A retrospective study on sperm cryopreservation in 1034 patients diagnosed with cancer in southern China.

Sperm cryopreservation is an effective fertility preservation method for cancer patients before anticancer treatments. However, there are little data on fertility preservation in large cohorts of patients with cancer in southern China. This retrospective cross-sectional study aimed to assess the fertility preservation status of 1034 newly diagnosed male patients with cancer in the Human Sperm Bank of Guangdong Province in southern China (Guangzhou, China). Of these, 302 patients had reproductive system tumors, mostly testicular cancers (99.0%), and 732 had other tumors, including lymphoma (33.1%), gastrointestinal cancer (16.3%), nasopharyngeal carcinoma (15.7%), leukemia (7.7%), sarcoma (3.6%), and others (23.6%). Patients with reproductive system tumors had lower sperm concentration and prefreezing and post-thawing progressive motility than those with non-reproductive system tumors (all P < 0.001). Differences in sperm concentration, progressive motility, and normal morphology rate were observed between patients with and without anticancer surgery before sperm cryopreservation (all P < 0.05). As of April 30, 2022, 63 patients used their cryopreserved sperm for assisted reproductive technology treatments and 39 pregnancies were achieved. This study provides valuable data on the fertility preservation status in newly diagnosed cancer patients in southern China, demonstrating that patients with reproductive system tumors had poor sperm quality for their pretreatment fertility preservation.

Evaluating an external quality assurance program for semen analysis in China during 2009-2020.

INTRODUCTION: Semen analysis (SA) plays a key role in guiding treatments of male reproductive diseases and infertility due to male factors; however, it remains challenging to conduct an accurate SA due to lack of standardization, highly subjective assessments, and problems with automated procedures. Therefore, quality assurance (QA) and teaching courses are essential for making the laboratory results more consistent. MATERIALS AND METHODS: The external quality assurance (EQA) scheme was organized by national human sperm bank technology training bases in Guangdong province in China between 2009 and 2020. Until 2020, 124 laboratories from China participated in the EQA program. The EQA scheme per year has been organized involving two semen aliquots for sperm concentration, two video recordings for motility, and two smears for sperm morphology. All samples used in the EQA scheme were obtained from different healthy donors or patients. RESULTS: We estimated that the median coefficient of variation (CV) of sperm concentration, ignoring the method used, was 26.6%. Using a 100 µm deep counting chamber led to a decreasing CV of 13.6%. For sperm motility, the median CV of nonprogressive motility was high (50.8%), but the CV of progressive motility (13.2%), immotile sperm (14.3%), and total motility (11.8%) were acceptable. The morphology assessment revealed large variability (44.4%) irrespective of the classification criteria. DISCUSSION: The reduction of interlaboratory variability is still a challenge during SA in China. Therefore, it is critical to increase awareness of joining EQA schemes and establish standardized training centers to follow WHO-recommended procedures toward Chinese standards.

[Role of full-time nurses in reception of sperm donors in the sperm bank].

OBJECTIVE: To explore the necessity of reception of sperm donors by full-time nurses in the sperm bank by analyzing the efficiency of sperm donation before and after staffing Guangdong Sperm Bank (GSB) with full-time nurses. METHODS: We selected 9 712 qualified sperm donors in GSB from January 1, 2016 to December 31, 2021 and compared the efficiency of sperm donation before and after staffing GSB with full-time nurses. RESULTS: After staffing GSB with full-time nurses, the proportion of qualified sperm donors screened from the quasi-qualified ones was dramatically increased from 66.2% (1 230/1 858) to 77.1% (3 252/4 218) (P < 0.01), that of HIV re-examinees after 6-month suspension from sperm donation increased from 84.6% (137/162) to 93.4% (599/641) (P < 0.01), and that of the candidate donors lost to follow-up during the screening period decreased from 23.2% (831/3 583) to 21.3% (1 308/6 129) (P = 0.034). CONCLUSION: After Guangdong Sperm Bank was staffed with full-time nurses for reception of sperm donors, the proportion of the candidate donors lost to follow-up was reduced and the efficiency of sperm donation was significantly improved. Individualized psychological intervention for the sperm donors by the nurses could dispel the worries of the donors and improve the compliance and efficiency of sperm donation.

[Causes of failure in autologous sperm preservation in the human sperm bank and countermeasures].

OBJECTIVE: To analyze the causes of failure in autologous sperm cryopreservation (ASCP) in the human sperm bank and propose some countermeasures to improve the success rate of ASCP and promote it in human sperm banks. METHODS: We retrospectively analyzed the reasons for and causes of failure in ASCP 1 156 males undergoing ASCP in the Human Sperm Bank of Guangdong Province from January 1, 2016 to December 31, 2019. RESULTS: Of the 1 156 cases of ASCP, 857 (74.1%) succeeded and 299 (25.9%) failed, with a failure rate of 56.1% (96/171) in the microdissection testicular sperm extraction (micro-TESE) group, 29.9% (67/224) in the reproduction insurance group, 21.2% (27/100) in the non-tumor disease group and 17.2% (109/525) in the tumor group, with statistically significant difference between the four groups (χ2 = 109.926, P < 0.01). The causes of failed ASCP included failure to extract semen (14.0% ï¼»42/299ï¼½), failure to meet the standard of sperm cryopreservation (67.6% ï¼»202/299ï¼½), giving up ASCP for low semen quality (7.4% ï¼»22/299ï¼½), and giving up ASCP for some other reasons (11.0% ï¼»33/299ï¼½), including worry about the reliability of cryopreservation technology (6.0% ï¼»18/299ï¼½), suspicion about the complexity of the ASCP procedures (3.0% ï¼»9/299ï¼½) and expectation for fertility recovery after chemotherapy withdrawal (2.0% ï¼»6/299ï¼½). CONCLUSIONS: In view of different causes of failure in ASCP, human sperm banks can provide individualized cryopreservation schemes, including guidance with masturbation or the use of sperm extraction instrument in sperm extraction, strengthening sperm preservation-related education and the awareness of reproduction protection and earlier sperm preservation among cancer patients, promoting the cryopreservation of microsamples of motile sperm by microsample or single sperm freezing, and development of testis tissue cryopreservation to preserve the fertility of children with cancer.

[Characteristics of sperm donors and the eligibility rate of screening for sperm donation].

OBJECTIVE: To investigate the relationship of the characteristics of sperm donors with the results of screening and provide some reference for the screening of sperm donors. METHODS: We statistically analyzed the screening data about 12 362 sperm donors at the Guangdong Human Sperm Bank from January 2003 to June 2017 and the relationship of the eligibility rate of screening with the donors' age, education, occupation, marriage, and fatherhood. RESULTS: Of the 12 362 sperm donors, 3 968 (32.1%) met the standards of semen quality and 3 127 (25.3%) filled all the requirements of sperm donation. The eligibility rate of screening was 27.7% in the donors aged 20－24 years, 24.3% in those aged 25－29 years, 23.8% in those aged 30－34 years, and 17.5% in those aged =≥35 years (P < 0.01); 23.5% in the senior high school students, 24% in the junior college students, 25.9% in the undergraduates, and 30.3% in the postgraduates (P < 0.01); 29.3% in the students versus 22.9% in the others (P < 0.01), 41.5% in the married versus 20.7% in the unmarried (P < 0.01), and 45.6% in the fathers versus 20.9% in the childless husbands (P < 0.01). CONCLUSIONS: A higher eligibility rate of screening was found among the sperm donors aged <35 years or with a bachelor's or higher degree, particularly among students.

Sperm DNA damage has a negative effect on early embryonic development following in vitro fertilization.

Sperm DNA damage is recognized as an important biomarker of male infertility. To investigate this, sperm DNA damage was assessed by the sperm chromatin dispersion (SCD) test in semen and motile spermatozoa harvested by combined density gradient centrifugation (DGC) and swim-up in 161 couples undergoing in vitro fertilization (IVF). Semen analysis and sperm DNA damage results were compared between couples who did or did not achieve pregnancy. The sperm DNA damage level was significantly different between the two groups (P < 0.05) and was negatively correlated with IVF outcomes. Logistic regression analysis confirmed that it was an independent predictor for achieving clinical pregnancy. The effects of different levels of sperm DNA damage on IVF outcomes were also compared. There were significant differences in day 3 embryo quality, blastocyst formation rate, and implantation and pregnancy rates (P < 0.05), but not in the basic fertilization rate between the two groups. Thus, sperm DNA damage as measured by the SCD appears useful for predicting the clinical pregnancy rate following IVF.

Association of decreased spermatozoa omega-3 fatty acid levels and increased oxidative DNA damage with varicocele in infertile men: a case control study.

Varicocele is commonly associated with male infertility because it impairs normal sperm morphology and activity. Polyunsaturated fatty acids (PUFA) are important determinants of sperm cell structure and function, but their relationship with varicocele remains unclear. The aim of the present study was to investigate the PUFA composition in spermatozoa of infertile men with varicocele and to evaluate the potential relationship between PUFA and varicocele. This case control study recruited 92 infertile men with varicocele, 99 infertile men without varicocele and 95 fertile male control subjects. Semen morphology and activity parameters were assessed and seminal plasma 8-hydroxy-2-deoxyguanosine (8-OHdG) content was determined by ELISA. Sperm concentrations of omega-3 and omega-6 fatty acids were measured by gas chromatography. Infertile men with varicocele had lower concentrations of omega-3 PUFA, higher omega-6:omega-3 PUFA ratios and greater oxidative DNA damage in spermatozoa compared with infertile men without varicocele and normal subjects. The degree of varicocele and DNA damage was associated with decreased omega-3 PUFA concentrations and semen quality in infertile men with varicocele. The findings suggest that omega-3 PUFA deficiency could be implicated in varicocele-associated infertility, and highlight the need for intervention trials to test the usefulness of omega-3 supplementation in reducing sperm abnormalities in infertile men with varicocele.

Analyses of the mitochondrial mutations in the Chinese patients with sporadic Creutzfeldt-Jakob disease.

Pathogenic mitochondrial DNA (mtDNA) mutations leading to mitochondrial dysfunction can cause a variety of chronic diseases in central nervous system (CNS). However, the role of mtDNA mutations in sporadic Creutzfeldt-Jakob disease (sCJD) has still been unknown. In this study, we comparatively analyzed complete mtDNA sequences of 31 Chinese sCJD patients and 32 controls. Using MITOMASTER and PhyloTree, we characterized 520 variants in sCJD patients and 507 variants in control by haplogroup and allele frequencies. We classified the mtDNAs into 40 sub-haplogroups of 5 haplogroups, most of them being Asian-specific haplogroups. Haplogroup U, an European-specific haplogroups mtDNA, was found only in sCJD. The analysis to control region (CR) revealed a 31% increase in the frequency of mtDNA CR mutations in sCJD versus controls. In functional elements of the mtDNA CR, six CR mutations were in conserved sequence blocks I (CSBI) in sCJD, while only one in control (P<0.05). More mutants in transfer ribonucleic acid-Leu (tRNA-Leu) were detected in sCJD. The frequencies of two synonymous amino-acid changes, m.11467A>G, p.(=) in NADH dehydrogenase subunit 4 (ND4) and m.12372G>A, p.(=) in NADH dehydrogenase subunit 5 (ND5), in sCJD patients were higher than that of controls. Our study, for the first time, screened the variations of mtDNA of Chinese sCJD patients and identified some potential disease-related mutations for further investigations.

The reference values for semen parameters of 1213 fertile men in Guangdong Province in China.

Semen samples were collected from 1213 fertile men whose partners had a time-to-pregnancy (TTP) ≤12 months in Guangdong Province in Southern China, and semen parameters including semen volume, sperm concentration, total counts, motility, and morphology were evaluated according to the World Health Organization (WHO) 2010 guideline. All semen parameters analyzed were normal in ~62.2% of the total samples, whereas ~37.8% showed at least one of the semen parameters below normal threshold values. The fifth centiles (with 95% confidence intervals) were 1.3 (1.2-1.5) ml for semen volume, 20 × 10 6 (18×10 6 -20×10 6 ) ml-1 for sperm concentration, 40 × 10 6 (38×10 6 -44×10 6 ) per ejaculate for total sperm counts, 48% (47%-53%) for vitality, 39% (36%-43%) for total motility, 25% (23%-27%) for sperm progressive motility, 5.0% (4%-5%) for normal morphology. The pH values ranged from 7.2 to 8.0 with the mean ± standard deviation at 7.32 ± 0.17. No effects of age and body mass index were found on semen parameters. Occupation, smoking and alcohol abuse, varicocele appeared to decrease semen quality. Sperm concentration, but not sperm morphology, is positively correlated with TTP, whereas vitality is negatively correlated with TTP. Our study provides the latest reference values for the semen parameters of Chinese fertile men in Guangdong Province, which are close to those described in the new WHO guidelines (5 th Edition).

[Semen quality of normal fertile men].

OBJECTIVE: To study the semen quality of confirmed fertile men with the time to pregnancy (TTP) of 12 months or less, and analyze the correlation of semen parameters with TTP. METHODS: We recruited 1 152 men aged 18 -50 years and with TTP of 12 months. We used questionnaire investigation, physical examination and semen analysis, calculated the normal reference ranges of semen parameters, and analyzed the effects of TTP and other biological characteristics on semen quality. RESULTS: Seminal examinations showed that the semen volume was 1.5 ml, sperm concentration 17 million per ml, total sperm number 39 million per ejaculate, total sperm motility 41%, progressive sperm motility 33%, normal sperm morphology 5.0%, sperm vitality 53%, and total number of progressively motile sperm 17 million per ejaculate in the 1 152 subjects. In comparison, the total number of progressively motile sperm was significantly smaller in those aged > or = 35 years (P < 0.01), morphologically normal sperm were markedly less in those with BMI > 25.0 (P < 0.01), and sperm concentration, total number of sperm, morphologically normal sperm rate and total number of progressively motile sperm were remarkably lower in those with BMI < 18. 5 (P < 0.05). Cigarette smoking significantly reduced the sperm volume (P < 0.01), and drinking (> 10 g per week) decreased the sperm volume and the total numbers of sperm, morphologically normal sperm and progressively motile perm (P < 0.05). TTP was negatively correlated with sperm concentration, total number of sperm and total number of progressively motile sperm (P < 0.01). The subjects with sexual abstinence of 5 -7 days showed markedly higher sperm concentration, total number of sperm and total number of progressively motile sperm than others (P < 0.01). CONCLUSION: In normal fertile men, the fifth centile of semen parameters is close to the WHO normal reference range, TTP is negatively correlated with semen quality, and age, BMI and lifestyle may affect some of the semen parameters.

[Application of factor analysis in comprehensive evaluation of semen quality].

OBJECTIVE: To explore the application of factor analysis in comprehensive evaluation of semen quality. METHODS: Using factor analysis, we examined the semen samples from normal fertile men and comprehensively evaluated their quality by extracting typical common factors from the sperm parameters, such as semen volume, sperm concentration, total number of sperm, total motility, progressive motility, vitality, sperm morphology, total number of progressive motile sperm, total number of valid progressive motile sperm, teratozoospermia index (TZI), sperm deformity index (SDI), curvilinear velocity (VCL), straight-line velocity (VSL), average path velocity (VAP), amplitude of lateral head displacement (ALH), linearity (LIN), wobble (WOB), straightness (STR), beat-cross frequency (BCF) and mean angular displacement (MAD). RESULTS: Based on the principle of the cumulative variance contribution rate of 85% or more, we extracted 6 common factors with the cumulative variance contribution rate of 86. 647%, which in sequence represented sperm count, velocity, direction of movement, deformity index, semen volume and normal sperm morphology. The composite factor scores were calculated by the formula of (36.243 * F1 + 23.342 * F2 + 8.910 * F3 + 8.500 * F4 + 5.538 * F5 +4.115 * F6)/ 86.647, with a median of -0.0180. With the 5th percentile as the lower reference limit, 95.1% of the fertile males met the WHO limit for composite factor scores, while only 79.2% of them met the limit for semen parameters (P = 0. 000). CONCLUSION: Compared with the routine detection of sperm parameters, factor analysis or composite factor scores could give a more accurate comprehensive evaluation of semen quality.

Whole tumour quantitative measurement of first-pass perfusion of oesophageal squamous cell carcinoma using 64-row multidetector computed tomography: correlation with microvessel density.

PURPOSE: To assess correlations between whole tumour first-pass perfusion parameters obtained with 64-row multidetector computed tomography (MDCT), and microvessel density (MVD) in oesophageal squamous cell carcinoma. MATERIALS AND METHODS: Thirty-one consecutive patients with surgically confirmed oesophageal squamous cell carcinomas were enrolled into our study. All the patients underwent whole tumour first-pass perfusion scan with 64-row MDCT. Perfusion parameters, including perfusion (PF), peak enhanced density (PED), blood volume (BV), and time to peak (TTP) were measured using Philips perfusion software. Postoperative tumour specimens were assessed for MVD. Pearson correlation coefficient tests were performed to determine correlations between each perfusion parameter and MVD. RESULTS: Mean values for PF, PED, BV and TTP of the whole tumour were 28.85 ± 20.29 ml/min/ml, 23.16 ± 8.09 HU, 12.13 ± 5.21 ml/100g, and 35.05 ± 13.85 s, respectively. Mean MVD in whole tumour at magnification (×200) was 15.75 ± 4.34 microvessel/tumour sample (vessels/0.723 mm(2)). PED and BV were correlated with MVD (r=0.651 and r=0.977, respectively, all p<0.05). However, PF and TTP were not correlated with MVD (r=0.070 and r=0.100, respectively, all p>0.05). CONCLUSION: The BV value of first-pass perfusion CT could reflect MVD in oesophageal squamous cell carcinoma, and can be an indicator for evaluating the tumour angiogenesis.

Whole tumour first-pass perfusion using a low-dose method with 64-section multidetector row computed tomography in oesophageal squamous cell carcinoma.

PURPOSE: To propose a low-dose method at tube current-time product of 50 mAs for whole tumour first-pass perfusion of oesophageal squamous cell carcinoma using 64-section multidetector row computed tomography (MDCT), and to assess the original image quality and accuracy of perfusion parameters. MATERIALS AND METHODS: Fifty-nine consecutive patients with confirmed oesophageal squamous cell carcinomas were enrolled into our study, and underwent whole tumour first-pass perfusion scan with 64-section MDCT at 50 mAs. Image data were statistically reviewed focusing on original image quality demonstrated by image-quality scores and signal-to-noise (S/N) ratios; and perfusion parameters including perfusion (PF, in ml/min/ml), peak enhanced density (PED, in HU), time to peak (TTP, in seconds) and blood volume (BV, in ml/100 g) for the tumour. To test the interobserver agreement of perfusion measurements, perfusion analyses were repeatedly performed. RESULTS: Original image-quality scores were 4.71±0.49 whereas S/N ratios were 5.21±2.05, and the scores were correlated with the S/N ratios (r=0.465, p<0.0001). Mean values for PF, PED, TTP and BV of the tumour were 33.27±24.15 ml/min/ml, 24.06±9.87 HU, 29.42±8.61 s, and 12.45±12.22 ml/100 g, respectively. Intraclass correlation coefficient between the replicated measurements of each perfusion parameter was greater than 0.99, and mean difference of the replicated measurements of each parameter was close to zero. CONCLUSION: Whole tumour first-pass perfusion with 64-section MDCT at low-dose radiation could be reproducible to assess microcirculation in oesophageal squamous cell carcinoma without compromising subjective original image quality of the tumour.

Earthquake-related versus non-earthquake-related injuries in spinal injury patients: differentiation with multidetector computed tomography.

INTRODUCTION: In recent years, several massive earthquakes have occurred across the globe. Multidetector computed tomography (MDCT) is reliable in detecting spinal injuries. The purpose of this study was to compare the features of spinal injuries resulting from the Sichuan earthquake with those of non-earthquake-related spinal trauma using MDCT. METHODS: Features of spinal injuries of 223 Sichuan earthquake-exposed patients and 223 non-earthquake-related spinal injury patients were retrospectively compared using MDCT. The date of non-earthquake-related spinal injury patients was collected from 1 May 2009 to 22 July 2009 to avoid the confounding effects of seasonal activity and clothing. We focused on anatomic sites, injury types and neurologic deficits related to spinal injuries. Major injuries were classified according to the grid 3-3-3 scheme of the Magerl (AO) classification system. RESULTS: A total of 185 patients (82.96%) in the earthquake-exposed cohort experienced crush injuries. In the earthquake and control groups, 65 and 92 patients, respectively, had neurologic deficits. The anatomic distribution of these two cohorts was significantly different (P < 0.001). Cervical spinal injuries were more common in the control group (risk ratio (RR) = 2.12, P < 0.001), whereas lumbar spinal injuries were more common in the earthquake-related spinal injuries group (277 of 501 injured vertebrae; 55.29%). The major types of injuries were significantly different between these cohorts (P = 0.002). Magerl AO type A lesions composed most of the lesions seen in both of these cohorts. Type B lesions were more frequently seen in earthquake-related spinal injuries (RR = 1.27), while we observed type C lesions more frequently in subjects with non-earthquake-related spinal injuries (RR = 1.98, P = 0.0029). CONCLUSIONS: Spinal injuries sustained in the Sichuan earthquake were located mainly in the lumbar spine, with a peak prevalence of type A lesions and a high occurrence of neurologic deficits. The anatomic distribution and type of spinal injuries that varied between earthquake-related and non-earthquake-related spinal injury groups were perhaps due to the different mechanism of injury.

Crush pelvic injury in the Sichuan earthquake evaluated by multidetector CT scanning.

CT scanning is sensitive and specific for the identification of pelvic fractures and injury to the pelvic wall soft tissue and the pelvic cavity. Crush pelvic trauma in an earthquake can be identified by multidetector CT scanning.

Pelvic crush fractures in survivors of the Sichuan earthquake evaluated by digital radiography and multidetector computed tomography.

OBJECTIVE: To investigate the profile of pelvic crush fractures in earthquake victims on digital radiography (DR) and multidetector computed tomography (MDCT). MATERIALS AND METHODS: One hundred and sixty-seven consecutive survivors of the 2008 Sichuan earthquake with pelvic crush fractures classified into types according to the Tile classification system, entered our study. One hundred and thirty-nine, and 28 patients underwent DR and MDCT scans, respectively. Data were reviewed retrospectively focusing on anatomical sites, numbers, and classification of pelvic ring fractures. RESULTS: Pelvic fractures occurred in the pubis in 88 patients (52.7%), in other pelvic bones in 32 (19.16%), and in both the pubis and other pelvic bones in 47 (28.14%). Pubic fractures were more common than fractures of other pelvic bones, and involvement of bilateral pubis was more common than that of the left or right pubis (all p < 0.05). As for the numbers of pelvic bones involved, multiple fractures occurred in 48.52% patients (81 out of 167) composed predominantly of fractures of two bones in 58.02% (47 out of 81), and were seen more often in bilateral pubis than in any other pelvic bones (p < 0.05). Regarding classifications of pelvic ring fractures, they were Type A in 31 patients (18.56%); Type B in 72 (43.11%), predominantly Type B2 in 26 (15.58%) and Type B3 in 28 (16.77%); and Type C in 64 (38.32%), predominantly Type C3 in 40 (23.95%). CONCLUSION: Pelvic crush fractures particularly including multiple pelvic fractures, occurring predominantly in bilateral pubis, and composed of Type C3 followed by Type B3 and Type B2, could be considered to be the profile of pelvic crush fractures in an earthquake.

Crush thoracic trauma in the massive Sichuan earthquake: evaluation with multidetector CT of 215 cases.

PURPOSE: To determine the multidetector computed tomographic (CT) features of crush thoracic traumas resulting from the massive Sichuan earthquake. MATERIALS AND METHODS: This study was approved by the ethics committee of the medical school, and informed consent was waived. A retrospective review was undertaken of 215 multidetector chest CT scans of 112 male and 103 female patients who sustained crush thoracic injuries in the Sichuan earthquake at 2:28 pm Beijing time, May 12, 2008, and were rescued in the authors' hospital. Multidetector chest CT studies were performed between May 12, 2008, and June 7, 2008. The authors looked for injuries to the thoracic cage, pulmonary parenchyma, and pleura. RESULTS: One hundred forty-three patients (66.5%; 95% confidence interval [CI]: 60.2%, 72.8%) had at least one rib fracture; the mean number of rib fractures per patient was 6 [corrected]. Forty-five of these patients (31.5% of 143 patients; 95% CI: 23.9%, 39.1%) had flail chest, with a total of 288 ribs fractured. There were 46 patients (21.4%; 95% CI: 15.9%, 26.9%) with at least one vertebral fracture. There were 77 vertebral fractures total; 36 of these fractures were in T1 through T10. Twelve patients (5.6%; 95% CI: 2.5%, 8.7%) had sternal fractures, and 48 patients (22.3%; 95% CI: 16.7%, 27.9%) had either scapular or clavicular fractures. There were 117 patients (54.4%; 95% CI: 47.7%, 61.1%) with pulmonary parenchymal injuries and 146 (67.9%; 95% CI: 61.7%, 74.1%) with pleural injuries. CONCLUSION: Crush thoracic trauma resulting from the massive Sichuan earthquake was a life-threatening injury; this type of injury has the potential for multiple fractures and pulmonary parenchymal injuries.

Adrenal sarcomatoid carcinoma: a rare case depicted on multi-detector row computed tomography.

Primary adrenal sarcomatoid carcinoma is rare malignant tumor with the characteristics of carcinoma and sarcoma. To date, only one case of primary sarcomatoid carcinoma in the adrenal gland was reported. We present here computed tomography appearance and pathological features of the case with primary adrenal sarcomatoid carcinoma confirmed by pathology. In addition, a brief review of the relevant literature is presented.