ABSTRACT
Primary ciliary dyskinesia (PCD) is a rare hereditary orphan condition that results in variable phenotypes, including infertility. About 50 gene variants are reported in the scientific literature to cause PCD, and among them, dynein axonemal assembly factor 4 ( DNAAF4 ) has been recently reported. DNAAF4 has been implicated in the preassembly of a multiunit dynein protein essential for the normal function of locomotory cilia as well as flagella. In the current study, a single patient belonging to a Chinese family was recruited, having been diagnosed with PCD and asthenoteratozoospermia. The affected individual was a 32-year-old male from a nonconsanguineous family. He also had abnormal spine structure and spinal cord bends at angles diagnosed with scoliosis. Medical reports, laboratory results, and imaging data were investigated. Whole-exome sequencing, Sanger sequencing, immunofluorescence analysis, hematoxylin-eosin staining, and in silico functional analysis, including protein modeling and docking studies, were used. The results identified DNAAF4 disease-related variants and confirmed their pathogenicity. Genetic analysis through whole-exome sequencing identified two pathogenic biallelic variants in the affected individual. The identified variants were a hemizygous splice site c.784-1G>A and heterozygous 20.1 Kb deletion at the DNAAF4 locus, resulting in a truncated and functionless DNAAF4 protein. Immunofluorescence analysis indicated that the inner dynein arm was not present in the sperm flagellum, and sperm morphological analysis revealed small sperm with twisted and curved flagella or lacking flagella. The current study found novel biallelic variants causing PCD and asthenoteratozoospermia, extending the range of DNAAF4 pathogenic variants in PCD and associated with the etiology of asthenoteratozoospermia. These findings will improve our understanding of the etiology of PCD.
Subject(s)
Adult , Humans , Male , Asthenozoospermia/genetics , Dyneins/genetics , East Asian People , Kartagener Syndrome/genetics , Mutation , Proteins/genetics , Semen/metabolismABSTRACT
Selective dorsal neurotomy (SDN) is a surgical treatment for primary premature ejaculation (PE), but there is still no standard surgical procedure for selecting the branches of the dorsal penile nerves to be removed. We performed this study to explore the value of intraoperative neurophysiological monitoring (IONM) of the penile sensory-evoked potential (PSEP) for standard surgical procedures in SDN. One hundred and twenty primary PE patients undergoing SDN were selected as the PE group and 120 non-PE patients were selected as the normal group. The PSEP was monitored and compared between the two groups under both natural and general anesthesia (GA) states. In addition, patients in the PE group were randomly divided into the IONM group and the non-IONM group. During SDN surgery, PSEP parameters of the IONM group were recorded and analyzed. The differences in PE-related outcome measurements between the perioperative period and 3 months' postoperation were compared for the PE patients, and the differences in effectiveness and complications between the IONM group and the non-IONM group were compared. The results showed that the average latency of the PSEP in the PE group was shorter than that in the normal group under both natural and GA states (P < 0.001). Three months after surgery, the significant effective rates in the IONM and non-IONM groups were 63.6% and 34.0%, respectively (P < 0.01), and the difference in complications between the two groups was significant (P < 0.05). IONM might be useful in improving the short-term therapeutic effectiveness and reducing the complications of SDN.
Subject(s)
Male , Humans , Premature Ejaculation/surgery , Intraoperative Neurophysiological Monitoring/methods , Prospective Studies , Neurosurgical Procedures/methods , Penis/surgery , Retrospective StudiesABSTRACT
Human parasites may interact with the microbiome parasitizing in human and mammalian intestines. The interplay between intestinal parasites and gut microbiota and its potential impacts have been widely reported; however, some parasites that do not parasitize in intestines may also affect the characteristic of gut microbiota. Hereby, we review the advances in the research on the impacts of parasites inside and outside of human intestines on the gut microbiota.
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Objective To investigate the immunological functions of heat shock protein 40 kDa of Schistosoma japonicum (SjHSP40). Methods The homology of the SjHSP40 protein sequence was analyzed and the B and T cell epitopes of SjHSP40 were predicted using bioinformatics tools. The full-length SjHSP40 gene was amplified using a PCR assay, and cloned into the prokaryotic expression vector pGEX-6P-1, which was transformed into Escherichia coli BL-21. The protein expression was induced with isopropyl β-D-thiogalactoside (IPDG), and then, the recombinant protein was purified with glutathione-sepharose 4B resin to yield the fusion protein GST-SjHSP40, which was checked with SDS-PAGE and Western blotting. Following immunization with GST-SjHSP40, the serum levels of anti-SjHSP40 IgG antibody and IgG1 and IgG2a subtypes were detected in BALB/c mice using ELISA. In addition, the effect of SjHSP40 on CD4+ T-cell subset differentiation was examined using flow cytometry. Results SjHSP40 contained 7 potential B cell epitopes and multiple T cell epitopes (CTL epitopes and Th epitopes). The prokaryotic expression plasmid pGEX-6p-1-SjSHP40 was successfully constructed, and the fusion protein GST-SjHSP40 was obtained following IPDG induction and protein purification. Significantly higher serum levels of anti-SjHSP40 IgG, IgG1 and IgG2a antibodies were detected in mice immunized with GST-SjHSP40 than in other groups; however, SjHSP40 showed no remarkable effects on CD4+ T-cell subset differentiation. Conclusions SjHSP40 may induce specific humoral immune responses in mice; however, it does not affect the balance of Th immune responses. It is suggested that SjHSP40 may be a potential vaccine candidate.
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To achieve the combination of ideological and political education curriculum and curriculum ideological and political education, the ideological and political education was integrated into the teaching of medical basic course Human Parasitology. Based on improving the cultivation of the teaching team, insisting on morality education and education-directed professional curriculum teaching, the pathway of integrating curriculum ideological and political education into medical science education was explored. Through putting the ideological and political elements contained throughout the professional curriculum teaching process, establishing new teaching patterns of integrating ideological and political education into the curriculum, and strengthening the collaboration between professional institutions and universities, we aimed to build Human Parasitology as a gold ideological and political education curriculum.
ABSTRACT
To achieve the combination of ideological and political education curriculum and curriculum ideological and political education, the ideological and political education was integrated into the teaching of medical basic course Human Parasitology. Based on improving the cultivation of the teaching team, insisting on morality education and education-directed professional curriculum teaching, the pathway of integrating curriculum ideological and political education into medical science education was explored. Through putting the ideological and political elements contained throughout the professional curriculum teaching process, establishing new teaching patterns of integrating ideological and political education into the curriculum, and strengthening the collaboration between professional institutions and universities, we aimed to build Human Parasitology as a gold ideological and political education curriculum.
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<p><b>Objective</b>To investigate the clinical effects of circumcision by surgical plane positioning with a disposable circumcision suture device in the treatment of phimosis and redundant prepuce.</p><p><b>METHODS</b>From September 2016 to June 2017, we treated 250 patients with phimosis or redundant prepuce, 127 by conventional circumcision (the control group) and the other 123 by surgical plane positioning with a disposable circumcision suture device (the observation group). We compared the operation time, intra-operative bleeding, preputial frenulum alignment, postoperative ecchymosis, and postoperative penile appearance between the two groups of patients.</p><p><b>RESULTS</b>Compared with the controls, the patients in the observation group showed significantly longer operation time ([4.48 ± 1.18] vs [7.17 ± 1.42] min, P<0.05), lower rates of intra-operative frenulum bleeding (15.0% [19/127] vs 4.1% [5/123], P<0.05) and frenulum misalignment (26.8% [34/127] vs 0.8% [1/123], P<0.05), higher incidence of postoperative ecchymosis (41.7% [53/127] vs 21.1% [26/123], P<0.05), and higher satisfaction of the patients with the postoperative penile appearance (92.9% [18/127] vs 98.4% [121/123], P<0.05). However, no statistically significant difference was found between the control and observation groups in intra-operative non-frenulum bleeding (4.7% [6/127] vs 1.6% [2/123], P = 0.164).</p><p><b>CONCLUSIONS</b>Circumcision by surgical plane positioning with a disposable circumcision suture device can effectively avoid preputial frenulum misalignment, reduce intra-operative bleeding, and improve postoperative penile appearance.</p>
Subject(s)
Humans , Male , Circumcision, Male , Disposable Equipment , Ecchymosis , Foreskin , Incidence , Operative Time , Penis , Congenital Abnormalities , General Surgery , Personal Satisfaction , Phimosis , General Surgery , Postoperative Complications , Postoperative Period , Suture TechniquesABSTRACT
Objective To explore the possible mechanisms by which Schistosoma japonicum heat shock protein 60(SjH-SP60)enhances CD4+CD25+regulatory T cell(Treg)immunosuppressive function.Methods An in vitro method was used to investigate the effect of SjHSP60 on Treg immunosuppressive activity.Co-cultures in transwells and in vitro suppression assay were performed to investigate how SjHSP60 enhanced the immunosuppressive function of Tregs.Intracellular cytokine staining combined with flow cytometry was used to detect Treg-expressing IL-10 and TGF-β,and flow cytometry was also used to analyze the expressions of Foxp3 and CTLA-4 in Tregs.Results SjHSP60 enhanced the immunosuppressive function of Tregs.Soluble cytokines IL-10 and TGF-β mediated inhibitory activity of SjHSP60-triggered Tregs.SjHSP60 induced significant increases in both IL-10 and TGF-β expressions of Tregs.Further investigation showed significant increased Foxp3 and CTLA-4 in SjHSP60-trggered Tregs.Conclusion SjHSP60 enhances Treg immunosuppressive function by promoting the expressions of IL-10 and TGF-β,possibly due to SjHSP60-mediated induction of Foxp3 and CTLA-4 in Tregs.
ABSTRACT
Premature ejaculation (PE) is a most common type of ejaculatory dysfunction, which has significant adverse effects on the life quality of the patients and their partners. Medication is currently the first choice for PE and psycho-behavior therapy is sometimes used as an adjuvant means. It is reported in a number of studies that medication alone or combined with psycho-behavior therapy has a great short-term efficacy and a very low risk of side effects. Conservative therapies for PE, however, have some obvious disadvantages such as easy recurrence after drug withdrawal, ineffectiveness in some cases, and so on. Thus, clinicians in China and abroad have developed and tried various surgical methods for the treatment of PE, most of which are reportedly safe and effective. However, International Society for Sexual Medicine guidelines for the diagnosis and treatment of PE recommended against surgical methods because of possible permanent loss of sexual function and insufficient reliable data, though without support from evidence or relevant literature. Although controversial, surgical treatment remains an effective and feasible strategy for refractory PE that does not respond to any conservative therapies. This review summarizes a variety of surgical techniques for PE, along with their basic principles, indications, effects and safety.
Subject(s)
Humans , Male , Behavior Therapy , China , Conservative Treatment , Ejaculation , Premature Ejaculation , Drug Therapy , General Surgery , Quality of Life , Recurrence , Sexual PartnersABSTRACT
Objective@#To investigate the effect of laparoscopic extraperitoneal (LSEP) high ligation of the spermatic vein in the treatment of varicocele.@*METHODS@#We retrospectively analyzed the clinical data about 80 cases of varieocele, 48 treated by LSEP and the other 32 by laparoscopic transabdominal retroperitoneal (LSTR) high ligation of the spermatic vein. We recorded the semen parameters before and at 1, 3 and 6 months after surgery, intraoperative blood loss, operation time, postoperative complications, time of gastrointestinal function recovery and rate of pregnancy, followed by comparison of the data obtained between the two groups of patients.@*RESULTS@#Semen parameters were remarkably improved in both the LSEP and LSTR groups of patients postoperatively as compared with the baseline (P 0.05). The intraoperative blood loss was less in the LSEP than in the LSTR group ([8.3 ± 5.2] vs [9.1 ± 6.1] ml, P >0.05), the operation time was shorter in the former than in the latter ([38.27 ± 9.23] vs [43.46 ± 11.72] min, P >0.05), and so was the time of gastrointestinal function recovery ([1.27 ± 0.26] vs [2.43 ± 0.41] d, P 0.05).@*CONCLUSIONS@#Laparoscopic extraperitoneal high ligation of the spermatic vein is safe and effective and has the advantage of quick recovery in the treatment of varicocele.
Subject(s)
Female , Humans , Male , Pregnancy , Blood Loss, Surgical , Emphysema , Laparoscopy , Ligation , Methods , Operative Time , Postoperative Complications , Recurrence , Retroperitoneal Space , Retrospective Studies , Scrotum , Spermatic Cord , Treatment Outcome , Varicocele , General Surgery , Veins , General SurgeryABSTRACT
Objective@#To investigate the clinical effect of microscopic spermatic vein ligation in the treatment of nutcracker phenomenon (NCP) complicated with left varicocele (VC).@*METHODS@#This retrospective study included 31 cases of NCP complicated with left VC treated in our hospital by subinguinal microscopic ligation of the left spermatic vein (group A, n = 11), open retroperitoneal high ligation of the left spermatic vein (group B, n = 11), or conservative therapy (group C, n = 9). The patients were followed up for 6-24 (15.3 ± 5.4) months. We compared the semen parameters, spermatic vein diameter, left testis volume, and recurrence rate among the three groups of patients before and after treatment.@*RESULTS@#Compared with the baseline, the semen quality parameters were significantly improved in both groups A and B at 6 months after treatment (P0.05), B ([9.77 ± 2.03] vs [9.96 ± 1.72] ml, P>0.05), or C ([9.83 ± 1.59] vs [10.48 ± 2.05] ml, P>0.05), nor in the recurrence rate between groups A and B (P>0.05).@*CONCLUSIONS@#Hematuria, proteinuria and other mild symptoms of nutcracker phenomenon complicated with left VC can be treated palliatively by microscopic ligation of the spermatic vein, which can relieve the clinical symptoms, improve the semen quality, and protect the testicular function of the patient.
Subject(s)
Humans , Male , Follow-Up Studies , Ligation , Methods , Recurrence , Renal Nutcracker Syndrome , General Surgery , Retroperitoneal Space , Retrospective Studies , Semen Analysis , Testis , Time Factors , Varicocele , Veins , General SurgeryABSTRACT
Objective@#To investigate the effect and safety of contrast-enhanced ultrasonography (CEUS) in the diagnosis of venous erectile dysfunction (VED).@*METHODS@#From June 2015 to March 2016, 43 ED patients underwent corpus cavernography, of whom 23 were diagnosed with and the other 20 without corpus cavernosal venous leakage (CCVL). All the patients received intracorporal injection of a vasoactive drug and CEUS.@*RESULTS@#Of the 23 patients with CCVL, 21 were confirmed by CEUS, including 12 cases of double venous leakage, 2 cases of single venous leakage, 5 cases of crural venous leakage, and 2 cases of the mixed type, while the other 2 showed no CCVL on CEUS. Of the 20 patients with CCVL, 2 presented CCVL on CEUS.@*CONCLUSIONS@#CEUS has the advantages of accuracy, safety, and less invasiveness in the diagnosis of VED.
Subject(s)
Humans , Male , Contrast Media , Impotence, Vasculogenic , Diagnostic Imaging , Injections , Penis , Diagnostic Imaging , Ultrasonography , Methods , VeinsABSTRACT
<p><b>Objective</b>To investigate the value of serum inhibin B (InhB) in predicting the results of testicular sperm extraction (TESE) in patients with azoospermia.</p><p><b>METHODS</b>This study included 191 cases of obstructive azoospermia (OA), 360 cases of nonobstructive azoospermia (NOA), and 100 male controls with normal semen parameters. According to whether sperm was found in TESE, the NOA patients were divided into a sperm-absence group (TESE-, n=127) and a sperm-presence group (TESE+, n=233). Blood samples were collected from the subjects between 8:00 and 10:00 am for measurement of the levels of serum InhB. The specificity and sensitivity of serum InhB predicting TESE outcome were analyzed with receiver operating characteristics curve (ROC).</p><p><b>RESULTS</b>The serum InhB level was significantly lower in the TESE- group ([19.7±34.8] pg/ml) than in the OA ([106.8±66.2] pg/ml), TESE+ ([98.2±62.4] pg/ml) and normal control group ([108.3±65.0] pg/ml) (P<0.01), but there were no statistically significant differences among the latter three groups (P>0.05). Analysis of ROC showed that the best cut-off value of serum InhB was 19.1 pg/ml. Under the cut-off value, AUCROC was 0.88, specificity 84.2%, sensitivity 90.1%, and accuracy 88.1%.</p><p><b>CONCLUSIONS</b>The serum InhB level is a good and non-invasively obtained index of spermatogenesis and should be measured for predicting the results of TESE.</p>
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<p><b>Objective</b>To explore aging-related changes in erectile function and the expressions of SIRT1 and other relevant factors in rats.</p><p><b>METHODS</b>We divided 40 male SD rats into four age groups of equal number: 2-month-old (2 mo), 8-month-old (8 mo), 14-month-old (14 mo), and 20-month-old (20 mo), measured the intracavernous pressure (ICP), mean arterial pressure (MAP), and ICP/MAP ratio by electrostimulation of the cavernous nerve, evaluated fibrosis in the corpus cavernosum by Masson's trichrome staining, detected the expressions of SIRT1, P53, and FOXO3a by Western blot, and determined the levels of NO and cGMP using the NO/cGMP kit.</p><p><b>RESULTS</b>Both the ICP/MAP ratio and the cGMP level were elevated with aging, reaching the peak at 8 months and then gradually decreased. Masson staining showed an aging-related increase of collagen fibers in the corpus cavernosum.The expression of SIRT1 was reduced while those of P53 and FOXO3a increased with aging.</p><p><b>CONCLUSIONS</b>Aging-related erectile dysfunction may be attributed to the reduced activity of the NO/cGMP pathway, apoptosis and oxidative stress, and SIRT1 may play a role in aging-related erectile dysfunction.</p>
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<p><b>Objective</b>To investigate the potential role of the RhoA/Rock signaling pathway in the formation of prostate cancer and the effects of the Rock inhibitor fasudil on the invasion, migration and apoptosis of human prostate cancer cells.</p><p><b>METHODS</b>Human prostate cancer cell lines PC3 and DU145 were treated with fasudil at the concentrations of 5, 10, 20, 40, 80, and 160 μmol/L, respectively, and those as negative controls cultured in the Ham's-F12 medium, all for 24 hours. Then, MTT assay was used to measure the cell inhibition rate and half maximal inhibitory concentration (IC50) value of fasudil, with 1/4 of IC50 as the medication dose for further investigation. The expressions of RhoA, RockⅠ, and RockⅡ proteins in the PC3 and DU145 cells were detected by Western blot and immunohistochemistry, and the invasion, migration and apoptosis of the cells were determined using the Transwell chamber, scratch wound healing assay and flow cytometry.</p><p><b>RESULTS</b>Fasudil inhibited the proliferation of the PC3 cells from (9.29±1.23)% at 5 μmol/L to (81.37±3.97)% at 160 μmol/L and that of DU145 from (7.59±1.54)% to (76.53±2.67)%, both in a dose-dependent manner (P<0.05 ). Significantly fewer PC3 and DU145 cells migrated into the lower compartment in the experimental group (39.2±8.4 and 34.2±6.7) than in the negative control (116.8±9.3 and 112.5±10.8) (P<0.05 ). The wound healing rates of the PC3 and DU145 cells were remarkably lower in the former ([37.26±1.17]% and [32.38±2.73]%) than in the latter ([78.12±4.16]% and [69.47±6.71]%) (P<0.05 ). Annexin V-FITC/PI double staining showed markedly increased apoptosis rates of PC3 and DU145 cells treated with fasudil ([31.88±2.49]% and [28.65±2.99]%) as compared with the negative controls ([7.51±2.28]% and [7.13±1.61]%) (P<0.05 ). The expressions of RockⅠ and RockⅡ were significantly reduced in the fasudil-treated cells in comparison with those of the control group (P<0.05 ) while that of RhoA showed no significant difference between the two groups (P>0.05 ).</p><p><b>CONCLUSIONS</b>The RhoA/Rock signaling pathway may play an important role in the formation of prostate cancer. Fasudil can significantly inhibit the proliferation, migration, and invasion and promote the apoptosis of human prostate cancer PC3 and DU145 cells by reducing RhoA/Rho kinase activity.</p>
Subject(s)
Humans , Male , 1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine , Pharmacology , Apoptosis , Cell Line, Tumor , Cell Movement , Cell Proliferation , Prostatic Neoplasms , Drug Therapy , Pathology , Signal Transduction , rho-Associated KinasesABSTRACT
<p><b>OBJECTIVE</b>To study the impact of left varicocele (VC) and varicocelectomy (VCT) on the apoptosis of spermatogenic cells and the levels of nitrogen monoxidum (NO) and interleukin 1 (IL-1) in the rat testis.</p><p><b>METHODS</b>We randomly divided 60 adolescent male SD rats into four groups of equal number: sham operation control, VC model 1 (VC1), VC model 2 (VC2), and VCT. We determined the semen quality and levels of NO and IL-1 in the testis tissue, detected the apoptosis of spermatogenic cells by TUNEL, and compared the indexes obtained among different groups.</p><p><b>RESULTS</b>An experimental VC model was successfully established by partially ligating the left renal vein of the rats. Sperm concentration and motility were significantly decreased in the VC1 ([1.54 ± 1.16] x 10⁶/ml and [44.23 ± 15.46]%) as compared with those in the sham operation group ([2.80 ± 1.62] x 10⁶/ml and [72.34 ± 12.62]%) (P < 0.05), but remarkably higher in the VCT ([1.82 ± 1.34] x 10⁶/mI and [51.21 ± 12.62]%) than in the VC2 group ([1.04 ± 1.21] x 10⁶/ml and [39.23 ± 13.21]%) (P < 0.05). The levels of NO and IL-1 in the left testes were markedly elevated in the VC1 ([0.172 ± 0.030] ng/ml and [1.468 ± 0.080 ] mg/ml) in comparison with those in the sham operation group ([0.134 ± 0.021] ng/ml and [0.782 ± 0.079 ] mg/ml) (P < 0.05), and significantly higher in the VC2 ([0.198 ± 0.020] ng/ml and [1.994 ± 0.090] mg/ml) than in the VCT group ([0.141 ± 0.010] ng/ml and [0.781 ± 0.036] mg/ml) (P < 0.05). However, the NO and IL-1 levels in the right testis showed no statistically significant differences between the two groups, and the two levels were positively correlated (r = 0.492, P < 0.01). The rats of the VC1 group exhibited remarkable apoptosis of spermatogenic cells in the bilateral testes, with significant differences in the apoptosis index ( AL) between the two sides (P < 0.05) as well as in the same side in comparison with the sham operation group (P < 0.01). The Als of spermatogenic cells in the bilateral testes showed statistically significant differences in the VCT (P < 0.05) but not in the VC2 group (P > 0.05), and those in the same side manifested dramatic differences between the VCT and VC2 groups (P < 0.01).</p><p><b>CONCLUSION</b>Varicocele induces changes of the NO and IL-1 levels in the testis tissue and increases the apoptosis of spermatogenic cells, which might be one of the causes of testis damage and spermatogenic dysfunction.</p>
Subject(s)
Animals , Male , Rats , Apoptosis , Germ Cells , Pathology , In Situ Nick-End Labeling , Interleukin-1 , Ligation , Nitrogen , Random Allocation , Semen Analysis , Spermatogenesis , Testis , Chemistry , Varicocele , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To compare the effects and complications of subinguinal microscopic ligation, laparoscopic transperitoneal varicocelectomy, laparoscopic retroperitoneal varicocelectomy, open retroperitoneal high ligation, and interventional embolotherapy in the treatment of varicocele.</p><p><b>METHODS</b>We conducted a retrospective study that included 632 varicocele patients treated by subinguinal microscopic ligation (group A, n = 79), laparoscopic transperitoneal varicocelectomy (group B, n = 120), laparoscopic retroperitoneal varicocelectomy (group C, n =137), open retroperitoneal high ligation (group D, n = 283), and interventional embolotherapy (group E, n = 13). We compared the baseline and 3-month postoperative semen parameters, postoperative complications, and pregnancy rate among the five groups of patients.</p><p><b>RESULTS</b>The operation time was longer in groups A ([2.02 ± 1.25] h) and E ([2.17 ± 1.02] h) than in the other three groups, while the postoperative hospital stay was the shortest in group E ([1.1 ± 0.1] d). Intestinal injury or incision bleeding occurred intraoperatively in 2 cases in group B and 1 case in group E. Postoperative scrotal edema developed in 3.7, 17, 10, and 19% of the patients in groups A, B, C, and D, respectively, but not in group E. The rate of 1-year recurrence was the lowest in group A (1.6%) and highest in group E (22%). Sperm concentration and the percentages of progressively motile sperm and morphologically normal sperm were improved postoperatively in all the patients (P < 0. 05), but there were no statistically significant differences among the five groups either in the above three parameters or in the postoperative pregnancy rate (P > 0. 05).</p><p><b>CONCLUSION</b>In the surgical treatment of varicocele, laparoscopic retroperitoneal approach involves short operation time and few complications, subinguinal microscopic ligation has the advantages of little injury, rapid recovery, and few complications but requires specialized microsurgical techniques, and interventional embolotherapy leaves no incision scar and needs only local anesthesia and 1-day postoperative hospital stay, which is uitable for those with a contraindication to anesthesia.</p>
Subject(s)
Female , Humans , Male , Pregnancy , Embolization, Therapeutic , Methods , Laparoscopy , Methods , Length of Stay , Ligation , Methods , Operative Time , Postoperative Complications , Postoperative Hemorrhage , Pregnancy Rate , Recurrence , Retroperitoneal Space , Retrospective Studies , Sperm Count , Urogenital Surgical Procedures , Varicocele , General Surgery , Vascular Surgical Procedures , MethodsABSTRACT
<p><b>OBJECTIVE</b>To explore the procedures of dynamic infusion cavernosometry and cavernosography (DICC) and their application in the diagnosis and classification of venous erectile dysfunction (VED).</p><p><b>METHODS</b>This study included 103 ED patients, aged 20 to 43 years, highly suspected of VED, with disease courses of 4 months to 6 years. DICC was performed and analyses were made on the results, especially the parameters of flow-to-maintain (FTM) and pressure decay (PD) in the corpus cavernosum.</p><p><b>RESULTS</b>Based on the parameters of FTM and PD, 21 of the patients were normal, 5 were suspected of VED, 39 had mild VED, 25 had moderate VED, and 13 had severe VED. Penile subcutaneous hematoma was found in 4 of the patients, all recovered after 3 to 5 days, with no other complications.</p><p><b>CONCLUSION</b>DICC is a reliable, safe and minimally invasive method for the diagnosis and classification of VED.</p>
Subject(s)
Humans , Male , Diagnostic Techniques, Urological , Hematoma , Impotence, Vasculogenic , Classification , Diagnosis , Penile Diseases , Penis , Diagnostic Imaging , Radiography , VeinsABSTRACT
<p><b>OBJECTIVE</b>To compare the clinical outcomes of fresh embryo transfer and cryopreserved-thawed embryo transfer in high-risk patients with ovarian hyperstimulation syndrome (OHSS).</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 1784 high-risk OHSS patients undergoing IVF-ET, who were divided into groups A (n=939) and B (n=845). The former received fresh embryo transfer and the latter cryopreserved-thawed embryo transfer. We compared gonadotropin (Gn) administration, body mass index (BMI), the prevalence of polycystic ovary syndrome (PCOS), the number of oocytes retrieved, and the rates of clinical pregnancy, embryo implantation and OHSS incidnece between the two groups.</p><p><b>RESULTS</b>Totally, 657 (69.97%) and 586 (69.35%) pregnancies were achieved in groups A and B, respectively, with 33 cases of moderate OHSS (3.5%) in the former and 30 (3.6%) in the latter. The prevalence of PCOS, the E2 level at hCG trigger, the number of oocytes retrieved, the number of mature oocytes, and the number of quality embryos were significantly lower in group A than in B (P <0.01). No statistically significant differences were found between the two groups in age, infertility duration, BMI, Gn administration, embryo implantation rate, clinical pregnancy rate, abortion rate, and OHSS incidence (P >0.05).</p><p><b>CONCLUSION</b>In IVF-ET cycles, cryopreserved-thawed embryo transfer does not influence the clinical outcome in high-risk OHSS patients and can avoid the incidence of severe OHSS.</p>
Subject(s)
Female , Humans , Pregnancy , Body Mass Index , Cryopreservation , Embryo Implantation , Embryo Transfer , Gonadotropins , Oocytes , Ovarian Hyperstimulation Syndrome , Epidemiology , Polycystic Ovary Syndrome , Pregnancy Rate , Prevalence , Retrospective Studies , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the differences in semen quality at different times of reanalysis and the correlation of sperm DNA fragmentation index (DFI) with sperm motility alteration using semen samples completely liquefied and normal in initial examination.</p><p><b>METHODS</b>We analyzed 127 semen samples up to the inclusion criteria with the computer-assisted semen analysis (CASA) system at 15, 30 and 60 min after semen collection, and obtained sperm morphology parameters and DFI by Shorr staining and acridine orange test (AOT) , respectively.</p><p><b>RESULTS</b>Sperm concentration, and the percentages of grades a and b sperm showed no statistically significant differences at the three time points (P > 0.05). The percentages of grades a + b and a + b + c sperm were significantly higher at 15 min than at 30 and 60 min after semen collection (P < 0.05), but with no significant difference between the latter two time points (P > 0.05). The incidence of alternation from normal to abnormal in at least one index of sperm motility at different times was 25.2%, but there were no significant differences in sperm DFI and morphology between the normal and abnormal groups (P > 0.05). Among the altered parameters of sperm motility from 15 to 60 min, the percentages of grades a, a + b and a + b + c sperm were all positively correlated with sperm DFI (P < 0.05).</p><p><b>CONCLUSION</b>Semen samples completely liquefied within 15 min after collection and normal in initial examination, when reanalyzed at 30 and 60 min, showed significant decreases in the percentages of grades a + b and a + b + c sperm, but not in the percentages of grades a and b sperm, and the parameters of sperm motility might be abnormal. Thus, at least 2 sperm analyses are required for a comprehensive evaluation of fertility. Significant difference between the results of the two analyses, and particularly a markedly reduced percentage of rapidly progressive sperm, might indicate sperm DNA damage, and thus the necessity of sperm DNA damage detection.</p>