ABSTRACT
Nonobstructive azoospermia (NOA) is a disease with complex etiology, genetic heterogeneity and phenotypic heterogeneity caused by multiple factors, including chromosome abnormalities, Y chromosome microdeletions, gene mutations and epigenetic modifications. At present, there is no unified and effective treatment strategy to restore spermatogenesis. The current treatment options include preoperative hormone optimization therapy, changing the testicular spermatogenesis microenvironment, and stem cell therapy. This article reviews the existing genetic etiology of NOA and related treatment methods, in order to provide reference for the clinical treatment.
ABSTRACT
Objective To evaluate the procedure of surgical treatment of intrahepatic biliary calculi with blood vessel variation in hepatic hilus. Method The clinical data of 57 patients with intrahepatic biliary calculi and blood vessel variation in hepatic hilus treated by biliary operation were retrospectively analyzed.Results The simply biliary operation was performed on 13 cases ; variant blood vessels were cut off and ligated in 14 cases;The bile duct and blood vessel across conversion operation were performed on 22 cases;and the intrahepatic cholangiojejunostomy was carried out in 8 cases. There were no severe postoperative complications and perioperative mortality.51 patients(89.6%) were followed up for 4 to 15 years with the exellent results in 43(84.3%)cases. There were residual stones in 7 cases,of them,5 patients had intermittent abdominal pain in the right upper quadrant; reoperation was performed on another 2 cases because of recurrent cholangitis. One died of variceal bleeding 1.5 years after operation. Conclusions In order to accomplish the complex operations of biliary tract and avoid ischemic damage of liver, proper operation should be chosen for patients with intrahepatic biliary calculi with blood vessel variation in hepatic hilus.