还少胶囊对奥硝唑诱导的弱精子症模型大鼠生殖功能损伤的保护机制研究

目的:探讨还少胶囊对奥硝唑(ORN)诱导的弱精子症模型大鼠生殖功能损伤可能的保护机制。方法:将SD雄性大鼠随机分为4组,每组10只,分别是空白对照组、模型组、还少胶囊组和左卡尼汀组,除空白对照组外,其余3组采用ORN 400 mg/(kg·d)灌胃大鼠28 d,制成弱精子症大鼠模型。并同时连续给药28 d后,处死大鼠,检测大鼠附睾中左卡尼汀的含量,精子浓度、活率,附睾组织中有机阳离子转运子2(OCTN2)mRNA的表达,并观察大鼠睾丸组织病理结构。结果:还少胶囊组、阳性对照药左卡尼汀组与模型组相比,附睾左卡尼汀的含量均可明显提高(6 366.5、6 934.7 mg/L vs 2 880.3 mg/L,P<0.01);改善精子浓度[(46.19±14.23)、(42.25±6.11)×10~6/ml vs(34.58±10.25)×10~6/ml,P<0.01]、活率[(61.34±7.98)%、(61.34±7.98)%vs(42.59±7.54)%,P<0.01];上调附睾OCTN2 mRNA的表达量(27.26、27.15 vs 26.07,P<0.01);同时还少胶囊组能保护ORN造模导致的睾丸生精细胞的病理损伤,使生精细胞在生精小管形态、排列方式、生精细胞的活跃程度上与空白对照组更加接近。结论:还少胶囊对ORN诱导的弱精子症大鼠模型生殖功能损伤具有保护作用,能提高模型大鼠的精子浓度与活率,其机制可能与上调附睾OCTN2 mRNA的表达量、提高附睾左卡尼汀的含量有关。     

虾青素在奥硝唑致少弱精子症大鼠氧化损伤中的保护作用研究

目的:探讨虾青素(AST)对奥硝唑(ORN)致少弱精子症大鼠精子质量的改善作用及其机制。方法:40只成年雄性SD大鼠,随机分成5组,每组8只。分别为A组(溶剂对照组):0.5%羧甲基纤维素钠溶剂+1 ml玉米油、B组(ORN低剂量造模组):ORN 400 mg/(kg·d)、C组(ORN高剂量造模组):ORN 800 mg/(kg·d)、D组(ORN低剂量造模+AST治疗组):ORN 400 mg/(kg·d)+AST 20 mg/(kg·d)、E组(ORN高剂量造模+AST治疗组):ORN 800 mg/(kg·d)+AST 20 mg/(kg·d),灌胃3周后水合氯醛腹腔麻醉大鼠;取1侧附睾尾部检测精子浓度和活力,另1侧附睾组织匀浆,检测谷胱甘肽过氧化物酶(GSH-Px)、谷胱甘肽还原酶(GR)、过氧化氢酶(CAT)、超氧化物歧化酶(SOD)活性及丙二醛(MDA)含量。结果:与A组相比,B组附睾尾精子活力,附睾GSH-Px、SOD活性显著降低,MDA含量显著上升(P﹤0.05);C组附睾尾精子活力、浓度、睾丸系数,附睾组织GSH-Px、GR、CAT、SOD活性均显著降低,而MDA含量显著上升(P﹤0.05)。AST治疗组:与B组相比,D组附睾尾精子活力和附睾组织SOD活性显著增加[(45.3±8.7)%vs(66.3±8.9)%;(116.7±25.3)U/mg prot vs(146.1±23.8)U/mg prot,P﹤0.05],而MDA含量显著下降[(1.68±0.45)nmol/mg prot vs(1.19±0.42)nmol/mg prot,P﹤0.05];与C组相比,E组实验后体重增量、精子活力显著增加,而MDA含量显著下降[(89.0±9.5)%vs(99.9±4.1)%;(17.9±3.5)%vs(27.3±5.3)%;(2.03±0.30)nmol/mg prot vs(1.52±0.41)nmol/mg prot,P﹤0.05]。结论:AST可提高ORN致大鼠少弱精子症模型的精子质量,其机制可能是提高了大鼠附睾的抗氧化能力。     

基于L-肉碱通路探讨灵归方对弱精子症大鼠生殖系统保护作用的实验研究

目的:探讨灵归方对奥硝唑(ORN)所致弱精子症大鼠生殖系统保护作用及其可能机制。方法:将40只体重200～230 g的雄性SD大鼠随机将其分为空白组、模型组、灵归方组、左卡尼汀组各10只。模型组:予400 mg/kg ORN灌胃;灵归方组:予灵归方浓缩液,按17.5 g生药/kg体重+400 mg/kg ORN灌胃;左卡尼汀组:予左卡尼汀100 mg/kg+400 mg/kg ORN灌胃;空白组:予等量0.5%羧甲基纤维素钠(CMC2Na);均1次/d,连续灌胃4周后,检测各组大鼠精液质量、附睾中L-肉碱的含量,大鼠附睾OCTN2 mRNA的表达并观察睾丸组织病理。结果:与模型组相比,各组精子浓度无统计学差异(P0.05),前向运动精子(PR)和前向+非前向运动(NP)精子百分率均高于模型组,差异有统计学意义(P0.01)。与模型组相比,各组附睾的肉碱含量均提高,有统计学差异(P0.01)。灵归方组、左卡尼汀组OCTN2 mRNA表达量明显高于模型组,有统计学差异(P0.05)。睾丸病理观察结果发现,与空白组比较,模型组异常结构生精小管明显增多,排列不整齐,生精小管管腔缩小加重,管腔内精子及精子细胞数量减少,空腔型生精小管明显增多,生精小管内部各级生精细胞缺失,排列层次紊乱,上皮部分变性并出现空泡征;左卡尼汀组及灵归方组大鼠睾丸组织结构趋于正常,生精小管中各级生精细胞排列基本规整,生精小管结构基本正常。结论:①ORN可诱导大鼠产生弱精子症,且与降低附睾L-肉碱含量可能有关;②灵归方可以改善奥硝唑诱导的弱精子症大鼠精液活力;③灵归方可以改善ORN诱导睾丸的病理组织结构;④灵归方可以提高附睾中OCTN2 mRNA在附睾中的表达,其可能与提高附睾肉碱浓度有关。     

L-肉碱对奥硝唑所致弱精子症大鼠的治疗作用

目的:探讨L-肉碱(LC)对奥硝唑(ORN)所致的弱精子症雄性大鼠的治疗作用。方法:性成熟雄性SD大鼠(200～230g)40只,随机均分为5组,连续灌胃20d,1次/d,每次1ml。A组(对照组):0.5%的羧甲基纤维素钠(溶剂);B组:ORN[400mg/(kg.d)];C组:ORN[400mg/(kg.d)]+LC[100mg/(kg.d)];D组:ORN[800mg/(kg.d)];E组:ORN[800mg/(kg.d)]+LC[100mg/(kg.d)]。将各组半数大鼠末次给药24h后,麻醉处死,取附睾,进行精子活力检测,并对附睾尾精子进行计数,剩余大鼠进行交配实验。结果:①与A组相比,B组,D组附睾头和附睾尾精子活力显著降低(P<0.05);精子数目显著减少(P<0.05)。②与B组相比,C组精子活力明显升高(P<0.05),精子数目明显增多(P<0.05),与A组比较无显著差异(P>0.05)。③E组大鼠的精子活力没有显著的提高,精子数目无明显增多,并且与D组相比没有差别(P>0.05)。结论:LC治疗后能提高ORN所致弱精子症大鼠的精子活力,增加精子密度。     

硫辛酸对奥硝唑所致少弱精子症大鼠精子发生的保护作用研究

目的:研究硫辛酸(LA)对奥硝唑(ORN)所致少弱精子症模型雄性大鼠生精功能的保护作用。方法:取70只雄性SD大鼠,随机分成7组,每组10只,分别为:A组(溶剂对照组):1 ml 0.5%羧甲基纤维素钠(CMC-Na)+1 ml橄榄油;B组(低剂量ORN造模组):400 mg/kg ORN+1 ml橄榄油;C组(低剂量ORN+低剂量LA治疗组):400 mg/kg ORN+50 mg/kg LA;D组(低剂量ORN+高剂量LA治疗组):400 mg/kg ORN+100 mg/kg LA;E组(高剂量ORN造模组):800 mg/kg ORN+1 ml橄榄油;F组(高剂量ORN+低剂量LA治疗组):800 mg/kg ORN+50 mg/kg LA;G组(高剂量ORN+高剂量LA治疗组):800 mg/kg ORN+100 mg/kg LA。连续给药20 d,处死大鼠,称量大鼠体重、睾丸、附睾、精囊重量,计算脏器指数,检测附睾精子计数及活力,睾丸、附睾做HE染色观察组织形态学改变。结果:与A组相比,E组大鼠体重增量、睾丸、附睾脏器指数明显减少[(117.67±11.53)g vs(88.11±12.65)g;(1.06±0.12)%vs(0.65±0.13)%;(0.21±0.03)%vs(0.17±0.01)%,P均0.01];与E组相比,F组大鼠附睾脏器指数明显增加[(0.17±0.01)%vs(0.20±0.02)%,P0.01],G组大鼠体重增量、睾丸、附睾脏器指数明显增加[(88.11±12.65)g vs(102.70±16.10)g,P0.05;(0.65±0.13)%vs(0.95±0.06)%,P0.01;(0.17±0.01)%vs(0.19±0.02)%,P0.05],精囊脏器指数各组之间并无明显差异。与A组相比,B组大鼠精子活力明显降低[(74.12±8.73)%vs(40.25±6.08)%,P0.01],E组大鼠精子计数与活力明显降低[(38.59±6.40)×105/100 mg vs(18.67±4.59)×105/100 mg;(74.12±8.73)%vs(27.58±8.43)%,P均0.01];与B组相比,C、D组大鼠精子活力明显增加[(40.25±6.08)%vs(58.13±7.62)%;(40.25±6.08)%vs(76.04±8.44)%,P均0.01];与E组相比,F、G组大鼠精子计数及活力明显增加[(18.67±4.59)×10~5/100 mg vs(25.63±9.66)×10~5/100 mg,P0.05;(18.67±4.59)×10~5/100 mg vs(29.92±4.15)×10~5/100 mg,P0.01;(27.58±8.43)%vs(36.56±11.08)%,P0.05;(27.58±8.43)%vs(45.05±9.59)%,P0.01]。A、B、C、D组大鼠睾丸、附睾组织形态学无明显改变。E组大鼠睾丸与A组相比,生精小管腔内可见坏死脱落的生精细胞,生精细胞层次不清,排列紊乱;附睾管腔中精子数目明显减少,并伴有较多非细胞成分存在。F、G组大鼠睾丸生精小管内精子数目增加,但仍可见到生精小管内有生精细胞脱落,生精细胞层次不清晰,排列紊乱,但较E组有明显改善;F、G组大鼠附睾管腔中精子数目明显减少,可见散在、脱落的生精细胞,但较E组有明显改善。结论:LA能够改善ORN对大鼠造成的生殖系统损伤,提高精子质量,对生殖系统有较好的保护作用。     

CatSper1在精索静脉曲张模型大鼠精子中的差异表达及左卡尼汀对其的保护作用

目的:通过制备精索静脉曲张大鼠模型,检测其附睾精子中精子特异性钙通道(CatSper1)的表达,观察左卡尼汀对大鼠精子CatSper1的影响。方法:70只雄性大鼠随机分为7组,每组10只。分别为对照组(A组),精索静脉曲张组(B组),精索静脉曲张+生理盐水组(C组),精索静脉曲张+小、中、大剂量左卡尼汀组(D、E、F组)和F+延长喂养14 d组(G组)。手术结扎部分左肾静脉制备精索静脉曲张大鼠模型,12周后,C组给予生理盐水1 ml/d,D、E、F组分别用左卡尼汀小[0.05 g/(kg·d)]、中[0.1 g/(kg·d)]、大[0.2 g/(kg·d)]剂量灌胃35 d,G组在F组基础上延长灌胃14 d;实验结束后处死大鼠,进行精子参数分析,应用RT-PCR以及Western印迹分别检测精子中CatSper1 mRNA及蛋白表达情况。结果:与A组比较,B组a+b级精子百分率、精子活率及浓度均不同程度下降(P0.01),B组精子CatSper1 mRNA及蛋白相对表达量均明显下降(1.44±0.67 vs 0.71±0.38;1.87±0.67 vs 0.84±0.42,P0.01)。与C组比较,应用左卡尼汀后,各组精子浓度无明显增加, a+b级精子百分率、精子活率以及精子CatSper1 mRNA及蛋白表达含量明显增高,尤其大剂量组F、G组增高更加明显(P0.01)。与F组比较,G组延长应用2周左卡尼汀,精子CatSper1 mRNA及蛋白表达量无明显增加(P0.05)。结论:精索静脉曲张模型大鼠精子中CatSper1表达下降,应用左卡尼汀后,CatSper1的表达量及a+b级精子百分率、精子活率明显增加。     

强精胶囊对精索静脉曲张大鼠附睾氧化/抗氧化系统的影响

目的:观察强精胶囊对精索静脉曲张大鼠附睾氧化/抗氧化系统的影响,探讨其促进附睾精子成熟的可能作用机理。方法:100只青春期雄性SD大鼠,随机抽取10只为假手术组,其余90只以缩窄左肾静脉建立精索静脉曲张大鼠模型。术后4周证实有72只大鼠造模成功,并随机分为模型组、强精胶囊高剂量组、强精胶囊中剂量组、强精胶囊低剂量组、五子衍宗胶囊组和少腹逐瘀胶囊组,每组12只。分别给予生理盐水和不同浓度的强精胶囊(0.216、0.108、0.054 g/ml)、五子衍宗胶囊(0.130 g/ml)、少腹逐瘀胶囊(0.146 g/ml)混悬液按10 ml/kg灌胃,每日1次,共4周,检测大鼠左侧附睾谷胱甘肽过氧化物酶(GPx)活性与丙二醛(MDA)含量。结果:与假手术组比较,模型组GPx活性降低,MDA含量升高;强精胶囊高剂量组GPx活性、MDA含量较模型组、中、低剂量组、五子衍宗胶囊组、少腹逐瘀胶囊组差异有统计学意义(P<0.01,或P<0.05)。结论:精索静脉曲张可致大鼠附睾GPx活性降低,MDA含量升高;强精胶囊能一定程度提高GPx活性,降低MDA含量;并可能通过此环节,改善附睾微环境及其调控功能,促进精子成熟,提高生育力。     

强精胶囊对精索静脉曲张大鼠附睾功能性指标及精子质量的影响

目的:观察强精胶囊对精索静脉曲张大鼠附睾功能性指标及精子质量的影响.方法:100只青春期雄性SD大鼠,随机抽取10只为假手术组,90只缩窄左肾静脉建立精索静脉曲张模型,随机分为模型组、强精胶囊高中低剂量组、五子衍宗胶囊组和少腹逐瘀胶囊组.分别给予相应药物灌胃,观察大鼠附睾精子密度与活力的变化,检测附睾α-糖苷酶的含量(葡萄糖氧化酶法)和L-肉毒碱的含量(DTNB法).结果:模型组大鼠附睾精子活力与密度低下、α-糖苷酶与L-肉毒碱含量低下;强精胶囊高剂量组精子活力与密度、α-糖苷酶与L-肉毒碱含量较中、低剂量组、五子衍宗胶囊组、少腹逐瘀胶囊组明显增高(P<0.01).结论:强精胶囊可以改善模型大鼠精子密度与活力,提高附睾α-糖苷酶与L-肉毒碱的含量.     

五子衍宗丸对少弱精子症模型大鼠精子线粒体膜电位及超微结构影响

目的:研究五子衍宗丸对少弱精子症模型大鼠精子线粒体膜电位(MMP)水平及线粒体超微结构的影响。方法:取体重为200～220 g雄性SD大鼠60只,随机分成正常组,模型组,对照组(黄精赞育胶囊组),五子衍宗丸低、中、高剂量组,除正常组外,其他各组大鼠灌服雷公藤多苷[30 mg/(kg.d)],连续8周,制备少弱精子症模型。造模结束后,正常组、模型组给予等容量蒸馏水[10 ml/(kg.d)],对照组给予黄精赞育胶囊溶液[3.01 g/(kg.d)],五子衍宗丸各组分别给予水提液,低剂量组[2.30 g生药/(kg.d)],中剂量组[4.60 g生药/(kg.d)],高剂量组[9.20 g生药/(kg.d)],连续30 d。末次给药后30 min,采用荧光流式细胞技术(JC-1染色)测定精子MMP水平(JC-1+%),并通过透射电镜观察精子线粒体超微结构的改变。结果:①MMP:JC-1+%和强度分别为:正常组70.80±4.92、4 360±945;模型组33.77±6.19、1 4685±496;对照组56.34±10.35、3 277±895;五子衍宗丸低剂量组40.80±10.40、2 016±767;中剂量组59.40±6.51、3 897±643;高剂量组60.71±7.81、3 371±6467。造模各组大鼠精子线粒体JC-1+%及强度均明显下降,与正常组比较差异有显著性意义(P均<0.05);连续给药30 d后,给药各组均能明显提高精子MMP,增加JC-1+%,除低剂量组外,其他用药各组与模型组比较差异有显著性意义(P均<0.05)。②精子线粒体超微结构:雷公藤造模后,精子外膜松散、变性,线粒体肿胀、大小不一、线粒体膜不完整,轴丝结构不清或出现断裂。给予五子衍宗丸30 d后,精子外膜及线粒体膜结构完整,减少线粒体肿胀,轴丝及微管结构基本正常。结论:雷公藤多苷能降低精子MMP水平,破坏线粒体的结构。五子衍宗丸能明显提高少弱精子症模型大鼠精子MMP水平,减轻精子线粒体结构损伤。保护精子线粒体结构与功能的完整是五子衍宗丸治疗少弱精子症的机制之一。     

强精片对弱精子症SD大鼠MAPK通路的影响研究

目的:观察强精片对弱精子症SD大鼠精液质量及MAPK通路的影响。方法:选取100只SD大鼠,采用单纯随机抽样方法分为空白对照组、模型组、强精片高剂量组、强精片中剂量组、强精片低剂量组,每组20只。除空白对照组外各组大鼠皆予奥硝唑(ORN)200 mg/(kg·d)灌胃造模,空白对照组大鼠1%羧甲基纤维素钠溶液1ml/100g灌胃,高剂量组、中剂量组、低剂量组均在灌胃ORN的同时,予不同剂量强精片:6 700 mg/(kg·d)、3 300 mg/(kg·d)、1 700 mg/(kg·d),每周给药6 d,1次/d,连续20 d。实验结束后予电镜观察睾丸组织、细胞凋亡情况,采用S-P法测定睾丸波形蛋白表达,Western印迹测定大鼠睾丸ERK1/2表达,ELISA法检测精液中TGF-β1表达量测定。结果:(1)电镜结果显示模型组大鼠睾丸精母细胞,细胞核呈圆形,染色质分布均匀,胞浆内,线粒体的脊断裂或消失、严重肿胀,粗面内质网扩张;与模型组相比,高剂量组、中剂量组、低剂量组大鼠睾丸精母细胞,细胞核呈圆形,染色质分布均匀,胞浆内,线粒体,粗面内质网,核糖体等细胞器结构清晰,均与对照组类似。(2)空白对照组、模型组、高剂量组、中剂量组、低剂量组ERK1/2、波形蛋白相对表达量、睾丸组织细胞凋亡率(%)、精液TGF-β1表达量(ng/ml)分别为(1.00±0.00)、(1.26±0.10)、(1.14±0.08)、(1.18±0.05)、(1.19±0.19),(0.16±0.01)、(0.17±0.01)、(0.16±0.01)、(0.17±0.09)、(0.17±0.00),(9.20±3.07)、(42.20±9.17)、(21.60±5.94)、(33.95±6.39)、(40.85±5.61),(627.67±26.07)、(566.73±68.44)、(621.78±30.80)、(583.93±44.24)、(587.69±59.29)。模型组睾丸组织内ERK1/2、波形蛋白表达量高于对照组(P0.01),模型组大鼠睾丸组织凋亡阳性细胞率较对照组明显升高(P≤0.01),而精液中TGF-β1表达量低于空白对照组(P≤0.05);与模型组相比,高剂量组ERK1/2表达量、波形蛋白表达量均明显降低(P0.01),中剂量组ERK1/2表达量、波形蛋白表达量均降低(P0.05),高剂量组大鼠睾丸组织凋亡阳性细胞率明显降低(P≤0.01),中剂量组大鼠睾丸组织凋亡阳性细胞率降低(P≤0.05),而高剂量组精液中TGF-β1表达量明显高于模型组(P0.05)。结论:强精片可能是通过抗氧化应激改善弱精子症大鼠的精子质量。     

Body composition assessment and methodology in nonathletic and athletic adolescent and adult males and females

The purpose of this review is to outline methodology for assessing body composition utilizing anthropometric and densitometric techniques. The objective of body composition assessment is to measure body fat and lean body mass. The quantity of these components varies due to growth, physical activity, dietary regimens, and aging. Anthropometric techniques incorporate selected skinfolds, circumferences, skeletal widths, or other variables to estimate body composition within k2.0-4.0%. These techniques are adequate for field testing of groups or individuals, but are population specific. Densitometry measures body volume irrespective of physique, sex, or age. This laboratory technique estimates body composition within 1.0-2.0%, is more difficult to administer, but is not population specific. Some limitation exists with any present technique due to biological variability and incomplete research of reference body composition in children, females, and the aged. J Orthop Sports Phys Ther 1984;5(6):336-347.     

Perioperative and long-term morbidity and mortality after above-knee and below-knee amputations in diabetics and nondiabetics

We performed a retrospective review of a vascular surgery quality assurance database to evaluate the perioperative and long-term morbidity and mortality of above-knee amputations (AKA, n = 234) and below-knee amputations (BKA, n = 720) and to examine the effect of diabetes mellitus (DM) (181 of AKA and 606 of BKA patients). All patients in the database who had AKA or BKA from 1990 to May 2001 were included in the study. Perioperative 30-day cardiac morbidity and mortality and 3-yr and 10-yr mortality after AKA or BKA were assessed. The effect of DM on 30-day cardiac outcome was assessed by multivariate logistic regression and the effect on long-term survival was assessed by Cox regression analysis. The perioperative cardiac event rate (cardiac death or nonfatal myocardial infarction) was at least 6.8% after AKA and at most 3.6% after BKA. Median survival was significantly less after AKA (20 mo) than BKA (52 mo) (P < 0.001). DM was not a significant predictor of perioperative 30-day mortality (odds ratio, 0.76 [0.39-1.49]; P = 0.43) or 3-yr survival (Hazard ratio, 1.03 [0.86-1.24]; P = 0.72) but predicted 10-yr mortality (Hazard ratio, 1.34 [1.04-1.73]; P = 0.026). Significant predictors of the 30-day perioperative mortality were the site of amputation (odds ratio, 4.35 [2.56-7.14]; P < 0.001) and history of renal insufficiency (odds ratio, 2.15 [1.13-4.08]; P = 0.019). AKA should be triaged as a high-risk surgery while BKA is an intermediate-risk surgery. Long-term survival after AKA or BKA is poor, regardless of the presence of DM.     

Postoperative nausea and vomiting and opioid-induced nausea and vomiting: guidelines for prevention and treatment

Postoperative nausea and vomiting (PONV) causes patient discomfort, lowers patient satisfaction, and increases care requirements. Opioid-induced nausea and vomiting (OINV) may also occur if opioids are used to treat postoperative pain. These guidelines aim to provide recommendations for the prevention and treatment of both problems. A working group was established in accordance with the charter of the Sociedad Espa?ola de Anestesiología y Reanimación. The group undertook the critical appraisal of articles relevant to the management of PONV and OINV in adults and children early and late in the perioperative period. Discussions led to recommendations, summarized as follows: 1) Risk for PONV should be assessed in all patients undergoing surgery; 2 easy-to-use scales are useful for risk assessment: the Apfel scale for adults and the Eberhart scale for children. 2) Measures to reduce baseline risk should be used for adults at moderate or high risk and all children. 3) Pharmacologic prophylaxis with 1 drug is useful for patients at low risk (Apfel or Eberhart 1) who are to receive general anesthesia; patients with higher levels of risk should receive prophylaxis with 2 or more drugs and baseline risk should be reduced (multimodal approach). 4) Dexamethasone, droperidol, and ondansetron (or other setrons) have similar levels of efficacy; drug choice should be made based on individual patient factors. 5) The drug prescribed for treating PONV should preferably be different from the one used for prophylaxis; ondansetron is the most effective drug for treating PONV. 6) Risk for PONV should be assessed before discharge after outpatient surgery or on the ward for hospitalized patients; there is no evidence that late preventive strategies are effective. 7) The drug of choice for preventing OINV is droperidol.