Objective To explore the features of transsphenoidal microsurgical treatment of male pro- lactinoma and to evaluate the sexual function before and after transsphenoidal microsurgery.Methods A se- ries of 23 cases male prolactinoma were analysed combined with retrospective and prospective study.9 casese with sexual disfunction had finished the International Index of Erectile Function with 15-item questionnnaire (ⅡEF-15) before and after the surgery.Results 8/10 cases treated with dopaminergic agonist combined with surgery achieved complete remission,while only 4/13 cases achieved complete remission with surgery on- ly(x~2=5.490,P=0.036).Aecoding toⅡEF-15,sexual function improved after surgery in 9 cases(paired- sample) t test,P＜0.05).Conclusion Transsphenoidal microsurgical treatment of prolactinoma may im- prove the male sexual functions.Dopaminergic agonist combined transsphenoidal microsurgery may achieve a better outcome.

OBJECTIVETo observe the effect of Zhibai Dihuang Decoction (ZDD) on mRNA and protein expressions of transient receptor potential family vanilloid subtype 1 (TRPV1) and transient receptor potential family vanilloid subtype 5 (TRPV5) in Ureaplasma urealyticum (UU)-infected rat semens and spermatogenic cells, and to explore the pathomechanism of UU-infected infertility and the intervention of ZDD.

METHODSTotally 45 were randomly selected from 60 4-5 months old SD rats. UU testicular infected animal models were set up after bladder inoculation of UU suspension. The remaining 15 rats were simultaneously injected with normal saline as a normal control group. After a successful modeling, UU infected model rats were randomly divided into the model group, the azithromycin group, and the ZDD group, 15 in each group. Rats in the ZDD group were administered with ZDD at the daily dose of 1 g/kg by gastrogavage. Rats in the azithromycin group were administered with azithromycin suspension at the daily dose of 0. 105 mg/kg by gastrogavage. Equal volume of normal saline was administered to rats in the normal control group and the model group. All medication was performed once daily for 21 successive days. Testes and epididymis were extracted after rats were killed and UU positive rates were compared among all groups. Sperm cells were separated using a mechanical separation technique. Sperm motility parameters were detected using color sperm motion detection system. mRNA and protein expressions of TRPV1 and TRPV5 in spermatogenic cells were determined by real-time quantitative PCR and Western blot.

RESULTSThe UU positive rate was obviously higher in the model group than in the normal control group [(86.7% (13/15 cases) vs. 0] P < 0.05). It was lower in the ZDD group [33.3% (5/15 cases)] and the azithromycin group [26.7% (4/15 cases)] than in the model group (P < 0.05). Compared with the normal control group, class A and B sperms were reduced, the linear velocity and the average velocity were significantly lowered, mRNA and protein expressions of TRPV1 and TRPV5 in spermated genic cells significantly decreased in the model group (P < 0.05). Compared with the model group, class A and B sperms were increased, linear and curve velocities and the average velocity were significantly elevated, mRNA and protein expressions of TRPV1 and TRPV5 significantly increased in the ZDD group and the azithromycin group (P < 0.05, P < 0.01). Compared with azithromycin group, class A and B sperms were increased, the linear velocity and the average velocity were significantly elevated, mRNA and protein expressions of TRPV1 and TRPV5 significantly increased in the ZDD group (P < 0.05, P < 0.01).

CONCLUSIONZDD could fight against UU infection and elevate semen quality, which might be associated with up-regulating mRNA and protein expressions of TRPV1 and TRPV5 in spermatogenic cells.

Animals ; Calcium Channels ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Infertility ; Male ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Semen Analysis ; Sperm Motility ; Spermatozoa ; TRPV Cation Channels ; metabolism ; Testis ; Ureaplasma Infections ; Ureaplasma urealyticum

OBJECTIVETo study the effect of Zhibai Dihuang Pill (ZBDHP) on urokinase-type plasminogen activator (uPA) and sperm quality in ureaplasma urealyticum (Uu) infection infertile patients.

METHODSRecruited were 80 infertility patients with Uu infection at Andriatrics Clinics and Department of Reproduction, including 130 cases of positive Uu semen and 50 cases of negative Uu semen. Patients with positive Uu semen were randomly assigned to the observation group (72 cases) and the control group (58 cases) according to the visit sequence. All patients took antibiotics for 2 weeks. Patients in the observation group additionally took ZBDHP, 6 g each time, twice daily. Those in the control group additionally took Vit E (100 mg each time, twice per day) and ATP (40 mg each time, twice per day). The therapeutic course for all was 90 days. Semen parameters and uPA contents of the sperm membrane were detected and comparatively analyzed.

RESULTSThe sperm membrane uPA content, the sperm motility, the sperm viability, and the percentage of normal morphology sperm in Uu positive infected patients were lower than those in Uu negative infected patients with statistical difference (P < 0.05), but with no significant difference in the sperm density between the two groups (P > 0.05). There was no statistical difference in pre-treatment sperm membrane uPA contents and sperm parameters between the two groups (P > 0.05). Compared with before treatment in the same group, the sperm membrane uPA content, the sperm motility, the sperm viability, and the percentage of normal morphology sperm obviously increased in the two groups with statistical difference (P < 0.05). After treatment, the sperm membrane uPA content increased more obviously in the observation group, with statistical difference when compared with the control group (P < 0.05).

CONCLUSIONSInfection with Uu leads to decreased uPA content of sperm membrance and the sperm motility. ZBDHP could effectively treat Uu infected infertility possibly through fighting against Uu damaged sperm membrane and make the sperm membrane uPA content return to normal, and elevate the fertilizability of sperms.

Anti-Bacterial Agents ; administration & dosage ; pharmacology ; therapeutic use ; Communicable Diseases ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Humans ; Infertility ; Infertility, Male ; Male ; Semen ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa ; Ureaplasma Infections ; drug therapy ; Ureaplasma urealyticum ; drug effects ; Urokinase-Type Plasminogen Activator ; metabolism

Objective To evaluate the dose distribution in clinical target volume (CTV) and organs-at-risk (OARs) in three dimension therapy plans in patients with squamous cell carcinoma of tongue receiving postoperative intensity-modulated radiotherapy (IMRT) or conventional radiotherapy (CRT) by dosimetric study. Methods Thirty-five patients with squamous cell carcinoma of tongue were divided into CRT group(n=17) and IMRT group(n=18). All patients underwent head-and-neck immobilization with a thermoplastic mask and planning CT scan, and target volume and OARs were contoured. Dose calculation and plan optimization were performed. All three dimension plans passed quality assurance before treatment. The dosimetry of therapy plans with IMRT or CRT in target volume and OARs dose distribution was compared by dose-volume histogram (DVH), conformity index (CI) and homogeneous index (HI). Results There were significant differences in D95 (isodose line to cover 95 percent target volume), CI, HI, minimum dose and maximum dose in CTV of therapy plans between patients with IMRT and CRT(P < 0.01), and there was no significant difference in mean dose of CTV(P > 0.05). The radiation dose on salivary glands (both parotid glands and contralateral submandibular gland) in patients with IMRT was significantly lower than that in patients with CRT(P < 0.01). Conclusion Compared with dose distribution of CRT plans, there are more advantages in improving dose distribution at the target volume and sparing salivary glands in IMRT therapy plans in patients with squamous cell carcinoma of tongue.

Objective To evaluate the stability and repeatability of gradient-echo sampling of spinecho (GESSE) sequence in measuring the R2'value in volunteers, by comparison with traditional GRE sequence (T2* map and T2 map). Methods Eight normal healthy volunteers were enrolled in this study and written informed consents were obtained from all subjects. MR scanning including sequences of GESSE,T2 map and T2 * map were performed in these subjects at resting status. The same protocol was repeated one day later. Raw data from GESSE sequence were transferred to PC to conduct postprocessing with the software built in house. R2'map and OEF map were got consequently. To obtain quantitative R2'and OEF values in the brain parenchyma, six ROIs were equally placed in the anterior, middle and posterior part of bilateral hemispheres. Both mean and standard deviation of R2 'and OEF were recorded. All images from T2 * map and T2 map were transferred to the Workstation for postprocessing. The ROIs were put at the same areas as those for GESSE sequence. R2'is defined as R2' = R2 * -R2,R2* = 1/T2*. The R2'value of GESSE sequence were compared with that of GRE sequence. Results The mean R2 'values of GESSE at the first and second scan and those of the GRE were (4.21 ±0.92),(4.45 ±0. 94) Hz and (7.37 ±1.47), (6. 42 ±2. 33) Hz 0. 035 respectively. The R2'value and OEF value obtained from GESSE were not significantly different between the first and second scan ( t = - 0. 83, - 1.48, P ＞ 0. 05 ). The R2' value of first GRE imaging had significantly statistical difference from that of second GRE inaging ( t = 1.80, P ＜ 0. 05 ). The R2' value of GESSE sequence was less than that of GRE sequence, and there was significantly statistical difference between them(t = 1.71 ,P＜0. 05). Conclusion The GESSE sequence has good stability and repeatability with promising clinical practicability.

OBJECTIVETo observe the effect of Tiancan Zhuangyang Powder (TCZYP) on the steroidogenic acute regulatory protein (stAR protein) expression of Leydig cells in model rats with partial androgen deficiency of aging male (PADAM).

METHODSPADAM rat model was prepared by cyclophosphamide induced reproductive system damage. Rats were randomly divided into four groups, i. e. the normal control group, the model group, the testosterone propionate group, and the TCZYP group. The general condition, body weight, tail suspension experiment and exhaustion swimming test, and the testicular index, etc. were observed to assess the state of rats. The serum total testosterone (TT), and free testosterone (FT) levels were detected by radioimmunoassay before and after treatment. The stAR protein expression level of Leydig cells were determined using immunohistochemical assay. Statistic analyses were performed.

RESULTSBy modeling with cyclophosphamide, serum TT and FT levels decreased (P<0.01), behavior changes were basically similar to PADAM (by tail suspension test), indicating a successful modeling. After treatment serum rTT and FT levels in the testosterone propionate group and the TCZYP group significantly increased when compared with before treatment and with the model group after treatment (P<0.01). There was no statistical difference between the TCZYP group and the testosterone propionate group (P>0.05). The immobility time in the tail suspension test were significantly shortened in the testosterone propionate group and the TCZYP group (P<0.05). The exhausted swimming time was more significantly prolongated than that of the model group (P<0.05). The stAR protein gray value significantly decreased (P<0. 01).

CONCLUSIONTCZYP could prevent serum TT and FT levels from decrease, improve stAR protein activities, and attenuate the depression state and muscular tension in PADAM rats. Its action was equivalent to that of testosterone propionate.

Androgens ; deficiency ; Animals ; Drugs, Chinese Herbal ; pharmacology ; Leydig Cells ; drug effects ; metabolism ; Male ; Phosphoproteins ; metabolism ; Rats ; Rats, Sprague-Dawley ; Testis ; drug effects ; metabolism

Carcinoma, Non-Small-Cell Lung ; pathology ; surgery ; China ; Forecasting ; Humans ; Lung Neoplasms ; pathology ; surgery ; Neoplasm Staging ; Surgical Procedures, Operative ; methods ; trends

OBJECTIVETo observe clinical curative effect of cake-separated moxibustion on impaired glucose regulation (IGR) and explore its action mechanism.

METHODSSixty cases were randomly divided into a simple lifestyle intervention group (control group) and a cake-separated moxibustion combined with lifestyle intervention group (observation group), 30 cases in each one. The control group was treated with lifestyle intervention. Based on lifestyle intervention, cake-separated moxibustion at Pishu (BL 20), Weishu (BL 21) and Yishu (EX-B 3) was applied to the observation group. Fast plasma glucose (FPG), two hours plasma glucose after oral glucose tolerance test (OGTT2hPG), fasting insulin (FINS), homa insulin resistance index (HOMA-IR), blood lipid, body mass index (BMI) and waist circumference (WC) were observed in the two groups before and after treatment.

RESULTSAfter treatment, the OGTT2hPG and FPG were both decreased significantly (both P<0.05) in the two groups, compared between the two groups, the differences of FPG [(0.41 +/- 0.42) mmol/L vs (0.05 +/- 0.08)mmol/L] and OGTT2hPG [(0.85 +/- 0.53)mmol/L vs (0.17 +/- 0.19)mmol/L] were both statistically significant. There were no significant changes in FINS, HOMA-IR, blood lipid, BMI and WC in the control group before and after treatment (all P>0.05), but FINS, HOMA-IR levels, triglycerides (TG), total cholest-erol (TC), low density lipoprotein (LDL-C), BMI and WC in the observation group were decreased obviously after treatment (all P<0.05), which had statistical differences between the two groups (all P<0.05).

CONCLUSIONThe cake-separated moxibustion combined with lifestyle intervention can obviously control blood glucose levels, improve insulin resistance and blood lipid levels, decrease BMI and WC.

Adult ; Aged ; Female ; Glucose ; metabolism ; Glucose Intolerance ; metabolism ; physiopathology ; therapy ; Humans ; Insulin ; Male ; Middle Aged ; Moxibustion ; Waist Circumference

OBJECTIVETo examine the relationship between reduction of serum fetuin A and coronary artery calcification (CAC) in patients starting hemodialysis.

METHODSTwenty-nine patients on chronic hemodialysis (duration of hemodialysis less than 6 months) were enrolled in this study. Serum fetuin A and such potential CAC-related risk factors as C-reactive protein (CRP), Ca, P, iPTH, body mass index (BMI) were examined. CAC was detected by multislice spiral CT scan (MSCT) and quantified by the modified Agaston's scoring system. All the 29 patients were followed up for 18 months to appraise the cardiovascular events defined as cardiac failure, angina pectoris or myocardial infarction.

RESULTSEleven patients (78.57%) were found to have CAC as detected by MSCT in low serum fetuin A (below the average serum concentration of 0.71 g/L) group, a rate significantly higher than that in high serum fetuin A group (7 patients, 46.67%, P<0.05). Serum fetuin A in these 29 patients was related with CAC score (Pearson correlation coefficient of -0.734, P=0.001) and stepwise regression analysis indicated that serum fetuin A (standardized beta=-0.568, P=0.003) and age (standardized beta=0.416, P=0.019) were independently correlated to CAC. Such factors as CRP, Ca, P, iPTH, Chol, TG, HDL-C, LDL-C, BMI and blood pressure were excluded from the regression equation. Reduction of serum fetuin A was associated with cardiovascular events (Spearman's rho -0.758, P<0.01). No significant difference was found between low and high serum fetuin A groups by Kaplan-Meier survival analysis (P=0.065).

CONCLUSIONReduced serum fetuin A may be a potential risk factor of coronary artery calcification, and can contribute to cardiovascular events in patients starting hemodialysis.

Adult ; Aged ; Blood Proteins ; metabolism ; Calcinosis ; blood ; etiology ; Coronary Vessels ; pathology ; Female ; Humans ; Male ; Middle Aged ; Renal Dialysis ; adverse effects ; Risk Factors ; alpha-2-HS-Glycoprotein

OBJECTIVETo investigate the complications of surgical treatments for femoral intertrochateric fractures using dynamic hip screw (DHS).

METHODSFrom Jan. 2002 to Dec. 2007, sixty-nine patients with intertrochanteric fractures were treated by dynamic hip screw fixation included 27 males and 42 females,with an average age of 72.9 years ranging from 53 to 96 years. According to Evans classification there were 10 cases in type I ,21 in type II, 22 in type III, and 16 in type IV, of which 51 patients (73.9%) suffered from systematic diseases preoperatively.

RESULTSFifty-seven patients were followed up for 8 to 70 months (41 months on average). Four patients died, 17 cases occurrenced systematic complications postoperatively. Internal fixation related complications occurred in 12 patients. There were 8 cases with mechanical failure of DHS including 4 of screw loosen,3 of cutting-out of device through femoral head and neck and 1 of plate breakage. Five patients had a coxa vara, and delayed union occurred in 4 patients.

CONCLUSIONUnstable fracture pattern produced high percentage of mechanical failure. In such cases DHS should not be the first choice for treatment. The appropriate treatment should be in relation to pre-operative fracture stability and osteoporosis.

Aged ; Aged, 80 and over ; Bone Screws ; Female ; Fracture Fixation, Internal ; adverse effects ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies