男性不育患者年龄与精子DNA碎片和精液常规参数的相关性分析

目的:分析男性不育患者年龄与精子DNA碎片率和精液常规参数的相关性.方法:按照年龄将85例男性不育患者分为三组.20～29岁组(n=31),30～ 35岁组(n=28),36 ～ 50组(n=26),采用染色质扩散(SCD)实验检测精子DNA碎片率,按照世界卫生组织标准检测精液常规各参数.采用SPSS 13.0软件包进行统计处理,分析精子DNA碎片率和精子参数在各组的差异及年龄与精子DNA碎片率和精液参数的相关性.结果:年龄与精子活力存在负相关关系(r=-2.31,P＜0.05),但与精子密度,精子形态和精子DNA碎片无相关性.精子密度与精子形态存在正相关关系(r=0.528,P＜0.01),与精子活力存在正相关关系,(r=0.31,P＜0.01).精子DNA碎片率与精液常规各参数无相关性.结论:随着男性年龄的增长,精子的活力可能降低,并影响男性的生育力,精子DFI与精液常规各参数无相关性.故精子DNA碎片检测可作为精液常规分析的补充,进一步反映男性的生育能力.     

不育症患者精子DNA碎片指数与精液参数关系分析

目的分析探讨男性不育症患者精子DNA碎片指数(DNA fragmentation index, DFI)与精液多项参数的相关性,以及精子DFI在评估男性生育力中的诊断价值。方法对146例不育症患者精液标本进行精液常规分析、精子形态学分析(Diff-Quik法)及DFI检测(精子染色质扩散法)。结果不育症患者精子DFI水平分为三组(A组:DFI≤15%;B组:15%DFI30%;C组:DFI≥30%)。A组与B组比较,年龄、精子存活率和前向运动(progressive,PR)比较有统计学意义(Z为-2.036,P0.05;-2.910、-3.155,P0.01);B组与C组比较,两组精子存活率和PR比较差异有统计学意义(Z分别为-4.602、-4.900,P0.01);其余各组及参数比较均无统计学意义(P0.05)。精子DFI与精子存活率、PR呈显著负相关(r分别为-0.558、-0.561,P0.01);与年龄、禁欲天数、精液体积、精子密度、正常形态精子百分率不存在相关性(P0.05)。结论精子DFI水平与精子存活率、前向运动精子百分率呈显著负相关;精子形态学和精子DNA碎片指数应作为评估精子结构和功能的常用实验室指标,指导临床药物干预和辅助生殖实验室技术开展。     

男性精子DNA碎片指数与精液参数的相关性分析

目的探讨男性不育症中精子DNA碎片指数(DFI)与常规精液参数的相关性。方法选取2018年4月至2019年10月天门市第一人民医院生殖医学科诊治的132例男性患者作为研究对象。检测精子DFI及常规精液参数,按DFI分为A组(DFI≤15%,44例)、B组(15%DFI25%,54例)、C组(DFI≥25%,34例)。比较三组精子总活力、前向运动精子率、精子存活率及精子浓度,分析DFI与各精液参数的相关性。结果 A组精子总活力、前向运动精子率和精子存活率分别为(55.55±13.01)%、(46.12±13.38)%和(84.84±7.25)%,B组分别为(45.89±17.67)%、(37.21±16.54)%和(80.13±8.99)%,C组分别为(33.33±20.32)%、(26.49±18.73)%和(73.17±12.04)%,三组间精子总活力、前向运动精子率、精子存活率比较,差异具有统计学意义(P0.01);精子浓度比较,差异无统计学意义(P0.05)。相关性分析结果显示,DFI与精子总活力、前向运动精子率、正常形态精子率及精子存活率呈显著负相关(r分别为-0.52、-0.50、-0.33、-0.53,均P0.001)。结论 DFI与精液参数存在中等以上相关性,在临床上可协同辅助评估男性精子质量。     

不育男性精子-透明质酸结合率与精液参数的相关性分析

目的分析不育男性精子-透明质酸结合率与精液参数的相关性。方法选取2017年10月至2018年12月广东省中医院生殖医学科诊治的162例男性不育患者作为研究对象。对这162例男性不育患者的精液参数进行回顾性分析,采用Spearman相关性分析分别分析精液常规参数、精子功能及精浆指标与精子-HA结合率间的相关性。结果精子顶体酶活性与精子-HA结合率呈正相关(r=0.253,P=0.017);精子核蛋白不成熟度与精子-HA结合率呈负相关(r=-0.601,P=0.007);精浆锌浓度与精子-HA结合率呈正相关性(r=0.351,P=0.049)。而精液常规参数、MAR阳性率、精子DNA碎片率、精浆α-葡糖苷酶、柠檬酸、果糖、弹性蛋白酶浓度与精子-HA结合率均无明显相关性,差异均无统计学意义(均P>0.05)。结论精子-HA结合率是反映精子成熟度及受精能力的重要指标,与其他精子不成熟度及功能指标有一定的相关性。     

麒麟丸联合维参锌胶囊治疗复发性流产史男性精子DNA损伤的临床观察

目的:探讨麒麟丸在男性不育患者精子DNA损伤中的保护作用。方法:选择66例合并有精子DNA完整性异常(DFI15%)的复发性流产史男性不育症患者,随机分为治疗组33例和对照组33例。治疗组口服麒麟丸联合维参锌胶囊;对照组单独服用维参锌胶囊,共3个月。于治疗前及治疗3个月末采用计算机辅助精子分析(CASA)系统与流式细胞仪分别检测精液常规参数和DFI。使用SPSS19.0统计软件对治疗前后各项精液参数及DFI进行数据分析。结果:治疗前治疗组与对照组的精子密度、精子活动率、前向运动精子百分比和DFI差异无统计学意义(P0.05)。治疗3个月后,治疗组精子活动率与对照组及治疗前相比有显著提高(P0.01);前向运动精子百分比与对照组及治疗前相比有显著提高(P0.01);精子密度比对照组及治疗前有显著提高(P0.05);DFI较对照组及治疗前显著下降(P0.05)。结论:应用麒麟丸联合维参锌胶囊治疗复发性流产史男性不育症患者,可以显著改善其精子活力与精子DNA完整性。     

精子DNA碎片指数与精液参数的相关性研究

目的：探讨男性精子DNA碎片与精液常规参数及精子顶体酶活性之间的关系。方法：收集生殖中心门诊553例男性患者精液标本,采用改良精子染色质扩散实验（SCD）检测精子DNA碎片指数（DFI）,按精子DFI结果分为DFI〈15%（I组）、15%≤DFI〈25%（II组）、DFI≥25%（III组）,同时检测精子密度、总数、（a＋b）级精子百分率、畸形率及顶体酶活性,对DFI与精液各项参数的相关性进行分析。结果：精子密度及精子总数与DFI无显著相关性;前向运动精子百分率随DFI升高逐渐降低,III组与I组间存在显著性差异;精子正常形态率随DFI的增加有下降的趋势,但是差异不显著;精子顶体酶活性随DFI升高而降低,组间均有显著性差异。结论：精子DNA碎片指数与前向精子百分率及精子顶体酶活性呈负相关。因此DFI可作为评估精子功能的一个较好的参考指标。     

精浆同型半胱氨酸与精子形态、DNA碎片指数在男性不育患者中的相关性研究

目的 研究精浆同型半胱氨酸(Hcy)与精子形态、DNA碎片指数(DFI)在男性不育患者中的相关性。方法 选取2019年6月至2022年6月三亚中心医院(海南省第三人民医院)诊治的105例男性不育患者作为研究对象,设为疾病组。另选取同期116例进行体检的有生育史且身体健康的男性作为对照组。根据精液参数将男性不育患者分为正常型组(n=28)、少弱精子症组(n=33)、少畸精子症组(n=23)、畸弱精子症组(n=21)。根据精子DNA完整性将男性不育患者分为DFI≤15%组(n=20)、15%相似文献   

肥胖对不育男性精子染色质结构、顶体功能及精液参数的影响

目的探讨肥胖对不育男性精子染色质结构、顶体功能与精液参数的影响。方法选取2017年1月至12月湘潭市中心医院生殖与遗传中心门诊诊治的363例不育男性患者作为研究对象。根据体重指数(BMI)分为正常体重组(n=135)、超重组(n=144)和肥胖组(n=84)。比较三组精液常规参数、正常形态精子率、精子DNA碎片指数(DFI)、色素酶A3(CMA3)阳性率、精子顶体酶活性及精浆生化参数(中性α-葡糖苷酶、果糖、柠檬酸、锌),并分析BMI与以上指标的相关性。结果与正常体重组相比,肥胖组前向运动精子率、正常形态精子率、顶体酶活性、精浆中性α-葡糖苷酶明显降低(P0.05),而CMA3阳性率、DFI显著升高(P0.05);超重组正常形态精子率、顶体酶活性均低于正常体重组,CMA3阳性率高于正常体重组(P0.05);BMI与前向运动精子率、正常形态精子率、精浆中性α-葡糖苷酶、顶体酶活性呈显著负相关(P0.05);BMI与CMA3阳性率、DFI呈显著正相关(P0.05)。结论肥胖能够引起不育男性患者精子活力、正常形态精子率、精子顶体酶活性的下降,造成精子染色质结构异常,是引起男性生育力降低的重要原因。     

不育男性年龄与精子核DNA碎片率及精液参数的相关性研究

目的:探讨不育男性年龄与精子核DNA碎片率及精液参数的关系。方法:选取于武汉大学人民医院生殖中心就诊的912名不育男性,按照年龄分组,分为三组:年龄20~29岁(A组)、年龄30~39岁(B组)、年龄≥40岁(C组),采用精子核染色体结构检测(SCSA)方法对三组912名男性精子核DNA碎片率(DFI)检测,同时按照WHO第五版标准进行精液常规分析;对年龄与精子核DNA碎片率、精子畸形率、精子密度和前向运动精子活率的关系进行分析。结果:精子浓度、精子畸形率与年龄无明显相关性,前向运动精子百分率与年龄有显著负相关关系,前向运动精子百分率随着年龄升高而显著降低,年龄与精子核DNA碎片率有显著正相关关系,精子核DNA碎片率随着年龄的增加而升高。结论:精子核DNA碎片率及精子前向运动精子百分率会受到年龄的影响,其生育力亦受到年龄的影响。     

精子DNA损伤与精液参数、胚胎发育及早期自然流产相关性分析

目的:探讨精子DNA完整性与精液参数、体外受精-胚胎移植(IVF-ET)/卵胞浆内单精子注射(ICSI)胚胎发育及早期自然流产的关系。方法:采用改良精子染色质扩散实验(SCD)检测1160个辅助生殖技术(ART)周期(899对夫妻)中精子DNA的完整性,以精子DNA碎片指数(DFI)为参数,将患者分为高DFI组(DFI≥25%)和低DFI组(DFI <25%),根据采用不同的体外受精方式将两组又分为IVF亚组和ICSI亚组,比较组间精液参数、受精率、卵裂率、可移植胚胎率、优胚率、临床妊娠率、早期流产率、分娩率。结果:精液参数(精液密度、精子活力、正常精子形态率)与DFI显著相关,差异具有统计学意义(P <0. 05),低DFI组中的IVF亚组的受精率、分娩率显著高于高DFI组,早期流产率显著低于高DFI组,差异具有统计学意义(P <0. 05),其余各亚组间的卵裂率、可移植胚胎率、优胚率、临床妊娠率均差异无统计学意义(P> 0. 05)。结论:精子DNA完整性与精液密度、精子活力、正常形态精子百分率呈负相关,对IVF的受精率、早期流产率和分娩率有显著影响,故建议在DFI≥25%时,优先考虑ICSI授精。同时建议将精子DNA完整性作为辅助生殖的常规精液指标。     

New fillers for the new man

ABSTRACT:  Two new collagen-based lidocaine-containing dermal fillers, ArteSense™/ArteFill™ (Artes Medical, San Diego, CA) and Evolence® (Colbar LifeScience Ltd., Herzliya, Israel), have proved to be of particular interest to men, many of whom seek a long-lasting or permanent correction. ArteFill™ has been available in the United States since 2006, and it is expected that Evolence® will reach the American market in 2008. The properties of the two products will be described, and experience based on the administration of many hundreds of syringes of both products by a Canadian dermatologist will be detailed here, with tips and precautions to optimize patient outcomes.     

Outcomes and adverse effects of ablative vs nonablative lasers for skin resurfacing: A systematic review of 1093 patients

It is generally believed that ablative laser therapies result in prolonged healing and greater adverse events when compared with nonablative lasers for skin resurfacing. To evaluate the efficacy of ablative laser use for skin resurfacing and adverse events as a consequence of treatment in comparison to other modalities, a PRISMA‐compliant systematic review (Systematic Review Registration Number: 204016) of twelve electronic databases was conducted for the terms “ablative laser” and “skin resurfacing” from March 2002 until July 2020. Studies included meta‐analyses, randomized control trials, cohort studies, and case reports to facilitate evaluation of the data. All articles were evaluated for bias. The search strategy produced 34 studies. Of 1093 patients included in the studies of interest, adverse events were reported in a total of 106 patients (9.7%). Higher rates of adverse events were described in nonablative therapies (12.2% ± 2.19%, 31 events) when compared with ablative therapy (8.28% ± 2.46%, 81 events). 147 patients (13.4%) reported no side effects, 68 (6.22%) reported expected, transient self‐resolving events, and five (0.046%) presented with hypertrophic scarring. Excluding transient events, ablative lasers had fewer complications overall when compared with nonablative lasers (2.56% ± 2.19% vs 7.48% ± 3.29%). This systematic review suggests ablative laser use for skin resurfacing is a safe and effective modality to treat a range of pathologies from photodamage and acne scars to hidradenitis suppurativa and posttraumatic scarring from basal cell carcinoma excision. Further studies are needed, but these results suggest that ablative lasers are a superior, safe, and effective modality to treat damaged skin.     

Genetic alterations in RAS‐regulated pathway in acral lentiginous melanoma

Studies integrating clinicopathological and genetic features have revealed distinct patterns of genomic aberrations in Melanoma. Distributions of BRAF or NRAS mutations and gains of several oncogenes differ among melanoma subgroups, while 9p21 deletions are found in all melanoma subtypes. In the study, status of genes involved in cell cycle progression and apoptosis was evaluated in a panel of 17 frozen primary acral melanomas. NRAS mutations were found in 17% of the tumors. In contrast, BRAF mutations were not found. Gains of AURKA gene (20q13.3) were detected in 37.5% of samples, gains of CCND1 gene (11q13) or TERT gene (5p15.33) in 31.2% and gains of NRAS gene (1p13.2) in 25%. Alterations in 9p21 were identified in 69% of tumors. Gains of 11q13 and 20q13 were mutually exclusive, and 1p13.2 gain was associated with 5p15.33. Our findings showed that alterations in RAS‐related pathways are present in 87.5% of acral lentiginous melanomas.     

Self‐resolving superficial primary cutaneous mucormycosis in a 7‐week‐old infant

A 7‐week‐old girl, born at 30 weeks' gestational age, presented to clinic for evaluation of a crop of vesicular lesions that were noted after removal of a bandage that had been in place for 4 days. A punch biopsy of the lesion revealed fungal elements that were later identified as Rhizopus spp. The lesion began to self‐resolve, and no further treatment was needed, with full resolution of the lesion by 1 month after presentation. Clinicians should be aware of the variable presentations of mucormycosis and consider fungal infection in the differential diagnosis when evaluating vulnerable patients with skin eruptions.     

Pathogenic role of IL-17 in psoriasis and psoriatic arthritis

Psoriasis is a chronic inflammatory skin disorder resulting from a complex network of cytokines and chemokines produced by various immune cell types and tissue cells. Emerging evidence suggests a central role of IL-17 and IL-23/T17 axis in the pathogenesis of psoriasis, giving a rationale for using IL-17-blocking agents as therapeutics.Three agents targeting IL-17 signaling are being studied in Phase III clinical trials: secukinumab and ixekizumab (IL-17 neutralizing agents), and brodalumab (IL-17 receptor antagonist). Preliminary results are highly promising for all anti-IL17 agents, creating fair expectations on this class of agents as the new effective therapeutic approach for the treatment of psoriasis.