X-ray images of the lower limb bone are the most commonly used imaging modality for clinical studies, and segmentation of the femur and tibia in an X-ray image is helpful for many medical studies such as diagnosis, surgery and treatment. In this paper, we propose a new approach based on pure dilated residual U-Net for the segmentation of the femur and tibia bones. The proposed approach employs dilated convolution completely to increase the receptive field, in this way, we can make full use of the advantages of dilated convolution. We conducted experiments and evaluations on datasets provided by Tianjin hospital. Comparison with the classical U-net and FusionNet, our method has fewer parameters, higher accuracy, and converges more rapidly, which means the high performance of the proposed method.

The clinical incidence of tumors in the manubrium is not high. Regardless of whether the tumor is primary or metastatic, the tumor should be completely removed as long as the patient is able to tolerate the surgery. This procedure can lead to sternal defects. Deciding on the method of defect reconstruction is a critical problem that clinicians face. In this , to reduce the limitations of the patient's upper body movement after surgery due to the inflexibility in the connections of the sternal prosthesis, we created a prosthesis using a computer-assisted design method and a 3-D technique, to completely preserve the agility of the sternum and maximize the patient's post-operational movement. The method used in the present study takes into consideration the individual's chest anatomy, sternum stress, and many other biological characteristics. Care is taken to measure the sternum size accurately, to provide personalized treatment, to accomplish precise results, and to reduce potential future damage. The patient's shoulder function was improved following the procedure.

Objective Lateral open‐wedge distal femoral osteotomy (DFO) has been used to treat valgus deformity of the knee, with good clinical outcomes. However, there is a lack of biomechanical studies regarding the angle of correction. The objective of this study was to apply computer‐aided design (CAD) for osteotomy planning in a three‐dimensional (3D) anatomical model and to assess the biomechanical differences among the varying correction angles on joint loading by finite element analysis (FEA). Methods To model different angles of lateral open‐wedge DFO correction, the CAD software package Mimics 21.0 was used to accurately simulate the operated knee. The femur was cut to 0°, 2°, 4°, 6°, 8°, and 10° of varus (equivalent to hip‐knee‐ankle angles of 180°, 178°, 176°, 174°, 172°, and 170°, respectively). The original knee model and the corrected models were processed by FE software. Then, the FE models were subjected to an axial force to obtain the von Mises stress (VMS) and shear stress distributions within the femoral cartilages and menisci. Results Under a compressive load of 740 N, the highest VMS in lateral and medial compartments of the intact knee model was 3.418 and 3.303 MPa. The maximum value of both the VMS and the shear stress in the lateral compartment decreased as the varus angle increased, but the corresponding values in the medial compartment increased. When the hip‐knee‐ankle (HKA) angle was 180°, the VMS in the lateral and medial compartments was balanced (3.418 and 3.303 MPa, respectively). Meanwhile, when the HKA angle was 178° (3.488 and 3.625 MPa, respectively), the shear stress in the lateral and medial compartments was balanced. In addition, the magnitude of change in the stress was significantly higher in the medial compartment (90.9%) than in the lateral compartment (19.3%). Conclusion The optimal correction angle of the valgus knee is close to neutral alignment or slightly varus (0° ‐ 2°). Overcorrection is not recommended, as it can result in a steep increase of the stress within the medial compartment and may accelerate the process of medial compartment OA.

The crisis of male infertility is an issue of human reproductive health worldwide. The Wuzi Yanzong pill (WZYZP) is a traditional Chinese medicine prescription that shows efficacy in kidney reinforcement and essence benefit to ameliorate male reproductive dysfunctions. However, the pharmacological mechanisms of the WZYZP on male infertility have not been investigated and clarified clearly. This study was designed to investigate the effects of the WZYZP on spermatogenesis disorder and explore its underlying pharmacological mechanisms. First, based on a network pharmacology study, 39 bioactive compounds and 40 targets of the WZYZP associated with spermatogenesis disorder were obtained, forming a tight compound-target network. Molecular docking tests showed tight docking of these compounds with predicted targeted proteins. The protein–protein interaction (PPI) network identified TP53, TNF, AKT1, Bcl-XL, Bcl-2, and IκBA as hub targets. The Kyoto Encyclopedia of Genes and Genomes pathway network and pathway-target-compound network revealed that the apoptosis pathway was enriched by multiple signaling pathways and multiple targets, including the hub targets. Subsequently, the chemical characterization of WZYZP was analyzed using liquid chromatography to quadrupole/time-of-flight mass spectrometry, and 40 compounds in positive ion mode and 41 compounds in negative ion mode in the WZYZP were identified. Furthermore, based on the prediction of a network pharmacology study, a rat model of spermatogenesis disorder was established to evaluate the curative role and underlying mechanisms of the WZYZP. The results showed that WZYZP treatment improved rat sperm quality and attenuated serum hormone levels, reversed histopathological damage of the testis, reduced cell apoptosis in testis tissues, and ameliorated the expression of the predicted hub targets (TP53, TNF-α, AKT1, NFκB, and IκBA) and the apoptosis related proteins (Bcl-XL, Bcl-2, Bax, Caspase 3, and Caspase 9). These results indicated that the WZYZP has a protective effect on spermatogenesis disorder, suggesting that it could be an alternative choice for male infertility therapy.

Background The current evidence on the association between obesity-associated markers and semen quality, serum reproductive hormones and lipids remains inconsistent. In this study, we tested the hypothesis that, in infertile Chinese men, body mass index (BMI) negatively correlates with sperm concentration, serum total testosterone (TT), and high-density lipoprotein cholesterol (HDL-C). The relationship between other obesity-associated markers and semen quality parameters, serum reproductive hormones, lipids and leptin were also investigated. Methods 181 Chinese infertile men were recruited from September 2018 to September 2019. Their obesity-associated markers, semen parameters, and serum reproductive hormones, lipids and leptin were detected. Statistical analysis was performed to assess the relationship between obesity-associated markers and semen quality, serum reproductive hormones, lipids and leptin. Result(s) Statistically negative correlation was found between other obesity-associated markers (e.g. waist-to-hip ratio and waist-to-height ratio) and semen parameters (e.g. sperm concentration, ratio of progressive motility and ratio of non-progressive motility), while no significant correlation was found between BMI and semen quality, serum reproductive hormones, lipids and leptin. Ratio of morphologically normal sperm was negatively correlated with serum lipids including total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), leptin and seminal superoxide dismutase. Ratio of progressive sperm, sperm concentration and ratio of morphologically normal sperm exhibited significantly lower values in overweight group than normal group. Estradiol (E2) and E2/TT were significantly higher in obese group than normal group, while TT level was significantly lower in obese group than normal group. Univariate and multivariate analysis indicated that TC was significantly associated with BMI. Serum leptin concentration was positively correlated with seminal leptin concentration in overweight and obese groups. Conclusion(s) No significant correlation was found between BMI and sperm concentration, serum TT and HDL-C, while other obesity-associated markers were found to negatively correlate with sperm concentration, ratio of progressive motility and ratio of non-progressive motility. Statistically significant correlations between serum reproductive hormones, lipids and leptin also existed in Chinese infertile men.

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Patients with ischemic stroke (IS) often suffered from the problem of erectile dysfunction (ED) and psychological disease. However, they are often ignored because these symptoms are more obvious in the convalescent stage of stroke, which affects the quality of sexual life of patients. This study aimed to investigate the incidence of ED, sexual quality of life, and mental state of patients after stroke, as well as analyze the relevant risk factors affecting their psychological status. A total of 361 IS patients were enrolled. The international erectile function index-5 scale was used to diagnose ED. Accordingly, the patients were divided into ED group and non-ED group. Magnetic resonance imaging was used to evaluate the brain lesions of patients. We assessed neurological deficits by the National Institutes of Health Stroke Scale score and patient health questionnaire-9 (PHQ-9) and general anxiety disorder-7 (GAD-7) were used to evaluate the depression and anxiety. The differences between the ED group and the non-ED group clinical factors were compared. The response rate was 88.6% (n = 320), and more than two-thirds of patients reported ED (77.8%). Patients with ED had higher PHQ-9 (8.40 ± 4.18 vs 4.94 ± 3.73, P < .01) and GAD-7 (6.73 ± 3.56 vs 4.51 ± 3.35, P < .01) scores, were more likely to have the frontal lobe (75.1% vs 49.3%, P < .01) and lateral ventricle (69.8% vs 53.5%, P = .01) lesions, with hypertension (75.1% vs 46.5%, P < .01) and hyperlipidemia (48.2% vs 25.4%), and on antihypertensive (67.9% vs 35.25, P < .01) and hypolipidemic drug (43.4% vs 16.9%, P < .01). Multivariate logistic regression analysis showed that antihypertensive drug (odds ratio [OR]: 2.50, 95% confidence interval [CI]: 1.02–6.10, P = .04), depression (OR: 1.18, 95% CI: 1.06–1.32, P < .01) and anxiety (OR: 1.13, 95% CI: 1.01–1.27, P = .04) might be the independent risk factors for ED group. ED is more common in male IS patients. Antihypertensive drug, depression and anxiety are the main factors affecting ED.

Background Many infertile couples might experience erectile dysfunction (ED) and significant changes in the quality of sexual life and psychological state though information is limited in secondary infertile men in China. To determine whether primary or secondary infertility is associated with ED, psychological disorders, and sexual performance. Methods This was a cross-sectional survey conducted at the Dongzhimen Hospital of Beijing University of Chinese Medicine (06/2019-01/2020). The participants completed a questionnaire including general information, sexual life, simplified International Index of Erectile Function (IIEF-5), Patient Health Questionnaire-9 (PHQ-9), and 7-item Generalized Anxiety Disorder Scale (GAD-7). Multivariable logistic regression was used to identify the factors associated with ED, depression, and anxiety. Results ED was more frequent in secondary vs. primary infertility (46.5 % vs. 26.7 %, P < 0.001). Compared with men with primary infertility, those with secondary infertility showed lower IIEF-5 scores (P < 0.001), higher occurrence of TOIF (P = 0.001), had a higher awareness of partner’s ovulation when having ED (P = 0.001), lower GAD-7 scores (P = 0.016), lower libido (P = 0.005), fewer intercourses per month (P = 0.001) and a lower sexual satisfaction score (P = 0.027). In the multivariate analysis, primary infertility was found to be an independent risk factor of anxiety (OR: 1.812, 95 %CI: 1.015–3.236). Some overlap is observed in factors associated with ED, psychological disorders, and sexual performance between primary and secondary infertility, but some factors are distinct. Conclusions The prevalence of ED in secondary infertility men was higher than that of primary infertility men, and the quality of sexual life was decreased. Primary infertility is an independent risk factor of anxiety.