Objective To compare clinical outcome of intracytoplasmic sperm injection(ICSI)cycle by using fresh and cryopreserved-thawed testicular and epididymal spermatozoa in azoospermic patients.Methods Between September 2006 and May 2007,208 azoospermic patients underwent in vitro fertilization(IVF)were treated in Center of Reproductive Medicine,Peking University Third Hospital.Those couples were divided into two groups based on their wishes,including 171 cases in fresh group and 37 cases in cryopreserved-thawed group.The cryopreserved testicular or epididymal spermatozoa were thawed and recovered before ICSI procedure iu thawed group.The outcomes of ICSI in each group were compared.including clinical outcomes(two pronuclear fertilization,high quality embryo,clinical pregnancy and embryo implantation)and pregnancy outcomes(spontaneous miscarriage,gestational weeks and neonatal birth weight).Results (1),The utilization rate were 92%(23/25)in cryopreserved-thawed testicular spermatozoa and 100%(12/12)in epididymal spermatozoa.(2)Between fresh and cryopreserved-thawed groups,no statistical difference was observed in two pronuclear fertilization rate[62.25%(973/1563)vs.64.53%(282/437),P=0.960],high quality embryo rate[78.9%(768/973)vs.79.1%(223/282),P=0.985],clinical pregnancy rate per embryo transfer[44.4%(60/135)vs.46.9%(15/32),P:0.688]and embryo implantation rate[29.3%(84/287)vs.33.3%(23/69),P=0.508].(3)No significant difference between flesh and cryopreserved group was found in spontaneous miscarriage rate (11%vs.7%,P＝1.000),gestational weeks(single birth:39.0 weeks vs.38.7 weeks,P:0.538;twins:36.8 weeks vs.36.3 weeks,P=0.571)and birth weight(single birth:3409 g vs.3350 g,P=0.699;twins:2584 g vs.2635 g,P=0.703).Conclusion It suggested that tissue from the azoospermic patients who underwent diagnostic testieular and epididymal biopsy should be eryopreseved for IVF-ET.

To investigate the changes in bcl-2, bax expression and neuron apoptosis in the hippocampus after the blockade of cervical lymphatics, the model of lymphostatic encephalopathy was established by occluding and removing both the superficial and deep cervical lymph nodes in rats. The animals were sacrificed at 1, 2, 3, 5, 7 and 14 d after operation. H and E staining was used to observe the structure of brain tissues and TUNEL staining was used to detect in situ cell apoptosis in the hippocampus. The expression of bcl-2 and bax in the hippocampus were examined by RT-PCR. The results showed that cerebroedema appeared at day 2 and was most serious at day 5 after the blockade of cervical lymphatics. The number of TUNEL positive cells began to increase at day 2 and reached the maximum at day 5. The expression of bax began to increase at day 1 and reached the maximum at day 2. The expression of bcl-2 began to decrease at day 1 and dropped to the minimum at day 5. The items mentioned above recovered to control level at day 14. These results suggest that lymphostatic encephalopathy following the blockade of cervical lymphatics result in changes in bcl-2 and bax expression in the hippocampus and that apoptosis is the main form of neuron death.
Animals ; Apoptosis ; physiology ; Female ; Hippocampus ; metabolism ; pathology ; Lymph Node Excision ; Lymphatic System ; physiology ; Male ; Neck ; Neurons ; cytology ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; bcl-2-Associated X Protein ; genetics ; metabolism

OBJECTIVETo explore the metabolism-related risk factors of cholelithiasis among residents in Beijing.

METHODSThe clinical data including previous disease history, findings of physical examination, and results of cholecystosonography of 2270 patients with cholelithiasis identified in the Health Screening Center of Peking Union Medical College Hospital between August 2007 and August 2010 were retrospectively reviewed (the case group). Meanwhile, 4336 healthy individuals during the same period were randomly chosen as the control group.

RESULTSTotal cholesterol, triglyceride, low-density lipoprotein cholesterol, fasting blood glucose, body mass index, and systolic blood pressure were positively correlated with the incidence of cholelithiasis (P < 0.05), while high-density lipoprotein cholesterol was negatively correlated (P < 0.05). Diastolic blood pressure showed no association with cholelithiasis (P > 0.05).

CONCLUSIONCholelithiasis is resulted from multiple factors including elevated blood lipids, blood glucose, and systolic blood pressure among residents in Beijing.

Adult ; Aged ; Blood Glucose ; Blood Pressure ; Case-Control Studies ; China ; epidemiology ; Cholelithiasis ; epidemiology ; metabolism ; Female ; Humans ; Lipids ; blood ; Male ; Middle Aged ; Risk Factors

OBJECTIVETo investigate the efficacy and safety of adefovir dipivoxil (ADV) in treating hepatic cirrhosis complicated with hepatitis B virus associated glomerulonephritis.

METHODSSix hepatic cirrhosis (Child-Pugh A grade, liver function compensated) patients complicated with hepatitis B virus associated glomerulonephritis diagnosed by renal biopsy, real time PCR and urinary protein tests were treated with ADV for one year in addition to a routine treatment. The dosage of ADV was 100mg daily.

RESULTSAfter 3 and 6 months treatment the negative conversion rates of HBV-DNA were 33.3% and 83.3%; the negative conversion rates of HBeAg were 16.7% and 66.7%; the positive conversion rates of HBeAb were both 16.7%; the recovery rates of ALT were 83.3% and 100.0%; and the recovery rates of TBil were 66.7% and 83.3% respectively. Protein in the urine of two patients was decreased to 0.3 g/d and in three patients it was 50% of the original values. After 1 year treatment the disease subsided fully in 3 and partially in 2 patients.

CONCLUSIONTreating hepatic cirrhosis complicated with hepatitis B virus associated glomerulonephritis using adefovir dipivoxil is effective and safe.

Adenine ; analogs & derivatives ; therapeutic use ; Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; Female ; Glomerulonephritis ; complications ; drug therapy ; virology ; Hepatitis B ; complications ; drug therapy ; Hepatitis B virus ; Humans ; Liver Cirrhosis ; complications ; drug therapy ; virology ; Male ; Middle Aged ; Organophosphonates ; therapeutic use ; Young Adult

OBJECTIVETo study the effect of Tadalafil combined with behavior therapy in helping obtain semen from infertile men in whom masturbation has failed.

METHODSSixty male infertile patients from whom masturbation had failed to obtain semen were equally assigned to receive Tadalafil combined with behavior therapy (combination group) or Tadalafil only (control group). All the patients took Tadalafil 20 mg orally the night before the day of semen collection by masturbation. Before this procedure, the patients of the combination group practiced masturbation 16 - 24 times at home.

RESULTSThe average ages of the patients were (37.0 +/- 5.1) yr and (37.5 +/- 5.2) yr and their IIEF-5 scores were 16.50 +/- 1.25 and 16.90 +/- 1.09 in the combination and the control group, respectively, neither with statistically significant difference between the two groups. Semen was successfully obtained from 9 patients (30.0%) of the combination group and 1 patient (3.33%) of the control group, with statistically significant difference between the two groups (chi2 = 7.680, P < 0.01).

CONCLUSIONBy training the patients and establishing a conditioned response to masturbation, Tadalafil combined with behavior therapy can significantly increase the success rate of semen collection from the male infertile patients in whom masturbation fails.

Adult ; Behavior Therapy ; Carbolines ; therapeutic use ; Humans ; Male ; Masturbation ; therapy ; Middle Aged ; Semen ; Tadalafil ; Treatment Failure ; Treatment Outcome

OBJECTIVEThis study was aimed to observe the efficacy of autologous stem cell transplantation (ASCT) for adult patients with acute lymphoblastic leukemia (ALL), and investigate related prognostic factors.

METHODSA total of 86 adult ALL patients underwent ASCT in Institute of Hematology and Blood Disease Hospital from November 2001 to January 2012 were followed up. Clinical characteristics and outcomes of all patients were retrospectively analyzed. Survival and univariate prognosis were analyzed by the Kaplan-Meier method and multivariate analysis by COX regression model.

RESULTSOutcomes were assessed in 81 cases, including 47 standard-risk and 34 high-risk patients. 1-, 3-, 5-, and 10-year leukemia-free survival (LFS) of standard-risk patients were (82.3±5.7)%, (76.9±6.5)%, (74.1±6.8)%, (67.4±8.9)% respectively,and relapse rates (RR) were as of (13.6±5.2)%, (21.6±6.4)%, (24.5±6.8)%, (31.3±9.0)% respectively. 1-, 3-, 5-, and 10-year LFS of high-risk patients were (55.8±8.9)%, (39.8±9.3)%, (39.8±9.3)%, (39.8±9.3)% respectively, and relapse rates (RR) were (38.8±9.2)%, (56.4±10.0)%, (56.4±10.0)%, (56.4±10.0)% respectively. T-ALL, white blood cell count(WBC) more than 30×109/L when first visited, increased LDH, positive fusion gene of TCR and bone marrow transplantation were the adverse prognostic factors. Multivariate analysis showed bone marrow transplantation was an independent adverse prognostic factor.

CONCLUSIONASCT was a choice for adult ALL patients when suitable donors were unavailable.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; therapy ; Prognosis ; Retrospective Studies ; Risk Factors ; Transplantation, Autologous ; Young Adult

Adult ; Carbolines ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Middle Aged ; Phosphodiesterase 5 Inhibitors ; therapeutic use ; Piperazines ; therapeutic use ; Purines ; therapeutic use ; Semen ; Sildenafil Citrate ; Specimen Handling ; Sulfones ; therapeutic use ; Tadalafil

OBJECTIVETo compare cell suspension examination with histopathology in detecting spermatozoa in the testicular tissue of non-obstructive azoospermia (NOA) patients, and to investigate the reliability of sperm retrieval and appropriate therapeutic options when the results of the two methods are inconsistent.

METHODSA total of 1 112 NOA patients underwent testicular sperm extraction (TESE), their testicular tissues subjected to cell suspension examination and histopathology, respectively.

RESULTSThe consistency rate of the two methods was 92.63%, with the sperm detection rate of 41.82% and non-sperm detection rate of 50.81%. Sperm were retrieved from 96.0% (24/25) of the patients on the day of oval retrieval, in whom sperm were found in cell suspension examination but not in histopathology. After intracytoplasmic sperm injection (ICSI), pregnancy was achieved in 8 cases (33.33%), abortion occurred in 4 (16.67%), and non-pregnancy in 12 (50.0%).

CONCLUSIONCell suspension examination combined with histopathology for detecting sperm in the testicular tissue of NOA patients gives instant, accurate, reliable and consistent results, and therefore insures successful sperm retrieval for NOA patients during the IVF cycle. In case of inconsistency between the results of the two methods, cell suspension examination is more helpful for clinical therapeutic option.

Adult ; Azoospermia ; pathology ; Biopsy ; Humans ; Male ; Middle Aged ; Sperm Count ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Spermatozoa ; pathology ; Suspensions ; Testis ; pathology ; Young Adult

OBJECTIVETo investigate the effects of simvastatin (Sim) and the interference by mevalonate (MVA) against its effect on DNA synthesis in rat cardiac fibroblasts (CFs).

METHODSCFs were isolated from neonatal SD rats by trypsin digestion and growth-arrested CFs were stimulated with Sim and/or MVA at varied concentrations for different time lengths, and the DNA synthesis in the cells was measured by (3)H-thymidine ((3)H-TdR) incorporation assay.

RESULTSSim decreased (3)H-TdR incorporation in the CFs in a concentration-dependent manner, and (3)H-TdR incorporation was significantly lower in cells treated with 1 x 10(-6) and 1 x 10(-5) mol/L Sim (1,175+/-202.66 and 771+/-164.86 cpm/2000 cells, respectively) than in the control cells (1,608+/-204.32 cpm/2000 cells, P<0.01). As the treatment time with 1 x 10(-5) mol/L Sim prolonged (for 6, 12, 18, 24, 36, 42, and 48 h), (3)H-TdR incorporation in CFs decreased gradually, showing an obvious inverse correlation with the treatment time (r=-919, P<0.01). (3)H-TdR incorporation in cells treated with 1 x 10(-6) to 1 x 10(-3) mol/L MVA and 1 x 10(-5) mol/L Sim rose steadily as MVA concentration increased. A significant difference in the incorporation was found between cells treated with both 1 x 10(-4)/1 x 10(-3) mol/L MVA and 1 x 10(-5) mol/L Sim (1,612+/-308.57 and 1,995+/-353.83 cpm/2000 cells, respectively) and the cells with 1 x 10(-5) mol/L Sim treatment alone (P<0.01); difference was also noted between cells treated with 1 x 10(-5) mol/L MVA and the control cells (P<0.05), but treatment with 1 x 10(-6) mol/L MVA did not produce much difference in comparison with the control cells (P>0.05) With the increase of treatment time (for 6, 12, 18, 24, 36, 42, 48 h), 1 x 10(-3) mol/L MVA caused steady increase in (3)H-TdR incorporation in the CFs, showing a significant positive correlation with the treatment time (r=0.968, P<0.01).

CONCLUSIONSim can decrease DNA synthesis in rat CFs and postpone the occurrence of myocardial fibrosis, which can be reversed by MVA.

Animals ; Animals, Newborn ; Cells, Cultured ; DNA ; biosynthesis ; Dose-Response Relationship, Drug ; Female ; Fibroblasts ; cytology ; drug effects ; metabolism ; Fibrosis ; prevention & control ; Hypolipidemic Agents ; pharmacology ; Male ; Mevalonic Acid ; pharmacology ; Myocardium ; metabolism ; pathology ; Myocytes, Cardiac ; cytology ; drug effects ; metabolism ; Rats ; Rats, Sprague-Dawley ; Simvastatin ; pharmacology ; Time Factors

BACKGROUNDRathke's cleft cyst (RCC) is one of the most common incidentally discovered sellar lesions, while symptomatic cases are relatively rare. Surgical treatment is recommended for symptomatic patients to drain the cyst content and to remove the capsule safely. The aim of this study was to clarify the clinical features, surgery considerations and therapy outcomes of symptomatic RCCs.

METHODSTotally 42 patients (19 males and 23 females) were retrospectively reviewed with the diagnosis of RCCs under surgery resection at the Affiliated Hospital of Medical College, Qingdao University between January 2005 and December 2010.

RESULTSPatients' age ranged from 6 to 67 years (mean of 41.6 years). The duration of symptoms ranged from 4 days to 10 years. Headache (69%), visual impairment (36%), and pituitary dysfunction (10%) were the most common presenting symptoms. The maximum diameter of cysts ranged from 6.0 to 46.7 mm (mean of 20.07 mm). Of the 42 patients, 36 underwent endonasal transsphenoidal approach and the others underwent transcranial approach. Thirty patients had a subtotal resection and decompression, while 12 patients had a total cyst resection. Cysts of 28 patients were lined by simple cubical or columnar epithelium, and cysts of 34 patients were filled by amorphous colloid material, that was the characteristic of RCCs. The majority of patients presented with a simple headache, and 93% of this group experienced a complete improvement after surgery. Twelve of 15 patients (80%) with preoperative visual deficits experienced an improvement in their vision after surgery. All of those patients with pituitary dysfunction experienced an improved endocrine status. The endocrinological complication usually was diabetes insipidus, and postoperative transient diabetes insipidus occurred in 13 (31%) patients without any permanent diabetes insipidus. The overall recurrence rate was 7% at a mean follow-up of 22 months (range 12 - 60 months).

CONCLUSIONSSurgical treatment is to drain the contents of the cyst and to remove the capsule as much as possible under the precondition that does not increase the complications. Biopsy and decompression procedures are recommended for most cases.

Adolescent ; Adult ; Aged ; Central Nervous System Cysts ; diagnosis ; pathology ; surgery ; Child ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult