ObjectiveTo analyse baseline information, semen, sex hormones and sexual function to understand the differences between male patient with epilepsy(MPWE) and healthy men. At the same time, we preliminarily evaluated the risk factors related to reproductive function in MPWE to provide clinical method for reducing the risk of infertility.MethodsWe collected data of 112 MPWE in the Department of Neurology, First Affiliated Hospital of Dali University from February 2019 to February 2020. Sixty-seven healthy male volunteers matching the age of the survey group were selected. All men completed semen and sex hormone test. Men with sexual life experience completed the International index of erectile function scale (IIEF-5) and the Premature ejaculation diagnostic tool (PEDT). MPWE completed the Quality of life in epilepsy-1(QOLIE-31). The baseline data, semen quality, sex hormone level and sexual function questionnaire scores of MPWE and healthy controls were compared. In addition, according to the diagnostic criteria of abnormal male reproductive function, MPWE were divided into abnormal group and normal group. Single factor analysis and binary logistic regression analysis were used to preliminarily explore the related risk factors of reproductive function in MPWE.ResultsCompared with the healthy control group, the proportion of married and childbearing, testosterone level, sperm concentration, sperm survival rate and IIEF-5 score in MPWE were significantly reduced (P<0.05). Compared with the normal group, age, body mass index, seizure frequency and drug type in the abnormal group were significant differences statistically (P<0.05). The total score and energy score of QOLIE-31 in the abnormal group were significantly lower than that in the normal group (P<0.05). Binary Logistic regression analysis indicated that energy score [B=?0.033, OR=0.967, 95%CI(0.937, 0.999)], age [B=0.879, OR=2.408, 95%CI (1.070, 5.416)], seizure frequency [B=1.788, OR=5.976, 95% CI (2.031, 17.589)].ConclusionThe reproductive function of MPWE is lower than that in healthy men. The total score, energy score, age, body mass index, seizure frequency and type of drugs will significantly affect the reproductive function of MPWE. Energy score, age and seizure frequency are independent risk factors that affect the reproductive function of MPWE. Abnormal reproductive function of MPWE was positively correlated with age and seizure frequency, but negatively correlated with energy score.
Objective To study the variety and the action of inflammatory cytokines and the relevant anti-inflammatory factors in acute pancreatitis (AP). Methods The authors observed the change of peripheral blood IL-6 and sTNFR in 41 patients with mild and severe AP in two groups on 1, 5, 14d after acute attack by ELISA. Results All cases recovered gradually in mild group (n＝22) after five days. Twelve patients improved gradually in severe group (n＝19) after 5-7 days. The level of sTNFR increased markedly in 2 groups at 1, 5, 14d(Ｐ＜0.001), and that of the severe group was markedly higher decreased gradually (Ｐ＜0.01). The level of IL-6 increased apparently only in severe group on 1d, 40.38 pg/ml∶12.4 pg/ml, (Ｐ＜0.001). The levels of IL-6 and sTNFR correlated respectively with severity of AP. Conclusion These results show that peripheral blood IL-6 and TNFα are useful index to supervise the severity and conversion and final results of AP.
Definitive chemoradiotherapy (dCRT) has become a cornerstone in the treatment of locally advanced esophageal cancer; however, local control remains suboptimal, and persistent lesions or locoregional recurrences after treatment are not uncommon. For patients without distant metastases but with local failure, whether surgical intervention can still offer curative potential remains a major clinical dilemma. Salvage esophagectomy (SE) offers potential long-term survival for selected patients, but this procedure is performed in the context of severe fibrosis, impaired local blood supply, and obscured anatomical planes following chemoradiotherapy, resulting in significantly higher perioperative risk compared to primary esophagectomy. Consequently, controversies exist regarding patient selection, preoperative restaging, choice of surgical approach, extent of lymphadenectomy, gastrointestinal reconstruction, and perioperative management. In recent years, with the refinement of restaging modalities such as PET/CT, the accumulation of experience in high-volume centers, and emerging evidence from clinical studies, the clinical role of SE has gradually shifted from a "high-risk salvage measure" to a "selective curative strategy aimed at achieving long-term survival in carefully selected patients". Nevertheless, standardized guidelines for patient selection, technical approaches, and perioperative management are still lacking. Based on current evidence and clinical experience, experts organized by the Integrated Esophageal Cancer Committee of Chinese Anti-Cancer Association systematically reviewed key issues regarding SE, including its definition, indications, preoperative evaluation, choice of surgical approach, lymphadenectomy, gastrointestinal reconstruction, and perioperative management, and formulated a Chinese expert consensus. This consensus aims to provide guidance for standardized assessment, appropriate referral, individualized surgical decision-making, and optimized perioperative management of patients with locoregional failure after dCRT. Ultimately, this will increase the likelihood of R0 resection, reduce the risk of severe complications, and promote the safer, more judicious, and standardized implementation of SE in high-risk scenarios.