Clinical and socioeconomic factors associated with delayed orchidopexy in cryptorchid boys in China: a retrospective study of 2423 cases

We investigated the associations of clinical and socioeconomic factors with delayed orchidopexy for cryptorchidism in China. A retrospective study was conducted on cryptorchid boys who underwent orchidopexy at Children's Hospital at Chongqing Medical University in China from January 2012 to December 2017. Of 2423 patients, 410 (16.9%) received timely repair by 18 months of age, beyond which surgery was considered delayed. Univariate analysis suggested that the laterality of cryptorchidism (P = 0.001), comorbidities including inguinal hernia/scrotal hydrocele (P < 0.001) or urinary tract disease (P = 0.016), and whether patients lived in a poverty county (P < 0.001) could influence whether orchidopexy was timely or delayed. Logistic regression analysis suggested that the following factors were associated with delayed repair: unilateral rather than bilateral cryptorchidism (odds ratio [OR]= 1.752, P < 0.001), absence of inguinal hernia or hydrocele (OR = 2.027, P = 0.019), absence of urinary tract disease (OR = 3.712, P < 0.001), and living in a poverty county (OR = 2.005, P < 0.001). The duration of postoperative hospital stay and hospital costs increased with the patient's age at the time of surgery.

Incidence characteristics of testicular microlithiasis and its association with risk of primary testicular tumors in children: a systematic review and meta-analysis

Background To systematically evaluate the incidence characteristics of testicular microlithiasis(TM)in children and its association with primary testicular tumors(PTT).Methods A systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis(PRISMA)statement.A priori protocol was registered in the PROSPERO database(CRD42018111119),and a literature search of all relevant studies published until February 2019 was performed.Prospective,retrospective cohort,or cross-sectional studies containing ultrasonography(US)data on the incidence of TM or the association between TM and PTT were eligible for inclusion.Results Of the 102 identified articles,18 studies involving 58,195 children were included in the final analysis.The overall incidence of TM in children with additional risk factors for FTT was 2.1%.In children,the proportion of left TM in unilateral cases was 55.7%,the frequency of bilateral TM was 69.0%,and proportion of classic TM was 71.8%[95%confidence interval(Cl)62.4-81.1%,P=0.0,72=0.0%].About 93.5%of TM remained unchanged,and newly detected PTT rate was very low(4/296)during follow-up.The overall risk ratio of TM in children with a concurrent diagnosis of PTT was 15.46(95%Cl 6.93-34.47,P<0.00001).Conclusions The incidence of TM in children is highly variable.Nonetheless,TM is usually bilateral,of the classic type,and remains stable or unchanged at follow-up.Pediatric patients with TM and contributing factors for PTT have an increased risk for PTT;however,there is no evidence to support mandatory US surveillance of children with TM.

Self-assembly and morphological characterization of two-component functional amyloid proteins

Functional amyloid has been increasingly applied as self-assembling nanostructures to construct multifunctional biomaterials.However,little has been known how different side domains,varied fusion positions and subunits affect self-assembly and morphologies of amyloid fibrils.Here,we constructed three groups of two-component amyloid proteins based on CsgA,the major protein components of Escherichia coli biofilms,to bridge these gaps.We showed that all fusion proteins have amyloid features,as indicated by Congo red assay.Atomic force microscopy（AFM） indeed reveals that these fusion proteins are able to self-assemble into fibrils,with an average diameter of 0.5-2 nm and length of hundreds of nanometers to several micrometers.The diameter of fibrils increases with the increase of the molecular weight of fusion domains,while the dynamic assembly of recombinant proteins was delayed as a result of the introduction of fusion domains.Moreover,fusion of the same functional domains but at intermediate position seems to cause the most interference on fibril assembly compared with those fused at C or Nterminus,as mainly short and irregular fibrils were detected.This phenomenon appears more pronounced for randomly coiled mussel foot proteins（Mfps） than for rigid chitin-binding domain（CBD）.Finally,increase of the molecular weight of tandem repeats in protein monomer seemed to increase the fibril diameter of the resultant fibrils,but either reduction of the tandem repeats of CsgA to one single belta-sheet loop or increase in the number of tandem repeats of CsgAs from one to four produced shorter and intermittent fibrils compared with CsgA control protein.These studies therefore provide insights into self-assembly of two-component amyloid proteins and lay the foundation for rational design of multifunctional molecular biomaterials.

Long-term follow-up results of testicular torsion in children

December 2020 to investigate the long-term follow-up results after testicular torsion(TT)in children.Boys with TT were divided into the salvage orchiopexy group and the orchiectomy group,and the baseline characteristics,ultrasonographic indications,intraoperative findings,testicular volumes,and adverse events during follow-up were compared.A total of 145 cases were included in this study.Approximately 56.6%of patients who underwent salvage orchiopexy had testicular atrophy(TA),and the median testicular volume loss of the testes was 57.4%.Age less than 6 years,delayed surgery,and intraoperative poor blood supply were associated with TA in pediatric TT after orchiopexy.Most atrophied testes appeared within 3-6 months after surgery.Compared with the corresponding age-matched healthy controls,the contralateral testicular volumes were larger in the orchiopexy(P=0.o01 without TA,and P=0.042 with TA)and orchiectomy groups(P=0.033).The adverse events were comparable in patients with orchiectomy or orchiopexy.In summary,follow-up before 3 months after surgery may not offer sufficient clinical value,while that 3 months after surgery should be regarded as the first follow-up time for testicular monitoring.The contralateral testes of patients with TT showed compensatory hypertrophy.We suggest performing orchiectomy when torsed testes are surgically assessed as Arda gradeⅢor inviable.