OBJECTIVETo investigate the semen quality and its influencing factors in preconception males in Nanjing area so as to provide some evidence for working out effective intervention measures.

METHODSTotally 687 men receiving preconceptional physical examination were enrolled in this study. A questionnaire survey was conducted among the subjects along with an analysis of their semen quality.

RESULTSThe median of sperm concentration was 63.3 x 10(6)/ml (95% CI [19.88-119] x 10(6)/ml). The median of grade a sperm was 33.03% (95% CI [19.38-55.05]%), that of grade a + b sperm was 52.08% (95% CI [39.53-69.37]%), and that of teratosperm was 91.75% (95% CI [69-100]%). The median concentration of seminal plasma PMN-elastase was 195.55 ng/ml (95% CI [76.16-3330.38] ng/ml) and that of seminal plasma zinc was 7.62 μmol/L (95% CI [1.5-23, 45] μmol/L). The positive rates of Ureaplasma urealyticum (UU), Chlamydia trachomatis (CT), and Gardnerella vaginalis (GV) were 42.4%, 0.3%, and 2.4%, respectively. The median of sperm DNA fragmentation index (DFI) of those whose wives had a history of adverse pregnancy was 20.25% (95% CI [2.15-68.25]%). Multivariate logistic regression analysis suggested that mental stress (OR 1.567, 95% CI [1.081-2.27]) and sedentariness (OR 1.772, 95% CI [1.211-2.592]) were independent risk factors for asthenospermia.

CONCLUSIONThe sperm quality of preconception males in Nanjing area is not encouraging, and it can be improved by changing undesirable lifestyle and reducing mental stress.

Adult ; Asthenozoospermia ; etiology ; China ; Chlamydia trachomatis ; isolation & purification ; DNA Fragmentation ; Gardnerella vaginalis ; isolation & purification ; Humans ; Leukocyte Elastase ; analysis ; Male ; Preconception Care ; Semen ; microbiology ; Semen Analysis ; statistics & numerical data ; Sperm Count ; statistics & numerical data ; Spermatozoa ; Ureaplasma urealyticum ; isolation & purification

OBJECTIVETo study the action mechanism of Qinggan Huoxue Recipe (QGHXR) and its disassembled recipes for treatment of alcoholic liver fibrosis (ALF) by observing their regulation on the expressions of matrix metalloproteinases (MMPs) and type 1 tissue inhibitor of metalloproteinase (TIMP-1).

METHODS130 male SD rats were randomly divided into the blank control group (n=10), the CCI4 group (n=10), and the modeling group (n=110). Rats in the modeling group were intervened by complex factors dominated as alcohol. Eight weeks later they were randomly divided into 4 subgroups, i.e., the model group (n=25), the QGHXR group (n= 15), the Qinggan Recipe (QGR) group (n=15), and the Huoxue Recipe (HXR) group (n=15). Eight model rats were selected for pathological analysis to monitor the development of the modeling at the 4th, 8th, and 10th week of the experiment. The rest rats died during the modeling. Corresponding medicines were given to these treatment groups (at the dose of 4.75 g/kg, 1.50 g/kg, and 3.25 g/kg). All rats were killed at the end of the 12th week. The protein and mRNA expressions of MMP-2, MMP-9, and TIMP-1 were detected using Western blotting, fluorescent quantitative polymerase chain reaction, and immunofluorescence method.

RESULTSCompared with the blank control group, the expressions of MMP-2, MMP-9, and TIMP-1 significantly increased in the model group (1.81 +/- 0.28 versus 0.53 +/- 0.04, 1.60 +/- 0.16 versus 0.45 +/- 0.05, 1.20 +/- 0.02 versus 0.35 +/- 0.07, P < 0.01). Compared with the model group, QGHXR and its disassembled recipes all could decrease the protein and mRNA expressions of TIMP-1 (0. 56 +/- 0.05, 0.67 +/- 0.02, 0.70 +/- 0.02 versus 1.20 +/- 0.02, P < 0.05), increase the expressions of MMP-2 and MMP-9 (4.18 +/- 0.53, 2.70 +/- 0.40, 2.38 +/- 0.22 versus 1.81 +/- 0.28, 3.31 +/- 0.06, 2.56 +/- 0.20, 1.87 +/- 0.05 versus 1.60 +/- 0.16, P < 0.05, P < 0.01). QGHXR was superior to its disassembled recipes (P < 0.05, P < 0.01).

CONCLUSIONThe action mechanisms of QGHXR and its disassembled recipes might possibly be correlated with regulating MMPs.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Liver Cirrhosis, Alcoholic ; drug therapy ; metabolism ; Male ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Phytotherapy ; Rats ; Rats, Sprague-Dawley ; Tissue Inhibitor of Metalloproteinase-1 ; metabolism

AIMTo study the protection mechanisms of K(ATP) channels on hippocampal CA1 neurons during chronic severe hypoxia.

METHODSp53 expression, DNA fraction, and cell apoptosis were examined in cultured hippocampal neurons in control group, hypoxia group, hypoxia group treated with K(ATP) channels antagonist and hypoxia group treated with K(ATP) channels agonist.

RESULTSIn the group of a 12 h long exposure to oxygen concentration of 0%, diazoxide (100 micromol/L), the K(ATP) channels agonist, reduced p53 expression and the hypoxia-induced apoptosis. In contrast, tolbutamide (100 micromol/L), the K(ATP) channels antagonist, significantly rose p53 expression and the hypoxia-induced apoptosis, which could be reversed by p53 inhibitor TSA.

CONCLUSIONK(ATP) channels protect hippocampal neurons against chronic severe hypoxia by suppressing p53 expression.

Adenosine Triphosphate ; metabolism ; Animals ; Apoptosis ; Cell Hypoxia ; Cell Survival ; Diazoxide ; pharmacology ; Genes, p53 ; Hippocampus ; cytology ; metabolism ; KATP Channels ; antagonists & inhibitors ; metabolism ; Neurons ; cytology ; metabolism ; Patch-Clamp Techniques ; Rats ; Rats, Sprague-Dawley ; Tolbutamide ; pharmacology

AIMTo study the effect of recombinant hirudin (rH) on tPA-induced fibrinolysis and the possible mechanism of its action.

METHODSThe effect of rH on thrombin-fibrin complex (Th-Fn) was detected by 99mTc labeled rH. In the in vitro clot lysis, tPA as plasminogen activator, and recalcified plasma as plasminogen resource were used to study the influence of rH on fibrinolysis by detecting TAFIa, D-Dimer and FXIII.

RESULTSIn a canine model of femoral artery thrombosis, a clear radioactivity strip was imaged in 30 - 60 min on a part image, and the femoral vein thrombosis developed at 30 min. rH efficiently inhibited clot regeneration. Addition of TM could inhibit clot lysis obviously, and CPI could shorten the delay of clot lysis which due to TAFIa. There was a dose-dependent relationship with TM concentration and TAFI activation. FXIII activation was inhibited by low concentration of rH ( < or = 0.2 u x mL(-1)), and the level of fibrinolysis product, D-Dimer, increased.

CONCLUSIONrH could inhibit the thrombin binding to fibrin. rH inhibited the activation of TAFI and FXIII by combining with thrombin which resulted in enhancement of thrombolysis.

Animals ; Blood Coagulation ; drug effects ; Carboxypeptidase B2 ; metabolism ; Carboxypeptidases ; antagonists & inhibitors ; Dogs ; Factor XIII ; metabolism ; Femoral Artery ; Femoral Vein ; Fibrinolysis ; drug effects ; Fibrinolytic Agents ; pharmacology ; Hirudins ; genetics ; pharmacology ; Male ; Plant Proteins ; pharmacology ; Protease Inhibitors ; Recombinant Proteins ; pharmacology ; Thrombomodulin ; metabolism ; Thrombosis ; metabolism ; Venous Thrombosis ; metabolism

Background The mortality of stroke patients is strongly affected by medical complications.However,there are limited data investigating the effect of in-hospital medical complications on the dependency of stroke patients worldwide.We prospectively and systematically investigated the effect of medical complications on dependency of patients at 3,6 and 12 months after stroke using the China National Stroke Registry (CNSR).Methods This prospective cohort study collected data of patients age ＞18 years with acute ischemic stroke in 132 clinical centers distributed across 32 provinces and four municipalities (including Hong Kong region) of China,from September 2007 to August 2008.Data on medical complications,dependency and other information were obtained from paper-based registry forms.Medical complications associated with stroke outcomes were assessed using multivariable Logistic regression.Results Of 11 560 patients with acute ischemic stroke,1826 (15.80％) presented with in-hospital medical complications.In-hospital medical complications were independent risk factors for dependency of patients at 3 months (adjusted odds ratio (OR) 2.367,95％ confidence interval (CI) 2.021-2.771),6 months (adjusted OR 2.257,95％ CI 1.922-2.650),and 12 months (adjusted OR 1.820,95％ CI 1.538-2.154) after acute ischemic stroke.Conclusion The results demonstrated that the short-term and long-term dependency of acute ischemic stroke patients is significantly associated with in-hospital medical complications in China.

Objective To investigate effect of global nursing care on rehabilitation effect of gynecologic cancer patients receiving laparoscopic surgery.Methods 115 cases of laparoscopic surgery in gynecologic cancer patients were randomly divided into two groups.the intervention group is 58 and the control group 57.Two groups with the laparoscopic surgery received a same routine care,in the intervention group patients received an intervention care consisted of cognitive behavioral intervention before surgery,postoperative pain,intervention and follow-up intervention after discharge as one of the whole individual nursing intervention model;In the control patients received traditional routine care before and after laparoscopic surgery.Intervention effects were observed in two groups.Results The intervention group at different times after the pain visual analogue scale (VAS) was significantly lower than the control group.72 h VAS in intervention group was ( 1.35 ±1.02),and was (2.76 ± 1.20) in control group,and the difference was significant ( t =6.79,P ＜ 0.01 ) ;days in hospital in intervention group was (7.15 ±2.15)d and (9.89 ±2.18) in control group,and the difference was significant ( t =6.79,P ＜ 0.01 ) ; The recurrence rate in intervention group ( 1.72％ ) was significantly lower than the control group ( 14.03％ ),and the difference was significant ( x2 =4.45,P ＜0.05).Conclusions Whole course of individualized nursing intervention care has promoted rehabilitation,increased the postoperative quality of life and improve the effect of laparoscopic surgery of patients.

OBJECTIVETo study the value of bone marrow biopsy imprint in evaluating cellularity.

METHODSThe bone marrow tissues were obtained by trephine biopsy from 272 patients, and then put on the slides to make the imprints. The imprints was stained by Wright-Giemsa method, and the bone marrow smears and imprints were examined simultaneously according to the bone marrow cellularity criteria.

RESULTIn bone marrow cellularity, four grades (distinct decrease, extreme decrease, distinct increase, and extreme increase) were significantly higher in bone marrow imprints than those in bone marrow smears (P <0.05), but there was no significantly differences between bone marrow imprints and sections (P >0.05). Using bone marrow sections as standard, in cellularily decreasing samples, the consistent rate of bone marrow imprints and smears were both high (84.4% and 97.9%), in the group of the normal and increased cellularity, the consistent rate of the bone marrow imprints (84.4% and 97.7%) was significantly higher than that in smears (60% and 64%, P<0.01). The sensitivity, specificity, Youden index, positive predictive value and positive likelihood rate of bone marrow imprints were all higher than those of the smears. Using the bone marrow sections as gold standard, in 124 cases with decreased cellularity in smears, the positive diagnosis rate for aplastic anemia and dyshaematopoiesis based on bone marrow imprints was 37.1% with a false positive rate of 7.3% which was lower than that of the bone marrow smears (false positive rate of 29.8%, P<0.01).

CONCLUSIONTo evaluate bone marrow cellularity, bone marrow imprint is better than bone marrow smear. The combination of the two examinations can make the diagnosis more convenient and quicker.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle ; Bone Marrow Examination ; methods ; Cell Count ; Child ; Female ; Humans ; Leukemia ; pathology ; Lymphoma ; pathology ; Male ; Middle Aged ; Sensitivity and Specificity

Objective To investigate the therapies choice of paraclinoid carotid micro-aneurysm.Methods Eighteen patients suffered from paraclinoid carotid microaneurysm,definitely diagnosed by clinical measures and images,were chosen in our study; their clinical data were retrospective analyzed; among them,4 cases suffered from carotid ophthalmic aneurysms,including 3 accepted endovascular treatment and 1 microsurgical clipping; 10 cases suffered from internal carotid artery posterior communicating artery aneurysm,and 3 of them got endovascular treatment and 1 microsurgical clipping; 3 cases had anterior choroidal artery aneurysm of internal carotid artery,including 1 received endovascular treatment and 2 microsurgical clipping; and one was diagnosed as having internal carotid artery bifurcation aneurysms and clipping was performed.Results One patient suffered from carotid ophthalmic aneurysm died from re-rupture after endovascular treatment.One patient suffered from internal carotid artery posterior communicating artery aneurysm died from re-rupture after stent assisted coil embolization.One suffered from internal carotid artery posterior communicating artery aneurysm got good recovery (a spring ring escaped when taking coil embolization of aneurysm,and microsurgical clipping was then performed).Others got well.Conclusion Micro-aneurysms located in supraclinoid intemal carotid arteries and ophthalmic artery can be performed stent assisted loose coil embolization,and others can be preferred craniotomy operation to clip the neck of aneurysms.

OBJECTIVETo investigate the effects of surgical treatment and prognosis of aneurysmal bone cyst (ABC) in mobile spine.

METHODSA total of 12 patients with ABC were operated on from 1996 to 2006, and the clinical data were retrospectively reviewed. The patients included 7 male and 5 female, aged from 16 to 52 years (mean, 29 years). Surgical interventions were selected according to WBB criteria. Seven patients underwent total spondylectomy, four underwent resection of posterior arch, one patient received sagittal resection only. Anti-poster or post-lateral approach reconstruction with bone-graft or bone cement and transpedicular screws fixation were performed in the cases. Eight cases received radiotherapy after the operation.

RESULTSThe mean operation blood lose was 3210 ml. The patients were followed-up for 10 to 116 months (mean, 41.8 months). Seven patients got complete recover of spinal cord function, 4 patients experienced local recurrence in 1-2 years post operation. One patient died of multiple metastasis of chondrosarcoma after radiotherapy.

CONCLUSIONSABC in spine is an aggressive disease with high local recurrence rate. Enbloc if possible provides the best result, with excellent prognosis. Radiotherapy should be selected carefully.

Adolescent ; Adult ; Bone Cysts, Aneurysmal ; diagnostic imaging ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Radiography ; Retrospective Studies ; Spinal Diseases ; diagnostic imaging ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the bowel control of the anus-preserving operation for elderly patients over 75 years with low rectal cancer.

METHODSThirty-nine elderly patients over 75 years with low rectal carcinoma (4-7 cm from anal verge) were treated during the study period. The patients were divided into different groups according to the surgical procedures and anastomotic locations. The bowel control and patients satisfaction were compared.

RESULTSThe time of recovering normal defecation frequency was (9.8+/- 2.9) months. There were no differences in bowel control and anorectal manometric findings between the lower anastomosis group and super-lower anastomosis group, the lower anastomosis group and anorectal anastomosis group. The patients in anorectal anastomosis group displayed significantly better bowel control and anorectal manometric findings than those in the super-lower anastomosis group (P< 0.05). The time of recovering normal defecation frequency in colonic J-pouch-anal anastomosis group was (7.7+/- 1.7) months, shorter than (10.6+/- 2.8) months in direct anastomosis group (P< 0.01). The complication rate of I degree incontinence was 36.1%, but there was no difference between the two groups. The anorectal manometric findings were better in J-pouch-anal anastomosis group than those in direct anastomosis group (P< 0.05).

CONCLUSIONColonic J-pouch-anal anastomosis for lower rectal carcinoma can significantly improve the bowel control in a short term without increasing the complication rate.

Aged ; Aged, 80 and over ; Anal Canal ; surgery ; Anastomosis, Surgical ; Defecation ; Fecal Incontinence ; etiology ; Female ; Humans ; Male ; Postoperative Period ; Rectal Neoplasms ; physiopathology ; surgery