OBJECTIVETo analyze the embryo development potential after intracytoplasmic injection of sperm from azoospermia patients with different spermatogenic functions.

METHODSWe performed ICSI with sperm retrieved from azoospermia patients with different spermatogenic functions using percutaneous epididymal sperm aspiration (PESA) and testicular sperm aspiration (TESA). Then we recorded and analyzed the rates of normal fertilization, cleavages, excellent embryos and pregnancies.

RESULTSNo statistically significant differences were found between the PESA and TESA groups in the rates of normal fertilization ([74.9 +/- 19.6] vs [66.3 +/- 22.7]%, P > 0.05), cleavages ([96.7 +/- 8.6] vs [92.8 +/- 19.8]%, P > 0.05), excellent embryos ([43.5 +/- 26.2] vs [35.0 +/- 29.4]%, P > 0.05) and pregnancies (44.0 vs 52.0%, P > 0.05). The normal fertilization rates in the patients with normal spermatogenesis, mild spermatogenic dysfunction (SD), moderate SD and severe SD were (77.8 +/- 18.4), (68.4 +/- 18.5), (73.5 +/- 19.8) and (51.4 +/- 27.9)%, respectively, with significant difference between the normal spermatogenesis and mild SD groups (P < 0.05) as well as between the severe SD and the other groups (P < 0.05); the cleavage rates were (96.7 +/- 9.2), (96.5 +/- 15.0), (93.9 +/- 12.1) and (93.7 +/- 11.1)%, respectively, with no significant difference among the four groups; the excellent embryo rates were (47.1 +/- 25.8), (40.3 +/- 27.6), (36.2 +/- 23.1) and (15.0 +/- 24.6)%, respectively, with significant difference between the severe SD and the other groups; the pregnancy rates were 54.8, 50.0, 13.6 and 10.0%, respectively, with significant differences among the four groups (P < 0.001).

CONCLUSIONICSI by PESA or TESA is an effective approach to azoospermia. There are no significant differences between PESA and TESA in the rates of normal fertilization, cleavages, excellent embryos and pregnancies. The severity of spermatogenic dysfunction affects fertilization and initial development of embryos, which were shown in the rates of normal fertilization, excellent embryos and pregnancies but not that of cleavages.

Adult ; Azoospermia ; physiopathology ; therapy ; Embryonic Development ; Epididymis ; Female ; Humans ; Male ; Pregnancy ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Spermatogenesis ; Young Adult

BACKGROUNDFunctional neuroimaging study has opened an avenue for exploring the pathophysiology of cluster headache (CH). The aim of our study was to assess the changes in brain activity in CH patients by the regional homogeneity method using resting-state functional magnetic resonance imaging technique.

METHODSThe functional magnetic resonance imaging scans were obtained for 12 male CH patients with spontaneous right-sided headache attacks during "in attack" and "out of attack" periods and 12 age- and sex-matched normal controls. The data were analyzed to detect the altered brain activity by the regional homogeneity method using statistical parametric mapping software.

RESULTSAltered regional homogeneity was detected in the anterior cingulate cortex, the posterior cingulate cortex, the prefrontal cortex, insular cortex, and other brain regions involved in pain processing and modulation among different groups.

CONCLUSIONIt is referred that these brain regions with altered regional homogeneity might be related to the pain processing and modulation of CH.

Adult ; Case-Control Studies ; Cluster Headache ; physiopathology ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Young Adult

OBJECTIVETo investigate the relationship between cell apoptosis and the quality of early mouse embryos, understand the significance of apoptosis-regulatory genes in early embryonic development, and explore a new approach to improving the embryo quality.

METHODSThe levels of cell apoptosis and proliferation in early mouse embryos in different developmental status (morphologically normal embryos, arrested embryos and fragmented embryos) were analyzed with terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL), caspase in situ fluorescence and Bcl-2 immunofluorescence, and immunofluorescent detection of proliferating cell nuclear antigen (PCNA).

RESULTSThe cells in arrested embryos and embryonic fragments showed positive results in TUNEL assay with enhanced caspase activity and lowered expressions of Bcl-2 and PCNA.

CONCLUSIONCell apoptosis in early mouse embryos may be closely related to embryonic arrest and fragmentation.

Animals ; Apoptosis ; Caspases ; metabolism ; Embryo, Mammalian ; cytology ; Female ; Mice ; Mice, Inbred Strains ; Pregnancy ; Proliferating Cell Nuclear Antigen ; metabolism ; Proto-Oncogene Proteins ; metabolism ; Proto-Oncogene Proteins c-bcl-2

AIM:To investigate the role of microRNA (miR)-199a-5p in myocardial fibrosis and the potential target of miR-199a-5p.METHODS:C57BL/6 mouse cardiac fibroblasts were isolated and cultured for cellular experimen-tal study.Dual-luciferase reporter assay was performed to confirm the interaction between miR-199a-5p and the 3'-untrans-lated region (3'-UTR) of silent information regulator 1 (SIRT1).The expression of SIRT1 and fibrosis markers collagen (Col) 1a1, Col3a1 and α-smooth muscle actin (α-SMA) at mRNA and protein levels was determined by RT-qPCR and Western blot, respectively.RESULTS:The expression levels of miR-199a-5p, Col1a1, Col3a1 andα-SMA were marked-ly increased in cardiac fibroblasts after treatment with angiotensin Ⅱ(AngⅡ).The over-expression of miR-199a-5p signif-icantly increased the expression of Col1a1, Col3a1 andα-SMA in cardiac fibroblasts.Moreover, the results of dual-lucifer-ase reporter assay revealed that miR-199a-5p interacted with the 3'-UTR of SIRT1.miR-199a-5p inhibited SIRT1 expres-sion at post-transcriptional level.Meanwhile, miR-199a-5p mimic, in parallel to SIRT1 siRNA, inhibited SIRT1 expres-sion, increased the expression of Col1a1, Col3a1 and α-SMA in cardiac fibroblasts.Inactivation of NF-κB signaling con-tributed to the decrease in miR-199a-5p in Ang II-treated cardiac fibroblasts .CONCLUSION:SIRT1 is a target gene of miR-199a-5p, which mediates the pro-fibrotic effect of miR-199a-5p on cardiac fibroblasts .

A case report of pneumonia vaccination followed by death due to Guillain-Barré syndrome was fully presented and discussed. The association between the vaccination and Guillain-Barré syndrome could not be completely ruled out; however, the diagnosis of coincidental event was preferred, which may provide a reference for future similar case investigation.

OBJECTIVETo identify the differentially expressed proteins in seminal plasma between subjects with normal fertility and those with delayed semen liquefaction by proteomic techniques.

METHODSSemen samples of 6 patients with delayed semen liquefaction and 11 subjects with normal fertility (control group) were collected. Seminal plasma were separated and examined with surface-enhanced laser desorption/ionization time of flight mass spectrometry to compare the protein expressions between the two groups.

RESULTSCompared with normal control group, 19 proteins were differentially expressed in the patients including 6 proteins with significant differences between the two groups, with m/z of 8696.621, 9770.076, 9512.309, 10202.64, 2941.903, and 9617.759, respectively (P<0.01).

CONCLUSIONScreening of differentially expressed proteins in seminal plasma may help understand the mechanism of delayed semen liquefaction for its potential clinical intervention.

Adult ; Humans ; Infertility, Male ; metabolism ; Male ; Proteomics ; methods ; Semen ; chemistry ; Seminal Plasma Proteins ; analysis ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

OBJECTIVETo evaluate the clinical outcomes of intracytoplasmic sperm injection (ICSI) and conventional in vitro fertilization (IVF) using sibling oocytes for treatment of primary and secondary infertility.

METHODSA total of 149 cycles of IVF and ICSI were conducted between January, 2003 and December, 2008 in our center, including 98 cycles in patients with primary infertility and 51 in those with secondary infertility. According to the embryos derived from ICSI, IVF and their combination, the clinical pregnancy rate, delivery rate and birth defect of the 3 groups were analyzed.

RESULTSThe fertilization failure rate of IVF was significantly higher in primary infertility group than in secondary infertility group (10.2% vs 3.9%, P<0.05). No fertilization failure occurred in ICSI group. The fertilization rates and good quality embryo rates in ICSI group were significant higher than those in IVF group, and the abnormal fertilization rate was significantly lower in ICSI group (P<0.05). No significant difference were found in the implantation rates, clinical pregnancy rates, delivery rates or the rates of birth defects of the offsprings between IVF, ICSI and IVF+ICSI groups.

CONCLUSIONIVF combined with ICSI may result in increased fertilization rate and avoid total fertilization failure with favorable clinical outcomes in patients with long-term infertility, and ICSI may not increase the birth defects of the offspring in these patients.

Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; methods ; Humans ; Infertility, Female ; therapy ; Middle Aged ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; Treatment Outcome ; Young Adult

Objective:To evaluate the intervention effects of aquatic therapeutic exercise on functioning and quality of life for children and youth with cerebral palsy within framework of World Health Organization Family International Classifications using systematic review. Methods:Literatures were retrieved and reviewed from the databases of Cochrane Library, PEDro, PubMed, EMBASE, Web of Knowledge, Web of Science, OVID, EBSCO, CMCI, CNKI, Wangfang and VIP until May, 2020. The randomized controlled trials (RCTs) about aquatic therapeutic exercise for children and youth with cerebral palsy for functioning were systematically reviewed. The data were analyzed with RevMan 5.3. Results:Nine RCTs were selected, including 162 children and youth. The score of Gross Motor Function Measure improved significantly after aquatic exercise (WMD = 6.31, 95 %CI 2.57 to 10.06, P < 0.001), as well as daily activities and quality of life. Conclusion:Aquatic therapeutic exercise can help improve the gross motor function of children and youth with cerebral palsy, and has positive effects on function of activity and quality of life.

Traditional Chinese medicine(TCM) preparations in medical institutions are an important source of research and development(R&D) of TCM new drug. With years of usage in therapy, these preparations' safety and effectiveness have generally been validated in clinic. However, there are still a few disadvantages in TCM new medicine development, such as similar prescriptions, excessive prescription ingredients, too broad clinical orientation, lack of solid clinical data, issue in pharmaceutical quality control, and intellectual property disputes. Nowadays, the Three-Combined Evaluation System has strengthened policy support for the new TCM R&D. In order to improve the success rate of TCM R&D, due to the difficulties within, this paper proposes the process of transforming TCM preparations in medical institutions into new TCM and advocates the evaluation for druggability based on Human Use Experience(HUE). The potencial preparations ought to follow traditional Chinese Medical theory, sufficient HUE data in indication, syndrome type of TCM, target population, usage, dosage, and course of treatment are required. Particular attention should be paid to the source, evolution, and improvement process of prescription, and evaluate the dosage, ingredients, and herb resources of prescription. To assess the feasibility of mass production, it is necessary to determine whether the pharmaceutical process is mostly consistent with the new drug and whether the dosage form is reasonable. By summarizing the clinical application of the preparations, the whole picture of its clinical application would be reveal as much as possible. It is beneficial to evaluate its clinical value and R&D prospect. In consideration of the lack of clinical safety data of preparations, safety profile needs to be collected according to the prescription. The quality of clinical data needs to be evaluated by focusing on the integrity and accuracy of data to reduce bias and confusion. Significant care should be paid to intellectual property protection to avoid legal disputes.
Drugs, Chinese Herbal/therapeutic use* ; Humans ; Medicine, Chinese Traditional ; Prescriptions ; Quality Control ; Syndrome

Objective:To test the reliability and validity of World Health Organization Disability Assessment Schedule (WHODAS 2.0) for assessment of functioning for people with chronic diseases. Methods:From December, 2017 to June, 2018, 346 patients with chronic diseases who received rehabilitation interventions in Huadong Hospital-Jing'an District Rehabilitation Medical Association were selected and evaluated with WHODAS 2.0, and re-evaluated after two weeks. According to the actual use of clinical rehabilitation, in order to improve the accuracy of functional measurement, the items had been added in the second domain Getting Around including Handling, Moving and Manipulating Objects, while added in the third domain Self Care including Caring for Body Parts and Toileting, and added in the fourth domain Getting Along with People including Establishing Formal Social Interpersonal Relationship, with a total of 40 items. The content reliability and structural validity of the scale with four items added were verified by internal consistency reliability, test-retest reliability and confirmatory factor analysis. Results:The Cronbach's α coefficient of the internal consistency reliability was 0.981, the Pearson coefficient of the test-retest reliability was 0.977 (P < 0.001). The final model of the scale with confirmatory factor analysis had good structural validity: the standardized factor loads between potential variables and corresponding measurement indicators were 0.710-0.960, and the standard errors were 0.023-0.066; Chi square degrees of freedom < 5, root-mean-square error of approximation < 0.1, standardized root mean square residual < 0.08, the comparatice fit index, normal of fit index, relative fit index, incremental fit index and Tucker-Lewis index all > 0.9; the reliability coefficients of the observed variables were > 0.5, the combined reliability of each potential variable > 0.6, and all the average variance extraction of each potential variable > 0.5, all P < 0.001, absolute value of the standardized residual < 3, Modification Index < 4. There was significant difference in the total score and scores of domains among the patients with different diseases (F > 10.21, P < 0.001) Conclusion:WHODAS 2.0 can be used as an assessment tool for the overall health and functioning for people with chronic diseases. Each item, including four new items added, had good content reliability and structural validity.