Background Hemodynamic alterations in the spermatic vein are implicated in infertility among patients with varicocele (VC). Contrast-enhanced ultrasound (CEUS), a powerful tool for hemodynamic analysis, remains unexplored for VC. This study aimed to demonstrate the feasibility of using CEUS to evaluate spermatic vein hemodynamics in patients with VC and establish a clear correlation between specific hemodynamic patterns and impaired semen parameters. This study included 165 patients with left-sided VC and 50 healthy volunteers. All participants underwent CEUS of the spermatic veins, along with maximum venous diameter and testicular volume measurements and serum sex hormone levels and routine semen analyses. The sperm DNA fragmentation index was measured in 146 patients with VC and 37 healthy controls. Results The analyses revealed four distinct perfusion patterns ofthe spermatic vein: steady flow, intermittent stasis, intermittent reflux, and filling defect. In healthy spermatic veins, the predominant perfusion patterns included steady flow and intermittent stasis. Spermatic veins with VC exhibited a significant increase in the intermittent reflux and filling defect patterns, with the proportion rising as the clinical grade increased. The four patterns were further grouped into the “steady flow & intermittent stasis” and “intermittent reflux & filling defect” patterns for logistic regression analyses; the intermittent reflux & filling defect pattern was revealed as an independent risk factor for impaired sperm concentration, total sperm counts, progressive motility, morphology, and DNA fragmentation index. Conclusions This study validated the feasibility of CEUS for assessing the hemodynamics of the spermatic vein and established the intermittent reflux & filling defect pattern as an independent predictor of impaired semen parameters.

BACKGROUND:A recent sham-controlled clinical study has shown that low-intensity pulsed ultrasound twice per week can safely and effectively treat patients with mild-to-moderate erectile dysfunction (ED). However, large-scale clinical trials are needed to verify its efficacy and safety and determine a reasonable treatment interval. AIM:To study whether low-intensity pulsed ultrasound therapy thrice per week is non-inferior to twice per week in patients with mild-to-moderate ED. METHODS:A randomized, open-label, parallel-group, non-inferiority clinical trial was conducted in 7 hospitals in China. A total of 323 patients with mild-to-moderate ED were randomized (1:1) into thrice per week (3/W) and twice per week (2/W) groups. Low-intensity pulsed ultrasound was applied on each side of the penis for 16 sessions. OUTCOMES:The primary outcome was response rate using the minimal clinically important difference in the International Index of Erectile Function (IIEF-EF) score at week 12. Secondary outcomes included Erection Hardness Score (EHS), Sexual Encounter Profile, Global Assessment Question, and Self Esteem and Relationship Questionnaire. RESULTS:Response rates in 3/W and 2/W groups were 62.0% and 62.5%, respectively. Treatment effect in the 3/W group was noninferior to that of the 2/W group, with rate difference lower bound of -0.01% [95% confidence interval -0.11 to 0.10%] within the acceptable margin (-14.0%). No significant difference was found among secondary outcomes. IIEF-EF score showed a significant increase from baseline in the 3/W group (16.8 to 20.7) and 2/W group (17.8 to 21.7), and the percentage of patients with EHS ≥3 increased in the 3/W (54.9% to 84.0%) and 2/W (59.5% to 83.5%) groups. There was no significant difference in response rate between the 2 groups after controlling for strata factors and homogeneous tests. No treatment-related adverse events were reported. CLINICAL IMPLICATIONS:Low-intensity pulsed ultrasound therapy displays similar efficacy and safety for mild-to-moderate ED when administered thrice or twice per week for 16 sessions. This study provides two options to suit patients' needs. STRENGTHS & LIMITATIONS:This is a large-sample, randomized, controlled, noninferiority trial study. Short-term follow-up and mostly younger patients are the main limitations. CONCLUSION:Low-intensity pulsed ultrasound therapy thrice and twice per week showed equivalent therapeutic effects and safety for mild-to-moderate ED in a young and generally healthy population. This therapy warrants further investigation of its potential value in rehabilitation of ED. Chen, H., Li Z., Li X., et al. The Efficacy and Safety of Thrice vs Twice per Week Low-Intensity Pulsed Ultrasound Therapy for Erectile Dysfunction: A Randomized Clinical Trial. J Sex Med 2022;19:1536-1545.

Cryopreservation of rare testicular-retrieved spermatozoa for intracytoplasmic sperm injection (ICSI) in patients with severe oligozoospermia and azoospermia remains a major challenge in clinical practice. This study evaluated the Cryopiece system as a potential technique to cryopreserve rare human spermatozoa for ICSI. Small numbers of ejaculated (24 patients) and testicular (13 patients) spermatozoa were cryopreserved using the Cryopiece system. The total number of recovered spermatozoa and motility were assessed after thawing. Thirty-seven couples underwent ICSI using spermatozoa cryopreserved by the Cryopiece system, and ICSI outcomes (rates of fertilization, embryo cleavage, and clinical pregnancy) were evaluated. The average sperm post-thaw retrieval rate was 79.1%, and motility was 29.7%. Ejaculated spermatozoa had a higher post-thaw motility (32.5%) than testicular spermatozoa (21.8%; P = 0.005). ICSI achieved a fertilization rate of 61.9%, embryo cleavage rate of 84.6%, and clinical pregnancy rate of 43.3%. The ICSI outcomes in the ejaculated and testicular frozen-thawed spermatozoa were similar. Assisted oocyte activation (AOA) after ICSI with motile (72.1%) or immotile (71.9%) spermatozoa resulted in a significantly higher fertilization rate than that when using motile spermatozoa without AOA (52.0%; P = 0.005). However, AOA did not enhance the clinical pregnancy rate (55.6% or 40.0% vs 35.3%; P = 0.703). The Cryopiece system is simple and useful for the cryopreservation of small numbers of ejaculated or testicular spermatozoa for ICSI in patients with severe oligozoospermia or nonobstructive azoospermia.

Objectives. Erectile dysfunction is a major comorbidity of diabetes. Stem cell transplantation is a promising method to treat diabetic erectile dysfunction. In this study, we evaluated whether low-intensity pulsed ultrasound (LIPUS) could enhance the efficacy of adipose-derived stem cells (ADSCs) and investigated the underlying molecular mechanism. Materials and methods. Sixty 8-week-old male Sprague–Dawley rats were randomly divided into the normal control (NC) cohort or the streptozocin-induced diabetic ED cohort, which was further subdivided into DM, ADSC, LIPUS, and ADSC+LIPUS groups. Rats in the ADSC or ADSC+LIPUS group received ADSC intracavernosal injection. Rats in the LIPUS or ADSC+LIPUS group were treated with LIPUS. The intracavernous pressure (ICP) and mean arterial pressure (MAP) were recorded at Day 28 after injection. The corpus cavernosum tissues were harvested and subjected to histologic analysis and ELISA. The effects of LIPUS on proliferation and cytokine secretion capacity of ADSCs were assessed in vitro. RNA sequencing and bioinformatic analysis were applied to predict the mechanism involved, and western blotting and ELISA were used for verification. Results. Rats in the ADSC+LIPUS group achieved significantly higher ICP and ICP/MAP ratios than those in the DM, ADSC, and LIPUS groups. In addition, the amount of cavernous endothelium and cGMP level also increased significantly in the ADSC+LIPUS group. In vitro experiments demonstrated that LIPUS promoted proliferation and cell cycle progression in ADSCs. The excretion of cytokines such as CXCL12, FGF2, and VEGF was also enhanced by LIPUS. Bioinformatic analysis based on RNA sequencing indicated that LIPUS stimulation might activate the MAPK pathway. We confirmed that LIPUS enhanced ADSC VEGF secretion through the Piezo-ERK pathway. Conclusion. LIPUS enhanced the curative effects of ADSCs on diabetic erectile dysfunction through the activation of the Piezo-ERK-VEGF pathway. ADSC transplantation combined with LIPUS could be applied as a synergistic treatment for diabetic ED.

The corpus cavernosum is the most important structure for penile erection, and its dysfunction causes many physiological and psychological problems. However, its cellular heterogeneity and signalling networks at the molecular level are poorly understood because of limited access to samples. Here, we profile 64,993 human cavernosal single-cell transcriptomes from three males with normal erection and five organic erectile dysfunction patients. Cell communication analysis reveals that cavernosal fibroblasts are central to the paracrine signalling network and regulate microenvironmental homeostasis. Combining with immunohistochemical staining, we reveal the cellular heterogeneity and describe a detailed spatial distribution map for each fibroblast, smooth muscle and endothelial subcluster in the corpus cavernosum. Furthermore, comparative analysis and related functional experiments identify candidate regulatory signalling pathways in the pathological process. Our study provides an insight into the human corpus cavernosum microenvironment and a reference for potential erectile dysfunction therapies.

Male infertility may be caused by genetic and/or environmental factors that impair spermatogenesis and sperm maturation. High-altitude (HA) hypoxic environments represent one of the most serious challenges faced by humans that reside in these areas. To assess the influence of the plateau environment on semen parameters, 2,798 males, including 1,111 native Tibetans and 1,687 Han Chinese individuals living in the plains (HCILP) who underwent pre-pregnancy checkups, were enrolled in this study. The semen samples of males were evaluated to determine conventional sperm parameters, sperm morphology, and sperm movement. Reproductive endocrine hormones (REHs) were detected in 474 males, including 221 Tibetans and 253 HCILP. Due to recurrent abortions in partners, the DNA fragmentation index (DFI) of 133 native Tibetans and 393 HCILP individuals was further compared. Luteinizing hormone (LH) (4.94 ± 2.12 vs. 3.29 ± 1.43 U/L), prolactin (11.34 ± 3.87 vs. 8.97 ± 3.48 nmol/L), E2/T (0.22 ± 0.11 vs 0.11 ± 0.05), median total sperm motility (61.20% vs. 51.56%), and DFI (23.11% vs. 7.22%) were higher in males from plateau areas while median progressive motility (PR) (35.60% vs. 41.12%), total number of PR sperms (51.61 vs. 59.63 mil/ejaculate), percentage of normal form sperms (3.70% vs. 6.00%), curvilinear velocity (36.10 vs. 48.97 μm/s), straight-line (rectilinear) velocity (14.70 vs. 31.52 μm/s), estradiol (103.82 ± 45.92 vs. 146.01 ± 39.73 pmol/L), progesterone (0.29 ± 0.27 vs. 2.22 ± 0.84 nmol/L), testosterone (4.90 ± 1.96 vs. 14.36 ± 5.24 nmol/L), and testosterone secretion index (ratio of testosterone to LH) (33.45 ± 22.86 vs 145.78 ± 73.41) were lower than those in males from the plains. There was no difference in median total sperm number (157.76 vs. 151.65 mil/mL), sperm concentration (52.40 vs. 51.79 mil/mL), volume (3.10 vs. 3.10 mL), total normal form sperms (5.91 vs. 6.58 mil/ejaculate, p50), and follicle-stimulating hormone (FSH) levels (4.13 ± 2.55 U/L vs 3.82 ± 2.35 U/L) between the two groups of males. The REH and sperm parameters of males from HA hypoxic environments were adaptively altered. Although the total number of PR sperm decreased and DFI increased, the Tibetan population that lives at HAs has been found to grown continuously and rapidly. These results supplement prior findings regarding the impact of HA on male reproductive function.

目的:探讨移居高原汉族、世居高原藏族和平原汉族男性精液参数特征,分析高原低氧环境对男性生精功能的影响.方法:从不育门诊收集非无精子症男性3 872例,其中移居汉族1 126例,世居藏族1 094例,平原汉族1 652例;行精液常规、精子形态学、精子运动轨迹分析,并分别对686 606例男性行精子DNA完整性检测与生殖内分泌激素测定,分别比较移居汉族、世居藏族及平原汉族男性生育力及生殖内分泌激素变化特征.结果:移居汉族男性较世居藏族和平原汉族男性精子总数(202.16×106/mL vs.144.81×106/mL vs.139.10× 106/mL)、精子活率(59.25％ vs.55.26％ vs.43.88％)和DFI (23.56％ vs.22.59％ vs.6.57％)升高,差异有极显著统计学意义(P＜ 0.001);但前向运动精子百分率(34.98％ vs.32.70％ vs.29.82％)、正常形态精子百分率(3.91％,3.83％ vs.7.18％)、VCL平均值(47.62 μm/s vs.37.02 μm/s vs.35.45 μm/s)、VS.L平均值(14.72 μm/s vs.14.22 μm/s vs.30.76 μm/s)等方面相互比较,则平原汉族＞移居汉族＞世居藏族,差异有极显著统计学意义(P＜0.001).平原汉族男性雌激素(E2)、睾酮(T)、Prog(孕激素)水平大于移居汉族和世居藏族,黄体生成素(LH)、泌乳素(PRL)则小于世居藏族和移居汉族,差异有极显著统计学意义(P＜0.001).结论:长期高原低氧环境使男性生殖内分泌激素及生精功能发生适应性改变,表现为雄激素水平、正常形态精子百分比和前向运动精子百分比下降,DFI增高,但这并不影响男性生殖能力,也不影响高原人口快速增长趋势.

Background: Cryopreservation of extremely few spermatozoa is still a major challenge for male fertility preservation. This study aims to evaluate the cooling rate, recovery rate, and retrieval rate, along with other parameters of spermatozoa that cryopreserved using Cryopiece, a novel carrier, for individual sperm cryopreservation. Methods: Semen samples from 60 fertile donors were collected, and each semen sample was screened for motile sperm and mixed with cryoprotective agent (CPA), and then frozen using Cryopiece, micro-straw, and mini-straws. The cooling rate, retrieval rate, and recovery rate, morphology, DNA fragmentation index (DFI) and mitochondrial membrane potential (MMP), were compared among the un-frozen sperm and the sperm cryopreserved using these carriers. Results: Cryopiece possessed the fastest cooling rate. After freeze-thaw, the average retrieval rate of sperm cryopreserved using Cryopiece was 96.25%, and the average recovery rate was 64.40%, which were higher than that of sperm cryopreserved using the other two carriers (71.42% and 54.30% for micro-straw, and 63.54% and 58.04% for mini-straw, respectively). There was no significant impact on DFI after sperm cryopreservation, and no significant difference in morphology between sperm cryopreserved using these carriers was observed. Though MMP of sperm changed significantly after cryopreservation, micro-straw maintained sperm MMP better than Cryopiece and mini-straw did, while no significant difference was observed in MMP between sperm cryopreserved using Cryopiece and mini-straw. Conclusions: Cryopiece produced satisfying retrieval and recovery rates in sperm cryopreservation and should be an ideal carrier for cryopreservation of small number of sperm.

BACKGROUND:Systematic reviews have focused on sperm recovery and post-thaw parameters after cryopreservation, but there is no information on the associated clinical outcomes. In recent years, an increasing number of studies have reported cryopreservation of a single sperm due to the importance of fertility preservation.OBJECTIVES:To assess whether the cryopreservation of single human spermatozoa improves clinical outcomes in patients with azoospermia or severe oligospermia.MATERIALS AND METHODS:We conducted an extensive literature search using the following databases: CENTRAL, CNKI, Cochrane Systematic Reviews, EMBASE, MEDLINE, PUBMED, and Web of Science for relevant studies published through December 31, 2019. We calculated the pooled proportions of cryopreservation of a single human spermatozoon to assess the recovery, survival, fertilization, pregnancy, miscarriage, and delivery rates. Subgroup analyses were performed for the following covariates, (a) different carriers, (b) year of publication, and (c) source of sperm.RESULTS:We included 25 studies, which included 13 carriers. The pooled proportion of recovery rate of spermatozoa cryopreserved was 92% (95% CI, 87%-96%), and the survival, fertilization, pregnancy, miscarriage, and delivery rates were 76% (95% CI, 69%-83%), 63% (95% CI, 58%-67%), 57% (95% CI, 39%-74%), 12% (95% CI, 0%-33%), and 40% (95% CI, 12%-71%), respectively. Based on the subgroup analysis, the recovery and survival rates of frozen spermatozoa in a subgroup of different carriers were statistically significant. In the past decade, frozen single human spermatozoon technology has improved the recovery rates of frozen-thawed spermatozoa. However, the differences in clinical outcomes of frozen spermatozoa in subgroups of different sources of sperm were not statistically significant.DISCUSSION AND CONCLUSION:The techniques for single human spermatozoa are feasible and efficient and may benefit patients with severe oligospermia or azoospermia.

Structural alterations in fibroelastic components of the penile corpus cavernousum (CC) may impair its compliance, resulting in venous leakage and erectile dysfunction (ED). Our study evaluated the effectiveness of noninvasive two-dimensional shear-wave elastography (2-D SWE) in quantifying penile CC lesions in rabbits with hyperlipidemia-induced ED. A total of 12 New Zealand white rabbits were randomly divided into two groups. Six were fed a high-cholesterol diet containing 2% cholesterol and 8.5% lard for 10 weeks and the other six were fed normal diet as controls. We measured the shear-wave elastic quantitative (SWQ) value of penile CC by 2-D SWE. Erectile function was investigated by intracavernous injection of papaverine, and immunohistochemical (IHC) staining and the western blot analysis to determine the penile CC lesions. After 10 weeks, the SWQ values obtained from penile CC were remarkably higher in the high-cholesterol-fed compared with the control group, and the ΔICP (ICP plateau minus ICP baseline)/MAP (ICP: intracavernous pressure, MAP: mean arterial pressure) was markedly decreased. The IHC staining and western blot revealed extracellular matrix (ECM) accumulation in penile cavernous tissues, and the smooth muscle cell (SMC) phenotypic transition was affected, as indicated by reduced alpha-smooth muscle actin and calponin-1 expression and increased phospho-myosin light chain20 (p-MLC20)/MLC20 and osteopontin expression. Hyperlipidemia resulted in ECM accumulation accompanied with SMC phenotypic transition in penile CC and impaired the erectile function eventually. These might, in turn, lead to variations in the SWQ values. It suggests that 2-D SWE may be a novel, noninvasive and effective approach that distinguishes penile CC lesions secondary to hyperlipidemia from normal.

Objective To analyze the pregnancy outcome of cases who underwent intracytoplasmic sperm injection (ICSI) with frozen-thawed sperm, which was rare and weak, cryopreserved by a novel micro-straw (LSL micro-straw). Methods The present study retrospectively analyzed the post-thaw results of cryopreserved human sperm from 83 severe infertility male patients (including oligospermia and asthenospermia). Then we investigated the evolution of embryo development and pregnancy outcome in 23 patients underwent ICSI. Results About 89.5% (94/105) frozen-thawed samples could observe motile sperm in quality control. About 73.9% (17/23) sperm were available in 18 ICSI cycles. The fertilization rate, the cleavage rate, the available embryo rate and the high-quality embryo rate were 78.0%, 92.5%, 62.7% and 78.0%, respectively. The implantation rate, the clinical pregnancy rate and the cumulative live birth rate were 31.1%, 52.5% and 55.6%, respectively. Totally 12 live births were obtained with no birth defects reported. Conclusion LSL micro-straw is a safe and feasible new carrier for cryopreservation of oligospermia and asthenospermia, which can be widely applicated in assisted reproductive technology. Key words: Rare human spermatozoa; Freezing and thawing; Novel micro-straw (LSL micro-straw); Intracytoplasmic sperm injection (ICSI); Pregnancy outcomes

Objective To observe the effect of Huangjing Zanyu Capsule (HZC) on sperm mitochondrial membrane potential (MMP) in asthenozoospermia patients. METHODS We assigned 70 asthenozoospermia patients to a treatment group (n = 39) and a control group (n = 31), the former treated with oral HZC at the dose of 4 capsules tid for 3 months while the latter left untreated. We obtained semen parameters from the patients and detected their sperm mitochondrial membrane potentials (MMP) by JC-1 staining and flow cytometry before and after medication, followed by comparison between the two groups. RESULTS The total effectiveness rate was 71.05% in the treatment group and natural pregnancy was achieved in 3 cases during the medication. A total of 35 patients in the treatment group and 30 controls completed all the laboratory examinations after a 3-month observation. Compared with the controls, the patients treated with HZC exhibited significant improvement after medication in MMP (variation value: ［1.19 ± 10.36］% vs ［20.28 ± 14.21］%, P <0.01), total sperm motility (variation value: ［3.46 ± 8.67］% vs ［20.68 ± 14.12］%, P <0.01), the percentage of progressively motile sperm (variation value: ［2.26 ± 8.29］% vs ［17.58 ± 12.73］%, P <0.01), and the percentage of morphologically normal sperm (variation value: ［0.23 ± 3.48］% vs ［3.37 ± 3.99］%, P <0.01). MMP was significantly correlated with total sperm motility (r = 0.69, P <0.01), progressive sperm motility (r = 0.75, P <0.01) and normal sperm morphology (r = 0.26, P <0.01). CONCLUSIONS Huangjing Zanyu Capsule can enhance sperm mitochondrial membrane potential and sperm mitochondrial function, thus improving total sperm motility, progressive sperm motility and normal sperm morphology. It is safe and effective for the treatment of asthenospermia.

You have accessJournal of UrologyInfertility: Therapy I1 Apr 2016PD05-09 EFFECTIVENESS OF INDIVIDUAL AND SMALL NUMBER OF HUMAN SPERMATOZOA CRYOPRESERVATION FOR FERTILITY PRESERVATION IN PATIENTS WITH SEVERE MALE FACTOR OF INFERTILITY Jianlin Hu, Jian Sun, Yuan Xu, Zijue Zhu, Xiaofeng Wan, Yuehua Gong, Yan Hong, Huixing Chen, Peng Li, Xiaohong Gao, Zhenbo Zhang, Zheng Li, and Yu Wu Jianlin HuJianlin Hu More articles by this author , Jian SunJian Sun More articles by this author , Yuan XuYuan Xu More articles by this author , Zijue ZhuZijue Zhu More articles by this author , Xiaofeng WanXiaofeng Wan More articles by this author , Yuehua GongYuehua Gong More articles by this author , Yan HongYan Hong More articles by this author , Huixing ChenHuixing Chen More articles by this author , Peng LiPeng Li More articles by this author , Xiaohong GaoXiaohong Gao More articles by this author , Zhenbo ZhangZhenbo Zhang More articles by this author , Zheng LiZheng Li More articles by this author , and Yu WuYu Wu More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2616AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the effectiveness of individual and small number of human spermatozoa cryopreservation in patients with severe male factor of infertility and to assess their clinical outcomes of intracytoplasmic sperm injection (ICSI) cycles with frozen-thawed sperm. METHODS We retrospectively analyzed 174 samples of 128 patients who underwent male fertility preservation by individual or small number of human spermatozoa cryopreservation. They came to our center from March to October in 2015, of whom 16 cases were subjected to 16 ICSI cycles with frozen-thawed sperm. We further investigated the rates of sperm recovery, fertilization, cleavage, transferable embryos, good-quality embryos and clinical pregnancy. RESULTS Among the 128 patients, 103 frozen samples were obtained by masturbation in 58 severe oligozoospermia or severe asthenozoospermia cases. A total of 8 samples were obtained by electroejaculation and 3 by conventional testicular sperm extraction (cTESE) in 11 ejaculation disorder (anejaculation or retrograde ejaculation) cases. Moreover, 48 samples were obtained by cTESE in 43 obstructive azoospermia(OA) cases and 5 non-obstructive azoospermia(NOA) cases, and 11 samples by Micro-dissection TESE(MD-TESE) in 11 NOA cases. We use cryotube, 0.25ml straw or cryotip as vectors for small number spermatozoa cryopreservation according to the semen quality and cryopiece for individual spermatozoa cryopreservation. The sperm recover rate was 94.74% (108/114) in 0.25ml straw group and 93.10%(27/29) in cryotip group. A total of 25 samples were frozen by cryopiece and 6 by cryotube without undergoing frozen-thawed tests. As to the outcomes of 16 ICSI cycles, all the frozen sperm samples were recovered successfully. The rates of fertilization, 2PN fertilization, cleavage, transferable and good-quality embryos were 79.64%(133/167), 75.45%(126/167), 97.74%(130/133), 56.92%(74/130), 42.31%(55/130), respectively. Fresh embryos were transferred in 13 of the 16 cycles, with the clinical pregnancy rate of 61.54%(8/13), including 3 singletons and 5 twins. CONCLUSIONS Techniques of individual and small number of human spermatozoa cryopreservation are effective methods of fertility preservation for severe male infertility patients. The clinical outcomes of ICSI cycles are good by using frozen-thawed sperm through these methods. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e172 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Jianlin Hu More articles by this author Jian Sun More articles by this author Yuan Xu More articles by this author Zijue Zhu More articles by this author Xiaofeng Wan More articles by this author Yuehua Gong More articles by this author Yan Hong More articles by this author Huixing Chen More articles by this author Peng Li More articles by this author Xiaohong Gao More articles by this author Zhenbo Zhang More articles by this author Zheng Li More articles by this author Yu Wu More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...