精索静脉曲张对精子DNA完整率的影响

目的 观察不同程度及不同中医证型之间精索静脉曲张患者的精子DNA完整率.方法 试验前取生育前检查正常精液标本20例,测定精子DNA完整率做预实验,其数值拟做参考指标.将78例精索静脉曲张伴不育患者根据临床症状分为轻度、中度、重度.并根据其中医证型分为瘀血阻络组、肝肾亏虚组,湿热瘀阻组,然后,测定其精子DNA完整率,分别与正常精子DNA完整率做对比.结果 轻度、中度、重度精索静脉曲张组病人的精子DNA完整性与精液常规正常组比较有显著性差异(P<0.05);不同中医证型精索静脉曲张组间病人的精子DNA完整性差异不大(P>0.05).结论 精索静脉曲张能够造成精子DNA完整性的损伤,其损伤程度与精索静脉曲张严重程度有密切关系,与中医证型关系不明显.     

显微镜下精索静脉结扎对精子DNA完整性的影响

目的探讨显微镜下精索静脉结扎对精索静脉曲张(VC)患者精子DNA完整性的影响,为临床男性不育症的治疗提供理论依据。方法 40例健康对照组及62例VC组测定精子DNA碎片率(DFI),VC组62例患者行显微镜下精索静脉结扎术,术后3个月及6个月复查精子DFI,与术前比较。结果术前VC组和对照组的DFI平均水平分别为(30.42±8.57)%和(12.26±5.57)%,组间差异具有统计学意义(P0.01);VC组患者术后3个月和6个月DFI平均水平分别为(22.65±5.57)%和(17.65±5.48)%。结论 VC可导致患者精子DFI偏高,行显微镜下精索静脉结扎后患者的精子DFI水平较术前明显降低;VC的分度以及术前精液分析正常与否和VC患者的精子DFI无明显相关性。     

丹红通精方对双侧精索静脉曲张术后精子质量的疗效观察

目的:探讨不同程度的精索静脉曲张(VC)对精子质量的影响及丹红通精方对双侧VC患者术后精子质量的影响。方法:将68例双侧VC患者随机分为对照组和治疗组各34例。对照组采用显微镜下精索静脉结扎术,治疗组在显微镜下行精索静脉结扎术后予"丹红通精方"中药颗粒口服,治疗前和治疗后检查精液多参数分析、正常形态精子率、精子顶体酶定量、抑制素B(INHB)、精子DNA碎片指数(DFI)。结果:不同程度的VC治疗前精子浓度、前向运动精子百分率、顶体酶、DFI比较无统计学意义。治疗3个月后,两组患者的精子浓度、精子总数、精子总活力、前向运动精子百分率、精子顶体酶均较治疗前提高,DFI较治疗前下降,治疗组的INHB较治疗前提高,且在提高精子总数、前向运动精子百分率、顶体酶,降低DFI方面,治疗组疗效优于对照组。结论:双侧的VC的严重程度与精液质量的下降无明确相关性。丹红通精方通过提高精子总数、前向运动精子百分率及顶体酶,降低DFI来改善VC患者术后精子质量,表明手术联合中药治疗双侧VC具有较好的疗效,值得进一步临床推广应用。其作用机制可能与抗氧化应激、改善生殖系统缺氧状态、进而改善生精环境及一定程度上改善睾丸支持细胞功能相关,但具体的信号通道尚未明确,需要进一步研究。     

多中心研究评价麒麟丸联合手术治疗精索静脉曲张伴不育症的疗效

目的:探索麒麟丸联合手术治疗对精索静脉曲张伴不育症的治疗效果。方法:回顾性分析2017年10月到2019年3月间于复旦大学附属中山医院、上海交通大学医学院附属国际和平妇幼保健院、上海长征医院、上海中医药大学附属曙光医院及复旦大学附属华东医院就诊手术治疗的精索静脉曲张伴不育症患者共180例。其中单纯手术治疗的对照组67例,另术后1周开始予以麒麟丸治疗者113例作为研究组,麒麟丸治疗周期为6个月。所有患者术前及术后第1、2、3、6个月检查精液常规,术前及术后6个月查精子DNA碎片率(DFI)。结果:全部患者术后及治疗期间无明显不适主诉及严重并发症。对照组术前精液检查提示精子浓度为(17.1±12.4)×10~6/ml,前向运动精子(PR)百分率为(22.8±10.9)%,精子活率为(33.6±13.5)%;DFI为(16.5±7.6)%;术后6个月复查精子浓度为(29.5±14.4)×10~6/ml,PR为(43.7±11.7)%;精子活率为(54.5±12.0)%;DFI为(13.3±4.4)%;术后6个月内配偶自然妊娠22例。研究组术前精液检查提示精子浓度为(16.8±10.7)×10~6/ml,PR为(21.8±11.3)%;精子活率为(32.8±14.0)%;DFI为(16.5±7.6)%;术后6个月复查精子浓度为(38.9±24.1)×10~6/ml,PR为(39.6±13.3)%;精子活率为(50.1±15.0)%;DFI为(11.8±4.8)%;术后6个月内自然妊娠55例。结论:麒麟丸联合手术治疗精索静脉曲张伴不育可更有效提高患者精液质量及配偶自然妊娠率。     

显微镜下精索静脉结扎术联合药物对改善少弱畸精子症患者精液质量的初步观察

目的探讨显微镜下精索静脉结扎术联合药物治疗精索静脉曲张所致少弱畸精子症的效果。方法选取2016年2月至2017年12月于中国人民解放军联勤保障部队第940医院收纳治疗的精索静脉曲张合并少弱畸精子症患者63例,随机分为两组,其中对照组31例,联合组32例,对照组患者进行常规药物治疗(左卡尼汀+迈之灵),联合组患者在药物治疗的同时联合显微镜下精索静脉结扎术;观察分析两组患者在精液质量上的改善情况。结果最终完成随访、资料完整者每组分别为30例。两组共60例患者治疗后精子浓度、液化时间、总活动率以及精子正常形态率均较治疗前有所改善(P0.05),联合组患者在治疗后各精液质量参数的改善均显著优于对照组患者(P0.05)。结论精索静脉曲张所致少弱畸精子症患者行药物治疗的同时联合显微镜下精索静脉结扎术,疗效优于单纯药物治疗者。     

显微精索静脉结扎手术联合少腹逐瘀汤治疗精索静脉曲张致少弱精子症

目的探讨保留动脉的显微精索静脉结扎术联合少腹逐瘀汤治疗精索静脉曲张(VC)致少弱精子症的临床疗效。方法选取50例精索静脉曲张性不育患者,随机分成观察组和对照组各25例,治疗组给予显微精索静脉结扎手术联合少腹逐瘀汤,日服一剂,分早晚服,连续服用3个月;对照组只行显微精索静脉结扎手术。结果两组患者均手术成功,术后症状消失,精子浓度、精液量、精子活力明显提高,畸形精子百分率明显降低,较手术前比较,差异有统计学意义(P<0.05)。而观察组3个月后患者各项精液参数改善显著,明显优于对照组(P<0.05)。结论显微精索静脉结扎手术联合少腹逐瘀汤治疗精索静脉曲张所致少弱精子症疗效满意,精液质量改善明显。     

复方氨基酸胶囊(8-11)联合左旋肉毒碱治疗弱精子症的临床研究

目的:观察联合应用复方氨基酸胶囊(8-11)和左旋肉毒碱类药物治疗特发性弱精子症的临床效果,并探讨其可能的治疗机理。方法:对多中心符合弱精子症诊断标准的120例特发性弱精子症病例,按照双盲、对照的原则随机分为：复方氨基酸胶囊(8-11)+左卡尼汀口服液作为治疗组;对照组单用左卡尼汀口服液;空白组为给予生活干预者,以上分组治疗疗程均为12周。收集治疗前后各组的精液标本。观察治疗前后精子活动率、中性α-葡糖苷酶含量、精子DNA碎片指数、ROS含量及Nrf2表达量。结果:复方氨基酸胶囊(8-11)与左旋肉毒碱对弱精子症患者精子活力有明显改善作用,治疗后治疗组附睾中性α-葡糖苷酶含量明显增加,ROS含量明显下降,Nrf2表达量明显增加。结论:复方氨基酸胶囊(8-11)联合左旋肉毒碱对弱精子症患者有较好的临床疗效,并未见不良反应。复方氨基酸胶囊(8-11)联合左旋肉毒碱对弱精子症患者的治疗机制可能是：通过调控精子Nrf2通道蛋白的高表达,降低ROS的产生,减轻氧化应激对精子活力的损伤。     

聚精汤联合硫辛酸治疗弱畸精子症的疗效观察

目的:观察聚精汤联合硫辛酸治疗弱畸精子症的临床疗效.方法:将符合纳入标准的50例弱畸精子症患者随机分为空白对照组10例、治疗组40例,空白对照组采用生育指导,治疗组采用聚精汤联合硫辛酸治疗.治疗12周后比较两组临床疗效和精液量、精子浓度、前向运动精子(PMS)百分率、畸形精子百分率、顶体完整率、精子DNA碎片指数(DF...     

左旋肉碱虾青素联合复方氨基酸胶囊治疗特发性弱畸形精子症的临床观察

目的探讨左旋肉碱虾青素联合复方氨基酸胶囊治疗特发性弱畸形精子症的临床疗效。方法选取100例符合条件的特发性弱畸形精子症患者,随机分为2组。观察组予梦兰康左旋肉碱虾青素联合复方氨基酸胶囊,对照组单纯给予复方氨基酸胶囊,疗程3月。比较治疗前后两组患者精液参数、精子DNA碎片指数(DFI)及不良反应。结果两组患者一般资料无统计学差异(P>0.05)。治疗前,两组患者间精液参数及精子DFI均无统计学差异(P>0.05)。治疗后,两组患者精液量、精子浓度、前向运动精子率、正常形态精子率及DFI均较治疗前显著改善(P<0.05),且观察组在前向运动精子率、正常形态精子率及精子DFI的改善程度上均显著优于对照组(P<0.05)。两组患者治疗过程中均未观察到明显不良反应。结论梦兰康左旋肉碱虾青素联合复方氨基酸胶囊治疗可有效改善特发性弱畸形精子症患者的精液参数,且无明显不良反应。值得进一步临床研究。     

三种术式治疗精索静脉曲张的疗效比较

目的:探讨精索静脉曲张三种手术方式的临床疗效.方法:回顾分析156例精索静脉曲张临床资料,其中经腹股沟精索静脉结扎术32例,腹膜后小切口精索静脉结扎86例,腹腔镜精索静脉结扎38例.随访术后复发和手术前后精子计数、精子活率及精子形态的变化情况.结果:三组均能提高精子活动率、改善活动力,减少精子畸形率.结论:三种手术方式均是治疗精索静脉曲张不育患者的有效方法,各有其优缺点.     

Assessing equine sperm-membrane integrity

The swelling of cells in a hypo-osmotic medium has been described as an important criterion for assessing the functional integrity of the sperm plasma membrane. The resistance of equine spermatozoa to osmolarity changes was studied by extending 98 semen samples collected from nine stallions in media at five osmolarities (300, 200, 150, 100, and 50 mOsmol l(-1)). The response of the cells was measured by the spermatocrit technique and eosin staining. Spermatocrit determines the increase on spermatozoal volume under hypo-osmotic conditions, a sign of functional integrity of sperm plasma membrane, whereas the eosin staining evaluates the viability of spermatozoa. A significant positive correlation (P<0.01) was observed between spermatocrit values and percentage of eosin-unstained cells. Spermatocrit measurements and eosin staining proved to be useful methods to evaluate the integrity of sperm plasma membrane under hypo-osmotic conditions and could be used as an additional criterion to predict semen preservation ability.     

Serosal integrity and intestinal adhesions

The study, carried out on 50 mongrel dogs, was designed to determine the necessity for surgical reperitonealization of bowel as well as the effect of raw intestinal surfaces on adhesion formation. Results showed that serosal denudation of the terminal ileum healed spontaneously in 70% of the dogs when denudation involved less that the entire antimesenteric border. Incisions to the submucosa healed spontaneously without adhesions in all cases, while dogs which had their incisions sutured formed dense adhesions in the area on the silk suture.     

Analysis of neuroelectric implant integrity

A 10-year follow-up study of neuroelectric implant integrity has been completed for 27 subjects who were treated for movement disorders associated with cerebral palsy. Data used for analysis included X-ray material, clinical data, and results from electrophysiological testing. Of the 21 subjects with subcutaneous receivers placed in the thoracic region, 81% experienced wire (67%) or receiver (14%) failure. Of the 6 subjects with subcutaneous receivers placed in the occipital region, there were no wire failures and one (17%) receiver failure. The occipital units lasted a minimum of 5.2 years without complications, whereas the thoracic units failed as early as 6 months after surgery, and lasted an average of 3.8 years. All wire fractures occurred between C1 and T1. Two types of fracture occurred, one consisting of a clean break and the other consisting of a scenario of bending and kinking, then thinning and fraying, and finally progressive multiple fragmentation. With a few exceptions the clean breaks occurred between C1 and C3, while the fraying scenario occurred between C6 and T1. Mechanisms for failure are discussed, as are results from material tests of wire samples.     

Detection of surgical glove integrity

Surgical glove integrity is essential for universal precautions; glove safety is verified by the water load test (WLT). Concerns regarding glove injury have prompted newer testing methodologies, including electrical conductance testing (ECT); however, the sensitivities of these tests are not known. We compared the sensitivity of WLT and ECT in detecting glove needle-stick injury in two commonly used brands of surgical gloves. Punctures were made with hollow-bore and solid surgical needles of various configurations. The WLT failed to detect glove holes from the smallest-caliber needles and only detected the injury in 60 per cent for the largest caliber. The ECT provided a graded index of glove injury in all holes made by both solid surgical needles and hollow-bore needles. The WLT is a poor test for clinical defects in latex surgical gloves; the ECT is significantly more sensitive and provides a gauge of the cross-sectional area of the defect. Interbrand differences in self-sealing properties of surgical gloves were evidenced and may be clinically relevant after glove perforation.     

Endothelial integrity after venous cryopreservation

Veins treated with dimethyl sulfoxide (DMSO) prior to freezing were compared with fresh veins with respect to fibrinolytic activity, morphologic changes, and endothelial viability. After storage for 3 to 8 weeks frozen veins retained their basic morphologic structure and fibrinolytic activity, but cell viability was lost. When such veins were placed in the canine femoral venous circulation, a high rate of thrombosis was noted. This could be prevented by treatment of the graft recipient with aspirin and dipyridamole. Frozen veins removed 5 days after grafting showed loss of endothelium and fibrinolytic activity. Implications of these findings with reference to “vein banking” are discussed.     

Sperm DNA integrity: correlation with sperm plasma membrane integrity in semen evaluated for male infertility

Previous independent studies have indicated that abnormally low parameters of sperm DNA integrity and sperm membrane integrity correlate to reduced fertility due in part to implantation disorders. The purpose of our study was to evaluate the relationship between sperm plasma membrane functional integrity assessed by the hypo-osmotic swelling test (HOST) and sperm DNA integriy test assesed by DNA fragmentation index (DFI). Semen samples from 102 random patients were evaluated in terms of standard semen parameters and assessed by DFI and HOST. Both tests showed a significant correlation to standard semen parameters (p < .05). In addition, patients with abnormal HOST results had a higher likehood of a subnormal or abnormal DFI result (p < .001). Our results suggest that a common sublethal insult may manifest as abnormalities in both the nucleus and the plasma membrane that act at the implantation and/or subsequent levels of development rather than at the fertilization stage.