Objective To observe the clinical efficacy of acupuncture in treating male idiopathic oligoasthenozoospermia. Method A hundred patients with oligoasthenozoospermia were recruited and randomized into a treatment group and a control group, 50 cases in each group. The treatment group was intervened by acupuncture, while the control group was by placebo acupuncture at non-meridian points. The clinical efficacies and changes of the relevant parameters of sperms after treatment were observed. Result The clinical efficacy of the treatment group was significantly better than that of the control group (P<0.05); in the treatment group, the relevant parameters of sperms were significantly improved after intervention (P<0.05); after intervention, the changes of the parameters in the control group were statistically insignificant (P>0.05); after intervention, the improvements of the relevant parameters of sperms in the treatment group were more significant than that in the control group (P<0.05). Conclusion Acupuncture can effectively improve the sperm density, sperm motility, and sperm viability, and enhance the recovery rate in treating infertility, and it’s easy-to-operate, without significant adverse reactions, safe, and reliable.

Gynecologic personnel training is an important part of traditional Chinese medicine(TCM) of qualified personnel in the new century. With the opportunities and challenges in these years, improving the quality of TCM Gynecologic personnel training to adapt to economic and social development has great significance. For the situation of Gynecologic students difficult to word, and poor ability to adapt clinical reasons, we propose a five complex combination of moral, intellectual, research, economics, thinking education model, training Gynecologic compound talents, educating more skilled talents for medical practice.

Silkworm is a holometabolous insect of Lepidoptera. During metamorphosis, significant morphological changes happen including the dissociation of old tissues and remodeling of new tissues. It has been reported that cathepsins are involved in these processes. Cathepsin is a kind of intracellular proteinase that exists in many species. It includes some subfamilies like cathepsin B, H and L. The studies on cathepsin are useful for clarifying the details of silkworm metamorphosis process. In total, 13 cathepsins were identified by screening the silkworm genome database. The basic information and the expression patterns about these genes were analyzed. Interestingly, an ovary-specific cathepsin L gene (Gene ID: BGIBMGAOO4622) was investigated by the data of silkworm microarray and real-time quantitative PCR (qPCR). The full-length cDNA is 1,209 bp, encoding a protein with 402 amino acids. Sequences alignment revealed that it has a high sequence similarity with cathepsin L of other species, and it is highly conserved in the active-site of the enzyme. The phylogenetic analysis showed that ovary-specific cathepsin L is clustered with other lepidopterous insects. Furthermore, this gene was cloned and prokaryotic expressed. Recombinant protein was present in inclusion body. Importantly, the qPCR result showed that the expression level of this gene is increasing during the early stage of pupal development and reaches the highest value at the 3rd day of pupal stage, which suggests that this gene may be involved in the process of development of the ovary and oocyte.
Animals ; Bombyx ; genetics ; Cathepsins ; genetics ; Insect Proteins ; genetics ; Phylogeny

Objective To observe the effects of different traditional Chinese medicine therapeutic methods on heart function and red cell volume distribution width (RDW) in patients with chronic heart failure (CHF). Methods A randomized, blinded and controlled study was conducted. One hundred and ninety patients with CHF accompanied by yang deficiency syndrome in Department of Cardiology of Chengdu Municipal First People's Hospital were divided into five contrast groups according to randomized envelope method:namely control group, warming yang group, nourishing yin group, activating blood group and combined warming yang and nourishing yin therapeutic group (combined group), each group being 38 cases. The patients not consistent with the criteria to enroll into the study and those lost contact were excluded from the study, thus the final total patients were 183 in number, including control 37, warming yang 36, nourishing yin 36, activating blood 37 and combined group 37 cases. All the cases were treated with routine medical therapy in accord to the guideline for CHF. In addition, placebo oral liquor was given to the control group, Wenyangjianxinling oral liquor (main ingredients:Aconiti Lateralis Radix Preparata, Astragali Radix, Chuanxiong Rhizoma, Epimedii Folium, Periplocae Cortex, Descurainiae Semen, Ginseng Radix et Rhizoma Rubra) was given to the warming yang group, Ophiopogonis Radix and Anemarrhenae Rhizoma oral liquor (main ingredients:Ophiopogonis Radix,Anemarrhenae Rhizoma) was taken by the nourishing yin group, Salviae Miltiorrhizae Radix and Chuanxiong Rhizoma oral liquor (main ingredients: Salviae Miltiorrhizae Radix, Chuanxiong Rhizoma) was administered by the activating blood group, and the main ingredients of oral liquors given to the warming yang and nourishing yin groups were assigned to the combined group, each group 10 mL, three times a day for one year. According to the prognosis, the patients were divided into survival group (168 cases) and death group (15 cases). The re-hospitalization situations such as aggravation of heart failure, acute myocardial infarction, angina, stroke, etc. were observed. The changes of hemoglobin (Hb) and RDW in the survival and death groups were investigated and compared between them. Results Compared with the control group, the rate of re-hospitalization was significantly decreased in the activating blood group [27.03% (10/37) vs. 54.05%(20/37), P<0.05];there were no statistical significant differences among all the other groups (all P>0.05). Before treatment, the levels of left ventricular ejection fraction (LVEF), fractional shortening (FS), the ratio of early to late ventricular filling velocities (E/A ratio) and E deceleration time (DT) showed no significant differences among five groups (all P>0.05). Compared with the control group at the same period, the LVEF, FS, E/A and DT were significantly increased in activating blood group and combined group after the treatment [LVEF: 0.453±0.131, 0.448±0.104 vs. 0.394±0.112, FS:(27.9±9.8)%, (27.0±11.5)%vs. (22.2±13.3)%, E/A:0.88±0.16, 0.92±0.20 vs. 0.75±0.27, DT (ms): 265.4±30.3, 251.4±37.5 vs. 225.7±35.4, all P < 0.05]. FS and DT were significantly increased in warming yang group after treatment [FS: (26.4±10.3)% vs. (19.7±7.4)%, DT: 242.0±38.7 vs. 216.3±50.9, both P < 0.05]. In the activating blood group, the level of RDW was elevated after treatment compared with that before treatment, but in the comparison with that in the control and nourishing yin groups, it was still obviously lower [(12.98±2.97)%vs. (14.37±2.52)%, (13.05±2.36)%, both P < 0.05]. The comparisons of Hb and RDW among other groups had no statistical significant differences (all P > 0.05). The level of Hb in death and survival groups also had no statistical significant difference (P > 0.05). The RDW of dead group was markedly higher than that of the survival group [(14.39±2.17)%vs. (13.02±2.08)%, P<0.05]. Conclusion The level of RDW is related to the prognosis of CHF patients, the level of RDW in death group is higher than that in survival group, and the activating blood circulation and removing blood stasis therapy can decrease the level of RDW, reduce the rate of re-hospitalization and improve the heart function in CHF patients.

Objective:To investigate the clinical effect of different bladder neck separation methods in robot-assisted laparoscopic radical prostatectomy (RARP).Methods:To retrospective analysis the data of robot-assisted laparoscopic radical prostatectomy (RARP)in our center from October, 2014 to October, 2018. All operations were performed by the same urologist. According to the different methods of bladder neck separationAccording to the different methods of bladder neck separation, all the patients were divided into four groups. Group A routine forward peeling method (500 cases): Make a 1cm incision at 12 o'clock on the front of the bladder neck, cut off the detrusor muscle and cut the bladder neck. Group B T-cut incision of the bladder neck (133 cases): identify the bladder and prostate Junction, T-shaped incision of the anterior wall of the bladder neck. Group C conventional stripping method combined with T-shaped incision of the bladder neck (81 cases). Group D lateral approach (36 cases): along the lateral side of the bladder neck and the medial posterior ligament of the prostate is separated and merges with the previously established Dirichlet space. The general data of patients were analyzed statistically.The average ages of groups A, B, C, and D were 63 years (62.5 to 67 years), 65 years (61 to 68 years), 66 years (64.5 to 70.5 years), and 62 years (59.5 to 66.5 years)respectively, there was no statistical significance difference in terms of age in 4 groups( P>0.05); PSA is 13 ng/ml(9.0 to 22 ng/ml), 7.4 ng/ml(6.4 to 26.0 ng/ml), 6.2 ng/ml(5.3 to 27.0 ng/ml), 14ng/ml(8.4 to 21.0 ng/ml), ( P>0.05); Gleason scores of puncture were 6.9(5 to 9), 7(6 to 12), 9(8 to 16), 10(6 to 18), ( P>0.05); the prostate volume was 66ml(42 to 78 ml), 70ml(50 to 89 ml), 53ml (43 to 72 ml), 80 ml (68 to 92 ml), ( P>0.05); the proportions of body mass index ≤25 kg/m 2 were 60.0%, 63.9%, 39.1%, 42.0%, and>25 kg/m 2 were 40%, 36.1%, 60.9%, and 58.0%, respectively, ( P>0.05). The operation time, bleeding volume, anastomosis time, postoperative hospital stay, postoperative complications, positive rate of proximal incision margin, urinary indwelling time, and urinary control rate in the four groups analyzed. Results:All 750 RARP operations were successful, and none were converted to open.The operation time of groups A, B, C, and D were 100 min(70 to 120 min), 89 min(70 to 95 min), 105 min(80 to 127 min), and 110 min(90 to 130 min), ( P>0.05); anastomosis time was 20.5 min (18.0 to 25.0 min)、16.1min (10.7 to 17.3 min)、25.4 min (18.9 to 27.0 min)、and 28.5 min (21.0 to 32.0 min), the anastomosis time in group B was significantly shorter than other groups ( P<0.05); the postoperative hospital stays were 9.3 days (8.0 to 13.0 days), 8.4 days (6.0 to 16.0 days), 10.8 days (8.0 to 16.0 days)and 7.8 days (7.0 to 14.0 days), ( P>0.05). Postoperative complications: Anastomotic fistula and ureteral injury occurred in 3 cases in group A, and no serious complications occurred in the other 3 groups. Proximal marginal positive rate: 40 cases (8.0%) in group A, 0 cases in group B, 6 cases (7.3%) in group C, 3 cases (8.3%) in group D, and low positive rate of margin incision in group B( P<0.05). The urinary indwelling time was 7 d (6 to 8 d), 6 d(4 to 8 d), 12 d(6 to 18 d), 10 d(6 to 13 d), ( P>0.05). Six-month postoperative urine control rate: 381 cases (75.2%) in group A, 102 cases (76.9%) in group B, 61 (75.4%) in group C, and 27 (73.8%) in group D, ( P>0.05). Conclusions:The above four method of bladder neck separation during robot-assisted laparoscopic radical prostatectomy is safe and feasible, which can effectively avoid ureteral damage. Each method can obtain better urine control within six months after surgery rate. The positive rate of proximal incision margin after T-shaped bladder neck was lowest among four groups.

Six patients with prostate cancer, treated by suprapubic extraperitoneal single-port robot-assisted radical prostatectomy, had been studied retrospectively from December 2019 to January 2020. All 6 patients have been treated by suprapubic peritoneum single port robot assisted laparoscopic surgery without other channels. The robot assisted laparoscopic radical prostatectomy via suprapubic peritoneum is safe and feasible when based on reasonable selection criteria of patients. It has been shown that the postoperative recovery was fast and the tumor control and continence rate were good under the short-term follow-up. However, the long-term outcome should be evaluated by a long-term follow-up.

Objective:To evaluate the feasibility and clinical efficiency of robot-assisted laparoscopic radical prostatectomy (RARP) via extraperitoneal PORT-free single incision approach.Methods:The data of 33 patients with prostate cancer underwent the extraperitoneal PORT-free single incision RARP from November 2020 to January 2021 in Sichuan Provincial People's Hospital was retrospectively reviewed. The average age was 66.7 (58-78) years, the median PSA was 20.77 (2.89, 56.44) ng/m, and the mean Gleason score was 7.0 (6.0-9.0). The mean prostate volume was 48.4 (25.0-220.0) ml. Clinical stage: 32 cases was in cT 2a-2cN 0M 0, 1 case in cT 3aN 0M 0. 16 cases had a history of operation. All 33 operations were performed by the same operator. All operations were performed by extraperitoneal PORT-free single-incision approach. The surgical condition, postoperative complication, pathology, and follow-up results were observed. Results:In this study, 33 operations were successfully completed without conversion to open or additional single hole channel instruments. The average operation time was 61.3 (38.0-120.0) min, with the mean intraoperative bleeding volume of 72.2 (45.0-220.0) ml and the mean bladder neck urethral anastomosis time of 11.7 (8.5-15.7) min. The mean postoperative hospital stay was 7.9 (6.0-15.0) d, the mean postoperative indwelling time of urinary catheter was 6.8 (6.0-14.0) d, and the mean postoperative evacuation time was 1.0 (0.5-3.0) d. The average incision length was 5.2 (4.6-5.8) cm. There was no obvious complications. The postoperative pathological stage: 21 cases were in < pT 3a, 12 cases were in ≥ pT 3a, and 6 cases (18.8%) had positive resection margin. 29 cases (88.9%) acquired satisfactory urinary continence after operation, and the frequency of urinary pad use was ≤ 1 tablet/day. Conclusions:The extraperitoneal single-incision RARP surgical channel without PORT is safe and feasible with a satisfying cosmetic effect, which saves costs and requires less specific channel device. Simultaneously, the new approach has strong replicability, short-term tumor control and urinary control effect with rapid postoperative recovery. However, the sample size of this study is relatively small, which needs further research and demonstration

Objective:To observe the changes of macular morphology and blood flow after minimally invasive vitrectomy (PPV) in patients with severe non-proliferative diabetic retinopathy (sNPDR).Methods:A prospective clinical study. From January 2020 to April 2021, 17 consecutive sNPDR patients with 17 eyes who were diagnosed and received PPV treatment at the Zhongshan Ophthalmic Center of Sun Yat-sen University were included in the study. There were 12 males with 12 eyes and 5 females with 5 eyes; the average age was 55 years old; the average duration of diabetes was 11 years; the average glycosylated hemoglobin was 7.9%. Before the operation and 1, 3, and 6 months after the operation, all the affected eyes underwent best corrected visual acuity (BCVA), standard 7-field fundus color photography, and optical coherence tomography angiography (OCTA). An OCTA instrument was used to scan the macular area of the affected eye with in the range of 3 mm×3 mm to measure the central subfoveal thickness (CST), the thickness of the ganglion cell complex (GCC) in the macular area, the thickness of the retinal nerve fiber layer (RNFL), and the superficial capillary plexus (SCP) vessel density and perfusion density in the macular area, macular avascular zone (FAZ) area, a-circularity index (AI). Before the operation and 6 months after the operation, the least significant difference test was used for the pairwise comparison.Results:Before the operation, 1, 3, and 6 months after the operation, the FAZ area of the macular area were 0.34±0.14, 0.35±0.10, 0.37±0.10, 0.36±0.13 mm 2, respectively; AI were 0.52±0.13, 0.54±0.11, 0.57±0.10, 0.60±0.11; CST was 282.6±66.7, 290.4±70.9, 287.2±67.5, 273.2± 49.6 μm; GCC thickness were 77.1±15.5, 74.3±13.9, 72.6±16.2, 78.5±18.3 μm; the thickness of RNFL was 97.9±13.8, 101.3±14.6, 97.7±12.0, 96.1±11.4 μm, respectively. The overall blood flow density of SCP in the macula were (16.79±1.43)%, (16.71±1.82)%, (17.30±2.25)%, (17.35±1.22)%; the overall perfusion density were 0.32±0.02, 0.32±0.03, 0.33±0.03, 0.33±0.02, respectively. After the operation, the CST increased first and then decreased; the thickness of RNFL increased 1 month after the operation, and then gradually decreased. Comparison of the parameters before and 6 months after the operation showed that the AI improved, and the difference was statistically significant ( P=0.049); the difference in FAZ area and the thickness of CST, GCC, and RNFL was not statistically significant ( P=0.600, 0.694, 0.802, 0.712); There was no statistically significant difference in the retina SCP blood flow density and perfusion density in the macular area ( P=0.347, 0.361). Conclusion:Compared with before surgery, there is no significant change in macular structure and blood flow density in sNPDR patients within 6 months after minimally invasive PPV.

BACKGROUNDNeovascular glaucoma is a refractory disease, and difficult to manage. The aim of this study was to evaluate the clinical outcomes of Ahmed glaucoma valve implantation (AGVI) in neovascular glaucoma (NVG) and non-NVG patients.

METHODSThis prospective, non-randomized study included 55 eyes of 55 patients with refractory glaucoma; 27 had NVG (NVG group) and 28 had non-NVG (non-NVG group). All of the patients underwent AGVI. The NVG group was adjunctively injected with intravitreal ranibizumab/bevacizumab (IVR/IVB) before AGVI. Intraocular pressure (IOP) was the primary outcome measure in this study. Surgical success rate, number of antiglaucoma medications used, best corrected visual acuity (BCVA), and postoperative complications were analyzed between the groups.

RESULTSAll of the patients completed the study (follow-up of 12 months). Kaplan-Meier survival curve analysis indicated that the qualified success rates in the NVG and non-NVG groups at 12 months were 70.5% and 92.9%, respectively; this difference was significant (P = 0.036). The complete success rates in the NVG and non-NVG groups at 12 months were 66.7% and 89.3%, respectively (P = 0.049). Compared with preoperative examinations, the postoperative mean IOP and use of medications were significantly lower at all follow-up time points in both groups (all P < 0.05). There were significant differences in BCVA between the two groups at the 12-month follow-up (χ(2) = 9.86, P = 0.020). Cox proportional hazards regression showed NVG as a risk factor for surgical failure (RR = 15.08, P = 0.033). Postoperative complications were similar between the two groups.

CONCLUSIONSAGVI is a safe and effective procedure in refractory glaucoma, but the success rate of surgery was related to the type of refractory glaucoma. The complete and qualified success rates of NVG patient adjunctive anti-vascular endothelial growth factor treatment are still lower than those of non-NVG patients.

Adult ; Aged ; Female ; Glaucoma ; surgery ; Glaucoma Drainage Implants ; Glaucoma, Neovascular ; surgery ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Prospective Studies