Mini percutaneous nephrolithotomy is a noninferior modality to standard percutaneous nephrolithotomy for the management of 20-40 mm renal calculi: A Multicenter randomized controlled trial

Background: High quality of evidence comparing mini percutaneous nephrolithotomy (mPNL) with standard percutaneous nephrolithotomy (sPNL) for the treatment of larger-sized renal stones is lacking. Objective: To compare the efficacy and safety of mPNL and sPNL for the treatment of 20–40 mm renal stones. Design, setting, and participants: A parallel, open-label, and noninferior randomized controlled trial was performed at 20 Chinese centers (2016–2019). The inclusion criteria were patients 18–70 yr old, with normal renal function, and 20–40 mm renal stones. Intervention: Percutaneous nephrolithotomy PNL was performed using either 18 F or 24 F percutaneous nephrostomy tracts. Outcome measurements and statistical analysis: The primary outcome was the one-session stone-free rate (SFR). The secondary outcomes included operating time, visual analog pain scale (VAS) score, blood loss, complications as per the Clavien-Dindo grading system, and length of hospitalization. Results and limitations: The 1980 intention-to-treat patients were randomized. The mPNL group achieved a noninferior one-session SFR to the sPNL group by the one-side noninferiority test (0.5% [difference], p < 0.001). The transfusion and embolization rates were comparable; however, the sPNL group had a higher hemoglobin drop (5.2 g/l, p < 0.001). The sPNL yielded shorter operating time (–2.2 min, p = 0.008) but a higher VAS score (0.8, p < 0.001). Patients in the sPNL group also had longer hospitalization (0.6 d, p < 0.001). There was no statistically significant difference in fever or urosepsis occurrences. The study's main limitation was that only 18F or 24F tract sizes were used. Conclusions: Mini mPNL achieves noninferior SFR outcomes to sPNL, but with reduced bleeding, less postoperative pain, and shorter hospitalization. Patient summary: We evaluated the surgical outcomes of percutaneous nephrolithotomy using two different sizes of nephrostomy tracts in a large population. We found that the smaller tract might be a sensible alternative for patients with 20–40 mm renal stones. This multicenter, parallel, open-label, and noninferior randomized controlled trial showed that mini percutaneous nephrolithotomy achieved noninferior stone-free rate with advantages of reduced blood loss, less postoperative pain, and shorter hospitalization. Mini percutaneous nephrolithotomy should be considered a sensible alternative treatment of 20–40 mm renal stones.grants from high-level development funding of Guangzhou Medical Universit

Effects of impregnation combined heat treatment on the pyrolysis behavior of poplar wood.

To investigate the effects of urea-formaldehyde (UF) resin impregnation combined heat treatment (IMPG-HT) on the pyrolysis behavior of poplar wood, the chemical composition, pyrolysis characteristics, pyrolysis kinetics, and gaseous products released during pyrolysis of untreated (control), IMPG-HT, IMPG and HT woods were analyzed. The results demonstrate that IMPG-HT changes pyrolysis behavior of poplar wood significantly. Unlike the control and HT samples, the thermogravimetric / derivative thermogravimetric (TG/DTG) curves of IMPG wood shift toward lower temperature, and the shoulder on DTG curves weaken or even disappear. The maximum mass loss rate of IMPG-HT samples decreases, and carbon residual yield increases to 23% or more and activation energy (E) increases sharply after conversion rate (α) reaching 0.80. HT improves the thermal stability of IMPG wood, which is represented by the increase of decomposition temperature (Td) and DTG peak temperature (Tpeak) and the higher E value of IMPG-HT wood. For the pyrolysis gaseous products, IMPG-HT wood produces nitrogen-containing gases (HNCO and NH3) due to the presence of UF resin, but the amounts of these gases are less than that produced by IMPG wood because the heat treatment had removed part of N elements

Associations of exposure to ambient fine particulate matter constituents from different pollution sources with semen quality: Evidence from a prospective cohort

The association between ambient fine particulate matter (PM2.5) exposure and semen quality remains inconclusive, possibly due to variations in pollution sources and PM2.5 compositions. Studies investigating the constituents of PM2.5 have been hindered by small sample sizes, and research exploring the relationships between PM2.5 pollution sources and semen quality is lacking. To address this gap, we conducted a comprehensive study based on the Anhui prospective assisted reproduction cohort to evaluate the associations between semen quality and the constituents and pollution sources of PM2.5. This study included 9013 semen samples from 4417 males in the urban districts of Hefei. The median concentrations of PM2.5 constituents, including eight metals and four water-soluble ions (WSIs), were measured for seven days per month at two monitoring stations during the 0–90-day exposure window. A linear mixed-effects model, weighted quantile sum regression, and positive matrix factorisation were used to evaluate the associations of the constituents and pollution sources of PM2.5 with semen quality. The results showed that exposure to PM2.5-bound metals (antimony, arsenic, cadmium, lead, and thallium) and WSIs (sulphate and chloride) were negatively associated with semen quality parameters. Moreover, mixtures of PM2.5-bound metals and WSIs were negatively associated with semen quality. Additionally, PM2.5 derived from traffic emissions was negatively associated with semen quality. In summary, our study revealed that ambient PM2.5 and its constituents, especially metals, were negatively associated with semen quality. Antimony, lead, and thallium emerged as the primary contributors to toxicity, and PM2.5 from traffic emissions was associated with decreased semen quality. These findings have important public health implications for the management of PM2.5 pollution in the context of male reproductive health.</p

Inverse association between ambient particulate matter and semen quality in Central China : Evidence from a prospective cohort study of 15,112 participants

Emerging evidence indicates that ambient particulate matter (PM) is harmful to male fertility, but the associations between ambient PM exposure and semen quality were inconsistent. This study aimed to quantitatively evaluate the association between ambient PM exposure and semen quality based on a large prospective cohort. Using data from the prospective assisted reproduction cohort in Anhui province, China, we included 15,112 males with 28,267 semen tests, whose partner has undergone assisted reproductive technology from September 1, 2015 to September, 22 2020. Individual ambient PM, gaseous air pollutants, and temperature exposures of the participants during 0–90, 0–9, 10–14, and 70–90 days before semen quality tests were evaluated using inverse distance weighting interpolation. Linear mixed-effects models were conducted to evaluate the relationship between PM2.5 and PM10 exposures and standardized semen quality parameters. Models were adjusted for age, body mass index, smoking, drinking, education attainment, occupation type, sampling month, temperature and the principal component of gaseous air pollutants. PM2.5 and PM10 were inversely associated with sperm concentration, total sperm count, total motility, progressive motility, total motile sperm count, and progressively motile sperm count during 0–90, 0–9, and 70–90 days period (all p 2.5 exposure on semen quality parameters during 0–90 days period were larger than 0–9 and 70–90 days periods, and the effects of PM2.5 on semen quality parameters were stronger than PM10. Our results showed that ambient PM2.5 and PM10 exposures were associated with semen quality, during 70–90 days and 0–9 days before sampling, and the entire spermatogenesis process. The effects of PM2.5 on semen quality parameters were stronger than PM10, and the long-term effects of PM2.5 and PM10, throughout spermatogenesis, were stronger than the short-term effects.</p

Linear and non-linear relationships between sulfur dioxide and semen quality: A longitudinal study in Anhui, China

Existing evidence indicates that ambient air pollutants pose a threat to human semen quality; however, these findings are sparse and controversial. Besides, their non-linear dose-response relationship has not yet been well investigated. This study aimed to explore the linear and non-linear associations of gaseous air pollutants exposure with semen quality based on a large longitudinal cohort. A total of 15,112 males (with 28,267 semen tests) from the Anhui prospective assisted reproduction cohort were analyzed. Individual air pollutants exposure before semen tests in four exposure windows (i.e., 0–9, 10–14, 70–90, and 0–90 days) were estimated by inverse distance weighting interpolation. Linear mixed-effects models, cubic spline analysis and piecewise regression were used to test the potential linear and non-linear dose-response relationships. Ambient SO2 exposure was negatively associated with all semen quality parameters (all p values 2 exposure with total sperm count, progressive motility, total motility, progressively motile sperm count, and total motile sperm count (p values for non-linearity 2 exposure with semen quality only when SO2 exposure was below the cut-off points identified by cubic spline analyses, which were all smaller than 40 μg/m3, the 2021 updated WHO air quality guideline level for SO2 exposure. Overall, we found that SO2 exposure was negatively associated with semen quality. Ambient SO2 exposure could reach the maximum hazardous dose even below the WHO air quality guideline level for SO2 exposure, suggesting a refinement to the current guideline.</p

Weakly Supervised 3D Segmentation via Receptive-Driven Pseudo Label Consistency and Structural Consistency

As manual point-wise label is time and labor-intensive for fully supervised large-scale point cloud semantic segmentation, weakly supervised method is increasingly active. However, existing methods fail to generate high-quality pseudo labels effectively, leading to unsatisfactory results. In this paper, we propose a weakly supervised point cloud semantic segmentation framework via receptive-driven pseudo label consistency and structural consistency to mine potential knowledge. Specifically, we propose three consistency contrains: pseudo label consistency among different scales, semantic structure consistency between intra-class features and class-level relation structure consistency between pair-wise categories. Three consistency constraints are jointly used to effectively prepares and utilizes pseudo labels simultaneously for stable training. Finally, extensive experimental results on three challenging datasets demonstrate that our method significantly outperforms state-of-the-art weakly supervised methods and even achieves comparable performance to the fully supervised methods

The Interannual Relationship between the Diabatic Heating over the South Asia and the Snow Depth over the Southern Tibetan Plateau in Late Spring to Early Summer: Roles of the Air Temperature

The southern Tibetan Plateau (TP) is snow covered during cold season but exhibits faster snow melting in early summer. Using in situ observations and improved satellite-derived data, the present study indicates that the snow depth (SD) over the southern TP exhibits distinction characteristics between late spring (i.e., P1: April 16th–May 15th) and early summer (i.e., P2: May 16th–June 14th). In terms of climate states, the snow melting rate over the southern TP in P2 is faster than that in P1. The acceleration of snow melting during P2 is mainly found over high elevation areas caused by the increase of local air temperature. Diagnoses of the thermodynamic equation further demonstrate that the warming over the southern TP during the two periods is mainly attributed to the meridional temperature advection and diabatic heating in situ. On the interannual time scale, the SD over the southern TP is closely related to diabatic heating over South Asia. During P1, the diabatic cooling from the southern Bay of Bengal eastward to the western South China Sea suppresses convection over the Bay of Bengal and southern TP and has resulted in an upper-level anomalous cyclone and cold temperature anomalies from the surface to 200 hPa over the southern TP, favoring the above-normal SD over the southern TP. On the other hand, SD over the southern TP in P2 is closely related to diabatic cooling over the northern Indochina Peninsula and diabatic heating over the southern China. But we could not prove that these diabatic heating anomalies can affect the SD over the southern TP by modulating local surface air temperature. This may be limited by the quality of the data and the simulation capability of the simple model

Islet transplantation improved penile tissue fibrosis in a rat model of type 1 diabetes

Abstract Background Glycaemic control is one of the most effective strategies for the treatment of diabetes-related erectile dysfunction (DMED). Compared to conventional anti-diabetic drugs and insulin, islet transplantation is more effective in the treatment of diabetic complications. The aim of this study was to investigate the efficacy of islet transplantation for reversing advanced-stage DMED in rats and to observe its influence on corpus cavernosum fibrosis. Methods Wistar rats were intraperitoneally injected with streptozotocin to establish a diabetes model. After 12 weeks, the rats were divided into 4 groups: diabetic, insulin, islet transplantation, and normal control. Following supplementation, the changes in blood glucose and weight were determined sequentially. Penile erectile function was evaluated by apomorphine experiments in the fourth week, and the penile corpus cavernosum was also collected for assessment by Masson staining, immunohistochemistry and Western blot to observe the spongy tissue and the related cellular changes at the molecular level. Results Islet transplantation significantly ameliorated penile erectile function in advanced-stage diabetic rats. The ratio of corpus cavernosum smooth muscle cells to fibroblasts and the expression level of α-SMA in the islet transplantation group were significantly higher than those in the diabetic and insulin groups. In addition, the expression levels of TGF-β1, p-Samd2, and connective tissue growth factor (CTGF) in the islet transplantation and insulin groups were much lower than those in the diabetic group, while those in the islet transplantation group were significantly lower than those in the insulin group. Conclusions Our findings strongly suggest that islet transplantation can promote the regeneration of smooth muscle cells and ameliorate corpus cavernosum fibrosis to restore its normal structure in advanced-stage diabetic rats. The possible mechanism of ameliorating corpus cavernosum fibrosis by islet transplantation may be associated with improvement of the hyperglycaemic status in diabetic rats, thereby inhibiting the TGF-β1/Samd2/CTGF pathway