Male infertility microsurgery represents the fastest growing sub-specialty in urology and clinical andrology over the past two decades. The importance of microsurgery for male infertility has risen as a part of the urologist's armamentarium in the medical and surgical management of male infertility. Despite the advances in male infertility microsurgery in China, the lack of standardized and well-organized training programs for male infertility microsurgery remains a serious problem affecting its development. In this article, Zhao and Peng have shared their experience with the learning curve of male infertility microsurgery at the Center for Male Reproductive Medicine and Microsurgery, Weill Medical College of Cornell University, which centers on how to pay attention to the details and basic principles of microsurgery. Male infertility microsurgery is physically, technically and mentally challenging, and must be first learned in the laboratory. Clinical success depends heavily upon appropriate training in a microsurgical laboratory. Good training can significantly reduce operation time and surgical errors as well as improve the quality of outcomes.
Andrology ; education ; Humans ; Infertility, Male ; surgery ; Male ; Microsurgery ; education

Adult ; Circumcision, Male ; Female ; Foreskin ; Humans ; Male ; Papillomaviridae ; Papillomavirus Infections ; etiology ; Retrospective Studies ; Sexual Partners

Clinical Laboratory Techniques ; standards ; Humans ; Male ; Quality Control ; Semen ; Sperm Count ; methods ; standards

HIV/STIs remain a major global public health problem. One of the global strategies for the prevention and control of HIV/STIs is to interrupt their transmission, which requires the public health methods based on scientific evidence and cost-effectiveness. The scale-up of male circumcision services in the priority countries of the HIV-prevention project in sub-Saharan Africa has been hampered by the scarcity of trained providers and relative technical difficulty of male circumcision techniques recommended by WHO and UNAIDS. Shang Ring is an innovative and disposable device for male circumcision, which has been safely used for over 600 000 males in China since 2006. Clinical studies of more than 3 000 cases of Shang Ring circumcision in China, Kenya, Zambia, and Uganda have demonstrated its safety, effectiveness, acceptability and ease of use. The most obvious advantages of Shang Ring include short procedure time (3-6 min), excellent postoperative cosmesis, low rate of complications, high acceptance by clients and providers, ease of use, and standardization for reliable performance. As an innovative technique, Shang Ring has a great potential for facilitating the safe and effective scale-up of circumcision services. This article comprehensively reviews the clinical studies of Shang Ring male circumcision in China and Africa.
Africa ; China ; Circumcision, Male ; instrumentation ; methods ; HIV Infections ; prevention & control ; Humans ; Male

OBJECTIVETo investigate the correlation between subjective assessment from clinician and patients and the objective measurement from active posterior rhinomanometry and acoustic rhinometry.

METHODSClinician and patients' assessment of nasal patency was achieved by visual analogue scale (VAS). Objective measurement included active posterior rhinomanometry and acoustic rhinometry. The mean of clinician's assessment and patients' VAS was compared by using paired-samples t-test. The correlation between unilateral nasal airflow resistance and unilateral nasal airway volume, unilateral minimal cross section area, and also subjective assessment and objective measurement of nasal patency were analysed by using Spearman correlation analysis in total patients.

RESULTSIn total of 316 patients, pre-decongestion and post-decongestion, unilateral nasal airflow resistance and unilateral nasal airway volume, unilateral minimal cross section area had significant negative correlation respectively (P = 0.000). The mean of clinician's assessment and patients' VAS had significant difference (P < 0.001) before and after decongestion. Clinician's assessment had significant positive correlation with patients' VAS, nasal airflow resistance, and significant negative correlation with nasal airway volume, minimal cross section area of nasal cavity before and after decongestion (P = 0.000). Patients' VAS had significant positive correlation with nasal airflow resistance, and significant negative correlation with nasal airway volume, minimal cross section area of nasal cavity before and after decongestion (P = 0.000). The correlation coefficients from clinician's assessment and objective measurements were greater than those from patients VAS and objective measurements.

CONCLUSIONSThe parameter of active posterior rhinomanometry had significant negative correlation with the parameters of acoustic rhinometry. Clinician assessment of nasal patency had significant positive correlation with patients' VAS; both of them had significant correlation with the parameters of rhinomanometry and acoustic rhinometry. Clinician's assessment was more objective and reliable to the parameters of objective measurement than patients' VAS.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Airway Resistance ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; physiopathology ; Nasal Obstruction ; diagnosis ; physiopathology ; Rhinometry, Acoustic ; Young Adult

Acquired Immunodeficiency Syndrome ; prevention & control ; China ; Circumcision, Male ; methods ; HIV Infections ; prevention & control ; Humans ; Male

Algorithms ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Humans ; Lung Neoplasms ; drug therapy

Human echinococcosis is a zoonotic larval cestode disease usually caused by Echinococcus granulosus or E. multilocularis. Infection is chronic taking years for symptoms to develop. Because diagnosis and treatment are difficult and reservoirs of infection are maintained in domestic livestock, dogs or wildlife, the disease is difficult to assess in terms of public health and requires long-term control interventions. Estimates of numbers of cystic echinococcosis cases that may occur in 2 large endemic zones, North Africa⁄Middle East and China⁄Central Asia, indicates > 423,000 and > 484,000 cases respectively. Globally, 3.6 million DALYs could be lost due to echinoccocosis. Echinococcosis is therefore a neglected disease which is under-reported and requires urgent attention in common with a number of other zoonoses in order to reduce morbidity and to help alleviate poverty in poor pastoral areas of the sub-tropics and temperate zones

Male circumcision can reduce men's risk of HIV infection from heterosexual intercourse by 60% and is therefore recommended as an important strategy for HIV prevention in Africa by WHO and UNAIDS. However, rapid expansion of male circumcision efforts could be greatly facilitated by a safer, more effective and acceptable male circumcision surgical technique or device. Shang Ring is a simple technique developed in China. It allows a circumcision to be completed with minimal bleeding, without suturing, and in only 3-5 min and reported complications are few. A standardized adult male circumcision surgical protocol utilizing the Shang Ring device was developed in 2008 in China. Several surgical training courses using this protocol were successfully held in 2009 and 2010 in China. A recent pilot clinical study of the Shang Ring was conducted to evaluate its safety and efficiency in Kenya in 2009. The results and acceptability among study participants were excellent and confirmed many of the advantages seen in the earlier Chinese studies from Wuhu, Ningbo and Xi'an, suggesting that the Shang Ring is safe for further studies in Africa, thus, could facilitate more rapid roll-out of adult male circumcision through task shifting, surgical efficiencies and better acceptability. Further international investigations of the Shang Ring technique have now been planned for Kenya and Zambia in 2011. Moreover, adult male circumcision utilizing the Shang Ring device is now being considered as ope of the potential candidate techniques to be used in the scale-up of adult male circumcision services for HIV prevention in WHO priority countries in Africa. This review article summarizes Shang Ring related clinical studies, seminars and surgical workshops, publications and presentations conducted between February 2008 and December 2010 in China, the United States and Africa.
Africa ; Circumcision, Male ; instrumentation ; methods ; HIV Infections ; prevention & control ; Humans ; Male

OBJECTIVESemen evaluation is the most important laboratory test for assessing male fertility. However, lack of strict quality control (QC) for semen analyses in hospital andrology laboratories makes it difficult and meaningless to compare semen data between different laboratories. This paper reports a comparative study on the accuracy of the Hemacytometer (Qiujing Inc., Shanghai, China), Makler (Sefi-Medical Instrument, Haifa, Israel), and Cell-VU (Millennium Sciences Inc., New York, USA) chambers for sperm counting.

METHODSBoth low [(18 +/- 2.5) x 10(6)/ml] and high [(35 +/- 5) x 10(6)/ml] pre-calibrated standard latex bead solutions (Hamilton Thorne Biosciences, USA) were used as the quality control solution to perform counts on the three different counting chambers. Bead counts for the three different chambers were compared, and variability within the chambers determined for standard solutions at low and high concentrations of latex beads, respectively.

RESULTSMean bead concentrations for the Cell-VU, Hemacytometer and Makler chambers were (37.63 +/- 4.89), (42.74 +/- 4.98) and (53.52 +/- 6.67) x 10(6)/ml respectively for a standard solution containing (35 +/- 5) x 10(6) beads/ml, and (18.22 +/- 1.77), (20.48 +/- 1.56), (24.97 +/- 4.75) x 10(6)/ml respectively for a standard solution containing (18 +/- 2.5) x 10(6) beads/ml. Mean bead concentrations for the Cell-VU chamber were consistently similar and close to the standard pre-calibrated bead solutions, while those for both the Hemacytometer and the Makler chambers were significantly overestimated (P < 0.001). The average coefficients of variation for the Cell-VU chamber were 7.51% for a higher concentration of the standard solution containing (36 +/- 5) x 10(6) beads/ml and 1.22% for a lower concentration of the standard solution containing (18 +/- 2.5) x 10(6) beads/ml, while the mean variation rates of the Hemacytometer and Makler chambers were 22.11% and 13.78% for a standard solution containing (36 +/- 5) x 10(6) beads/ml, and 52.91% and 38.72% for a standard solution containing (18 +/- 2.5) x 10(6) beads/ ml, respectively.

CONCLUSIONSemen analysis is one of the most important tests for male fertility evaluation, but the data obtained from commercially available counting chambers may differ markedly in accuracy and reliability. Results from this comparative study demonstrated that the Cell-VU chamber exhibits significantly more accurate and less variable results than those of the Hemacytometer and Makler chambers. To ensure the best possible evaluations and accurate diagnoses, we therefore recommend that Cell-VU be used as the standard counting chamber for routine semen analyses in andrology laboratories.

Blood Cell Count ; instrumentation ; Humans ; Male ; Quality Control ; Sperm Count ; instrumentation ; standards