OBJECTIVETo evaluate the relationship between infection of Chlamydia Trachomatis(Ct) and apoptosis of spermatogenic cells.

METHODSApoptotic spermatogenic cells were examined by Wright-Giemsa staining and the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate(dUTP)-biotin nick-end labeling(TUNEL) technique.

RESULTSApoptosis rate of Ct infective group was significantly higher than that of normal group(P < 0.01).

CONCLUSIONSCt infection may cause the apoptosis of spermatogenic cells, which affords an objective evidence for illustrating the mechanism of Ct-infection-induced male infertility.

Adult ; Apoptosis ; Chlamydia Infections ; complications ; pathology ; Chlamydia trachomatis ; Humans ; In Situ Nick-End Labeling ; Infertility, Male ; etiology ; Male ; Spermatocytes ; pathology ; Staining and Labeling

Objective To evaluate the effect of dexmedetomidine on sevoflurane anesthesia-in-duced cortical epileptiform electroencephalogram ( EEG) activity in the neonatal rats. Methods Forty clean-grade healthy Sprague-Dawley rats, aged 4-6 days, weighing 8-15 g, were divided into 5 groups (n＝8 each) using a random number table method: control group ( C group), sevoflurane group ( S group), dexmedetomidine plus sevoflurane group (D+S group), dexmedetomidine plus alpha 2-adrenocep-tor antagonist atipamezole plus sevoflurane group (D+A+S group), and atipamezole plus sevoflurane group (A+S group). After the electrode was correctly placed, the EEG was continuously monitored, and normal saline 5 μl∕g was intraperitoneally injected at 58 min of monitoring in group C, dexmedetomidine 25 μg∕kg was intraperitoneally injected in group D+S, dexmedetomidine 25 μg∕kg and atipamezole 250 μg∕kg were intraperitoneally injected in group D+A+S, and atipamezole 250 μg∕kg was intraperitoneally injected in group A+S. Anesthesia was induced by inhaling 6% sevoflurane for 3 min starting from 60 min of monitoring and then maintained by inhaling 2. 1% sevoflurane for 1 h. The total duration, the number and average du- ration of epileptic waves were recorded during anesthesia. Blood samples were obtained from the left ventri-cle after the end of anesthesia for blood gas analysis. Rats were then sacrificed and blood samples were col-lected for measurement of the serum corticosterone concentration. Results No epileptic wave was found in group C. The serum concentration of corticosterone was significantly higher in the other four groups than in group C ( P＜0. 05). Compared with group S, the total duration of epileptic wave was significantly short-ened, the number of epileptic wave was reduced, and the concentration of corticosterone was decreased in group D+S (P＜0. 05), and no significant change was found in the total duration, the number and average duration of epileptic waves or serum concentration of corticosterone in D+A+S and A+S groups (P＞0. 05). Compared with group D+S, the total duration of epileptic wave was significantly prolonged, the number of epileptic wave was increased, and the serum concentration of corticosterone was increased in D+A+S and A+S groups (P＜0. 05). Conclusion Dexmedetomidine can inhibit the occurrence of cortical epileptiform EEG activity induced by sevoflurane anesthesia in the newborn rats, and the mechanism may be related to improving the hypothalamus-pituitary-adrenocortical axis hyperfunction mainly through activating the central 2-adrenoceptor.

Objective To evaluate the effect of bilateral thoracic paravertebral block (TPVB) combined with general anesthesia on early recovery after Nuss procedure in patients with pectus excavatum.Methods Sixty patients of both sexes with pectus excavatum,aged 8-18 yr,with body mass index＜ 18.5-32.0 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective Nuss procedure,were divided into 2 groups by using a random number table method:general anesthesia group (group GA,n=30) and bilateral TPVB combined with general anesthesia group (group TPVB+ GA,n=30).Bilateral TPVB was performed at the level of T5 under ultrasound guidance at 30 min before operation in group TPVB+GA.Anesthesia was induced by intravenous injection of fentanyl,propofol and rocuronium and maintained by inhalation of sevoflurane,intravenous infusion of remifentanil 0.1-0.5 μg · kg-1 · min-1,and intermittent intravenous boluses of rocuronium.Patients received patient-controlled intravenous analgesia after operation.Tramadol 1-2 mg/kg or dizocin 0.1 mg/kg was intravenously injected as rescue analgesic,maintaining visual analogue scale score ≤ 3 within 2 days after operation.The intraoperative consumption of remifentanil,postoperative consumption of snfentanil,requirement for rescue analgesia and development of nausea and retching/vomiting were recorded.Quality of recovery was assessed using the Quality of Recovery-15 at 1 and 2 days after operation.Results Compared with group GA,the intraoperative consumption of remifentanil,postoperative consumption of sufentanil,rate of rescue analgesia and incidence of nausea and vomiting were significantly decreased,and Quality of Recovery-15 scores were increased at 1 and 2 days after operation in group TPVB +GA (P＜0.05).Conclusion Bilateral TPVB combined with general anesthesia can reduce the perioperative consumption of opioids and is beneficial for the early recovery after Nuss procedure in patients with pectus excavatum.

Objective To evaluate the effect of dexmedetomidine on the long-term anxiety state after sevoflurane anesthesia in neonatal rats and the role of different central subtypes of α2 receptors.Methods A total of 216 clean-grade healthy male Sprague-Dawley rats,aged 4-6 days,weighing 8-15 g,were divided into 6 groups (n =36 each) using a random number table method:control group (group C),sevoflurane group (group S),dexmedetomidine + sevoflurane group (group D+S),dexmedetomidine + α2 receptor antagonist atipamezole + sevoflurane group (group D+A+S),dexmedetomidine + α2A receptor antagonist BRL44408 + sevoflurane group (group D+B+S),and dexmedetomidine + α2C receptor antagonist JP1302 + sevoflurane group (group D+J+S).Anesthesia was induced by inhaling 6％ sevoflurane for 3 min and maintained by inhaling 2.1％ sevoflurane for 6 h.At 30 min before anesthesia induction,dexmedetomidine 25 μg/kg was intraperitoneally injected in group D+S,dexmedetomidine 25 μg/kg and atipamezole 250 μg/kg were intraperitoneally injected in group D + A + S,dexmedetomidine and α2A receptor antagonist BRL44408 1.5 mg/kg were intraperitoneally injected in group D+B+S,and dexmedetomidine 25 μg/kg and α2C receptor antagonist JP1302 3 mg/kgwere intraperitoneally injected in group D+J+S.Twelve rats in each group were randomly selected and sacrificed after the end of anesthesia,blood samples were collected for blood gas analysis,and the serum corticosterone concentration was measured by enzyme-linked immunosorbent assay.The elevated plus maze was performed when the left rats in each group were 60 days old,and 12 rats were selected when the they were 80 days old to perform the restraint stress test.Results Compared with group C,the percentage of time of staying at the open arm was significantly decreased,the total motion distance was shortened,and the serum corticosterone concentration was increased after the end of anesthesia and during the restraint stress test in S,D+A+S and D+B+S groups (P＜0.05),and no significant change was found in the parameters mentioned above in D+S and D+J+S groups (P＞0.05).Compared with group S,the percentage of time of staying at the open arm was significantly increased,the total motion distance was prolonged,and the serum corticosterone concentration was decreased after the end of anesthesia and during the restraint stress test in group D+S and group D+J+S (P＜0.05),and no significant change was found in the parameters mentioned above in group D+A+S and group D+B+S (P ＞0.05).Compared with group D+S,the percentage of time of staying at the open arm was significantly decreased,the total motion distance was shortened,and the serum corticosterone concentration was increased after the end of anesthesia and during the restraint stress test in D+A+S and D+B+S groups (P＜0.05),and no significant change was found in the parameters mentioned above in group D+J +S (P＞ 0.05).Conclusion Dexmedetomidine can reduce the long-term anxiety state after sevoflurane anesthesia in neonatal rats,and the mechanism may be related to activating central α2A receptors and improving hypothalamic-pituitary-adrenocortical axis hyperfunction.

Objective To evaluate the effect of dexmedetomidine on the long-term sensorimotor gating system after sevoflurane anaesthesia in neonatal rats.Methods One hundred forty-four clean-grade healthy male Sprague-Dawley rats,aged 4-6 days,weighing 8-15 g,were divided into 4 groups (n =36 each) using a random number table method:control group (group C),sevofluraue group (group S),dexmedetomidine plus sevoflurane group (group D + S),and dexmedetomidine plus α2 receptor antagonist atipamezole plus sevoflurane group (group D+A+S).In group S,anesthesia was induced with 6％ sevofluraue for 3 min and maintained with 2.1％ sevoflurane,and the anesthesia time was 6 h in total.Dexmedetomidine 25 μg/kg was intraperitoneally injected in group D.In group D +A+ S,dexmedetomidine 25 μg/kg and atipamezole 250 μg/kg were intraperitoneally injected,and the other treatments were similar to those previously described in group S.Twelve rats in each group were randomly selected after anesthesia and sacrificed,and blood samples were collected for determination of serum corticosterone concentrations by enzyme-linked immunosorbent assay.Twenty-four rats were randomly selected in each group,and prepulse inhibition (PPI) of startle test was performed at 70 days after birth.PPI rate (PP3％,PP6％,PP12％) was calculated.The serum corticosterone concentration was measured by restraint stress test on 80 days after birth.Results There was no significant difference in PP6％ or PP12％ among the four groups (P＞0.05).Compared with group C,PP3％ was significantly decreased,and the serum corticosterone concentration was increased after the end of anesthesia and during restraint stress test at 80 days after birth in S and D+A+ S groups (P＜0.05),and no significant change was found in the parameters mentioned above in group D (P＞0.05).Compared with group S,PP3％ was significantly increased,and the serum corticosterone concentration was decreased after the end of anesthesia and during restraint stress test at 80 days after birth in group D (P＜0.05),and no significant change was found in the parameters mentioned above in group D+ A+S (P＞0.05).Compared with group D,PP3％ was significantly decreased,and the serum corticosterone concentration was increased after the end of anesthesia and during restraint stress test at 80 days after birth in group D+A+S (P＜0.05).Conclusion Dexmedetomidine can alleviate the damage to long-term sensorimotor gating system after sevoflurane anesthesia in neonatal rats,and the mechanism may be related to activating central α2 receptors and improving hypothalamic-pituitary-adrenal axis hyperfunction.

Objective To evaluate the role of hippocampal CD200 receptor 1(CD200R1)in peri-operative neurocognitive disorders(PND)in mice.Methods Sixty clean-grade male C57BL/6 mice,aged 9-10 months,weighing 32-38 g,were used in the study.The experiment was performed in two parts.Ex-periment Ⅰ Thirty-six mice were divided into 2 groups(n＝18 each)using a random number table meth-od: control group(group C)and PND group.Group C only received isoflurane anesthesia.Partial left lo-bectomy of the liver was performed under isoflurane anesthesia in group PND.Contextual fear conditioning test was performed at 1,3 and 7 days after surgery,and the freezing time was recorded.The mice were then sacrificed,and the hippocampus was isolated for determination of interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)contents(by enzyme-linked immunosorbent assay)and CD200 and CD200R1 expression(by Western blot).ExperimentⅡ Twenty-four mice were divided into 2 groups(n＝12 each)using a random number table method: CD200-Fc group and IgG1-Fc group.Recombinant proteins CD200-Fc and human IgG1-Fc were injected into the lateral cerebral ventricle in CD200-Fc group and IgG1-Fc group,respectively.Partial left lobectomy of the liver was performed after the end of injection.Contextual fear conditioning test was performed at 1 and 3 days after surgery,and the freezing time was recorded.Re-sults Experiment Ⅰ Compared with group C,the freezing time in the contextual fear conditioning test was significantly shortened,and the contents of IL-1β were increased at 1 and 3 days after surgery,the contents of TNF-α were increased at 3 and 7 days after surgery,and the expression of CD200 and CD200R1 was up-regulated at 1 day after surgery in group PND(P＜0.05).ExperimentⅡ Compared with IgG1-Fc group,the freezing time in the contextual fear conditioning test was significantly prolonged at 1 day after surgery in CD200-Fc group(P＜0.05).Conclusion Up-regulated expression of hippocampal CD200R1 is the endogenous protective mechanism of PND in mice.

Mycoplasma pneumoniae pneumonia (MPP) complicated with cerebral venous sinus thrombosis (CVST) is rare.We retrospectively analyzed the clinical data of two patients with refractory mycoplasma pneumoniae pneumonia (RMPP) complicated with CVST who were hospitalized in Xi′an children′s Hospital from December 2018 to April 2019, inquired the relevant literature, analyzed the clinical diagnosis and treatment characteristics, and discussed the diagnosis and treatment measures of RMPP complicated with CVST.Two cases were 6-year-old girls with fever and cough as the main symptoms.After physical examination, the respiratory sounds of the affected lung decreased, and the sounds of phlegm and dampness could be heard in both lungs.Mycoplasma pneumoniae (MP) antibody and RNA were positive.Chest CT showed lobar pneumonia with a large number of pleural effusion.The effect of macrolide antibiotics anti infection treatment was not good.Headache symptoms occurred during the course of the disease, and serum D-dimer increased significantly.Brain MRI showed CVST, including 1 case with lower extremity pain, and B-ultrasound showed right lower extremity arterial embolism.After anti infection, thrombectomy, anticoagulation and symptomatic treatment, 2 cases were discharged.When children with MPP, especially those with RMPP, have extracranial thrombosis and/or neurological symptoms, accompanied by elevated serum D-dimer, the possibility of CVST should be considered, and brain MRI examination should be performed in time to confirm and actively treat, which can reduce or avoid the occurrence of sequelae.Thrombosis may be related to excessive inflammatory reaction and vascular endothelial injury caused by MP infection.

Objective:To analyze the effect of spine-pelvis sagittal parameters and sagittal orientation of facet joint on degeneration of cranial L 3,4 facet joint (facet joint degeneration, FJD) after L 4-S 1 posterior lumbar interbody fusion (PLIF). Methods:Patients with lumbar degenerative diseases who underwent L 4-S 1 PLIF from January 2012 to December 2016 were retrospectively investigated, there were 54 cases, including 28 males and 26 females. Age: 54.59±5.48 years (range, 45-60 years). X-ray, CT, MRI and Weishuapt grade was used to evaluate the degeneration of L 3,4 facet joint at the cranial adjacent segment. The general information and the sagittal parameters of spine pelvis at the last follow-up were compared between the two groups. The former included age, gender, body mass index (BMI), bone mineral density (BMD), follow-up time and preoperative diagnosis. The latter included lower lumbar lordosis angle (LLL), lumbar lordosis angle (LL), pelvis incidence (PI), pelvis tilt (PT), sacrum slope (SS), the height of the intervertebral space (HD), the angle of cranial facet joint, Oswestry disability index (ODI), Japanese Orthopedic Association (JOA) lumbar function score and improvement rate were compared at the same time. Independent sample t-test was used to compare continuous variables between groups; comparison of categorical variable components χ 2 test or Fisher's exact test. Multivariate logistic regression analysis was used to predict the risk factors of adjacent FJD. Results:Postoperative follow-up was 33.44±6.85 months (range, 24-36 months), there were 17 patients in the degenerative group and 37 patients in the non degenerative group. There were no significant differences in age, gender, BMI, BMD, follow-up time or preoperative diagnosis between the two groups. LLL, LL and SS also showed no significant difference. At the last follow-up, PI (56.28°±6.03° vs. 47.87°±8.30°, t=3.74, P=0.001), PT (17.90°±7.06° vs. 14.41°±5.51°, t=1.97, P=0.042) and the joint angle of the cephalic facet (58.48°±2.00° vs. 54.69°±3.01°, t=4.72, P=0.072) in the degenerative group were greater than those in the non-degenerative group. In the subgroup analysis of lumbar lordosis distribution, the difference between the two groups was statistically significant (χ 2=9.90, P=0.006). The HD in the degenerative group 7.50±3.60 mm was significantly lower than that in the non degenerative group 9.30±2.79 mm ( t=2.00, P=0.031). Multivariate logistic regression analysis showed that increase of PI ( OR=1.22, P=0.005) and magnified cephalic facet joint angle ( OR=2.04, P=0.008) were risk factors for adjacent segment facet degeneration. At the last follow-up, the ODI improvement rate in the degenerative group (58.14%±13.41% vs. 70.18%±8.03%, t=4.11, P<0.001) and the JOA score improvement rate (44.72%±9.53% vs. 68.86%±8.55%, t=0.43, P=0.001) were lower than those in the non degenerative group. Conclusion:The increase of PI and sagittal facet (increased joint angle of proximal facet) are risk factors of adjacent segment FJD after lumbar fusion; The abnormal distribution of lower lumbar lordosis and poor PT recovery in adjacent segment FJD patients after lumbar fusion are more obvious, which may be related to the increase of PI; After lumbar fusion, the orientation of adjacent facet joint tended to be sagittal.

ObjectiveTo assess the effects of testicular sperm and epididymal sperm on the outcomes of ICSI for patients with obstructive azoospermia.

METHODSWe searched PubMed, MEDLINE, EMBASE, Cochrane, CNKI, VIP, CBM, and Wanfang Database up to December 2015 for published literature relevant to ICSI with testicular or epididymal sperm for obstructive azoospermia patients. According to the inclusion and exclusion criteria, two reviewers independently conducted literature screening, data extraction and quality assessment of the included trials, followed by meta-analysis with the RevMan 5.3 software.

RESULTSA total of 14 studies were identified, involving 1 278 patients and 1 553 ICSI cycles. ICSI with epididymal sperm exhibited a significantly higher fertilization rate than that with testicular sperm (RR = 1.08, 95% CI 1.05－1.11, P<0.01). No statistically significant differences were observed between the epididymal and testicular sperm groups in the rates of cleavage (RR = 1.04, 95% CI 0.99－1.10, P = 0.13), good-quality embryo (RR = 1.01, 95% CI 0.93－1.09,P = 0.85), implantation (RR = 1.14, 95% CI 0.75－1.73, P = 0.55), clinical pregnancy (RR = 1.14, 95% CI 0.98－1.31, P = 0.08), and miscarriage (RR = 0.86, 95% CI 0.53－1.39,P = 0.54).

CONCLUSIONSICSI with epididymal sperm yields a markedly higher fertilization rate than that with testicular sperm, but has no statistically significant differences from the latter in the rates of cleavage, good-quality embryo, implantation, clinical pregnancy, and miscarriage in the treatment of obstructive azoospermia.

ObjectiveTo explore Mycoplasma genitalium (MG) infection in the urogenital tract of infertile men and its influence on semen quality.

METHODSSemen samples were collected from 352 infertile males in the Center of Reproductive Medicine of Nanjing General Hospital from March to July 2015. MG infection was detected by real-time fluorescence simultaneous amplification and testing and semen analyses were conducted according to the WHO Laboratory Manual for the Examination and Processing of Human Semen (5th Ed) on the semen pH value, semen volume, total sperm count, sperm concentration, total sperm motility, percentages of progressively motile sperm (PMS) and immotile sperm (IMS), and sperm DNA fragmentation index (DFI). The data obtained were subjected to statistical analysis by t-test and non-parametric test (Wilcoxon test).

RESULTSMG infection was found in 3.4% (12/352) of the infertile patients. Compared with the MG-positive cases, the MG-negative ones showed a significantly higher semen volume (［2.85 ± 0.14］ vs ［3.84 ± 0.12］ ml, P = 0.008) and percentage of PMS (［15.86±1.72］ vs ［60.95 ± 5.63］ %, P = 0.032) but a lower DFI (［30.73 ±2.24］ vs ［20.71 ± 1.55］%, P = 0.014). However, no statistically significant differences were observed between the two groups in the semen pH value (7.38 ±0.02 vs 7.39 ± 0.01, P = 0.774), sperm concentration (［52.96 ± 15.78］ vs ［60.05 ± 4.29］×10⁶/ml, P = 0.683), sperm count (［154.15 ± 46.37］ vs ［221.56 ± 15.43］×106, P = 0.236), total sperm motility (［29.04 ± 3.11］ vs ［33.52 ± 1.51］ %, P = 0.626), or percentage of IMS (［23.57 ± 0.99］ vs ［62.34 ± 1.69］ %, P = 0.691).

CONCLUSIONSUrogenital MG infection is common in infertile males and potentially affects the semen quality, especially sperm vitality of the patient.

DNA Fragmentation ; Humans ; Infertility, Male ; microbiology ; physiopathology ; Male ; Male Urogenital Diseases ; microbiology ; Mycoplasma Infections ; complications ; Mycoplasma genitalium ; Semen ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa ; physiology