Sperm DNA fragmentation index (DFI) refers to the percentage of DNA strand breaks in the total sperm. Many studies suggest that elevated DFI can lead to male infertility and early spontaneous abortion. High-DFI patients are more likely to fail in assisted reproduction and preliminary treatment or prevention methods have been developed for this population. This review focuses on the impact of DFI on clinical pregnancy outcomes and progress in the studies of its treatment.
Abortion, Spontaneous ; Chromatin ; DNA Fragmentation ; Female ; Humans ; Infertility, Male ; Male ; Pregnancy ; Pregnancy Outcome ; Sperm Injections, Intracytoplasmic ; Spermatozoa

Background and purpose:Nowadays, about therapy of laryngeal carcinoma, people are paying more and more widely attention to ifnding out how to improve quality of patients’ life besides radical surgery. For glottic laryngeal carcinoma which invading anterior commissure or bilateral vocal cord, we performed modiifed frontolateral partial laryngectomy or modiifed cricohyoidoepiglottopexy, and contrastive analyzed the therapeutic efifcacy of the two ways. Methods:Sixty cases patients of glottic laryngeal carcinoma who treated in Hunan Provincial Tumor Hospital during 2005 to 2010, which invaded the anterior commissure or bilateral vocal cord, were randomly attributed to two groups as A and B;30 patients of group A were underwent modiifed frontolateral partial laryngectomy and repaired with bilateral sternohyoid muscle lfap, 30 patients of group B were treated by modiifed cricohyoidoepiglottopexy. Follow-up time of each patient was 5 years postoperation and clinical data were retrospectively analyzed. Results:The 5-year survival rate was 86.7%in group A as well as 83.3%in group B, and there was no statistical difference between two groups (P=0.718). Pronunciation function:22 cases in group A and 21 cases in group B whose pronunciation function can be competent in the noisy environment, and can pronounce“a”and“i”vowel;8 cases in group A and 9 cases in group B can pronounce only a“ha”,“hi”sound, that couldn’t communicate with others in a noisy environment. There was no statistical difference in pronunciation function between the two groups (P=0.774). Incidence of deglutition disorder 4 weeks postoperation:group A was 0 (0/30), group B was 16.7%(5/30), and the difference between the two groups was statistically signiifcant (P=0.026);average time of extubation postoperation:group A was (10±2.3) d, group B was (20±4.6)d, and the difference between the two groups was statistically signiifcant (P=0.0000);recurrence rate of dyspnea after extubation:group A was 16.7%(5/30), group B was 0 (0/30), and there was statistically signiifcant difference between the two groups (P=0.026). Conclusion: For the glottic laryngeal carcinoma which invading anterior commissure or bilateral vocal cord, there was no statistical difference in 5-years survival rate and function of pronunciation between modified frontolateral partial laryngenctomy and modified cricohyoidoepiglottopexy postoperation. The former had less postoperative deglution disorder, earlier extubation time, and to some extent, alleviated the suffering of the patients, but part of these patients needed secondary surgery due to dyspnea which resulted by radioactive tissue adhesion after extubation. The latter had more serious deglution disorder postoperation, longer recovery time, and relatively longer time to extubating, showed no again dyspnea after extubation, and had more extensive adaptation disease. In a word, each way of operation has its advantage respectively.

OBJECTIVETo explore the procedures of dynamic infusion cavernosometry and cavernosography (DICC) and their application in the diagnosis and classification of venous erectile dysfunction (VED).

METHODSThis study included 103 ED patients, aged 20 to 43 years, highly suspected of VED, with disease courses of 4 months to 6 years. DICC was performed and analyses were made on the results, especially the parameters of flow-to-maintain (FTM) and pressure decay (PD) in the corpus cavernosum.

RESULTSBased on the parameters of FTM and PD, 21 of the patients were normal, 5 were suspected of VED, 39 had mild VED, 25 had moderate VED, and 13 had severe VED. Penile subcutaneous hematoma was found in 4 of the patients, all recovered after 3 to 5 days, with no other complications.

CONCLUSIONDICC is a reliable, safe and minimally invasive method for the diagnosis and classification of VED.

Diagnostic Techniques, Urological ; adverse effects ; Hematoma ; etiology ; Humans ; Impotence, Vasculogenic ; classification ; diagnosis ; Male ; Penile Diseases ; etiology ; Penis ; blood supply ; diagnostic imaging ; Radiography ; Veins

Adult ; Female ; Humans ; Male ; Middle Aged ; Otosclerosis ; surgery ; Stapes Surgery ; methods

Objective To establish a specific, sensitive and simple assay for the detection of Brugia malayi larva in Anopheles sinensis .Methods Using a new DNA purification technique (Microcon 100) and two pairs of oligonucleotide primers (p1, p2 and p3,p4) suitable for detecting B malayi in seven areas in our country, the mosquito vectors infected by B malayi were detected by polymerase chain reaction(PCR).Results This PCR method could amplify separately a 322 basepair(bp) and a 155 bp DNA fragment and detect as few as 1/64 of one L 1 in 1 mosquito,the detectable limit was nearly 4 pg DNA of filarial larvae, and it could also detect 1 infected mosquito with one L 3 of B malayi in pools of up to 200 mosquitoes. In contrast,no such specific 322 bp or 155 bp DNA band was detected in Dilofilaria immitis and normal mosquito.Conclusion This PCR techique established for supervision of mosquito vector in B malayi endemic areas is specific,sensitive,and simple.

Premature ejaculation (PE) is a most common male sexual dysfunction with complex pathogenesis. An increasing number of scholars agree that PE is a disorder associated with abnormal neurobiology, which involves the central neurotransmitter system, peripheral nerve function of the nerve tissue structure, and neurological biochemistry. This review focuses on the neurobiological mechanisms of PE, expecting to gain a deeper insight into the possible etiology, objective and reliable diagnostic methods, and individualized treatment of the disease.
Biochemical Phenomena ; Ejaculation ; Humans ; Male ; Neurotransmitter Agents ; physiology ; Peripheral Nervous System ; physiopathology ; Premature Ejaculation ; etiology

BackgroundIdiopathic epiretinal membranes(ERMs) is a common eye disease condition that leads to progressive decline of visual acuity. Studying the risk factors relating to this disease will shed light on its pathogenesis and allow opthalmologists to screen the affected individuals among the high-risk population and prepare for prevention and management strategies. ObjectiveThis survey was to investigate the risk factors of idiopathic ERMs in the population undergoing routine health check-ups. MethodsThe clinical data of idiopathic ERMs was obtained from the population of routine health check-ups in Peking Union Medical College Hospital from November 2009 to October 2010. The examination outcomes were compared between the individuals with and without idiopathic ERMs. The demographic and clinical factors associated with idiopathic ERMs were analyzed and assessed using univariate and multivariate logistic regression analyses. Result A total of 27 400 people were included in the survey and idiopathic ERMs were diagnosed in 76 cases. No obvious eye complaint was obtained from the idiopathic ERMs. The number of people affected with idiopathic ERMs was 12 ( 12/11 659 ) in the below 40 years group, 21 (21/4595) in the 51-60 years group and 32 (32/2544) in the over 60 years group. Hypertension, diabetes, diedyslipidemia, renal function insufficiency ,and cataract were found in 42％ ,5％ ,66％ ,6％ and 8％ of the patients, respectively. The univariate logistic regression analyses revealed that significant correlations were found between age,hypertension,hyperlipidemia and history of cataract( P＜0. 01 ). Multivariate regression models showed that the risk of idiopathic ERMs increased in age of 51-60( OR=2. 5,95％ CI:1. 2-5.4,P=0.02) and over 60 years( OR =7.3,95％ CI:3.4-15.6 ,P＜0.01 ) and patients suffering from hyperlipidemia ( OR--2. 1,95％ CI:1. 3-3.5, P＜0. 01 ). ConclusionsOver the age of 50 years and hyperlipidemia are primary risk factors of idiopathic ERM.

OBJECTIVE: To summarize the experience of improving survival rate of microsurgical free flap transfers for head and neck reconstruction. METHOD: One hundred and seventy-nine consecutive microsurgical free flap transfers performed in patients with head and neck region defects after surgical procedure due to carcinoma were reviewed. The microsurgical free flap survival rate and postoperative complication were evaluated. RESULT: The overall success rate of flap was 98.9%. The overall complication rate was 7.8%. The flap crisis rate was postoperative flap crisis incidence rate was 4.4%. The success rate of immediate surgical exploration within 6 hours successfully rescued the flap in were 6 six cases, and the other else two cases cut died flap and repaired the region defect in the head and neck with pectoralis major myocutaneous flap. CONCLUSION Key factors in improving the succeess rate are to guarantee vascular anastomosis patency, to achieve a good haemostasis, and to promptly closely observe discover blood vessel flap crisis after operation in the first 6 hours and immediate surgical exploration.
Anastomosis, Surgical ; Carcinoma ; surgery ; Female ; Free Tissue Flaps ; transplantation ; Head and Neck Neoplasms ; surgery ; Humans ; Image Processing, Computer-Assisted ; Male ; Postoperative Complications ; Survival Rate ; Thigh

OBJECTIVE: To review the clinical manifestations and management of nasal sinus mucoceles invaded the skull base and orbit. METHOD: Medical records for 30 patients of paranasal sinus mucoceles invaded the skull base and orbit were reviewed retrospectively. CT and MRI were important tools for diagnosing nasal sinus mucocele. The patients received endoscopic surgery to remove mucocele, some of them were operated auxiliary incision. Steroid therapies were given after the operations and routine examination with endoscopy were carried out during follow-up. RESULT: All cases were successfully performed surgery without complications after the surgeries, or the majority of symptoms. However, vision recovery was observed only in some patients. Recovery of vision depended on the timing of surgery and severity of initial visual loss. Delay treatment can seriously compromise the recovery of vision impairment. Moreover, the patients without light perception before surgery had poor visual recovery even when optic nerve decompressions were performed. CONCLUSION Endoscopic surgery has effect on nasal sinus mucocele with visual loss. Because visual recovery depends on prompt diagnosis and surgical intervention,a good understanding of the disease and prompt imaging studies are important.
Adult ; Aged ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mucocele ; pathology ; surgery ; Orbit ; pathology ; surgery ; Paranasal Sinus Diseases ; pathology ; surgery ; Retrospective Studies ; Skull Base ; pathology ; surgery ; Young Adult

OBJECTIVETo compare the effects and complications of subinguinal microscopic ligation, laparoscopic transperitoneal varicocelectomy, laparoscopic retroperitoneal varicocelectomy, open retroperitoneal high ligation, and interventional embolotherapy in the treatment of varicocele.

METHODSWe conducted a retrospective study that included 632 varicocele patients treated by subinguinal microscopic ligation (group A, n = 79), laparoscopic transperitoneal varicocelectomy (group B, n = 120), laparoscopic retroperitoneal varicocelectomy (group C, n =137), open retroperitoneal high ligation (group D, n = 283), and interventional embolotherapy (group E, n = 13). We compared the baseline and 3-month postoperative semen parameters, postoperative complications, and pregnancy rate among the five groups of patients.

RESULTSThe operation time was longer in groups A ([2.02 ± 1.25] h) and E ([2.17 ± 1.02] h) than in the other three groups, while the postoperative hospital stay was the shortest in group E ([1.1 ± 0.1] d). Intestinal injury or incision bleeding occurred intraoperatively in 2 cases in group B and 1 case in group E. Postoperative scrotal edema developed in 3.7, 17, 10, and 19% of the patients in groups A, B, C, and D, respectively, but not in group E. The rate of 1-year recurrence was the lowest in group A (1.6%) and highest in group E (22%). Sperm concentration and the percentages of progressively motile sperm and morphologically normal sperm were improved postoperatively in all the patients (P < 0. 05), but there were no statistically significant differences among the five groups either in the above three parameters or in the postoperative pregnancy rate (P > 0. 05).

CONCLUSIONIn the surgical treatment of varicocele, laparoscopic retroperitoneal approach involves short operation time and few complications, subinguinal microscopic ligation has the advantages of little injury, rapid recovery, and few complications but requires specialized microsurgical techniques, and interventional embolotherapy leaves no incision scar and needs only local anesthesia and 1-day postoperative hospital stay, which is uitable for those with a contraindication to anesthesia.

Embolization, Therapeutic ; adverse effects ; methods ; Female ; Humans ; Laparoscopy ; adverse effects ; methods ; Length of Stay ; Ligation ; adverse effects ; methods ; Male ; Operative Time ; Postoperative Complications ; Postoperative Hemorrhage ; Pregnancy ; Pregnancy Rate ; Recurrence ; Retroperitoneal Space ; Retrospective Studies ; Sperm Count ; Urogenital Surgical Procedures ; adverse effects ; Varicocele ; surgery ; Vascular Surgical Procedures ; adverse effects ; methods