OBJECTIVETo discuss how some pre-analysis processes influence the results of semen analysis and how to minimize their influence on the accuracy of laboratory results based on the concept of total quality management (TQM).

METHODSWe conducted semen quality analyses for 21 male volunteers, who had abstained from tobacco and alcohol for over 72 days for the purpose of fertilization, before and after the abstinence, and obtained their seminal parameters at 0.5, 1, 2 and 3 hours after semen sample collection.

RESULTSSperm concentration, sperm motility and the percentage of grade a + b sperm were significantly higher after the abstinence of tobacco and alcohol than before (P < 0.01). With the lengthening of post-ejaculation time, there was a significant decrease in sperm motility and the percentage of grade a + b sperm (P < 0.05), but not in sperm concentration (P > 0.05).

CONCLUSIONA lot of factors may affect the results of semen analysis, including the subjects' habits of drinking and smoking and the length of time after semen collection. Therefore, every procedure of semen analysis has to be dealt with very carefully so as to meet the requirements of TQM and achieve most reliable results for clinical use.

Adult ; Humans ; Male ; Quality Control ; Semen Analysis ; methods ; standards ; Smoking Cessation ; Sperm Count ; Sperm Motility ; Temperance

Objective: This study aimed to determine the effect of radiotherapy (RT) on the risk of herpes zoster (HZ) in patients with gynecological cancers via a nationwide population-based study. Methods: Based on patient data obtained from the National Health Insurance Research Database, 1928 gynecological cancer patients were identified with 1:1 matching for RT and non-RT cohorts by age, index date, and cancer type. Another cohort consisting of 964 noncancer individuals matched was used as normal control. The incidence of HZ was compared between cancer patients with and without RT. Age, comorbidities, cancer-related surgery and chemotherapy (CT), and cancer type were adjusted as confounders. Results: The risk of HZ in cancer patients was higher than that of non-cancer individuals (14.23 versus 8.34 per 1,000 person-years [PY], the adjusted hazard ratio [aHR]=1.38, p=0.044). In the cancer population, the incidence of HZ for the RT and non-RT cohorts was 20.55 versus 10.23 per 1,000 PY, respectively (aHR=1.68, p=0.009). Age >50 years was an independent factor for developing HZ. The 5-year actuarial incidence for patients receiving neither RT nor CT, RT alone, CT alone, and combined modalities was 5.4%, 6.9%, 3.7%, and 9.9%, respectively (p<0.001). In the RT cohort, the risk rose rapidly in the first year, becoming steady thereafter. Conclusion This population-based study showed that gynecological cancer patients receiving RT combined with CT had the highest cumulative risk of HZ. Health care professionals should be aware of the potential toxicities.

Acute cholecystitis and several gallbladder stone-related conditions, such as impacted common bile duct stones, cholangitis, and biliary pancreatitis, are common medical conditions in daily practice. An early cholecystectomy or drainage procedure with delayed cholecystectomy is the current standard of treatment based on published clinical guidelines. Cirrhosis is not only a condition of chronically impaired hepatic function but also has systemic effects in patients. In cirrhotic individuals, several predisposing factors, including changes in the bile acid composition, increased nucleation of bile, and decreased motility of the gallbladder, contribute to the formation of biliary stones and the possibility of symptomatic cholelithiasis, which is an indication for surgical treatment. In addition to these predisposing factors for cholelithiasis, systemic effects and local anatomic consequences related to cirrhosis lead to anesthesiologic risks and perioperative complications in cirrhotic patients. Therefore, the treatment of the aforementioned biliary conditions in cirrhotic patients has become a challenging issue. In this review, we focus on cholecystectomy for cirrhotic patients and summarize the surgical indications, risk stratification, surgical procedures, and surgical outcomes specific to cirrhotic patients with symptomatic cholelithiasis.

Acute cholecystitis and several gallbladder stone-related conditions, such as impacted common bile duct stones, cholangitis, and biliary pancreatitis, are common medical conditions in daily practice. An early cholecystectomy or drainage procedure with delayed cholecystectomy is the current standard of treatment based on published clinical guidelines. Cirrhosis is not only a condition of chronically impaired hepatic function but also has systemic effects in patients. In cirrhotic individuals, several predisposing factors, including changes in the bile acid composition, increased nucleation of bile, and decreased motility of the gallbladder, contribute to the formation of biliary stones and the possibility of symptomatic cholelithiasis, which is an indication for surgical treatment. In addition to these predisposing factors for cholelithiasis, systemic effects and local anatomic consequences related to cirrhosis lead to anesthesiologic risks and perioperative complications in cirrhotic patients. Therefore, the treatment of the aforementioned biliary conditions in cirrhotic patients has become a challenging issue. In this review, we focus on cholecystectomy for cirrhotic patients and summarize the surgical indications, risk stratification, surgical procedures, and surgical outcomes specific to cirrhotic patients with symptomatic cholelithiasis.

OBJECTIVETo study vertebral body stress distribution of normal disc, post-Diskectomy and artificial disk respectively by 3-D finite element methods, and to explore artificial intervertebral disk insertion impact on stress distribution of vertebral body.

METHODSModels of normal disk, post-Diskectomy, artificial disk and L(4 - 5) motion segment were established by using finite element software MSC. MARK, then vertebral body stress was analyzed through model of L(4 - 5) motion segment respectively.

RESULTSThe vertebral body's stress was the smallest after insertion of artificial intervertebral disk (AID), and its stress distributed equally. But the stress under post-discectomy was bigger than the normal disc's in all the motion state. On the other hand, the stress distribution state of the post-discectomy changed while the spine were in different motion state, during the spine flexion, the stress in the anterior of vertebral body was the biggest; While extension, in the posterior and in right flexion state, the biggest stress was in the right. While vertical compression and rotation, the stress distributed equally.

CONCLUSIONThe results illustrate that the vertebral body's stress is the smallest after insertion of AID in 3 groups of all motion state, and its stress distributes equally. But the level of vertebral body stress increases after discectomy comparing with the normal group. In generally, it is much more reasonable that the disc is reconstructed with AID because of the biomechanical effect on vertebral body made by AID insertion.

Diskectomy ; Finite Element Analysis ; Humans ; Intervertebral Disc ; physiology ; surgery ; Lumbar Vertebrae ; physiology ; surgery ; Models, Biological ; Prostheses and Implants ; Prosthesis Implantation ; Stress, Mechanical

OBJECTIVETo observe and compare perioperative myocardial enzyme changes in 107 patients with congenital (CHD, n = 53), rheumatic (RHD, n = 40) and coronary artery (CAD, n = 14) diseases, and to find whether different diseases can affect the release and recovery of myocardial enzymes after heart operations.

METHODSOn the day before operation and the 1st, 3rd, 5th and the 8th day after operation, the venous blood was taken to measure the release of myocardial enzymes: aspartate aminotransferase (AST), creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), lactate dehydrogenase (LDH) and LDH-1.

RESULTSAll the enzymes measured before operation in three groups were in the normal range; their release increased abruptly on the 1st day postoperatively to 2 - 15 times of those before operation; on the 3rd day, they recovered to some degrees, and on the 8th day they recovered to normal in all groups except LDH and LDH-1 in rh and CAD groups. Because the aortic cross-clamp time (CCT) had a good positive correlation to the release of myocardial enzymes, those patients whose CCT was over 60 minutes in three groups were compared revealing that the CCT was not different between three groups (P < 0.05). The release of CK, CK-MB and AST was significantly higher in CHD60 group than those in CHD60 and CAD60 groups, they recovered afterwards; while the release of DH and LDH-1 was higher in CAD60 group than those in CAD60 and in CHD60 groups from the 1st day to the 8th day postoperatively.

CONCLUSIONSThe release of all the 5 enzymes measured before operation was in normal range in selected CHD, RHD and CAD patients. The release peak and the recovery order of all enzymes were the same in three groups. The release of CK, CK-MB and AST was higher in CHD60 group than those in RHD60 and CAD60 groups on the 1st day. The release of LDH and LDH-1 was higher in RHD60 group than those in CHD60 and CAD60 groups from the 1st day to the 8th day postoperatively. The shorter the CCT is, the less the release of myocardial enzymes. Using the release of LDH and LDH-1 to evaluate the recovery of myocardial injury after open-heart operations was recommended.

Adolescent ; Adult ; Aspartate Aminotransferases ; blood ; Child ; Coronary Artery Bypass ; Coronary Artery Disease ; blood ; enzymology ; surgery ; Creatine Kinase ; blood ; Creatine Kinase, MB Form ; blood ; Female ; Heart Defects, Congenital ; blood ; enzymology ; surgery ; Humans ; Intraoperative Period ; Isoenzymes ; blood ; L-Lactate Dehydrogenase ; blood ; Male ; Middle Aged ; Myocardium ; enzymology ; pathology ; Rheumatic Heart Disease ; blood ; enzymology ; surgery ; Time Factors

OBJECTIVETo detect the level of fasting plasma homocysteine (Hcy) in patients with oligospermia and/or asthenospermia and to investigate its clinical significance.

METHODSSemen quality analyses and fasting plasma Hcy determination were performed for 86 infertility patients (21 with oligospermia, 32 with asthenospermia and 33 with oligo-asthenospermia) and 19 normal fertile volunteers. The results were compared.

RESULTSThe level of plasma Hcy was significantly higher in the infertility patients than in the normal controls (P < 0.05) and negatively correlated with sperm concentration (r = -0.433, P < 0.01), the percentage of grade a sperm (r = -0.303, P < 0.05) and the percentage of grade a+b sperm (r = -0.339, P < 0.01).

CONCLUSIONThe increased level of human plasma Hcy directly or indirectly affects spermatogenesis and correlates negatively with oligospermia and/or asthenospermia.

Adult ; Asthenozoospermia ; blood ; Case-Control Studies ; Homocysteine ; blood ; Humans ; Male ; Oligospermia ; blood ; Sperm Count ; Sperm Motility

OBJECTIVETo assess the differences between the main parameters obtained by sperm quality analyzer V (SQA-V) and computer-aided sperm analysis system (CASA), and to investigate their application to sperm quality analysis for fertile and infertile men.

METHODSTwelve fresh semen samples from fertile volunteers and 73 from infertility patients were detected with SQA-V and CASA for sperm concentration and motility, the percentage and concentration of motile sperm, sperm motility index (SMI), amplitude of lateral head displacement (ALH), beat cross frequency (BCF), curvilinear velocity (VCL), straight line velocity (VSL), average path velocity (VAP), linearity (LIN = VSL/VCL) and straightness (STR = VSL/VAP). The correlation between the parameters obtained by the two devices were analyzed.

RESULTSSignificant differences were observed in the above parameters between the fertile and infertile groups. An obvious consistency was noted between the results from SQA-V and those from CASA in sperm concentration (r = 0.58, P < 0.01), motile sperm concentration (r = 0.75, P < 0.01) and average sperm velocity (r = 0.59, P < 0.01). Significant correlations were found between the SMI from SQA-V and STR, LIN, BCF, VCL, VSL and VAP from CASA (P < 0.05).

CONCLUSIONThere is a consistency between the results from SQA-V and those from CASA. Both the devices can detect the seminal differences between different cohorts of patients.

Adult ; Diagnosis, Computer-Assisted ; Humans ; Infertility, Male ; diagnosis ; Male ; Semen Analysis ; methods ; Sperm Count ; Sperm Motility

OBJECTIVETo investigate the correlation of premature ejaculation (PE) with central lumber intervertebral disc herniation (CLIDH) and the pathogenesis of PE, and to search for a convenient, effective and non-invasive method for the treatment of PE.

METHODSA total of 263 selected PE patients underwent CT, and those that were found with CLIDH were randomized into a treatment group (n=180) and a control (n=60), the former treated by lumbar traction and the latter with sertraline hydrochloride tablets, both for 24 weeks. CIPE-5 scores of all the patients were analyzed, and the ejaculation latency and sexual satisfaction were recorded before and after the treatment.

RESULTSAmong the 263 PE patients, CLIDH was confirmed in 240 (91%). After the treatment, CIPE-5 scores, ejaculation latency and sexual satisfaction were markedly improved in the treatment group, with significant statistic difference from pre-treatment (P < 0.01). Significant differences were also observed between the treatment and the control groups after the treatment (P < 0.05), but not in the control group between pre- and post-treatment.

CONCLUSIONCLIDH may be one of the important causes of most "unexplainable" PE cases. And lumbar traction, non-invasive, highly effective and easily manipulable, has provided a new access to the diagnosis and treatment of the PE patients with CLIDH.

Adult ; Ejaculation ; Humans ; Intervertebral Disc Displacement ; complications ; surgery ; Lumbar Vertebrae ; Male ; Middle Aged ; Sexual Dysfunction, Physiological ; etiology ; therapy ; Traction

Animals ; Cytoskeletal Proteins ; biosynthesis ; genetics ; Drugs, Chinese Herbal ; pharmacology ; Hepatocytes ; metabolism ; ultrastructure ; Rats ; Rats, Sprague-Dawley