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To investigate the efficacy of Ursolic acid in alleviating neuropathic pain in rats with spinal nerve ligation (SNL), the SNL rat model was surgically induced. Different concentrations of Ursolic acid and manipulated target mitogen-activated protein kinase 1 (MAPK1) were administered to the SNL rats. Fecal samples were collected from each group of rats for 16S rDNA analysis to examine the impact of gut microbiota. Molecular docking experiments were conducted to assess the binding energy between Ursolic acid and MAPK1. In vivo studies were carried out to evaluate the expression of inflammatory factors and signaling pathways in spinal cord and colon tissues. Ursolic acid was found to have a beneficial effect on pain reduction in rats by increasing plantar withdrawal latency (PWL) and paw withdrawal threshold (PWT). Comparing the Ursolic acid group with the control group revealed notable differences in the distribution of Staphylococcus, Allobaculum, Clostridium, Blautia, Bifidobacterium, and Prevotella species. Network pharmacology analysis identified MAPK1 and intercellular adhesion molecule-1 (ICAM1) as common targets for Ursolic acid, SNL, and neuropathic pain. Binding sites between Ursolic acid and these targets were identified. Additionally, immunofluorescent staining showed a decrease in GFAP and IBA1 intensity in the spinal cord along with an increase in NeuN following Ursolic acid treatment. Overexpression of MAPK1 in SNL rats led to an increase in inflammatory factors and a decrease in PWL and PWT. Furthermore, MAPK1 counteracted the pain-relieving effects of Ursolic acid in SNL rats. Ursolic acid was found to alleviate neuropathic pain in SNL rats by targeting MAPK1 and influencing gut microbiota homeostasis.
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Antígenos Nucleares , Microbioma Gastrointestinal , Proteína Quinasa 1 Activada por Mitógenos , Proteínas del Tejido Nervioso , Neuralgia , Ratas Sprague-Dawley , Triterpenos , Ácido Ursólico , Animales , Neuralgia/tratamiento farmacológico , Neuralgia/metabolismo , Triterpenos/farmacología , Microbioma Gastrointestinal/efectos de los fármacos , Masculino , Proteína Quinasa 1 Activada por Mitógenos/metabolismo , Ratas , Médula Espinal/efectos de los fármacos , Médula Espinal/metabolismo , Simulación del Acoplamiento Molecular , Modelos Animales de Enfermedad , Nervios Espinales/efectos de los fármacos , Analgésicos/farmacología , Colon/efectos de los fármacos , Colon/microbiología , Colon/metabolismo , Proteína Ácida Fibrilar de la Glía/metabolismoRESUMEN
BACKGROUND: Threatened preterm labor (TPL) is an important obstetrical challenge. Pregnant women with TPL may develop psychological and physical problems such as mental health disorders, sleep disturbance, and hormonal circadian rhythm disruption. This study aimed to investigate the current state of mental health, sleep quality, and circadian rhythms of cortisol and melatonin secretion in pregnant women with TPL and normal pregnant women (NPW). METHODS: A prospective observational clinical study was conducted at a maternal and child health hospital in Fuzhou, China, between June and July 2022. A total of 50 women between 32 and 36 weeks of gestation (TPL group, n = 20; NPW group, n = 30) were recruited. Data on anxiety symptom (Zung's Self-rating Anxiety Scale, SAS), depression symptom (Edinburgh Postnatal Depression Scale, EPDS), subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI) and objective sleep outcomes (measured by actigraphy) of the pregnant women were collected at the time of enrolment. Salivary samples were collected once every 6 h (i.e., at 06:00, 12:00, 18:00, and 00:00) during 2 consecutive days to measure the circadian rhythm of hormone (cortisol and melatonin). RESULTS: There were no differences found in the total scores of SAS, EPDS scores, subjective sleep quality between the TPL and NPW groups (P > 0.05). In contrast, significant differences were found in sleep efficiency, total sleep time, wake time after sleep onset, and average awakening time between the groups (P < 0.05). The circadian rhythm of melatonin secretion was disrupted in the TPL group (P = 0.350); however, it was maintained in the NPW group (P = 0.044). The circadian rhythm of cortisol secretion was disrupted in both groups (P > 0.05). CONCLUSIONS: In the third trimester of pregnancy, women with TPL suffer from poorer sleep quality and disruption of circadian rhythm of melatonin secretion compared with NPW. Nevertheless, there were no differences found in mental health (i.e., anxiety and depression) and circadian rhythm of cortisol secretion. Large-scale studies should be conducted to evaluate these changes in women with TPL. TRIAL REGISTRATION: The study was registered from Chinese Clinical Trial Registry (Number: ChiCTR2200060674) on 07/06/2022.
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Melatonina , Trabajo de Parto Prematuro , Recién Nacido , Niño , Femenino , Humanos , Embarazo , Mujeres Embarazadas , Calidad del Sueño , Salud Mental , Hidrocortisona , Ritmo Circadiano , SueñoRESUMEN
BACKGROUND: Parenting sense of competence is not only indispensable to the wellbeing of the parents of premature infants, but is also pivotal to the overall development of these infants. This study examined the level of parenting sense of competence and its associated factors in Chinese parents of preterm infants. METHODS: This cross-sectional study was performed at a university teaching hospital in Fuzhou (China) from December 2021 to April 2022. Data were collected using the Parenting Sense of Competence Scale, Edinburgh Postnatal Depression Scale, Social Support Rating Scale, Parenting Care Knowledge Subscale, Parenting Care Skill Subscale, and a sociodemographic questionnaire. RESULTS: A total of 401 Chinese parents were included in the analysis. The average parenting sense of competence scale score was 70.93 ± 13.06. After controlling for demographic characteristics, parenting knowledge (ß = 0.149, P = 0.013), parenting skills (ß = 0.241, P < 0.001), social support (ß = 0.184, P < 0.001) and depression (ß = -0.272, P < 0.001), were significantly associated with the parenting sense of competence score, and explained 43.60% of the variance in this score. CONCLUSIONS: Chinese parents of preterm infants were found to have a moderate parenting sense of competence. This could be further improved through efforts aimed at reducing depressive symptoms and increasing parenting knowledge, parenting skills, and social support.
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Recien Nacido Prematuro , Responsabilidad Parental , Humanos , Lactante , Recién Nacido , Estudios Transversales , Pueblos del Este de Asia , PadresRESUMEN
BACKGROUND: Fighting against the COVID-19 pandemic, front-line nurses were under unprecedented psychological pressure. Therefore, it is necessary to promptly evaluate the psychological status of nurses during the COVID-19 epidemic period. AIM: To investigate nurses' mental health during the COVID-19 pandemic, and to test the mediating role of social support and psychological resilience between coping and mental health. DESIGN: This was a descriptive, cross-sectional survey which used a structural equation model. METHOD: In total, 711 registered nurses were included. All participants were invited to complete a socio-demographic questionnaire, the general health questionnaire, the trait coping style questionnaire, the perceived social support scale and the Conner-Davidson Resilience scale. RESULTS: In total, 50.1% nurses had high risk of mental health. Positive coping positively affected social support and psychological resilience, while it negatively affected mental health. Negative coping negatively affected social support and psychological resilience, while it positively affected mental health. Social support positively affected psychological resilience, while it negatively affected mental health. In addition, social support mediated coping and psychological resilience, and coping and mental health. Moreover, psychological resilience negatively affected mental health, and it mediated coping and mental health.
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COVID-19 , Enfermeras y Enfermeros , Resiliencia Psicológica , Humanos , Salud Mental , Pandemias , Estudios Transversales , Adaptación Psicológica , Apoyo SocialRESUMEN
Impaired wound healing presents great health risks to diabetics. Encouragingly, the current clinical successfully found out meaningful method to repair wound tissue, and stem cell therapy could be an effective method for diabetic wound healing with its ability to accelerate wound closure and avoid amputation. This minireview aims at introducing stem cell therapy for facilitating tissue repair in diabetic wounds, discussing the possible therapeutic mechanism and clinical application status and problems.
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We aimed to assess the feeding pattern and influencing factors within six weeks postpartum on exclusive breastfeeding duration among Chinese mothers. This study was conducted using 2:1 matched case-control study. Cases and controls were matched for maternal age, parity and mode of birth. A total of 210 women were included. Approximately 67.9% of women stopped exclusive breastfeeding within the first six weeks postpartum. Maternal non-exclusive breastfeeding intention, lower maternal educational level, mother-infant skin to skin contact over one hour, unsatisfied breastfeeding self-evaluation and maternal unhealthy condition within the first six weeks were risk factors for ceasing exclusive breastfeeding early.
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Lactancia Materna , Madres , Lactante , Embarazo , Femenino , Humanos , Estudios de Casos y Controles , Periodo Posparto , Edad MaternaRESUMEN
OBJECTIVE: To explore and compare the current mainstream testicular tissue freezing methods, namely vitrification and controlled slow freezing, and optimize the best testicular tissue freezing methods. METHODS: Testicular tissues of 3-week-old mice and <2-year old prepubertal cynomophage monkeys were collected and cut to 6-26 mm3, and divided into three groups: Fresh group, vitrification group and controlled slow freezing group were resuscitated after 5-7 days of freezing. HE staining, immunofluorescence staining, TUNEL staining and Western blot were used to evaluate the frozen-thawed testicular tissue. RESULTS: 1. In the testes of C57BL6/J mice, the expression level of spermatogonial stem cell marker UCHL1 in the controlled slow freezing group was higher than that in the vitrification group, and the content of apoptotic cells (TUNEL+ cells) was lower than that in the vitrification group. 2. In the testicular tissue of cynomolgus monkeys, the expression levels of spermatogonial stem cell markers UCHL1 and cell proliferation marker PCNA in the CSF group were higher than those in the vitrification group. CONCLUSION: Both vitrification and CSF can successfully preserve the testes of immature mice and cynomolgus monkeys before puberty. However, in the vitrification, there are more frozen damaged areas in the testicular tissue with the frozen volume of 6-26mm3, which may affect the cryopreservation of spermatogonial stem cells in the testicular tissue.
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Espermatogénesis , Vitrificación , Masculino , Animales , Ratones , Congelación , Macaca fascicularis , Testículo , Criopreservación/métodosRESUMEN
OBJECTIVES: To study the effect of parent-child cooperative music therapy on the core symptoms of children with autism spectrum disorder (ASD) and their mothers. METHODS: In this prospective study, 112 children with ASD and their mothers were divided into a music therapy group and an applied behavior analysis (ABA) group using a random number table (n=56 each). The children in the ABA group were treated with ABA, and those in the music therapy group were given parent-child cooperative music therapy in addition to the ABA treatment. The duration of intervention was 8 weeks for both groups. Childhood Autism Rating Scale (CARS), Autism Behavior Checklist (ABC), Parenting Stress Index-Short form (PSI-SF), Family APGAR Index, and Herth Hope Index (HHI) were used to evaluate the core symptoms of children with ASD and the parenting stress, family APGAR index, and hope level of mothers before and after intervention. RESULTS: A total of 100 child-mother dyads completed the whole study, with 50 child-mother dyads in each group. After intervention, the children in the music therapy group had significantly lower total score of ABC scale and scores of sensation, social interaction, and somatic movement, as well as a significantly lower total score of CARS than those in the ABA group (P<0.05). After intervention, compared with the mothers in the ABA group, the mothers in the music therapy group had significantly higher total score of PSI-SF and score of parent-child dysfunctional interaction, significantly higher total score of HHI and scores of each dimension, and significantly higher total score of APGAR and scores of cooperation and intimacy (P<0.05). CONCLUSIONS: Parent-child cooperative music therapy combined with ABA can alleviate the core symptoms of children with ASD, reduce the parenting stress of their mothers, and improve family APGAR index and hope level.
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Trastorno del Espectro Autista , Musicoterapia , Trastorno del Espectro Autista/terapia , Niño , Femenino , Humanos , Madres , Relaciones Padres-Hijo , Estudios ProspectivosRESUMEN
Background: Spinal cord injury (SCI) damages the autonomic nervous system and affects the homeostasis of gut microbiota. Ursolic acid (UA) is a candidate drug for treating nervous system injury due to its neuroprotective and antioxidant functions. The purpose of our study was to investigate the role of UA on SCI and its mechanism. Methods: UA was administered to SCI mice and the solvent corn oil was used as control. The weight of the mice was recorded daily. Mice feces were collected 21 days after surgery for 16S rRNA-amplicon sequencing and untargeted metabolomics analysis. The expressions of NF-κB, IL-1ß, and TNF-α in the spinal cord and colon tissues of mice were detected by Western blot and Enzyme-linked immunosorbent assay, respectively. Immunohistochemistry was used to analyze the expression of NeuN, NF-200, and synapsin in the spinal cord tissues. Results: UA treatment increased body weight and soleus muscle weight of SCI mice. UA treatment inhibited inflammatory response and protected neuronal activity in SCI mice. UA improved the relative abundance of Muribaculaceae, Lachnospiraceae_NK4A136_group, and Alloprevotell genus in the gut tract of SCI mice. SCI destroyed the Glutamine_and_D-glutamate_metabolism, Nitrogen_metabolism, Aminoacyl-tRNA_biosynthesis, and Taurine_and_hypotaurine_metabolism in the gut of mice, which might be alleviated by UA. Conclusions: UA treatment could inhibit SCI progression by improving the gut environment and metabolic changes, promoting synaptic regeneration and anti-inflammatory effects.
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The gestational weight gain (GWG) range of Chinese women with gestational diabetes mellitus (GDM) remains unclear. Our objective was to identify the ranges of GWG in Chinese women with GDM and to investigate the associations between prepregnancy body mass index (BMI), GWG and maternal-infant adverse outcomes. Cases of GDM women who delivered singletons from 2013 to 2018 in a public hospital were collected. Logistic regression analysis was used to assess the joint effects of prepregnancy BMI and GWG on maternal-infant adverse outcomes. Ultimately, 14,578 women were collected. The ranges of GWG in Chinese women with GDM were different from the National Academy of Medicine's (NAM) recommendation. The ranges of GWG of Chinese women with GDM in the underweight, normal weight, overweight and obese groups were 5.95-21.95 kg, 4.23-21.83 kg, 0.88-21.12 kg and - 1.76 to 19.95 kg, respectively. The risks of large for gestational age (LGA), macrosomia and caesarean delivery were significantly increased with the increasing prepregnancy BMI. Furthermore, the risks of LGA, macrosomia and caesarean delivery were significantly higher in the normal weight group with a GWG higher than the NAM recommendation. Similarly, in the overweight group with a GWG higher than the NAM recommendation, the risks of LGA were significantly higher, while the risks of macrosomia were significantly lower. Overall, we determined the range of GWG in different prepregnancy BMI groups. And GDM women with high prepregnancy BMI and excessive GWG were associated with the higher risks of maternal-infants adverse outcomes in China.
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Macrosomía Fetal/epidemiología , Ganancia de Peso Gestacional , Obesidad/epidemiología , Resultado del Embarazo , Pueblo Asiatico , China/epidemiología , Femenino , Humanos , Recién Nacido , EmbarazoRESUMEN
OBJECTIVE: To investigate the expression rules of FOXO1a, FOXO3a, FOXO4 and FOXO6 proteins in the human testis, and explore their roles in the development and progression of testicular aging. METHODS: We collected the para-carcinoma testis tissue from 4 testis cancer patients aged 28, 31, 32 and 46 years, and the testis tissue from another 2 PCa patients aged 66 and 81 years after castration surgery from January 2018 to December 2020. We detected the expressions of FOXO1a, FOXO3a, FOXO4 and FOXO6 proteins in the testis tissue by Western blot, determined the locations of FOXO1a, FOXO3a, FOXO4 and FOXO6 in the testis cells by immunofluorescence staining, and performed semi-quantitative and statistical analyses using image J and SPSS 23.0 software, respectively. RESULTS: The expression levels of FOXO1a and FOXO3a proteins were significantly decreased in the testis tissue of the elderly patients (P < 0.01), with an age-dependent reduction in the proportion of the positive cells. No statistically significant difference was observed in the expression levels of FOXO4 and FOXO6 between different age groups. FOXO1a was mainly expressed at the base of the seminiferous tubules, FOXO3a and FOXO4 in the Leydig cells, and FOXO6 in the seminiferous tubules. In addition, FOXO4 underwent age-related nuclear translocation in the senescent Leydig cells, suggesting its involvement in the aging of Leydig cells. CONCLUSION: FOXO1a/3a/4 may be closely related to human testicular aging and corresponding pathological changes, but its underlying mechanism remains to be further explored.
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Envejecimiento , Testículo , Anciano , Humanos , Masculino , Testículo/metabolismo , Células Intersticiales del Testículo/metabolismo , Túbulos Seminíferos/metabolismo , Factores de Transcripción , Proteína Forkhead Box O1 , Factores de Transcripción Forkhead/metabolismoRESUMEN
OBJECTIVES: To study the effects of parent-child painting and creative crafting therapy on the core symptoms of preschool children with mild-to-moderate autism spectrum disorder (ASD) and the parenting stress and hope level of their mothers. METHODS: A total of 56 preschool children with mild-to-moderate ASD and their mothers were divided into an experimental group and a control group using the block randomization method, with 28 pairs in each group. The subjects in the control group received an applied behavior analytic intervention and those in the experimental group received parent-child painting and creative crafting therapy in addition to the intervention in the control group. The intervention time was 20 weeks for both groups. Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), Parenting Stress Index-Short Form (PSI-SF), and Herth Hope Index (HHI) were used to evaluate the core symptoms of children and the parenting stress and hope level of their mothers before and after 20 weeks of intervention. RESULTS: Forty-nine child-mother pairs completed the study (25 pairs in the intervention group and 24 pairs in the control group). The children in the experimental group had significantly lower scores of social interaction, language, social communication, and social motivation and total scores of ABC and SRS compared with those in the control group (P<0.05). The mothers in the experimental group had significantly lower scores of parental distress and parent-child dysfunctional interaction and total score of PSI-SF (P<0.05) and significantly higher total score of HHI and scores of each dimension compared with those in the control group (P<0.05). CONCLUSIONS: The combination of applied behavior analytic intervention with parent-child painting and creative crafting therapy can more effectively improve the core symptoms and social interaction of preschool children with mild-to-moderate ASD, reduce the parenting stress of mothers and improve their hope level.
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Trastorno del Espectro Autista , Trastorno del Espectro Autista/terapia , Preescolar , Femenino , Humanos , Madres , Relaciones Padres-Hijo , Responsabilidad Parental , Estudios ProspectivosRESUMEN
AIM: To evaluate related factors with the change of spherical equivalents (ΔSE) and determine the suitable predictor of clinically significant ΔSE (≥0.50 D) with cyclopentolate hydrochloride on Chinese children. METHODS: A total of 145 right eyes of 145 children aged 4 to 15y were enrolled. Intraocular pressure, axial length and lag of accommodation (LOA) were assessed before cycloplegia induced by 3 drops of 1% cyclopentolate at 5-minute intervals. SE was measured before and 1h after the first drop of cyclopentolate. ΔSE was compared between different gender groups and among refractive groups. Multivariate linear regression analysis was performed to find related factors with ΔSE. ROC analysis was used to figure out the suitable predictor of clinically significant ΔSE. RESULTS: For the total 145 eyes, the mean SE reached up to -0.70±1.86 D from -1.30±1.62 D, with the mean ΔSE of 0.60±0.55 D. The mean ΔSE were 0.63±0.55 D and 0.57±0.56 D respectively in the male and female group (P=0.40). The mean ΔSE was significantly different among different refractive groups (P<0.0001), with the ΔSE of hyperopia group (1.12±0.64 D) larger than that of the emmetropia (0.56±0.43 D, P=0.001) and myopia group (0.32±0.28 D, P<0.0001). The ΔSE was correlated with LOA (B=-0.54, P<0.0001), cycloplegic SE (B=0.10, P<0.0001) and age (B=-0.04, P=0.015). ROC curve indicated that LOA predicted clinically significant ΔSE by 82% [area under the curve (AUC)=0.82] alone, while the value was slightly improved to 85% (AUC=0.85) in combination with axial length and 86% (AUC=0.86) in association with axial length as well as age. CONCLUSION: After cycloplegia with cyclopentolate, the ΔSE decreases with larger LOA, longer axial length and older age. Specifically, LOA plays a more vital role in predicting clinically significant ΔSE.
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Diabetic erectile dysfunction (DED) is a common complication of diabetes mellitus, significantly impairing the quality of life of patients. The conventional clinical treatment still has limitations. Stem cells (SCs), as a type of cells with multidirectional or directional differentiation capability and sustainable self-renewal potential, are widely used in regenerative medicine and tissue engineering. With the continuous update of regenerative medicine theory and the success of animal experiments, SCs as a treatment for male erectile dysfunction, especially DED, have attracted widespread attention because of curable possibility. This review focus on the current progress in the clinical application of SC treatment for DED. Moreover, we summarize the development prospects of SCs in the field of DMED therapy.
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In December, 2019, several cases of novel coronavirus pneumonia (NCP) were reported in Wuhan, Hubei. Since then, more and more NCP cases, confirmed or suspected, have been found in China and other parts of the world, and the virus is now showing a tendency towards a wider spread. During the NCP epidemic, all medical workers are confronted with special challenges in the diagnosis and treatment of various diseases and required of even more accurate therapeutic protocols as well as stricter observation of the principles for the prevention and control of NCP. Therefore, the Andrology Branch of Chinese Medical Association convened relevant experts to summarize the special points for andrologic clinicians to attend to in the diagnosis and treatment of male diseases during the NCP epidemic.
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Andrología , COVID-19/epidemiología , Enfermedades del Sistema Endocrino/diagnóstico , Enfermedades Urogenitales Masculinas/diagnóstico , China/epidemiología , Enfermedades del Sistema Endocrino/terapia , Humanos , Masculino , Enfermedades Urogenitales Masculinas/terapia , PandemiasRESUMEN
Since the outbreak of coronavirus disease 2019 (COVID-19), more than 130,000 people worldwide have been infected. Many studies show that the testis is one of the organs with a high expression of angiotensin-converting enzyme 2 (ACE2), the receptor/binding protein of SARS-CoV-2, which has aroused public concerns about the possible damage to male fertility. This article presents a review and analysis of the existing literature, aiming to achieve an objective understanding of the significance of the ACE2 expression in the testis. Hitherto, clinical and laboratory data available on COVID-19 are not sufficient to provide any direct evidence that the testis is a target organ of the virus. Whether the coronavirus damages fertility in male patients with COVID-19 requires further investigation. In the absence of sufficient research-based evidence, damage of the virus to male fertility should not be over-interpreted.
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COVID-19/complicaciones , Fertilidad , Infertilidad Masculina/virología , Enzima Convertidora de Angiotensina 2 , Humanos , MasculinoRESUMEN
Testis is the male gonad with the main functions of secreting androgens and producing sperm. Testicular aging can induce sexual and reproductive dysfunctions and a series of systemic symptoms, which not only seriously affect the life quality of elderly and middle-aged men but are also closely related to the development and progression of chronic diseases, such as vascular and metabolic disorders. This review focuses on the concept, clinical manifestations, pathogenesis, evaluation methods and intervention strategies of testicular aging, as well as the prospects for its future research directions, aiming to help clinicians gain a deeper insight into and attach more importance to this condition, so as to improve its prevention and treatment.
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Envejecimiento/patología , Testículo/fisiopatología , Anciano , Andrógenos , Humanos , Masculino , Persona de Mediana Edad , EspermatozoidesRESUMEN
Non-obstructive azoospermia (NOA) is an important factor that causes male infertility. Stem cells are a group of cells capable of self-renewal and multi-directional differentiation, and embryonic stem cells and induced pluripotent stem cells can generate spermatozoa through differentiation, which, however, is confronted with ethical constraints and the risk of tumorigenesis. Spermatogonial stem cells can produce haploid gametes by differentiation but human spermatogonial stem cells are difficult to be cultured in vitro. Mesenchymal stem cells promote spermatogenesis through paracrine activity, and Leydig stem cells act on sperm production by secreting testosterone. 2D co-culture of multiple stem cells and 3D testicular organ culture can promote spermatogenesis by simulating a better spermatogenic microenvironment of the testis. Some progress has been achieved in the treatment of NOA by stem cell therapy despite existing problems and difficulties. This review summarizes the advances in the studies of stem cell therapy for NOA and introduces its application prospects and existing problems so as to provide some reference for the relevant researches and application.
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Azoospermia , Trasplante de Células Madre , Azoospermia/terapia , Humanos , Masculino , Técnicas de Cultivo de Órganos , Espermatogénesis , Espermatozoides , TestículoRESUMEN
With the decline in male fertility in recent years, strategies for male fertility preservation have received increasing attention. In this study, by reviewing current treatments and recent publications, we describe research progress in and the future directions of stem cell-based therapies for male fertility preservation, focusing on the use of spermatogonial stem cells (SSCs), SSC niches, SSC-based testicular organoids, other stem cell types such as mesenchymal stem cells, and stem cell-derived extracellular vesicles. In conclusion, a more comprehensive understanding of the germ cell microenvironment, stem cell-derived extracellular vesicles, and testicular organoids will play an important role in achieving male fertility preservation.
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AIM: To evaluate the effectiveness of Grand Seiko Ref/Keratometer WAM-5500 compared to Topcon KR800 autorefractor in detecting refractive error in large scale vision screening for Chinese school age children with the WHO criteria. METHODS: A total of 886 participants were enrolled with mean age of 9.49±1.88y from Tianjin, China. Spherical equivalent (SE) was obtained from un-cycloplegic autorefraction and cycloplegic autorefraction. Topcon KR 800 (Topcon) and Grand Seiko WAM-5500 (WAM) autorefractors were used. Bland-Altman Plot and regression were generated to compare their performance. The overall effectiveness of detecting early stage refractive error was analyzed with receiver operating characteristic (ROC) curves. RESULTS: The mean SE was -0.98±1.81 diopter (D) and the prevalence of myopia was 48.9% defined by WHO criteria according to the result of cycloplegic autorefraction. The mean SE of un-cycloplegic autorefraction with Topcon and WAM were -1.21±1.65 and -1.20±1.68 D respectively. There was a strong linear agreement between result obtained from WAM and cycloplegic autorefraction with an R2 of 0.8318. Bland-Altman plot indicated a moderate agreement of cylinder values between the two methods. The sensitivity and specificity for detecting hyperopia were 90.52% and 83.51%; for detecting myopia were 95.60% and 90.24%; for detecting astigmatism were 79.40% and 90.21%; for detecting high myopia were 98.16% and 98.91% respectively. CONCLUSION: These findings suggest that both Grand Seiko and Topcon autorefractor can be used in large-scale vision screening for detecting refractive error in Chinese population. Grand Seiko gives relatively better performance in detecting myopia, hyperopia, and high myopia for school age children.