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Owing to the early suffering age and the rising incidence of type 1 diabetes (T1D), the resulting male reproductive dysfunction and fertility decline have become a disturbing reality worldwide, with no effective strategy being available. Icariin (ICA), a flavonoid extracted from Herba Epimedium , has been proved its promising application in improving diabetes-related complications including diabetic nephropathy, endothelial dysfunction and erectile dysfunction. Ensuring the future reproductive health of children and adolescents with T1D is crucial to improve global fertility. However, its roles in the treatment of T1D-induced testicular dysfunction and the potential mechanisms remain elusive. The purpose of this present study was to investigate whether ICA ameliorates T1D-induced testicular dysfunction as well as its potential mechanisms. T1D murine model was established by intraperitoneal injection of STZ with or without treated with ICA for eleven weeks. Morphological, pathological and serological experiments were used to determine the efficacy of ICA on male reproductive function of T1D mice. Western blotting, Immunohistochemistry analysis, qRT-PCR and kit determination were performed to investigated the underlying mechanisms. We found that replenishment of ICA alleviated testicular damage, promoted testosterone production and spermatogenesis, ameliorated apoptosis and blood testis barrier impairment in streptozotocin-induced T1D mice. Functionally, ICA treatment triggered adenosine monophosphate protein kinase (AMPK) activation, which in turn inhibited the nuclear translocation of nuclear factor kappa B p65 (NF-κB p65) to reduce inflammatory responses in the testis and activated nuclear factor erythroid 2-related factor 2(Nrf2), thereby enhancing testicular antioxidant capacity. Further studies revealed that supplementation with the AMPK antagonist Compound C or depletion of Nrf2 weakened the beneficial effects of ICA on testicular dysfunction of T1D mice. Collectively, these results demonstrate the feasibility of ICA in the treatment of T1D-induced testicular dysfunction, and reveal the important role of AMPK-mediated Nrf2 activation and NF-κB p65 inhibition in ICA-associated testicular protection during T1D. [Display omitted] [ABSTRACT FROM AUTHOR]

Suturing is a crucial clinical skill for nurse practitioners (NPs), but the effectiveness of traditional training methods (e.g., physical suture kits combined with video content) is low. This study compared the effectiveness and usability of a mobile-based web app (MoWa) developed for NPs to learn simple suturing skills with those of traditional instructional video–based training. The MoWa system utilizes mobile devices to simulate hands-on suturing and provides learning guidance and feedback to support self-learning with a physical suturing kit. Fifty-four suturing novices (NPs) were recruited as participants, divided into an experimental group (EG: 28 participants) and a control group (CG: 26 participants), and instructed to self-learn for 3 weeks. Learning effectiveness and system usability were evaluated through a pretest and posttest. The EG exhibited significant improvements in learning outcomes, self-confidence, self-efficacy, and learning anxiety and expressed satisfaction with the MoWa system. Furthermore, the EG also considerably enhanced learning outcomes, self-efficacy, and learning anxiety compared to the CG, with no significant difference in self-confidence. The MoWa system combined with deliberate practice is an effective strategy for supporting suturing skills training. • App to support hands-on learning of simple suturing skills with real-time feedback • App improved learning performance of NPs and reduced their learning anxiety. • App plus practice can be an effective strategy to support suturing skills learning. [ABSTRACT FROM AUTHOR]

Objective RENAL nephrometry score (RNS) has been proposed as an anatomical classification system for renal masses to investigate the influence on perioperative outcomes and complications. The aim of this study was to assess the system for external validation on laparoscopic partial nephrectomy (LPN). Materials and methods The single-surgeon database enrolled patients who had undergone LPN from December 2008 to September 2013. Renal tumors were divided into low-, intermediate-, and high-complexity groups according to the RNS sum score. We reviewed perioperative outcomes including operation time (OT), length of stay (LOS), estimated blood loss (EBL), ischemia time (IT), conversion to open surgery rate, estimated glomerular filtration rate (eGFR), and complications. We also assessed the individual characteristic parameters in the present study. The data was collected retrospectively and analyzed by SPSS Statistics 18. Results A total of 53 patients were enrolled, with a mean age of 49.2 years. Of the 53 patients, there were 15 low-, 26 intermediate-, and 12 high-RNS lesions. Significant difference was observed in major complication rate between low- and high-score groups. Both radius and nearness were independent predictors of major complication rate. Also, there was a significant difference in eGFR change between low- and high-complexity tumor group. Fair degree correlation was found between IT and eGFR change ( p < 0.05). Conclusion The RNS is a valuable tool to categorize renal tumors based on the anatomic features when predicting major complication rate. The renal function can be affected after a high-complexity tumor surgery is performed. Also, IT is a fair degree correlation factor of the renal function loss. [ABSTRACT FROM AUTHOR]

To reveal the effects of different fertilization regimes on weed communities in wheat fields under a rice-wheat rotation system, a survey was conducted before wheat harvest in 2014 after a 4-year- long-term recurrent fertilization scheme. Weed species types, density, height and diversity index under different fertilization and straw-returning schemes in wheat fields were studied and complemented with a canonical correspondence analysis on weed community distribution and soil nutrient factors. Twenty weed species were recorded among 36 wheat fields belonging to 19 genera and 11 families. Beckmannia syzigachne, Hemistepta lyrata, Malachium aquaticum and Cnidium monnieri were widely distributed throughout the sampled area. Long-term fertilization appeared to reduce weed species richness and density, particularly for broadleaf weeds, but increased weed height. Diversity and evenness indices of weed communities were lower and dominance indices were higher in fields where chemical fertilizers were applied alone or combined with organic fertilizers, especially, where organic-inorganic compound fertilizer was used, in which it readily caused the outbreak of a dominant species and severe damage. Conversely, diversity and evenness indices of weed communities were higher and dominance indices were lower when the straw was returned to the field combined with chemical or organic fertilizers, in which weed community structures were complex and stable with lower weed density. Under these conditions weeds only caused slight reduction of wheat growth. [ABSTRACT FROM AUTHOR]