bFGF促进特发性少弱精子症生精细胞增殖超微结构改善及临床观察

目的：探讨碱性成纤维细胞生长因子（ｂＦＧＦ）对特发性少弱精子症的作用。方法：应用ｂＦＧＦ对３４例特发性少弱精子症的患者进行治疗,并采用免疫组织化学、放射免疫及电镜技术等观察患者治疗前后睾丸生精细胞增殖情况、超微结构、血生殖激素及精液质量的变化。结果：治疗后所有患者睾丸生精细胞增多（Ｐ〈０．０５）,排列较治疗前规整,细胞超微结构改善。精液质量及血生殖激素（催乳素、卵泡刺激素、黄体生成素、睾酮）水平均     

少精子症患者精液沉淀物乳酸脱氢酶同工酶凝胶电泳分析

本文运用乳酸脱氢酶同工酶聚丙烯酰胺凝胶电泳分析法，分析比较了少精子症、弱精子症、精液正常者的精液沉淀物乳酸脱氢酶同工酶百分比活性。结果显示：少精子症患者的ＬＤＨ－Ｃ４同工酶百分比活性４６％显著低于精液正常者的７１％（Ｐ＜０．０１）及弱精子症患者的６７％（Ｐ＜０．０１）；相对的，少精子症的ＬＤＨ５同工酶百分比活性１６％显著高于精液正常者的４．８％（Ｐ＜０．０１）和弱精子症的６．３％（Ｐ＜０．０１）。本文认为少精子症者精液沉淀物ＬＤＨＣ４活性降低与其精液中的各类细胞诸如未成熟的精子细胞、白细胞及一些微生物的相对增加有关     

克罗米芬联合己酮可可碱治疗特发性少、弱精子症的临床研究

目的探讨克罗米芬＋己酮可可碱治疗特发性少、弱精子症的临床效果。方法选取门诊少、弱精子症患者300例,随机分为两组,A组（n=156）口服克罗米芬（50mg,q.d）＋己酮可可碱缓释片（400mg,b.i.d）＋VitE（100mg,t.i.d）;B组（n=144）只服用VitE（100mg,t.i.d）,共3个月,比较两组间各自用药前后的精液参数。进一步将A组患者分成少精子症（n=69）和弱精子症（n=87）2组,比较两者联合药物治疗前后精液各参数。结果（1）联合药物治疗3个月后,A组的精子活率、a级活动精子率、（a＋b）级活动精子率等参数明显增加（P〈0.05）,但精液量、精子密度和活动精子总数无明显差异（P〉0.05）;B组精液各参数没有明显变化。（2）少精子症组联合药物治疗后精子密度、精子活率、活动精子总数明显提高（P〈0.05）;而弱精子症组仅精子活率明显提高（P〈0.05）,精子密度和活动精子总数没有明显变化（P〉0.05）。结论克罗米芬＋已酮可可碱能显著提高特发性少精子症患者的精子密度、精子活率、活动精子总数,以及特发性弱精子症的精子活率。     

特发性精液质量异常的诊断与治疗

特发性精液质量异常包括特发性少、弱、畸形精子症、特发性无精子症以及特发性精液液化异常。导致特发性精液质量异常的可能原因包括年龄、附属性腺的非炎症性功能改变、感染因素、基因异常、精子线粒体改变、环境污染物的影响和细微的激素改变等。诊断特发性少、弱、畸形精子症和无精子症需要经过全面的病史询问、体格检查、精液分析、生殖激素检查、遗传学检查、免疫学检查等以排除已知的可能病因。特发性少弱畸形精子症的治疗包括使用克罗米芬、他莫西芬、重组FSH、安特尔、锌硒宝、左卡尼汀、重组生长激素、己酮可可碱等西药类、中成药以及中西医结合治疗等;特发性无精子症可在使用促精子生成药的基础上使用辅助生殖技术治疗;特发性精液液化异常主要通过中医药、中西医结合和体外处理技术治疗。随着诊断技术的发展,有望建立更加特异的精液质量异常的治疗措施和降低特发性精液质量异常的发生率。     

通里攻下法治疗肠源性内毒素血症的临床观察——附34例？…

我们选择临床中急性弥漫性腹膜炎患者，给予通里攻下法配合常规治疗，进行临床观察。结果表明：腹膜炎病人血中内毒素含量增高（Ｐ〈０．０１），并引起ＴＮＦ、ＰＧＦ１α和ＴＸＢ２的增高（Ｐ〈０．０１）。术后用通里攻下法的代表方剂大承气汤、承气合剂治疗，能使血中ＬＰＳ、ＴＮＦ、ＴＸＢ２含量下降（Ｐ〈０．０１ Ｐ〈０．０１ Ｐ〈０．０５），机体恢复加快，抗生素的使用减少（Ｐ〈０．０５）。通里攻下法是一种治疗肠源     

阴囊温度升高与男性不育的关系

对２２例生育，４４例精索静脉曲张（ＶＣ）患者，１７例特发性无精子症（ＩＡ）患者行远红外阴囊测温，并对无精子者行睾丸活检。结果发现：（１）ＶＣ患者阴囊温度显著高于生育者（Ｐ〈０．００１）而低于ＩＡ（Ｐ〈０．００１）。（２）ＶＣ精液正常者阴囊温度与生育者无差异而显著低于ＶＣ精液异常者（Ｐ〈０．０１）。（３）ＩＡ与ＶＣ合并精子症阴囊温度无显著差异。（４）阴囊温度升高使生精细胞减少，精子成熟障碍，特别是Ｓ     

213例不育男性抗精子抗体与精液有关参数的分析

我们检测了９００多例男性不育症患者的血清、精浆抗精子抗体（ＡｓＡｂ）和精液各项指标，对其中２１３例ＡｓＡｂ阳性患者的精液有关参数与ＡｓＡｂ的关系进行了分析，并与生育男性组作了比较。结果表明，ＡｓＡｂ阳性患者的精子密度、精子活率、精子顶体完整率、精浆免疫抑制物（ＳＰＩＭ）及α－糖苷酶均明显低于生育组（Ｐ＜０．０１），不育男性ＡｓＡｂ阳性组ＳＰＩＭ阳性率也明显高于ＡｓＡｂ阴性组（Ｐ＜０．０１）。此外，血清与精浆ＡｓＡｂ同为阳性组的精子活率明显低于单纯血清或精浆ＡｓＡｂ阳性组（Ｐ＜０．０１）。     

bFGF及PDGFR表达与肾移植慢性排斥血管病变和肾小球损？…

目的 探讨碱性成纤维细胞生长因子（ｂＦＧＦ）及血小板源性生长因子受体（ＰＤＧＦＲ）的表达与肾移植慢性排斥反应血管病变及肾小球损伤之间的关系。方法 采用免疫组化ＳＰ法检测２３例排斥肾组织、１２例正常肾组织、１４例远离癌的正常肾组织血管及肾小球中ｂＦＧＦ及ＰＤＧＦＲ的表达。结果 ｂＦＧＦ及ＰＤＧＦＲ在排斥组织血管平滑肌细胞、内膜层及肾小球中的表达明显高于正常组织及癌组织（Ｐ〈均０．０１）。结论 ｂＦＧ     

糖尿病纤维连接蛋白血小板聚集功能改变临床分析

为探讨ＮＩＤＤＭ患者Ｆｎ、ＰＡＧ改变与缺血性心脑血管病的关系，分析５３例ＮＩＤＤＭ患者Ｆｕ、ＰＡＧ测定结果，并与５３名健康人比较。患者组Ｆｎ明显高于（Ｐ〈０．０１），前者ＰＡＧ（１）、ＭＡＲ、Ｉ与后者有显著统计学差异（Ｐ〈０．０１）。患者组中并发症组与无并发症组Ｆｎ、Ｉ较对照组有明显统计学差异（Ｐ〈０．０１），并发症组ＰＡＧ（１）、ＭＡＲ明显高于对照组（Ｐ〈０．０５）。ＮＩＤＤＭ患者Ｆｎ降低、ＰＡ     

b-FGF在肾癌组织中表达的临床意义

目的 探讨ｂ－ＦＧＦ（碱性成纤维细胞生长因子）在肾癌中表达的临床意义。方法 采用斑点杂交技术和免疫组化技术测定２０例肾癌患者癌组织、癌旁和正常肾组织ｂ－ＦＧＦ表达情况。结果 肾癌组织中ｂ－ＦＧＦ表达明显高于癌旁和周围正常肾组织（Ｐ〈０．０１），ｂ－ＦＧＦ表达升高与肿瘤分期、分级密切相关，与肿瘤大小无明显关系。结论 ｂ－ＦＧＦ为肾癌组织自身分泌，与肾癌的发生和发展密切相关。     

Effects of L-carnitine combined with pancreatic kininogenase on thioredoxin 2, thioredoxin reductase 1, and sperm quality in patients with oligoasthenospermia

BackgroundTo study the effects of L-carnitine (LC) combined with pancreatic kininogenase on thioredoxin 2 (Trx 2), thioredoxin reductase 1 (TrxR 1), and sperm quality in patients with oligoasthenospermia.MethodsA total of 300 male infertility patients with oligoasthenospermia who were treated in the andrology clinic of our hospital from December 2019 to December 2020 were randomly divided into an LC group and combined treatment group, and 50 males with normal semen were selected as a control group. The computer-assisted semen analysis system (CASA) was used to detect the total number, vitality, and forward motility of the sperm before and after treatment, and sperm morphology was detected by the Diff-Quik method of the sperm staining kit. Sperm chromatin dispersion (SCD) method was used to detect sperm DNA fragments, and Western-blot was used to detect the protein expression of Trx 2 and TrxR 1.ResultsThere were no significant differences in sperm density, motility rate, forward motile sperm rate, and DNA fragmentation rate in oligoasthenospermia patients before treatment (P>0.05). However, after 1 month of treatment, the sperm density, motility rate, and forward motile sperm rate were all higher than before treatment (P<0.05), while the DNA fragmentation rate was lower than before treatment. At the same time, each index of semen in the combination group was higher than that in the LC group (P<0.05), and the total effective rate in the combination group was significantly higher than in the LC group (P<0.01). The expression of Trx2 protein in oligoasthenospermia patients was significantly increased (P<0.05), while the expression of TrxR1 protein was significantly decreased (P<0.05). After 3 months of treatment, the expression of Trx2 protein was significantly decreased (P<0.05), while the expression of TrxR1 protein was significantly increased (P<0.05).ConclusionsThe results suggest Trx 2 and TrxR 1 may be candidate protein markers for oligoasthenospermia. LC combined with pancreatic kininogenase in the treatment of male oligoasthenospermia can effectively promote sperm maturation, enhance sperm motility, and improve semen quality, which has high application value.     

Cinnoxicam and L-carnitine/acetyl-L-carnitine treatment for idiopathic and varicocele-associated oligoasthenospermia

The objective of this study was to detect a therapy for idiopathic and varicocele-associated oligoasthenospermia (OAT). Idiopathic and varicocele OAT patients were randomized into 3 groups. Each group was composed of varying degrees of left varicoceles (graded into 5 grades with echo-color Doppler) and of idiopathic OATs. Group 1 used a placebo, group 2 used oral L-carnitine (2 g/d) + acetyl-L-carnitine (1 g/d), group 3 used L-carnitine/acetyl-L-carnitine + 1 x 30-mg cinnoxicam suppository every 4 days. Drugs were administered for 6 months. The groups were composed as follows: group 1, 71 varicoceles and 47 idiopathic OATs; group 2, 62 varicoceles and 39 idiopathic OATs; group 3, 62 varicoceles and 44 idiopathic OATs. Sperm concentration, motility, and morphology before during and after treatments were assessed. Pregnancy rates and side effects were recorded. Group 1 did not have modified sperm patterns during treatment. Group 2 had significantly increased sperm patterns at 3 and 6 months into therapy in idiopathic patients and in patients with grades I, II, and III varicocele, but not in grades IV and V. Group 3 had significantly increased sperm parameters in all patients, with the exception of grade V varicocele. Group 3 sperm patterns proved significantly higher during therapy than group 2. All sperm patterns fell to baseline after therapy suspension. Minor side effects occurred. Pregnancy rates were 1.7% (group 1), 21.8% (group 2), and 38.0% (group 3) (P <.01). L-carnitine/acetyl-L-carnitine + cinnoxicam suppositories proved a reliable treatment for low-grade varicoceles and idiopathic OATs.     

复方玄驹胶囊联合维生素E对不育患者精子染色质损伤的影响

目的:初步探讨复方玄驹胶囊联合维生素E治疗方案对轻度少精子症和/或弱精子症患者精子染色质损伤的临床疗效。方法:50例精液异常的男性不育患者随机分为实验组(n=24)和对照组(n=26),分别予以复方玄驹胶囊+维生素E和单纯维生素E治疗3个月,运用计算机辅助精液分析系统(CASA)及精子染色质结构分析(SCSA)方法分析两组患者治疗前后精液常规参数和精子DNA损伤指数(DFI),比较治疗前后精液常规参数及精子DFI的变化。结果:实验组治疗后前向运动精子率为(21.55±8.68),对照组为(21.47±11.53),两组相比差异没有统计学意义(P>0.05)。在实验组中治疗前DFI为34.09±10.32,治疗后DFI为29.57±12.19,与治疗前相比显著下降(P<0.05)。结论:复方玄驹胶囊联合维生素E治疗可有效改善不育患者精液质量,对精子染色质损伤有一定的改善作用。     

重组人生长激素应用于特发性弱精子症的临床疗效和安全性观察

目的:观察重组人生长激素治疗特发性弱精子症的临床疗效和安全性。方法:采用随机对照实验设计,按WHO的标准诊断为特发性弱精子症40例患者,随机均分为应用组和对照组。在常规治疗下,应用组加用重组人生长激素,每次4U,隔日晚上皮下注射,对照组不加用重组人生长激素;疗程3个月。治疗前后按WHO标准进行精液分析,同时监测性激素、甲状腺功能、肝肾功能、血脂、血糖等指标。最终应用组18例,对照组18例完成本观察。结果:精子存活率应用组提高了(28.60±32.89)%,对照组提高了(8.42±25.87)%,差异有显著性(P<0.01);(a+b)级精子,应用组提高了(18.56±21.19)%,对照组提高了(8.12±24.34)%,差异有显著性(P<0.05);精子密度、精子总量的改善应用组较对照组差异有显著性(P<0.05)。结论:重组人生长激素对特发性弱精子症有辅助治疗效果、安全性高、能提高精子密度和精子总数。     

复方玄驹胶囊与麒麟丸治疗少弱精症的临床观察

目的 观察复方玄驹胶囊、麒麟丸治疗少弱精症患者的疗效.方法 采用服药前后自身对照及两种药物相互对照的临床研究方法,对100例少弱精症患者随机分为两组.一组口服复方玄驹胶囊（3粒,3次/日）、一组口服麒麟丸（6g,3次/日）,12周为一个疗程.以精子密度和（a＋b）级精子为主要疗效指标,以a级精子、精子活动率为次要疗效指标,评价两种药物的效果.结果 有95例患者完成了临床研究,两组在精子密度、（a＋b）级精子、a级精子和精子活动率,治疗完成后较治疗前均有显著性差异（P＜0.05）.治疗完成后两组在精子密度、（a＋b）级精子、a级精子差异有统计学意义（P＜0.05）,而在精子活动率上无统计学差异（P＞0.05）.结论 两药物对少弱精症患者精液质量的提高均有一定的治疗效果,复方玄驹胶囊对少弱精症的效果较麒麟丸更佳.     

复方玄驹胶囊治疗少弱精子症患者的多中心临床研究

目的:观察复方玄驹胶囊治疗少弱精子症患者的疗效。方法:采用多中心、开放性、自身前后对照的临床研究方法,对120例少弱精子症患者采用口服复方玄驹胶囊(3粒,3次/d)治疗12周。以精子密度和(a+b)级精子为主要疗效指标,以a级精子、精子活动率及精液量为次要疗效指标,评价复方玄驹胶囊治疗效果。结果:有107例患者完成了临床研究,与治疗前相比,除精液量仅在治疗12周后明显增加(P<0.01)外,精子密度、a级精子和(a+b)级精子及精子活动率等精液参数在治疗4、8和12周后具有显著改善(P均<0.01)。此外,与治疗4周后相比,精子密度、a级精子和(a+b)级精子及精子活动率等精液参数在治疗8周和12周后也有显著改善(P<0.05或0.01);同样,与治疗8周后相比,精液参数在治疗12周后也有显著改善(P均<0.01)。治疗12周后,精子密度增加了63.28%,达到正常标准的病例数为73例(68.22%);(a+b)级精子提高了63.17%,达到正常标准的病例数为39例(36.45%);a级精子提高了78.56%,达到正常标准的病例数为34例(31.78%);精子活动率提高了44.36%,达到正常标准的病例人数为77例(71.96%);精液量增加了18.13%。结论:复方玄驹胶囊可明显提高少弱精子症患者精液质量,未见明显不良反应。     

来曲唑联合复方玄驹胶囊治疗肥胖性少弱精子症的临床疗效观察

目的观察来曲唑、枸橼酸氯米芬分别联合复方玄驹胶囊及维生素E治疗肥胖性少弱精子症的临床疗效。方法选取2018年8月至2020年8月在洛阳市妇幼保健院生殖医学研究所就诊的188例肾阳不足型肥胖性少弱精子症患者,随机分为来曲唑联合组(A组)和枸橼酸氯米芬联合组(B组)各94例,疗程为3个月,以精子浓度、精子前向运动百分率和生殖激素(FSH、LH、E 2、T)水平为观察指标进行治疗前、后疗效评估。结果精液质量上,治疗前,两组患者的精子浓度和前向运动百分率均无显著性差异;治疗3个月后,两组患者均有显著提升,且A组患者的精子浓度[(26.32±2.59)×10⁶/ml vs.(21.48±3.37)×10⁶/ml]显著高于B组,即A组精子浓度增加更加显著(P<0.05)。生殖激素水平的比较:与治疗前相比,治疗后A组患者的LH[(5.31±2.24)U/L vs.(3.84±1.47)U/L]及T[(1.73±0.06)nmol/L vs.(1.12±0.05)nmol/L]水平显著升高(P<0.05),E 2水平[(152.16±55.89)pmol/L vs.(206.69±60.44)pmol/L]显著下降(P<0.05),T/E 2比值显著升高(P<0.05);B组中仅有T水平[(1.53±0.07)nmol/L vs.(1.17±0.06)nmol/L]显著改善,且A组E 2水平与T/E 2比值显著高于B组(P<0.05)。结论对于肾阳不足型肥胖性少、弱精子症,尤其是高E 2而T/E 2值相对较低的患者,以来曲唑为主效药物的联合用药在提高精子数量、改善精子活力方面具有显著效果,值得临床推广。     

Comparison of semen quality in older and younger men attending an andrology clinic

The effects of age on semen quality were analysed in patients referred to an andrology outpatient clinic in a retrospective study covering a period of 3 years. Semen analyses of older men (n = 66; > or = 50 years; median: 53) were compared with those of young patients (n = 134; 21-25 years; median 24). The duration of sexual abstinence was longer among older patients (median: 5.5 vs. 5.0 days; + 10%, P < 0.05). Even after adjustment for duration of sexual abstinence, progressive motility (- 27%, P < 0.01), percentage of morphologically normal spermatozoa (- 44%, P < 0.01) and semen volume (- 29%, P < 0.0005) were significantly lower in older than in younger men. Impaired sperm morphology was mainly attributed to abnormal staining of flagella (+ 50%, P < 0.05) and an increased portion of coiled or bent tails (+ 44%, P = 0.001) indicating epididymal dysfunction. Total sperm count and sperm concentration were unaffected by age. Age-dependent changes in accessory gland function, as indicated by fructose concentration (- 27%, P < 0.05), was correlated with lower semen volume. Moreover, serum testosterone levels were significantly reduced in the group of older men (median: 3.0 vs. 3.6 ng ml-1; -17%, P < 0.005).