suggesting their associations with spermatogenesis. Decreased expressions of HSPA1L and HSPA9 in low-motility spermatozoa were validated by Western Blot and immunofluorescence quantification analysis. HSPA1L was mainly expressed on sperm post-acrosome and midpiece, whilst HSAP9 was mainly expressed on acrosome and sperm tail. HSPA1L antibody could inhibit sperm motility validated by antibody blocking experiment, whilst HSPA9 antibody showed no significant effect on sperm motility. The study demonstrated that low-motility spermatozoa from fertile men had poor sperm quality, in which differential expressed proteins were promising markers for evaluating sperm quality, understanding mechanism of male infertility with unexplained causes, and providing new idea for male infertility research.

3D reconstruction of the specular surface using an iterative stereoscopic deflectometry method.

Phase measuring deflectometry (PMD) is an effective technique for three-dimensional measurement of specular surfaces. However, the ambiguity of monoscopic PMD and the time-consuming searching process of stereoscopic PMD are challenges for specular surface reconstruction. To solve it, we propose an iterative reconstruction algorithm for the stereoscopic phase measuring deflectometry system free of the time-consuming searching process for each pixel. An arbitrary seed point on the specular surface is accurately obtained via a coarse-to-fine optimization means without any other expensive and complicate auxiliaries. Then, a plane with the height of seed point is set as the initial surface form for the iteration, in which the pinhole model is used to find the linear relation to update the surface form. The converging height is the output as the final result. Simulations and experiments verify the feasibility and efficiency of our proposed method based on the stereoscopic phase measuring deflectometry system. The accuracy and robustness are comprehensively evaluated as well.

Establishment and characterization of a gill cell line from pearl gentian grouper (Epinephelus lanceolatus♂×Epinephelus fuscoguttatus♀) and its application in cadmium toxicology.

A novel gill cell line from pearl gentian grouper (Epinephelus lanceolatus♂×Epinephelus fuscoguttatus♀, PGGG cell line) was established, its application in cadmium (Cd) toxicology was demonstrated in this study. Primary cultures and PGGG subcultures were carried out at 25 °C in Dulbecco's Modified Eagle medium/F12 medium (1:1; pH 7.2) supplemented with 15% fetal bovine serum (FBS). Primary PGGG cells were spindle-shaped, proliferated into a confluent monolayer within two weeks and were continuously subcultured over passage 60. The growth of cells at passages 20, 40, and 60 was examined. Chromosome analysis revealed that the chromosomal number of normal PGGG cells was 48, but the number of cells with the normal chromosomes number decreased during the passaging process. Cadmium is one of the most toxic metals in aquatic systems and has been associated with multiple animal and human health problems. To interpret the cytotoxicity and related mechanisms of cadmium, PGGG cells were used as an in vitro model. After treatment with cadmium at concentrations ranging from 1 µM to 500 µM, PGGG cells demonstrated dose- and time-dependent cytotoxicity, manifested as morphological abnormalities and a viability decline. Further, it was found that the reactive oxygen species (ROS) and malondialdehyde (MDA) levels were elevated following cadmium exposure, and related genes involved in the antioxidant system, including those encoding catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR), and Kelch-like- ECH-associated protein 1 (Keap1), were regulated differently. In addition, PGGG cells treated with cadmium had the typical features associated with apoptosis, including phosphatidylserine (PS) externalization; upregulated expression of caspase-3, -8, and -9; and apoptotic body formation. In general, the PGGG cell line may serve as a useful tool for studying the toxic mechanisms of cadmium or other toxicants or for toxicity testing and environment monitoring.

Micrometer-level 3D measurement techniques in complex scenes based on stripe-structured light and photometric stereo.

Compared with existing depth cameras, such as RGB-D, RealSense and Kinect, stripe-based structured light (SL) has the potential for micrometer-level 3D measurement; this can be attributed to its higher coding capacity. While surface texture, high-reflective region, and occlusion remain some of the main sources leading to degraded reconstruction quality in complex objects, methods that are only based on SL cannot completely solve such problems in complex object reconstruction. In this paper, we developed an advanced fusion strategy for the reconstruction of complex objects in micrometer-level 3D measurement. This includes solving the above-mentioned inherent problems of a stripe-based SL system with the aid of photometric stereo (PS). Firstly, to improve the robustness of decoding and eliminate the effects of noise and occlusion on stripe detection, a novel scene-adaptive decoding algorithm based on a binary tree was proposed. Further, a robust and practical calibration method for area light sources in the PS system, which utilizes the absolute depth information from SL system, was introduced. A piecewise integration algorithm, which is based on a subregion divided by Gray code, was proposed by combining the depth values from SL with the normal information from PS. Remarkably, this method eliminates the effects of surface texture and high-reflective region on the reconstruction quality and improves the resolution to camera-level resolution. In experimental parts, a regular cylinder was reconstructed to demonstrate micrometer-level measurement accuracy and resolution enhancement by the proposed method. Then, improvement of the reconstruction accuracy for objects with surface texture was validated with a regular pyramid that had textures on it and a white paper with characters printed on it. Lastly, a complex object containing multiple phenomena was reconstructed with the newly proposed method to show its effectiveness for micrometer-level 3D measurement in complex objects. Evaluation of our proposed method shows the improvement of the proposed method on the existing methods being used for micrometer-level 3D measurement in complex objects.

Dot-coded structured light for accurate and robust 3D reconstruction.

Speckle dots have the advantage of easy projection, which makes them good candidate features of structured light (SL) cameras, such as Kinect v1. However, they generally yield poor accuracy due to block matching. To improve their accuracy, this paper proposes a dot-coded SL, the coding information of which is added into dot distribution. Some of the dots are arranged regularly to provide easy-to-locate corner features, while others are specially designed to form different shapes of unique identification. A Gaussian-cross module and a simplified ResNet have been proposed to conduct robust decoding. Various experiments are performed to verify the accuracy and robustness of our framework.

Accurate infrared structured light sensing system for dynamic 3D acquisition.

3D real-time acquisition plays a vital role in computer graphics and computer vision. In this paper, we present a dynamic IR structured light sensing system with high resolution and accuracy for real-time 3D scanning. We adopt the Gray code combined with stripe shifting as our 3D acquisition's coding strategy and parallelize the algorithm via the GPU in our IR 3D scanning system. Our built-up system can capture dense and high-precision 3D model sequences with a speed of 29 Hz. Furthermore, we propose a practical calibration method to obtain accurate calibration parameters for our system. Finally, various experiments are performed to verify the feasibility and accuracy of our proposed IR structured light sensing system.

Eliminating the Effect of Reflectance Properties on Reconstruction in Stripe Structured Light System.

The acquisition of the geometry of general scenes is related to the interplay of surface geometry, material properties and illumination characteristics. Surface texture and non-Lambertian reflectance properties degrade the reconstruction results by structured light technique. Existing structured light techniques focus on different coding strategy and light sources to improve reconstruction accuracy. The hybrid system consisting of a structured light technique and photometric stereo combines the depth value with normal information to refine the reconstruction results. In this paper, we propose a novel hybrid system consisting of stripe-based structured light and photometric stereo. The effect of surface texture and non-Lambertian reflection on stripe detection is first concluded. Contrary to existing fusion strategy, we propose an improved method for stripe detection to reduce the above factor's effects on accuracy. The reconstruction problem for general scene comes down to using reflectance properties to improve the accuracy of stripe detection. Several objects, including checkerboard, metal-flat plane and free-form objects with complex reflectance properties, were reconstructed to validate our proposed method, which illustrates the effectiveness on improving the reconstruction accuracy of complex objects. The three-step phase-shifting algorithm was implemented and the reconstruction results were given and also compared with ours. In addition, our proposed framework provides a new feasible scheme for solving the ongoing problem of the reconstruction of complex objects with variant reflectance. The problem can be solved by subtracting the non-Lambertian components from the original grey values of stripe to improve the accuracy of stripe detection. In the future, based on stripe structured light technique, more general reflection models can be used to model different types of reflection properties of complex objects.

Single-Shot Structured Light Sensor for 3D Dense and Dynamic Reconstruction.

Structured light (SL) has a trade-off between acquisition time and spatial resolution. Temporally coded SL can produce a 3D reconstruction with high density, yet it is not applicable to dynamic reconstruction. On the contrary, spatially coded SL works with a single shot, but it can only achieve sparse reconstruction. This paper aims to achieve accurate 3D dense and dynamic reconstruction at the same time. A speckle-based SL sensor is presented, which consists of two cameras and a diffractive optical element (DOE) projector. The two cameras record images synchronously. First, a speckle pattern was elaborately designed and projected. Second, a high-accuracy calibration method was proposed to calibrate the system; meanwhile, the stereo images were accurately aligned by developing an optimized epipolar rectification algorithm. Then, an improved semi-global matching (SGM) algorithm was proposed to improve the correctness of the stereo matching, through which a high-quality depth map was achieved. Finally, dense point clouds could be recovered from the depth map. The DOE projector was designed with a size of 8 mm × 8 mm. The baseline between stereo cameras was controlled to be below 50 mm. Experimental results validated the effectiveness of the proposed algorithm. Compared with some other single-shot 3D systems, our system displayed a better performance. At close range, such as 0.4 m, our system could achieve submillimeter accuracy.

An Accurate Calibration Means for the Phase Measuring Deflectometry System.

Calibration is a critical step for the phase measuring deflectometry system. Existing calibration methods are mainly optimizing the calibration parameters with respect to the 2D re-projection error criterion. However, such a procedure cannot reduce metric errors in the practical application. Therefore, an accurate and practical calibration method is proposed. In which, conventional calibration means is first applied for the primary calibration. Then, a precise square planar mirror is used for the optimization of system calibration parameters. All the intrinsic and extrinsic parameters are considered as a global multi-objective optimization problem. Three metric error criteria are introduced to evaluate the 3D reconstruction accuracy of the reference mirror. Compared with classical calibration means, which apply the parameter optimization in 2D image space to minimize the re-projection errors, the proposed optimization approach is executed in 3D space directly. An experiment and comparison are conducted to verify that the proposed optimal calibration approach can effectively reduce the system deviation and to improve the system measurement accuracy.

Crocin reduces Aspergillus fumigatus-induced airway inflammation and NF-κB signal activation.

Chronic obstructive pulmonary disease (COPD) is a chronic airway inflammation and its exacerbation is often accompanied by Aspergillus fumigatus (A. fumigatus) infection. Increasing evidences demonstrated the potent antioxidant and -inflammatory effects of crocin. However, the role of crocin in A. fumigatus-induced inflammation is still unknown. We aimed to evaluate the role of crocin in inflammation response induced by A. fumigatus in human bronchial epithelial cells and the possible mechanisms. BEAS-2B and NHBE cells were pretreated with crocin for 24 h, and then A. fumigatus conidia were added for 24 h. A. fumigatus treatment exhibited a significant higher TNF-α, IL-8, IL-6, and IL-1ß level (P < 0.05), whereas crocin pretreatment significantly inhibited A. fumigatus induced the pro-inflammatory cytokines (P < 0.05). NF-κB inhibitor PDTC inhibited pro-inflammatory cytokines release triggered by A. fumigatus (P < 0.05). Furthermore, crocin suppressed A. fumigatus induced NF-κB p65 nuclear translocation, the phosphorylation of IKKα and IκBα, the degradation of IκBα and NF-κB reporter activity. Crocin pretreatment also resulted in an inhibition of A.fumigatus-induced ROS production (P < 0.05). Taken together, these results indicate that crocin may prevent A. fumigatus-induced inflammation through suppressing NF-κB signal pathway.

KLF2 attenuates bleomycin-induced pulmonary fibrosis and inflammation with regulation of AP-1.

Pulmonary fibrosis (PF) is a chronic, fibrosing interstitial pneumonia and devastating disease. Here we investigated the potential roles of Kruppel-like factor 2 (KLF2) on pulmonary fibrosis and inflammation response. A mouse model of pulmonary fibrosis was established by intratracheal injection of bleomycin (BLM). The mRNA and protein levels of KLF2 were assayed by RT-PCR and Western blotting respectively. The extent of lung fibrosis was determined using hematoxylin and eosin (HE) staining and Masson's trichrome staining, and the hydroxyproline content was quantified. RT-PCR was used to evaluate the mRNA expression of collagen type 1a1 (col1a1), col3a1, α-SMA, TNF-α, IL-1ß and IL-6. The concentrations of TNF-α, IL-1ß, and IL-6 in bronchoalveolar lavage fluid (BALF) and lung tissue were examined by ELISA. Also, the effects of KLF2 on activator protein-1 (AP-1) were evaluated by measuring the c-Jun and c-Fos protein levels. We found that KLF2 was remarkably downregulated in BLM-treated rats, both in mRNA and protein levels. Additionally, overexpression of KLF2 attenuated the destruction of the alveolar space and pulmonary interstitial collagen hyperplasia, and deposition reduced the expression of col1a1, col3a1, and α-SMA, and blocked the production of TNF-α, IL-1ß, and IL-6 in BALF and lung tissue in vivo. Moreover, adenoviral transduction of KLF2 inhibited TGF-ß1-induced expression of col1a1, col3a1, and α-SMA in vitro. Mechanically, BLM up-regulated c-Jun and c-Fos expression, which was impeded by KLF2 overexpression. Taken together, our data indicate that KLF2 attenuates pulmonary fibrosis and inflammation, possibly through the regulation of AP-1.

Tetracaine induces apoptosis through a mitochondrion-dependent pathway in human corneal stromal cells in vitro.

PURPOSE: Tetracaine is a local anesthetic widely used in ocular diagnosis and ophthalmic surgery and may lead to some adverse effects and complications at a clinical dose. To assess the cytotoxicity and molecular toxicity mechanisms of tetracaine, we used human corneal stromal (HCS) cells as an in vitro model to study the effects of tetracaine on HCS cells. MATERIALS AND METHODS: The cytotoxicity of tetracaine on HCS cells was investigated by examining the changes of cell growth, morphology, viability and cell cycle progressing when HCS cells were treated with tetracaine at concentrations from 10 g/L to 0.078125 g/L. To prove the hypothesis that the cytotoxicity of tetracaine on HCS cells was related with apoptosis induction, we further detected multiple changes in HCS cells, including plasma membrane (PM) permeability, phosphatidylserine (PS) orientation, genomic DNA integrality, and cell ultrastrcuture after treated with tetracaine. Furthermore, the pro-apoptotic signalling pathway induced by tetracaine was explored through detecting the activation of various caspases, the changes of mitochondrial transmembrane potential (MTP), the expression level of Bcl-2 family proteins and the amount of mitochondria-released apoptosis regulating proteins in cytoplasm. RESULTS: Tetracaine at concentrations above 0.15625 g/L had a dose- and time-dependent cytotoxicity to HCS cells, which resulted cell growth inhibition, proliferation retardation, morphological abnormalities and decreased viability. Meanwhile, we found that the HCS cells treated with tetracaine had typical features associated with apoptosis, including an increase in PM permeability, PS externalization, DNA fragmentation and apoptotic body formation. Tetracaine not only resulted in caspase-3, caspase-8 and caspase-9 activation and disruption of MTP but also downregulated Bcl-2 and Bcl-xL and upregulated Bad and Bax, along with the upregulation of cytoplasmic cytochrome c (Cyt. c) and apoptosis-inducing factor (AIF). CONCLUSIONS: These results suggested that tetracaine-induced apoptosis might be triggered through Fas death receptors and mediated by Bcl-2 family proteins in the mitochondria-dependent pathway. Our findings identified the cytotoxicity and molecular mechanisms of tetracaine, which could provide a reference value for the safety of this medication and prospective therapeutic interventions in eye clinic.

Construction of Anterior Hemi-Corneal Equivalents Using Nontransfected Human Corneal Cells and Transplantation in Dog Models.

Tissue-engineered human anterior hemi-cornea (TE-aHC) is a promising equivalent for treating anterior lamellar keratopathy to surmount the severe shortage of donated corneas. This study was intended to construct a functional TE-aHC with nontransfected human corneal stromal (ntHCS) and epithelial (ntHCEP) cells using acellular porcine corneal stromata (aPCS) as a carrier scaffold, and evaluate its biological functions in a dog model. To construct a TE-aHC, ntHCS cells were injected into an aPCS scaffold and cultured for 3 days; then, ntHCEP cells were inoculated onto the Bowman's membrane of the scaffold and cultured for 5 days under air-liquid interface condition. After its morphology and histological structure were characterized, the constructed TE-aHC was transplanted into dog eyes via lamellar keratoplasty. The corneal transparency, thickness, intraocular pressure, epithelial integrity, and corneal regeneration were monitored in vivo, and the histological structure and histochemical property were examined ex vivo 360 days after surgery, respectively. The results showed that the constructed TE-aHC was highly transparent and composed of a corneal epithelium of 7-8 layer ntHCEP cells and a corneal stroma of regularly aligned collagen fibers and well-preserved glycosaminoglycans with sparsely distributed ntHCS cells, mimicking a normal anterior hemi-cornea (aHC). Moreover, both ntHCEP and ntHCS cells maintained positive expression of their marker and functional proteins. After transplantation into dog eyes, the constructed TE-aHC acted naturally in terms of morphology, structure and inherent property, and functioned well in maintaining corneal clarity, thickness, normal histological structure, and composition in dog models by reconstructing a normal aHC, which could be used as a promising aHC equivalent in corneal regenerative medicine and aHC disorder therapy.

Updated incidence rates and risk factors of esophageal cancer in Nan'ao Island, a coastal high-risk area in southern China.

Esophageal cancer (EC) is one of the most common cancers in China. The purpose of this study was to investigate the updated incidence rates and risk factors of EC in Nan'ao Island, where the EC incidence rate was chronically the highest in southern China. To calculate the annual incidence rate, data on 338 EC cases from Nan'ao Cancer Registry system diagnosed during 2005-2011 were collected. A case-control study was conducted to explore the EC risk factors. One hundred twenty-five alive EC patients diagnosed during 2005-2011 and 250 controls were enrolled into the case-control study. A pre-test questionnaire on demography, dietary factors, drinking water treatment, and behavioral factors was applied to collect information of all participants. The average EC incidence rates during 2005-2011 were 66.09/105, 94.62/105, 36.83/105 for both genders, males and females, respectively, in Nan'ao Island. The EC incidence rate in males was 2.40- to 4.55-fold higher than that in females in the period from 2006 to 2011 (P < 0.05). Considering the onset age, males tend to be much younger than females and reached peak incidence rate at a younger age (P < 0.05). Drinking water treatment by filter (odds ratio [OR] = 0.28, 95% confidence interval [95% CI] = 0.13-0.58) and fruit consumption (OR = 0.55, 95% CI = 0.32-0.94) reduced the risk for EC. On the contrary, the pickled vegetables consumption (OR = 2.64, 95% CI = 1.46-4.76) and liquor drinking (OR = 2.32, 95% CI = 1.21-4.44) increased the risk for EC. These results may be of importance for future research on EC etiology and prevention strategies.

Anatomical study of the communicating branches of cords of the brachial plexus and their clinical implications.

The aim of this study was to investigate the occurrence and patterns of the communicating branches of cords of the brachial plexus (BPs). This study was performed with 50 fixed adult cadavers (all 100 sides). The BPs were exposed, the presence of the communicating branches of BPs were determined, measured, and photographed. The communicating branches were identified in 27 sides of the BPs. According to enthesis, the communicating branches between the medial and lateral cords (25 sides) were divided into five types. The most common branches connected the lateral cord with the medial root of the median nerve (16 sides). All the communicating branches between the lateral and medial cords obliquely crossed anterior to the axillary artery and passed below the thoracoacromial artery trunk. The distance of the communicating branch with the origin of thoracoacromial artery trunk was 1.60 ± 0.64 cm. The length, transverse diameter, and anteroposterior diameter of communicating branch were 1.67 ± 0.62 cm, 1.77 ± 0.63 mm, and 1.91 ± 0.34 mm, respectively. These anatomical data about the communicating branches will be helpful for surgeons who perform surgical procedures in the cervical and axillary regions.

A global perspective: characteristics of infertility-related randomized clinical trials.

BACKGROUND: Infertility is a prevalent global condition, and emerging reproductive technologies may enhance its evaluation and treatment. Understanding the current features of randomized clinical trials in infertility is crucial for improving study design and ensuring the translation of results for patient benefits. OBJECTIVES: To investigate the primary characteristics of randomized clinical trials related to infertility and areas where require improvement. MATERIALS AND METHODS: We conducted a search on the International Clinical Trials Registry platform for eligible infertility trials between 2003 and 2022. The distribution ratio of various characteristics uploaded by infertility-related studies on the platform was analyzed and compared according to sex and registration year. RESULTS: Out of the total trials, 85.3% (1,906) included only women, 8.6% (192) included only men, and 6.1% (136) included couples. The majority of retrieved trials followed a parallel arm design (91.0%) and were non-industry-funded (92.2%), with a median planned sample size of 131 patients (interquartile range 75-270). Among these trials, 54.5% (1,217) were conducted in Asia. The most common primary purpose of infertility-related trials was treatment (88.8%), with over half of the investigated interventions focusing on medication (57.9%). DISCUSSION: Asia is the leading region for research, and the drug therapy is still widely used and updated. However, support care for infertile couples has also received some preference. Areas that require improvement and promotion include addressing male infertility and focusing on underserved regions like Africa. The results also highlight deficiencies in trial registration and masking methods, emphasizing the need for better regulation and facilitation of infertility trials in the post-COVID-19 era. CONCLUSION: Based on the current status of infertility RCT studies, greater attention should be paid to infertile men and populations in underdeveloped regions like Africa in future studies, together with a standardized registration and implementation procedures.

Altered regional brain activity and functional connectivity in primary intravaginal anejaculation patients revealed by resting-state fMRI.

ABSTRACT: Ejaculation is regulated by the central nervous system. However, the central pathophysiology of primary intravaginal anejaculation (PIAJ) is unclear. The present study aimed to examine the changes in regional brain activity and functional connectivity underlying PIAJ. A total of 20 PIAJ patients and 16 healthy controls (HCs) were enrolled from September 2020 to September 2022 in the Department of Andrology, Nanjing Drum Tower Hospital (Nanjing, China). Magnetic resonance imaging data were acquired from all participants and then were preprocessed. The measures of fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), and functional connectivity (FC) were calculated and compared between the groups. PIAJ patients showed increased fALFF values in the left precuneus compared with HCs. Additionally, PIAJ patients showed increased ReHo values in the left precuneus, left postcentral gyrus, left superior occipital gyrus, left calcarine fissure, right precuneus, and right middle temporal gyrus, and decreased ReHo values in the left inferior parietal gyrus, compared with HCs. Finally, brain regions with altered fALFF and ReHo values in PIAJ patients showed increased FC with widespread cortical regions, which included the frontal, parietal, temporal, and occipital regions, compared with HCs. In conclusion, increased regional brain activity in the parietal, temporal, and occipital regions, and increased FC between these brain regions, may be associated with PIAJ occurrence.