Will male semen quality improve with environmental quality? / 亚洲男科学杂志(英文版)

Wenzhou has improved its environmental quality because of comprehensive environmental remediation; nevertheless, the semen quality of infertile males remains unclear. This study determined whether better environmental quality improved semen quality in this region. We recorded semen quality data from 22 962 infertile males from January 2014 to November 2019 at the Center for Reproductive Health of The First Affiliated Hospital of Wenzhou Medical University (Wenzhou, China). Patients were predominantly 30-35 years old (33.1%) and workers (82.0%), with high school education or lower (77.6%); more than a half of the patients (52.6%) were Wenzhou household registration; and most patients (77.5%) had abnormal semen quality. Patients who were older than 40 years and workers, and those with Wenzhou household registration, had significantly worse semen quality (all P < 0.05). From 2014 to 2019, progressive sperm motility, total sperm motility, and semen volume showed increasing linear trends in all patients (P = 0.021, 0.030, and 0.005, respectively), yet normal sperm morphology showed a linearly decreasing trend (P = 0.046). Sensitivity analyses for subgroups yielded similar results. In conclusion, the improvement of environmental quality and better function of the accessory glands are associated with progressive sperm motility, total sperm motility, and semen volume. Normal sperm morphology is influenced by occupational exposures and personal lifestyle and does not improve with environmental quality.

Analysis of semen quality of 38 905 infertile male patients during 2008-2016 in Wenzhou, China / 亚洲男科学杂志(英文版)

This study analyzed the trend in semen quality of infertile male patients in Wenzhou, China, based on the data obtained from 38 905 patients during 2008-2016 in The First Affiliated Hospital of Wenzhou Medical University (Wenzhou, China). The results showed that only 24.9% of the patients had normal semen quality. For the semen quality of infertile male patients, that of the workers and 40-year-olds was significantly worse than the other occupational and age groups. For all the infertile patients, low semen volume, asthenozoospermia, and teratozoospermia accounted for 8.4%, 50.5%, and 54.1%, respectively. During 2008-2016, the annual mean percentage of fast forward motile spermatozoa, percentage of total forward motile spermatozoa, and percentage of spermatozoa with normal morphology decreased linearly with slopes of -2.11, -2.59, and -0.70, respectively. The proportion of patients with asthenozoospermia and multi-abnormal spermatozoa increased during 2008-2016 with slopes of 4.70 and 4.87, respectively, while for low semen volume, it decreased with a slope of -0.47 in the same time period. The proportion of patients with teratozoospermia increased from 2008 to 2011 and from 2011 to 2016 with slopes of 17.10 and 2.09, respectively. In general, the deteriorating trend of semen quality of infertile male patients in Wenzhou was obvious. Future efforts should be made to reveal the adverse influences on semen quality, such as occupational exposure, environmental quality, and living habits. Furthermore, more pervasive reproduction health education is necessary.

The three-dimensional reconstruction of penile suspensory ligament and adjacent structures based on the MRI image / 中华整形外科杂志

<p><b>OBJECTIVE</b>To establish a three-dimensional image of the penile suspensory ligament, and explore a stereoscopic and multi angle observation method of patient' s penile suspensory ligament.</p><p><b>METHODS</b>This study selected the patients with small penis from our hospital as subjects. The participants were conducted on magnetic resonance imaging (MRI) examination before operation. Afterwards, the results of MRI were imported into 3D reconstruction software (MIMICS 10.0), and the suspensory ligament of penis, the pubic symphysis and other related structures were reconstructed for observation.</p><p><b>RESULTS</b>The pubic symphysis, penis and corpus spongiosum can be quite clearly displayed in the thin-section MRI images. In addition, penile suspensory with patchy distribution can be visible between lower part of ligament pubic symphysis and corpus cavernosum. Finally, we can reconstruct the three-dimensional structures through MIMICS 10.0, and then precisely describe the suspensory ligament's start-stop point, the angle with cavernous body of penis and the attached area in the corpus cavernosum penis.</p><p><b>CONCLUSION</b>Based on the MRI 3D reconstruction of deep penile suspensory ligament and adjacent structures, we can carry out dynamic, three-dimensional multi angle observation of patients deep penile suspensory ligament, and can use the reconstructed image to provide certain theory basis for the judgement of the corpus cavernosum penis extension length and penile suspensory ligament depth before penis extension operation.</p>

Comparative study of oncologic outcomes after multivisceral resection for stage IIC colorectal cancer between inflammatory and malignant adhesion / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the differences in oncologic outcomes between inflammatory adhesion and malignant adhesion in patients with stage IIC colorectal cancer after multivisceral resection(MVR).</p><p><b>METHODS</b>A retrospective review was undertaken of 287 patients who underwent MVR for stage IIC CRC, 120 patients for stage IIB, and 140 patients for IIIA. Patients were divided into two groups: inflammatory adhesion(IA) and malignant invasion(MI).</p><p><b>RESULTS</b>There were 153 patients with colon cancer and 135 patients with rectal cancer in the stage IIC group. The overall survival was significantly lower in the MI group at 5 years(38.5% vs. 59.4%, P<0.05). Stage IIC patients with IA had similar survival rate to the patients with stage IIB CRC. Compared to the MA group, patients with stage IIIA CRC showed significant differences in 5 years overall survival rate. Univariate analysis showed that differentiation, adhesion pattern, and complication were significant prognostic factors for patients with colon cancer, while pathological characteristics, adhesion pattern, and differentiation were significant for rectal cancer.</p><p><b>CONCLUSIONS</b>MI is an adverse prognostic factor for patients with stage IIC CRC. T4 should be further classified according to the adhesion pattern.</p>

Treatment strategy and pattern evaluation of 314 patients with recurrence of rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the treatment strategy, prognosis and pattern of recurrence in patients with rectal cancer.</p><p><b>METHODS</b>From May 1979 to November 2006, 314 patients with recurrence after rectal cancer resection were included in this study. Patients were divided into two groups: local recurrence (LR) and distant metastasis (DM). The clinicopathologic features, treatment strategies and prognosis were analyzed.</p><p><b>RESULTS</b>Of the 314 patients with recurrence, 168 (53.5%) were LR with a mean recurrence-free interval (RFI) of (24.7+/-1.9) months and 146 (46.5%) were DM with a mean RFI of (22.7+/-1.9) months. Compared to the DM group, the patients in the LR group showed no significant difference in clinicopathological data except the time to recurrence (P<0.01), primary tumor location (P=0.043), and the postoperative use of chemoradiotherapy (P=0.007). Mean recurrence-specific survival(RSS) was (24.7+/-1.9) months for LR and the 3- and 5-year survival rates were 0.48 and 0.25. The 3- and 5-year survival rates in patients with DM were 0.33 and 0.16 with a mean RSS of (22.7+/-1.9) months. The difference was statistically significant (P<0.01). Cox regression analysis for RSS showed that the time to recurrence, TNM stage, and treatment strategy (including procedure and the use of postoperative chemoradiation) were independently prognosis factors for the patients with recurrence rectal cancer (all P<0.01). Subgroup analyses revealed no significant differences in RFI or RSS among different subgroups within either LR or DM groups.</p><p><b>CONCLUSIONS</b>Patients of rectal cancer with LR have a better survival than those with DM. Moreover, radical resection can improve the prognosis of patients with recurrence of rectal cancer, especially for patients with early TNM stage of the primary tumor and later period of recurrence.</p>

Analysis of clinicopathologic features and prognosis in 2414 patients with rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the clinicopathologic factors associated with prognosis in patients with rectal cancer.</p><p><b>METHODS</b>Clinicopathologic data of 2414 patients with rectal cancer, treated in the Affiliated Tumor Hospital of Harbin Medical University from May 1976 to December 2003, were analyzed retrospectively. Cox regression model was used to assess independent factors associated with prognosis.</p><p><b>RESULTS</b>The median survival time was 58 months and the 5-year overall survival rate was 45.1%. Tumors were stage I( in 75.2%, stage II( in 48.1%, stage III( in 21.3%, and stage Ⅳ( in 8.8% of the patients. The 5-year overall survival rates during the three study periods were 41.2%(1976-1986), 43.0%(1987-1996), and 49.1%(1997-2003)(P<0.01). On univariate analysis, age, time at diagnosis, histological type, distant metastasis, type of surgery, intent of surgery, gross morphology, pathologic T stage, lymphatic invasion, bowel obstruction, and TNM stage showed statistically significant association with survival. Independent prognostic factors on multivariable analysis were gross tumor morphology chi-squared value(CV):68.744, pT(CV:81.344), lymphatic invasion(CV:42.951), bowel obstruction(CV:37.856) and TNM stage(CV:85.329).</p><p><b>CONCLUSIONS</b>Survival in patients with rectal cancer is improved over time. TNM stage is the most important prognostic factor for survival in patients with rectal cancer.</p>

Time pattern and prognostic evaluation of the recurrence of rectal cancer after resection / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the regular pattern and prognostic evaluation of patients with recurrent rectal cancer after resection.</p><p><b>METHODS</b>Three hundred and fourteen cases with recurrent rectal cancer after resection treated between May 1979 and November 2006 were classified into three groups according to the recurrence intervals (<3 years, 3-5 years, >5 years). The survival rates and prognosis in the three groups were analyzed and compared retrospectively.</p><p><b>RESULTS</b>Of the 314 patients, the cancer relapsed in 247 cases (78.7%) in less than 3 years, and the recurrence occurred predominantly within 2 years (207 cases, 65.9%) after the operation. The neoplasm in 41 cases (13.3%) recurred in 3-5 years after the operation, and 26 cases (8. 3%) in more than 5 years after the resection. Disease-free interval, Dukes stage, neoplasm gross type, histological type, T stage, lymphatic and distant metastasis were associated with the prognosis on univariate analysis. And disease-free interval and tumor Dukes stage were independent prognostic factors for survival rate on multivariate analysis. Disease-free interval and progression-free survival were related positively with survival time.</p><p><b>CONCLUSIONS</b>The rectal cancer patients should be followed-up intensively for 2 years after the operation and moderately from then on. Disease-free interval and progression-free survival could be taken as the best predictors of long-term cure and prognosis.</p>