Association of Meteorological Factors with Labial Adhesions in Children: A 7-year Retrospective Analysis with 9,467 Cases

Labial adhesions (LA)(also called labial agglutination) are defined as partial or complete agglutination of labia minora. The condition commonly occurs in girls during childhood with an estimated prevalence of 0.6%–5%and a peak incidence in the age-group of 13–24 months[1]. Over half of all patients present with symptoms related to urinary outlet obstruction[2].

Bioinformatic identification of key genes and molecular pathways in the spermatogenic process of cryptorchidism

This study aims to determine key genes and pathways that could play important roles in the spermatogenic process of patients with cryptorchidism.The gene expression profile data of GSE25518 was obtained from the Gene Expression Omnibus(GEO)database.Microarray data were analyzed using BRB-Array Tools to identify differentially expressed genes(DEGs)between high azoospermia risk(HAZR)patients and controls.In addition,other analytical methods were deployed,including hierarchical clustering analysis,class comparison between patients with HAZR and the normal control group,gene ontology(GO),Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis,and the construction of a proteineprotein interaction(PPI)network.In total,1015 upregulated genes and 1650 downregulated genes were identified.GO and KEGG analysis revealed enrichment in terms of changes in the endoplasmic reticulum cellular component and the endoplasmic reticulum protein synthetic process in the HAZR group.Furthermore,the arachidonic acid pathway and mTOR pathway were also identified as important pathways,while RICTOR and GPX8 were indentified as key genes involved in the spermatogenic process of patients with cryptorchidism.In present study,we found that changes in the synthesis of endoplasmic reticulum proteins,arachidonic acid and the mTOR pathway are important in the incidence and spermatogenic process of cryptorchidism.GPX8 and RICTOR were also identified as key genes associated with cryptorchidism.Collectively,these data may provide novel clues with which to explore the precise etiology and mechanism underlying cryptorchidism and cryptorchidism-induced human infertility.

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.

Diagnosis,treatment,outcome,and reasons for delayed treatment of cryptorchidism with torsion in children:a 16-year retrospective study in a large pediatric medical center

We describe and summarize the diagnosis,treatment,and reasons for delayed treatment of children with cryptorchidism torsion in Children's Hospital of Chongqing Medical University.The study included 19 cases of cryptorchidism torsion.The age of the children ranged from 16 days to 12 years(median:6 years).The interval from diagnosis to surgery varied from 4 h to 16 days(median:3 days).Ultrasound was performed in all cases.Fifteen cases had cryptorchidism torsion,2 cases had a soft tissue mass in the inguinal region,and 2 cases had an inguinal/abdominal teratoma.Five cases were treated with an orchidopexy,12 cases were treated with orchiectomy,and 2 cases received resection of a testicular tumor.The 5 children with an orchidopexy were followed up from 1 month to 7 years(median:3 years),with 1 child having a testis retraction and no blood supply.Of the 12 children who had an orchiectomy,three had delayed diagnosis due to family unawareness of the condition,while other delays were due to delayed referral from primary care facilities.The relative rarity and insufficient awareness of cryptorchidism torsion resulted in a low rate of testicular salvage.Therefore,hospitals of all levels should be fully aware of cryptorchidism with torsion and ensure a male child's genital system and inguinal region are examined to improve the success rate of testicular salvage.

X-box binding protein 1 caused an imbalance in pyroptosis and mitophagy in immature rats with di-(2-ethylhexyl)phthalate-induced testis toxicity

As a widely used plasticizer,di-(2-ethylhexyl)phthalate(DEHP)is known to induce significant testicular injury.However,the potential mechanism and effects of pubertal exposure to DEHP on testis development remain unclear.In vivo,postnatal day(PND)21 male rats were gavaged with 0,250,and 500 mg/kg DEHP for ten days.Damage to the seminiferous epithelium and disturbed spermatogenesis were observed after DEHP exposure.Meanwhile,oxidative stress-induced injury and pyroptosis were activated.Both endoplasmic reticulum(ER)stress and mitophagy were involved in this process.Monoethylhexyl phthalate(MEHP)was used as the biometabolite of DEHP in vitro.The GC-1 and GC-2 cell lines were exposed to 0,100μM,200μM,and 400μM MEHP for 24 h.Reactive oxygen species(ROS)generation,oxidative stress damage,ER stress,mitophagy,and pyroptosis were significantly increased after MEHP exposure.The ultrastructure of the ER and mitochondria was destroyed.X-box binding protein 1(XBP1)was observed to be activated and translocated into the nucleus.ROS generation was inhibited by acetylcysteine.The levels of antioxidative stress,ER stress,mitophagy,and pyroptosis were decreased as well.After the administration of the ER stress inhibitor 4-phenyl-butyric acid,both mitophagy and pyroptosis were inhibited.Toyocamycin-induced XBP1 down-regulation decreased the levels of mitophagy and pyroptosis.The equilibrium between pyroptosis and mitophagy was disturbed by XBP1 accumulation.In summary,our findings confirmed that DEHP induced a ROS-mediated imbalance in pyroptosis and mitophagy in immature rat testes via XBP1.Moreover,XBP1 might be the key target in DEHP-related testis dysfunction.

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.

The effects of repeated propofol anesthesia on spatial memory and long-term potentiation in infant rats under hypoxic conditions

Propofol is widely used as an intravenous drug for induction and maintenance in general anesthesia.Hypoxemia is a common complication during perianesthesia.We want to know the effect of propofol on spatial memory and LTP(Long-term potentiation)under hypoxic conditions.In this study,84 seven-day-old SpragueeDawley rats were randomly assigned into six groups(n Z 14)-four control groups:lipid emulsion solvent t 50%oxygen(CO),lipid emulsion solvent t room air(CA),lipid emulsion solvent t 18%oxygen(CH),and propofol t 50%oxygen(propofoleoxygen,PO);and two experiment groups:propofol t room air(propofol eair,PA),and propofol t 18%oxygen(propofolehypoxia,PH).After receiving propofol(50 mg/kg)or the same volume of intralipid intraperitoneal(5.0 ml/kg),injected once per day for seven consecutive days,the rats were exposed to 18%oxygen,50%oxygen and air,until recovery of the righting reflex.We found that the apoptotic index and activated caspase-3 increased in the PH group(P<0.05)compared with the PA group,fEPSP(field excitatory postsynaptic)potential and success induction rate of LTP reduced in all propofol groups(P<0.05).Compared with the PO group,the fEPSP and success induction rate of LTP reduced significantly in the PA and PH groups(P<0.05).Moreover,compared with CH group,the average time of escape latency was longer,and the number of platform location crossings was significantly reduced in the PH group(P<0.05).Thus,we believe that adequate oxygen is very important during propofol anesthesia.

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.

DEHP exposure destroys blood-testis barrier (BTB) integrity of immature testes through excessive ROS-mediated autophagy

Di-(2-ethylhexyl)phthalate(DEHP),is known to impair testicular functions and reproduction.However,its effects on immature testis Blood-testis barrier(BTB)and the underlying mechanisms remain obscure.We constructed a rat model to investigate the roles of autophagy in BTB toxicity induced by DEHP.SpragueeDawley rats were developmentally exposed to 0,250 and 500 mg/kg DEHP via intragastric administration from postnatal day(PND)1 to PND 35.Testicular morphology,expressions of BTB junction proteins and autophagy related proteins were detected.In addition,expressions of oxidative stress markers were also analyzed.Our results demonstrated that developmental DEHP exposure induced decreasing organ coefficients of immature testes and severe testicular damage in histomorphology.The expressions of junctional proteins were down-regulated significantly after DEHP treatment.Intriguingly,DEHP simultaneously increased the number of autophagosomes and the levels of autophagy marker LC3-II and p62,suggesting that the accumulated autophagosomes resulted from impaired autophagy degradation.Moreover,the expressions of HO-1 and SOD levels remarkably decreased after DEHP exposure.Vitamins E and C could alleviate the DEHP-induced oxidative stress,reverse the autophagy defect and restore the BTB impairment.Taken together,DEHP exposure destroys immature testis blood-testis barrier(BTB)integrity through excessive ROSmediated autophagy.

Retinoic acid can improve autophagy through depression of the PI3K-Akt-mTOR signaling pathway via RARαto restore spermatogenesis in cryptorchid infertile rats

Cryptorchidism-caused adult infertility is a common component of idiopathic reasons for male infertility.Retinoic acid(RA)has a vital effect on the spermatogenesis process.Here,we found that the expression of c-Kit,Stra8,and Sycp3 could be up-regulated via the activation of retinoic acid receptorα(RARα)after RA supplementation in neonatal cryptorchid infertile rats.We also demonstrated that the protein expression of PI3K,p-Akt/pan-Akt,and p-mTOR/mTOR was higher in cryptorchid than in normal testes,and could be suppressed with RA in vivo.After RA treatment in infertile cryptorchid testis in vivo,the levels of the autophagy proteins LC3 and Beclin1 increased and those of P62 decreased.Biotin tracer indicated that the permeability of blood-testis barrier(BTB)in cryptorchid rats decreased after RA administration.Additionally,after blocking the RARαwith AR7(an RARαantagonist)in testicle culture in vitro,we observed that compared with normal testes,the PI3K-Akt-mTOR signaling pathway and the autophagy pathway was increased and decreased,respectively,which were coincident with cryptorchisd testes in vivo.Additionally,the appropriate concentrations of RA treatment could depress the PI3K-Akt-mTOR signaling pathway and improve the autophagy pathway.The results confirmed that RA can rehabilitate BTB function and drive key protein levels in spermatogonial differentiation through depressing the PI3K-Akt-mTOR signaling pathway via RARα.