1.Analysis of factors affecting the success rate of microsperm extraction in patients with idiopathic non-obstructive azoospermia
Zixuan XUE ; Yangyi FANG ; Jiayuan PAN ; Zhigao HUANG ; Yanlin TANG ; Li ZHANG ; Haitao ZHANG ; Wenhao TANG ; Defeng LIU ; Jiaming MAO ; Haocheng LIN ; Lianming ZHAO ; Zhe ZHANG ; Kai HONG
Chinese Journal of Urology 2024;45(12):932-939
Objective:This study aims to investigate the determinants influencing the efficacy of microsurgical sperm retrieval in individuals diagnosed with idiopathic non-obstructive azoospermia (iNOA).Methods:A retrospective analysis was performed on the clinical data of 757 patients diagnosed with iNOA who underwent microsurgical sperm extraction at Peking University Third Hospital between January 2019 and December 2021. The median age of patients was 31(29, 33)years, and the duration of infertility was 3(2, 5)years. A total of 169 patients (22.3%) received preoperative pharmacological treatment with agents such as follicle-stimulating hormone, human chorionic gonadotropin, or aromatase inhibitors. Additionally, 327 patients (43.2%) underwent testicular biopsy (TESA) prior to surgery. Among these, 51 cases (15.9%) exhibited sperm presence on smear microscopy, while 57 cases (17.8%) demonstrated sperm presence on pathological examination. The pathological classifications of the biopsies included 102 cases (31.9%) of reduced spermatogenic function, 66 cases (20.6%) of delayed sperm maturation, and 63 cases (19.7%) of sertoli cell-only syndrome.Preoperative median pituitary prolactin(PRL)was 9.1(6.5, 12.5)ng/ml, follicle-stimulating hormone (FSH)20.1(14.2, 28.5)U/L, luteinizing hormone (LH)7.9(5.5, 11.3)U/L, testosterone(T)117 .0(81.3, 154.0)nmol/L, estradiol(E2)8.7(6.3, 11.8)pmol/L. Under general anesthesia, patients underwent microsurgical testicular incision for sperm retrieval.The surgical testicular volume was measured at a median of 6(5, 10) ml. Among the cases studied, 59 patients (7.7%) underwent left testicular surgery, 213 patients (28.1%) underwent right testicular surgery, and 485 patients (64.0%) underwent bilateral testicular surgery. Furthermore, 44 patients (5.8%) underwent a second microsurgical sperm retrieval procedure, while 4 patients (0.5%) underwent a third procedure.Based on the presence of sperm identified during the surgical procedure, participants were categorized into a sperm retrieval group and a non-sperm retrieval group. Clinical data of these two groups were analyzed. A subgroup analysis was performed on the observed indicators. Both univariate and multivariate logistic regression analyses were employed to examine the factors influencing the micro sperm retrieval rate.Results:Among the 757 iNOA patients, 255(33.7%) obtained sperm through micro sperm retrieval, while 502(66.3%) did not obtain sperm through micro sperm retrieval. The age of sperm-receiving group was higher than that of the non-sperm-receiving group [32(30, 35)years vs. 30(28, 33)years, P<0.01], and the course of infertility was longer than that of the non-sperm-receiving group [3.0(2.0, 5.5)years vs. 3.0(2.0, 4.0)years, P=0.004]. There was no significant difference in the sperm acquisition rate in the subgroup with or without preoperative drug treatment [38.5%(65/169)vs. 32.7%(185/566), P=0.164]. There was statistical significance in the sperm collection rate of different TESA results in subgroups [85.7%(24/28)of sperm were detected by microscopic smear and pathological examination and 75.9%(22/29)of sperm were detected by pathological examination and no sperm were detected by microscopic smear and 17% of sperm were not detected by microscopic smear and pathological examination (42/247), P<0.01). The rate of spermatogenesis in the subgroup with low spermatogenic function was significantly higher than that in the subgroup with spermatogenic maturation retardation and sercell-only syndrome [47.1%(48/112), 12.1%(8/66)vs. 11.1%(7/63), P<0.01]. There was no significant difference in testicular volume between the seminal and non-seminal groups [6.0(5.0, 10.0)ml vs. 6.0(5.0, 9.5)ml, P=0.862]. Pituitary prolactin [8.3(5.8, 12.0)ng/ml vs. 9.3(7.5, 13.0)ng/ml, P=0.001] and FSH[18.3(11.8, 27.4)U/L vs. 20.7(15.2, 28.7)U/L, P=0.005] in spermated group were lower than those in non-spermated group. Luteinizing hormone [7.6(5.1, 11.0)U/L vs. 8.0(5.6, 11.5)U/L, P=0.126], testosterone [8.8(6.0, 11.8)nmol/L vs. 8.7(6.4, 11.7)nmol/L, P=0.607], estradiol [124.0(87.8, 156.0)nmol/L vs. 114.5(79.9, 151.3)nmol/L, P=0.105] had no significant difference. The recovery rate of the first operation was higher than that of the second operation [97.7%(43/44)vs. 81.8%(36/42), P=0.032]. The sperm retrieval rate of bilateral operation was significantly lower than that of unilateral operation [6.0% bilateral (29/485)vs. 86.4% left (51/59)vs. 82.2% right (175/213), P<0.01]. The proportion of no sperm on one side of bilateral operation and only 4.7%(23/485)on the opposite side were obtained. The results of multivariate analysis showed that >30 and ≤40 years old subgroup ( OR=2.226, 95% CI 1.364-3.632, P=0.001), >40 and ≤50 years old subgroup ( OR=4.282, 95% CI 1.457-12.588, P=0.008)was higher than that of >20 and ≤30 years old subgroup. The sperm acquisition rate of the sperm subgroup was significantly increased by smear microscopy and pathological examination ( OR=6.486, 95% Cl 1.444-29.127, P=0.015), while the sperm acquisition rate of the sperm subgroup was not significantly decreased by smear microscopy and pathological examination ( OR=0.420, 95% Cl 0.200-0.881, P=0.022). The pathological type of puncture was associated with lower spermatogenesis maturation block ( OR=0.099, 95% CI 0.019-0.509, P=0.006). Higher FSH (>7.6 U/L)was associated with lower sperm yield ( OR=0.324, 95% CI 0.122-0.856, P=0.023). Conclusions:Age, FSH level, results of testicular biopsy and pathologic type of biopsy are independent factors affecting the sperm retrieval rate of iNOA patients undergoing micro-TESE. The success rate of sperm retrieval diminished following multiple surgical procedures. Furthermore, for patients who did not have sperm successfully retrieved from one side, that the likelihood of sperm retrieval from contralateral surgery would also be low.
2.Retrospective study on the impact of penile corpus cavernosum injection test on pe-nile vascular function
Yan CHEN ; Kuangmeng LI ; Kai HONG ; Shudong ZHANG ; Jianxing CHENG ; Zhongjie ZHENG ; Wenhao TANG ; Lianming ZHAO ; Haitao ZHANG ; Hui JIANG ; Haocheng LIN
Journal of Peking University(Health Sciences) 2024;56(4):680-686
Objective:To investigate the impact of age,various hormonal levels,and biochemical markers on penile cavernous body vascular function in patients with erectile dysfunction(ED).Me-thods:A retrospective analysis of clinical data from male patients with ED who underwent color duplex Doppler ultrasonography(CDDU)and intracavernosal injection test(ICI)at the Reproductive Medicine Center of Peking University Third Hospital from January 2020 to August 2023.Data were managed and processed using SPSS 29.0,and a multivariable Logistic regression analysis was conducted.Results:A total of 700 ED patients were included,with 380 showing negative ICI results and 320 positive.In the study,84 patients had a peak systolic velocity(PSV)<25 cm/s,while 616 had PSV ≥ 25 cm/s;202 patients had end-diastolic velocity(EDV)>5 cm/s,and 498 had EDV ≤5 cm/s.264 patients had ab-normal PSV and/or EDV results,and 436 had normal results for both.Patients with vascular ED had sig-nificantly lower estrogen levels(t=-3.546,P<0.001),lower testosterone levels(t=-2.089,P=0.037),and a higher rate of hyperglycemia(x2=12.772,P=0.002)compared with those with non-vascular ED.The patients with arterial ED were older(t=3.953,P<0.001),had a higher rate of hyperglycemia(x2=9.518,P=0.009),and a higher estrogen/testosterone ratio(t=2.330,P=0.020)compared with those with non-arterial ED.The patients with mixed arteriovenous ED had higher age(t=3.567,P<0.001),lower testosterone levels(t=-2.288,P=0.022),a higher rate of hyperglycemia(x2=12.877,P=0.002),and a larger estrogen/testosterone ratio(t=2.096,P=0.037)compared with those with normal findings.Multifactorial Logistic regression analysis indicated that higher levels of estrogen were a protective factor for vascular ED(OR=1.009,95%CI:1.004-1.014),and glucose 7.0 mmol/L was a risk factor(OR=0.381,95%CI:0.219-0.661).Older age was a risk factor for arte-rial ED(OR=0.960,95%CI:0.938-0.982).Additionally,older age(OR=0.976,95%CI:0.958-0.993)and glucose levels of 5.6-6.9 mmol/L(OR=0.591,95%CI:0.399-0.876)were also risk fac-tors for mixed arterio-venous ED.Conclusion:Hyperglycemia and aging may impair penile cavernous body vascular function,while higher levels of estrogen may have a protective effect on it.
3.Analysis of factors affecting the success rate of microsperm extraction in patients with idiopathic non-obstructive azoospermia
Zixuan XUE ; Yangyi FANG ; Jiayuan PAN ; Zhigao HUANG ; Yanlin TANG ; Li ZHANG ; Haitao ZHANG ; Wenhao TANG ; Defeng LIU ; Jiaming MAO ; Haocheng LIN ; Lianming ZHAO ; Zhe ZHANG ; Kai HONG
Chinese Journal of Urology 2024;45(12):932-939
Objective:This study aims to investigate the determinants influencing the efficacy of microsurgical sperm retrieval in individuals diagnosed with idiopathic non-obstructive azoospermia (iNOA).Methods:A retrospective analysis was performed on the clinical data of 757 patients diagnosed with iNOA who underwent microsurgical sperm extraction at Peking University Third Hospital between January 2019 and December 2021. The median age of patients was 31(29, 33)years, and the duration of infertility was 3(2, 5)years. A total of 169 patients (22.3%) received preoperative pharmacological treatment with agents such as follicle-stimulating hormone, human chorionic gonadotropin, or aromatase inhibitors. Additionally, 327 patients (43.2%) underwent testicular biopsy (TESA) prior to surgery. Among these, 51 cases (15.9%) exhibited sperm presence on smear microscopy, while 57 cases (17.8%) demonstrated sperm presence on pathological examination. The pathological classifications of the biopsies included 102 cases (31.9%) of reduced spermatogenic function, 66 cases (20.6%) of delayed sperm maturation, and 63 cases (19.7%) of sertoli cell-only syndrome.Preoperative median pituitary prolactin(PRL)was 9.1(6.5, 12.5)ng/ml, follicle-stimulating hormone (FSH)20.1(14.2, 28.5)U/L, luteinizing hormone (LH)7.9(5.5, 11.3)U/L, testosterone(T)117 .0(81.3, 154.0)nmol/L, estradiol(E2)8.7(6.3, 11.8)pmol/L. Under general anesthesia, patients underwent microsurgical testicular incision for sperm retrieval.The surgical testicular volume was measured at a median of 6(5, 10) ml. Among the cases studied, 59 patients (7.7%) underwent left testicular surgery, 213 patients (28.1%) underwent right testicular surgery, and 485 patients (64.0%) underwent bilateral testicular surgery. Furthermore, 44 patients (5.8%) underwent a second microsurgical sperm retrieval procedure, while 4 patients (0.5%) underwent a third procedure.Based on the presence of sperm identified during the surgical procedure, participants were categorized into a sperm retrieval group and a non-sperm retrieval group. Clinical data of these two groups were analyzed. A subgroup analysis was performed on the observed indicators. Both univariate and multivariate logistic regression analyses were employed to examine the factors influencing the micro sperm retrieval rate.Results:Among the 757 iNOA patients, 255(33.7%) obtained sperm through micro sperm retrieval, while 502(66.3%) did not obtain sperm through micro sperm retrieval. The age of sperm-receiving group was higher than that of the non-sperm-receiving group [32(30, 35)years vs. 30(28, 33)years, P<0.01], and the course of infertility was longer than that of the non-sperm-receiving group [3.0(2.0, 5.5)years vs. 3.0(2.0, 4.0)years, P=0.004]. There was no significant difference in the sperm acquisition rate in the subgroup with or without preoperative drug treatment [38.5%(65/169)vs. 32.7%(185/566), P=0.164]. There was statistical significance in the sperm collection rate of different TESA results in subgroups [85.7%(24/28)of sperm were detected by microscopic smear and pathological examination and 75.9%(22/29)of sperm were detected by pathological examination and no sperm were detected by microscopic smear and 17% of sperm were not detected by microscopic smear and pathological examination (42/247), P<0.01). The rate of spermatogenesis in the subgroup with low spermatogenic function was significantly higher than that in the subgroup with spermatogenic maturation retardation and sercell-only syndrome [47.1%(48/112), 12.1%(8/66)vs. 11.1%(7/63), P<0.01]. There was no significant difference in testicular volume between the seminal and non-seminal groups [6.0(5.0, 10.0)ml vs. 6.0(5.0, 9.5)ml, P=0.862]. Pituitary prolactin [8.3(5.8, 12.0)ng/ml vs. 9.3(7.5, 13.0)ng/ml, P=0.001] and FSH[18.3(11.8, 27.4)U/L vs. 20.7(15.2, 28.7)U/L, P=0.005] in spermated group were lower than those in non-spermated group. Luteinizing hormone [7.6(5.1, 11.0)U/L vs. 8.0(5.6, 11.5)U/L, P=0.126], testosterone [8.8(6.0, 11.8)nmol/L vs. 8.7(6.4, 11.7)nmol/L, P=0.607], estradiol [124.0(87.8, 156.0)nmol/L vs. 114.5(79.9, 151.3)nmol/L, P=0.105] had no significant difference. The recovery rate of the first operation was higher than that of the second operation [97.7%(43/44)vs. 81.8%(36/42), P=0.032]. The sperm retrieval rate of bilateral operation was significantly lower than that of unilateral operation [6.0% bilateral (29/485)vs. 86.4% left (51/59)vs. 82.2% right (175/213), P<0.01]. The proportion of no sperm on one side of bilateral operation and only 4.7%(23/485)on the opposite side were obtained. The results of multivariate analysis showed that >30 and ≤40 years old subgroup ( OR=2.226, 95% CI 1.364-3.632, P=0.001), >40 and ≤50 years old subgroup ( OR=4.282, 95% CI 1.457-12.588, P=0.008)was higher than that of >20 and ≤30 years old subgroup. The sperm acquisition rate of the sperm subgroup was significantly increased by smear microscopy and pathological examination ( OR=6.486, 95% Cl 1.444-29.127, P=0.015), while the sperm acquisition rate of the sperm subgroup was not significantly decreased by smear microscopy and pathological examination ( OR=0.420, 95% Cl 0.200-0.881, P=0.022). The pathological type of puncture was associated with lower spermatogenesis maturation block ( OR=0.099, 95% CI 0.019-0.509, P=0.006). Higher FSH (>7.6 U/L)was associated with lower sperm yield ( OR=0.324, 95% CI 0.122-0.856, P=0.023). Conclusions:Age, FSH level, results of testicular biopsy and pathologic type of biopsy are independent factors affecting the sperm retrieval rate of iNOA patients undergoing micro-TESE. The success rate of sperm retrieval diminished following multiple surgical procedures. Furthermore, for patients who did not have sperm successfully retrieved from one side, that the likelihood of sperm retrieval from contralateral surgery would also be low.
4.Relationship between serum reproductive hormones and sperm parameters and surgical outcomes in Micro-TESE
Chenyao DENG ; Defeng LIU ; Wenhao TANG ; Lianming ZHAO ; Haocheng LIN ; Jiaming MAO ; Zhe ZHANG ; Yuzhuo YANG ; Haitao ZHANG ; Hui JIANG ; Kai HONG
Journal of Modern Urology 2023;28(12):1032-1037
【Objective】 To investigate the relationship between serum reproductive hormones and sperm parameters and outcomes of micro-testicular sperm extraction (Micro-TESE). 【Methods】 Clinical data of 1 091 patients treated in our hospital during Jan. and Dec.2021 were retrospectively analyzed. According to the sperm concentration,the patients were divided into non-obstructive azoospermia (NOA) group (group A,n=418),normal sperm concentration group (group B,n=615),mild to moderate oligospermia group (group C,n=18),severe oligospermia group (group D,n=18),and obstructive azoospermia group (group E,n=22). In group A,244 cases treated with Micro-TESE were grouped into the sperm-acquired group (Micro-TESE positive group,n=82) and non-sperm-acquired group (Micro-TESE negative group,n=162),and according to the pathological types of testicular tissue,the patients were divided into normal testicular tissue with hypospermatogenesis group (HYPO group,n=129),maturation arrest group (MA group,n=10),and support-only cell syndrome group (SCO group,n=122). Differences in semen parameters and reproductive hormone levels were compared,and relationship between reproductive hormones and sperm parameters and Micro-TESE outcomes was determined with Pearson correlation analysis. 【Results】 In the sperm concentration subgroup,the testicular volume of group A was lower than that of group B and group E (P<0.05); the levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in group A were the highest (P<0.05),but the level of testosterone (T) was the lowest (P<0.05); the levels of anti-mullerian hormone (AMH) and serum inhibin B (INHB) in group A were lower than those in group B and group E (P<0.05),the normal sperm morphology rate in group B was higher than that in group A and group E (P<0.05); the percentage of forward moving sperm in group B was the highest (P<0.05). Pearson correlation analysis revealed that sperm concentration,normal sperm morphology rate,and percentage of forward moving sperm were negatively correlated with age,FSH,LH (P<0.05),and positively correlated with testicular volume,T,AMH,and INHB (P<0.05). NOA patients were grouped according to testicular histology and pathology. The INHB in the SCO group was the smallest of the three groups (P<0.05); the FSH and LH levels in the SCO group were higher than those in the MA group (P<0.05),while the 17β-estradiol (E
5.Analysis of clinical outcome of asynchronous micro-TESE and ICSI in patients with non-obstructive aoospermia caused by AZFc deletion
Jiaming MAO ; Defeng LIU ; Lianming ZHAO ; Haocheng LIN ; Zhe ZHANG ; Yuzhuo YANG ; Haitao ZHANG ; Kai HONG ; Rong LI ; Hui JIANG
Chinese Journal of Reproduction and Contraception 2023;43(9):944-948
Objective:To evaluate the therapeutic effect of micro-dissection testicular extraction (micro-TESE) combined with intracytoplasmic sperm injection (ICSI) technology, and guide the clinical treatment of non-obstructive azoospermia (NOA) with azoospermia factor (AZF) c-region deletion.Methods:Through retrospective study, the clinical data of NOA patients with AZFc deletion were analyzed who underwent asynchronous micro-TESE in Reproductive Medicine Centre of Peking University Third Hospital from January 2015 to December 2019. The clinical outcomes of ICSI in patients who successfully obtained sperm were followed up, including fertilization rate, good-quality embryo rate, clinical pregnancy rate, abortion rate and live birth rate.Results:A total of 47 patients with NOA caused by AZFc deletion underwent asynchronous micro-TESE and 28 cases successfully found spermatozoa during the operation. The sperm retrieval rate (SRR) was 59.6% (28/47). Totally 25 cases cryopreserved testicular spermatozoa and 15 cases underwent thawed-sperm ICSI and 14 of them found enough spermatozoa for ICSI. Among the 28 patients who successfully found sperm during the first micro-TESE operation, 14 gave up the use of sperm and another 14 later used the thawed sperm for ICSI. A total of 14 cryopreserved sperm ICSI cycles were carried out, followed by 11 embryo transfer cycles. Only one patient successfully gave birth to one health boy. After that 11 patients underwent the second synchronous micro-TESE and spermatozoa were all successfully found during the operation. Eleven cycles used fresh sperm for ICSI followed by 11 embryo transfer cycles. Finally, 3 patients successfully gave birth to 1 boy and 2 girls.Conclusion:Patients of NOA caused by AZFc deletion have a high probability of successfully obtaining spermatozoa in testis through micro-TESE for ICSI to breed offspring with their own biological characteristics. For patients failed in the first asynchronous procedure, the second synchronous micro-TESE with fresh spermatozoa for ICSI can be considered to improve the utilization rate of sperm and the final live birth rate.
6.Analysis of clinical outcome of asynchronous micro-TESE and ICSI in patients with non-obstructive aoospermia caused by AZFc deletion
Jiaming MAO ; Defeng LIU ; Lianming ZHAO ; Haocheng LIN ; Zhe ZHANG ; Yuzhuo YANG ; Haitao ZHANG ; Kai HONG ; Rong LI ; Hui JIANG
Chinese Journal of Reproduction and Contraception 2023;43(9):944-948
Objective:To evaluate the therapeutic effect of micro-dissection testicular extraction (micro-TESE) combined with intracytoplasmic sperm injection (ICSI) technology, and guide the clinical treatment of non-obstructive azoospermia (NOA) with azoospermia factor (AZF) c-region deletion.Methods:Through retrospective study, the clinical data of NOA patients with AZFc deletion were analyzed who underwent asynchronous micro-TESE in Reproductive Medicine Centre of Peking University Third Hospital from January 2015 to December 2019. The clinical outcomes of ICSI in patients who successfully obtained sperm were followed up, including fertilization rate, good-quality embryo rate, clinical pregnancy rate, abortion rate and live birth rate.Results:A total of 47 patients with NOA caused by AZFc deletion underwent asynchronous micro-TESE and 28 cases successfully found spermatozoa during the operation. The sperm retrieval rate (SRR) was 59.6% (28/47). Totally 25 cases cryopreserved testicular spermatozoa and 15 cases underwent thawed-sperm ICSI and 14 of them found enough spermatozoa for ICSI. Among the 28 patients who successfully found sperm during the first micro-TESE operation, 14 gave up the use of sperm and another 14 later used the thawed sperm for ICSI. A total of 14 cryopreserved sperm ICSI cycles were carried out, followed by 11 embryo transfer cycles. Only one patient successfully gave birth to one health boy. After that 11 patients underwent the second synchronous micro-TESE and spermatozoa were all successfully found during the operation. Eleven cycles used fresh sperm for ICSI followed by 11 embryo transfer cycles. Finally, 3 patients successfully gave birth to 1 boy and 2 girls.Conclusion:Patients of NOA caused by AZFc deletion have a high probability of successfully obtaining spermatozoa in testis through micro-TESE for ICSI to breed offspring with their own biological characteristics. For patients failed in the first asynchronous procedure, the second synchronous micro-TESE with fresh spermatozoa for ICSI can be considered to improve the utilization rate of sperm and the final live birth rate.
7.Multifactor analysis of postoperative patency of microsurgical vasoepididymostomy
Shouyang WANG ; Kai HONG ; Yu TIAN ; Yichang HAO ; Lianming ZHAO ; Jiaming MAO ; Defeng LIU ; Haocheng LIN ; Wenhao TANG ; Hui JIANG ; Lulin MA ; Jie QIAO
Chinese Journal of Urology 2018;39(6):441-445
Objective To analyze the factors which may affect postoperative patency of microsurgical vasoepididymostomy (VE).Methods Ninety-four patients underwent VEs from September 2014 to June 2016 in the Department of Urology,Peking University Third Hospital,with average age of (30.7 ± 4.8) years,and body mass index (BMI) of (25.1 ± 3.0) kg/m2.Semen analyses were performed 1 month,3 months and 5 to 6 months after the operation.The following semen analyses were performed every 3-6 months thereafter.Patency was defined by finding sperms in twice or more analyses during the followup until August 2017.Patients were followed up by face-to-face or telephone interview.Seven factors (age,BMI,bilateral or unilateral anastomosis,anastomosis sites,the adjustment of anastomosis sites,motility and quantity of sperms found in epididymal fluid) were analyzed by Chi-square analysis and multifactor logistic regression analysis.Results Eighty-two patients were followed up (87.2%,82/94) while 12 patients were lost of follow-up.The mean follow-up time was 19 months.Sperms were found in the ejaculate in 59 patients postoperatively.The overall patency rate was 72.0% (59/82),and natural paternity rate was 32.8% (19/58).Patients ≤28 years old and those >28 years old had patency rates of 89.3% (25/28) and 63.0% (34/54,P =0.012),respectively.Patients with BMI <26.0 kg/m2 and BMI≥26.0 kg/m2 had patency rates of 80.4% (41/51) and 58.1% (18/31,P =0.029),respectively.Patency rate of bilateral surgery was 72.1% (44/61) and of unilateral surgery was 71.4% (44/62,P =0.727).Patency rate of caput anastomosis achieved 75.0% (15/20) and of corpus/caudal anastomosis was 71.0% (44/62,P =0.727).Patency rates of patients with and without adjustment of anastomosis sites were 77.8% (7/9) and 71.2% (52/73,P =0.680),respectively.Patency rates of a lot,a few,motile and seldom-motile sperms in epididymal fluid were 74.3% (55/74) vs.50.0% (4/8,P =0.146) and 70.0% (28/40) vs.73.8% (31/42,P =0.701),respectively.Multifactor logistic regression analysis showed that age was well associated with patency rate (OR=4.705,95%CI 1.181-18.742,P=0.028).Conclusions Age ≤28 years is an independent factor leading to higher patency rates.Patients with lower BMIs and younger could have higher patency rates.Factors of anastomosis sides,anastomosis sites,the adjustment of anastomosis sites,motility and quantity of sperms found in epididymal fluid showed no statistical difference in patency rates.
8.Outcome of treatment of Y chromosome AZFc microdeletion patients
Lianming ZHAO ; Hui JIANG ; Kai HONG ; Haocheng LIN ; Wenhao TANG ; Defeng LIU ; Jiaming MAO ; Yin LIAN ; Lulin MA
Journal of Peking University(Health Sciences) 2016;48(4):607-611
Objective:To discuss the treatment options for patients with azoospermia factor (AZF)c microdeletion on Y chromosome.Methods:One hundred and eighty three patients,who were diagnosed as AZFc microdeletion on Y chromosome in Peking University Third Hospital,were recruited in our stu-dy.In order to get better treatment option for this kind of patients,we retrospectively analyzed their clinic data including the treatment process and pregnancy outcome and found out the characteristics of their se-men.Results:Among the 183 patients,sperms can be found in ejaculated semen in 105 patients (57.4%,105 /183).One hundred and three patients (98.1%,103 /105)were diagnosed as severe or extremely severe oligospermia.Regular medication was given to 98 patients,6 patients (6.1%,6 /98) of which got natural pregnancy.The other 99 patients who have sperms in their semen received intracyto-plasmic sperm injection (ICSI),68 patients (68.7%,68 /99)of which got pregnancy.Seventy eight patients were diagnosed as azoospermia among all the 183 patients.Forty nine patients received testicular sperm aspiration (TESA),and 21 patients choose to receive micro-TESE directly.Among the 49 patients with TESA,sperms were retrieved in 17 patients (34.7%,17 /49),and sperms were not retrieved in 32 patients (65.3%,32 /49),of which 12 patients (37.5%,12 /32)gave up treatment and 20 patients (62.5%,20 /32)choose micro-TESE.Among the 41 patients who choose to receive micro-TESE,ope-ration has been done on 19 patients,of which 11 patients (57.9%,11 /19)got sperms.Among the 11 patients,TESA has been done on 6 patients before micro-TESE,of which 4 patients (66.6%,4 /6)got sperms.ICSI has already been done on 7 azoospermia AZFc microdeletion patients who underwent micro-TESE,of which 4 patients (57.1%,4 /7)get pregnancy.Conclusion:AZFc microdeletion patients who had sperms were always diagnosed as severe or extremely severe oligospermia.ICSI was their first choice instead of drug therapy.For AZFc microdeletion patients who were diagnosed as azoospermia, TESA was one of their choices,however,the success rate is not high.Micro-TESE is still possible to get sperms even after the failure of TESA.Therefore,we may choose micro-TESE instead of TESA in some azoospermia patients in order to reduce surgical trauma on patients.
9.Extraction, purification technology and antineoplastic effects of solamargine.
Zhaohui TANG ; Yan ZHANG ; Na LI ; Lianming XU ; Binjiang ZHAO ; Wei XIAO ; Zhenzhong WANG ; Yu'an BI
China Journal of Chinese Materia Medica 2011;36(16):2192-2195
OBJECTIVETo extract and purify of solamargine from Solanum nigrum, and to research its antineoplastic effects.
METHODS. nigrum was extracted refluently with 80% alcohol, solamargine was purified with silica gel column chromatography and recrystallization, and then conducted its structure identification and purity checks. Screened the effect on human tumor cell groth inhibition in vitro by MTT assay, and researched on the features in mice with H22 liver cancer or Ehrlich ascites tumor of solamargine.
RESULTThe concent of solamargine reached 97.9%. Solamargine had significantly inhibition on 6 tumor cells in vitro, and it had significantly inhibition on mice with H22 liver cancer or ehrlich ascites tumor in the 2.4 mg x kg(-1) dose of i.v.
CONCLUSIONSolamargine have the antineoplastic effect.
Animals ; Antineoplastic Agents, Phytogenic ; isolation & purification ; Cell Line, Tumor ; Female ; Humans ; Mice ; Mice, Inbred ICR ; Solanaceous Alkaloids ; isolation & purification ; pharmacology
10.Role of the IGF/HGF/Gln on the culture of the intestinal organoid in vitro
Dongnan HE ; Qin HAN ; Ning LI ; Lianming LIAO ; Weiming ZHU ; Baojun YU ; Gefei WANG ; Chunhua ZHAO ; Jieshou LI
Parenteral & Enteral Nutrition 2004;0(05):-
Objective: To investigate the nutritious effects of IGF, HGF and Gln on intestinal mucosal precursor cells in vitro.Methods: Different combinations of IGF,HGF and Gln were used to observe their effects on the expansion and development of the cultured intestinal mucosal precursor cells.Results: The combination of IGF,HGF and Gln could markedly promote the expansion of cultured intestinal mucosal precursor cells.Although IGF or HGF alone could promote the expansion of intestinal mucosal precursor cells, they had little effects on the development.On the contrary,Gln alone can promote the development of intestinal mucosal precursor cells,but it had little effects on their expansion.Conclusion: IGF,HGF or Gln alone has little effects on the expansion and development of the intestinal mucosal precursor cells.When they are used together,they can efficiently provide the essential stimuli for the expansion of the cultured intestinal mucosal precursor cells in vitro and enable the recombination of the different cells and formation of intestinal mucosa-like structure in vitro.

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