Simplified total arch reconstruction with a stented graft for extended aortic arch dilation.

Background: Reconstruction of the aortic arch and its three supra-aortic vessels remains a great surgical challenge with postoperative complications. We present a simplified total arch reconstruction with a modified stent graft (s-TAR) and compared its operative outcomes with conventional total arch replacement (c-TAR). Methods: This retrospective analysis of prospectively collected data from all consecutive patients who had ascending aortic aneurysm with extended aortic arch dilation and underwent simultaneous ascending aorta replacement and aortic arch reconstruction with the s-TAR or c-TAR between 2018 and 2021. The indication for intervention was maximum diameter of ascending aorta >55 mm and aortic arch in zone II >35 mm. Results: A total of 84 patients were analyzed: 43 in the s-TAR group and 41 in the c-TAR group. No inter-group differences were found for sex, age, comorbidities, or EuroSCORE II results. All patients were successfully treated with s-TAR or c-TAR, and none died intraoperatively. Cardiopulmonary bypass, selective cerebral perfusion, and lower-body circulatory arrest time were significantly shorter in the s-TAR group, which also had a lower incidence of prolonged ventilation and transient neurologic dysfunction. No patient in either group experienced permanent neurologic dysfunction. The incidence of recurrent laryngeal nerve injury and paraplegia was markedly increased in the c-TAR group; however, no such events were observed in the s-TAR group. Both perioperative blood loss and the incidence of reoperation for bleeding were significantly lower in the s-TAR group. The in-hospital mortality rate was 0% in the s-TAR group and 4.9% in the c-TAR group. The s-TAR group had significantly shorter intensive care unit (ICU) stay and lower total hospitalization costs. Conclusions: The s-TAR technique is a safe and effective alternative for total arch reconstruction with shorter operation time, lower rate of postoperative complications and lower total hospitalization costs compared with c-TAR.

[Vasectomy not associated with prostate cancer: a meta-analysis].

OBJECTIVE: To evaluate the association between vasectomy and prostate cancer. METHODS: We searched comprehensively the databases, CBMDisc, CMCC, CMAC, CNKI (from 1978 to January 6, 2009), and PubMed (from 1965 to January 6, 2009) using the key words "vasectomy" and "prostate cancer", screened the retrieved literature according to the inclusion and exclusion criteria, performed a Meta-analysis with the software RevMan 4.2 after identification of the relevant data, and calculated the overall pooled OR (95% CI) as well as that of the association of prostate cancer with <20 and > or =20 yr vasectomy. RESULTS: A total of 20 088 cases and 232 506 controls in 27 reports (7 cohort and 20 case-control studies) were included in this investigation. The overall pooled OR (95% CI) was 1.10 (0.97-1.24), and those of <20 and > or =20 yr vasectomy were 0.94 (0.83-1.06) and 1.05 (0.90-1.23), respectively. CONCLUSION: No existing literature show any positive association between vasectomy and prostate cancer.

[Seminal plasma levocarnitine significantly correlated with semen quality].

OBJECTIVE: To investigate the relationship of seminal plasma levocarnitine with sperm concentration, vitality and motility. METHODS: Enrolled in this study were 64 infertile men, who were divided according to the results of routine sperm tests into a normozoospermia (n = 12), an oligozoospermia (n = 16), an asthenozoospermia (n = 20) and an oligoasthenozoospermia group (n = 16). The level of seminal plasma levocarnitine was detected by LC-MS-MS, the concentration of seminal plasma testosterone measured by chemiluminescence immunoassay, the correlation of seminal plasma levocarnitine with sperm concentration, motility and vitality determined by bivariate correlation analysis with SPSS15.0, and so was the correlation between the carnitine and sperm concentration by partial correlation analysis with seminal plasma testosterone as a control variable to exclude the influence of testosterone. RESULTS: The concentrations of total seminal plasma levocarnitine, free seminal plasma levocarnitine and seminal plasma acetolevocarnitine were (91.33 +/- 40.49) mg/L, (40.89 +/- 24.13) mg/L and (50.44 +/- 21.90) mg/L; the Pearson coefficients of correlation of the levocarnitine level with sperm motility, vitality and concentration were 0.161 (P = 0.235), 0.114 (P = 0.370) and 0.637 (P < 0.001), those of free seminal carnitine with sperm motility and vitality were 0.325 (P = 0.024) and 0.316 (P = 0.029), respectively, with the oligozoospermia group excluded, and that of partial correlation between the concentrations of seminal levocarnitine and sperm was 0.641 (P < 0.001). CONCLUSION: The level of seminal plasma levocarnitine is positively correlated with sperm motility and vitality, and more significantly with sperm concentration.

[A meta-analysis of Ureaplasma urealyticum infection and Chinese male infertility].

OBJECTIVE: To investigate the correlation between Ureaplasma urealyticum infection and infertility in Chinese males. METHODS: According to the results of the heterogeneity test, a comprehensive quantitative analysis was made of 49 papers on Ureaplasma urealyticum infection and Chinese male infertility by RevMan 4.2.2. The impacts of different sample volumes on the research findings were compared, and the sensitivities of culture and PCR detections analyzed respectively. RESULTS: Ureaplasma urealyticum had a significant negative impact on Chinese male fertility. Based on different samples of literature, two rounds of screening and analysis were carried out and two different conclusions derived. The first was OR = 4.43 (95% CI: 3.77-5.22), with the OR values of culture and PCR detections as 4.25 (95% CI: 3.59-5.03) and 5.35 (95% CI: 3.37-8.47), and the second was OR = 4.28 (95% CI: 3.52-5.20), with the OR values of culture and PCR detections as 4.24 (95% CI: 3.41-5.28) and 4.42 (95% CI: 2.73-7.17). CONCLUSION: There is a significant correlation between Ureaplasma urealyticum and Chinese male infertility. The conclusion of study is significantly influenced by the sample volume, which should be reasonably designed. The sensitivity of PCR detection is higher than that of culture detection.