Dear Editor,Inguinal hernia repair(IHR)performed during childhood is a prevalent etiological factor for obstructive azoospermia(OA)attributed to vasal injury.OA couples can achieve pregnancy through intracytoplasmic s...Dear Editor,Inguinal hernia repair(IHR)performed during childhood is a prevalent etiological factor for obstructive azoospermia(OA)attributed to vasal injury.OA couples can achieve pregnancy through intracytoplasmic sperm injection or natural pregnancy after microsurgical anastomosis.Recent advancements have highlighted the potential utility of laparoscopy-assisted vasovasostomy for treating OA caused by childhood herniorrhaphy.展开更多
Vasectomy is a safe and effective method of contraception used by 42-60 million men worldwide. Approximately 3%-6% of men opt for a vasectomy reversal due to the death of a child or divorce and remarriage, change in f...Vasectomy is a safe and effective method of contraception used by 42-60 million men worldwide. Approximately 3%-6% of men opt for a vasectomy reversal due to the death of a child or divorce and remarriage, change in financial situation, desire for more children within the same marriage, or to alleviate the dreaded postvasectomy pain syndrome. Unlike vasectomy, vasectomy reversal is a much more technically challenging procedure that is performed only by a minority of urologists and places a larger financial strain on the patient since it is usually not covered by insurance. Interest in this procedure has increased since the operating microscope became available in the 1970s, which consequently led to improved patency and pregnancy rates following the procedure. In this clinical update, we discuss patient evaluation, variables that may influence reversal success rates, factors to consider in choosing to perform vasovasostomy versus vasoepididymostomy, and the usefulness of vasectomy reversal to alleviate postvasectomy pain syndrome. We also review the use of robotics for vasectomy reversal and other novel techniques and instrumentation that have emerged in recent years to aid in the success of this surgery.展开更多
Individuals with congenital absence of the vas deferens(CAVD)may transmit cystic fibrosis(CF)-causing variants of the cystic fibrosis transmembrane conductance regulator(CFTR)gene to their offspring through assisted r...Individuals with congenital absence of the vas deferens(CAVD)may transmit cystic fibrosis(CF)-causing variants of the cystic fibrosis transmembrane conductance regulator(CFTR)gene to their offspring through assisted reproductive technology(ART).We aimed to delineate the spectrum and estimate the prevalence of CF-causing variants in Chinese individuals with CAVD through a cohort analysis and meta-analysis.CFTR was sequenced in 145 Chineseindividuals with CAVD.CFTR variants were classified as CF-causing or non-CF-causing variants regarding clinical significance.A comprehensive genotype analysis was performed in Chinese individuals with CAVD,incorporating previous studies and our study cohort.The prevalence of CF-causing variants was estimated through meta-analysis.In our cohort,56 differentCFTR variants were identified in 108(74.5%)patients.Twenty variants were categorized as CF-causing and were detected in 28(19.3%)patients.A comprehensive genotype analysis of 867 patients identified 174 differentCFTR variants.Sixty-four were classified as CF-causing variants,56.3%of which had not been previously reported in Chinese patients with CF.Meta-analysis showed that 14.8%(95%confidence interval[CI]:11.0%-18.9%)CAVD cases harbored one CF-causing variant,and 68.6%(95%CI:65.1%-72.0%)CAVD cases carried at least one CFTR variant.Our study underscores the urgent need for extensiveCFTR screening,including sequencing of whole exons and flanking regions and detection of large rearrangements and deep intronic CF-causing variants,in Chinese individuals with CAVDbefore undergoing ART.The established CF-causing variants spectrum may aid in the development of genetic counseling strategies and preimplantation diagnosis to prevent the birth of a child with CF.展开更多
River confluences represent an integral component of the fluvial system,with the potential to disrupt downstream longitudinal trends in the main river through inputs of water,sediments,and other materials,such as wood...River confluences represent an integral component of the fluvial system,with the potential to disrupt downstream longitudinal trends in the main river through inputs of water,sediments,and other materials,such as woody debris.These various inputs at confluence zones result in a high degree of morphological and,consequently,ecological diversity.This study examines the potential relationship between the spatial characteristics of the catchment and the parameters of the confluence hydrodynamic zones(CHZs).A total of 15 tributaries and their adjacent CHZs were selected for analysis along a 50 km reach of the VsetínskáBečva River in the Javorníky and Hostýn-Vsetín Mountains in the Czech part of the Outer Western Carpathians.The VsetínskáBečva River is highly channelized,with the majority of channelization efforts involving riverbank stabilization,weirs,or grade control structures.The study hypothesized a correlation between the spatial arrangement of the channel,as indicated by the channel width symmetry ratio,and the angle between the tributary and main-stem river,and the increased morphological activity,evidenced by changes in average bed depth at the CHZs.The correlation coefficient(r)and p significance were employed to describe the relationships among the parameters.The results indicated a significant correlation between channel width and the catchment area symmetry ratio(r=0.747,p=0.001),likely influenced by channel regulation works(e.g.,channel shape or size),which are often artificially adjusted to accommodate local hydrological conditions and flood discharges for flood protection.A significant inverse correlation between channel width symmetry ratio and average main-stem channel depth was also found(r=-0.584,p=0.022).展开更多
基金supported by the National Key R&D Program of China(No.2022YFC2702701)Shanghai Scientific and Technological Project(No.20Y11907600)Clinical Research Innovation Plan of Shanghai General Hospital(No.CTCCR-2021C17).
文摘Dear Editor,Inguinal hernia repair(IHR)performed during childhood is a prevalent etiological factor for obstructive azoospermia(OA)attributed to vasal injury.OA couples can achieve pregnancy through intracytoplasmic sperm injection or natural pregnancy after microsurgical anastomosis.Recent advancements have highlighted the potential utility of laparoscopy-assisted vasovasostomy for treating OA caused by childhood herniorrhaphy.
文摘Vasectomy is a safe and effective method of contraception used by 42-60 million men worldwide. Approximately 3%-6% of men opt for a vasectomy reversal due to the death of a child or divorce and remarriage, change in financial situation, desire for more children within the same marriage, or to alleviate the dreaded postvasectomy pain syndrome. Unlike vasectomy, vasectomy reversal is a much more technically challenging procedure that is performed only by a minority of urologists and places a larger financial strain on the patient since it is usually not covered by insurance. Interest in this procedure has increased since the operating microscope became available in the 1970s, which consequently led to improved patency and pregnancy rates following the procedure. In this clinical update, we discuss patient evaluation, variables that may influence reversal success rates, factors to consider in choosing to perform vasovasostomy versus vasoepididymostomy, and the usefulness of vasectomy reversal to alleviate postvasectomy pain syndrome. We also review the use of robotics for vasectomy reversal and other novel techniques and instrumentation that have emerged in recent years to aid in the success of this surgery.
基金supported by the National Natural Science Foundation of China(grant No.82171588)the Fundamental Research Funds for the Central Institutes(grant No.2023GJZD01).
文摘Individuals with congenital absence of the vas deferens(CAVD)may transmit cystic fibrosis(CF)-causing variants of the cystic fibrosis transmembrane conductance regulator(CFTR)gene to their offspring through assisted reproductive technology(ART).We aimed to delineate the spectrum and estimate the prevalence of CF-causing variants in Chinese individuals with CAVD through a cohort analysis and meta-analysis.CFTR was sequenced in 145 Chineseindividuals with CAVD.CFTR variants were classified as CF-causing or non-CF-causing variants regarding clinical significance.A comprehensive genotype analysis was performed in Chinese individuals with CAVD,incorporating previous studies and our study cohort.The prevalence of CF-causing variants was estimated through meta-analysis.In our cohort,56 differentCFTR variants were identified in 108(74.5%)patients.Twenty variants were categorized as CF-causing and were detected in 28(19.3%)patients.A comprehensive genotype analysis of 867 patients identified 174 differentCFTR variants.Sixty-four were classified as CF-causing variants,56.3%of which had not been previously reported in Chinese patients with CF.Meta-analysis showed that 14.8%(95%confidence interval[CI]:11.0%-18.9%)CAVD cases harbored one CF-causing variant,and 68.6%(95%CI:65.1%-72.0%)CAVD cases carried at least one CFTR variant.Our study underscores the urgent need for extensiveCFTR screening,including sequencing of whole exons and flanking regions and detection of large rearrangements and deep intronic CF-causing variants,in Chinese individuals with CAVDbefore undergoing ART.The established CF-causing variants spectrum may aid in the development of genetic counseling strategies and preimplantation diagnosis to prevent the birth of a child with CF.
基金supported by an internal grant of the University of Ostrava[SGS03/PŘF/2024-The influence of man on the landscape and the landscape on a man III].
文摘River confluences represent an integral component of the fluvial system,with the potential to disrupt downstream longitudinal trends in the main river through inputs of water,sediments,and other materials,such as woody debris.These various inputs at confluence zones result in a high degree of morphological and,consequently,ecological diversity.This study examines the potential relationship between the spatial characteristics of the catchment and the parameters of the confluence hydrodynamic zones(CHZs).A total of 15 tributaries and their adjacent CHZs were selected for analysis along a 50 km reach of the VsetínskáBečva River in the Javorníky and Hostýn-Vsetín Mountains in the Czech part of the Outer Western Carpathians.The VsetínskáBečva River is highly channelized,with the majority of channelization efforts involving riverbank stabilization,weirs,or grade control structures.The study hypothesized a correlation between the spatial arrangement of the channel,as indicated by the channel width symmetry ratio,and the angle between the tributary and main-stem river,and the increased morphological activity,evidenced by changes in average bed depth at the CHZs.The correlation coefficient(r)and p significance were employed to describe the relationships among the parameters.The results indicated a significant correlation between channel width and the catchment area symmetry ratio(r=0.747,p=0.001),likely influenced by channel regulation works(e.g.,channel shape or size),which are often artificially adjusted to accommodate local hydrological conditions and flood discharges for flood protection.A significant inverse correlation between channel width symmetry ratio and average main-stem channel depth was also found(r=-0.584,p=0.022).
