Effect of transient scrotal hyperthermia on sperm parameters,seminal plasma biochemical markers,and oxidative stress in men

In this experimental prospective study, we aimed to analyze the effect of transient scrotal hyperthermia on the male reproductive organs, from the perspective of sperm parameters, semen plasma biochemical markers, and oxidative stress, to evaluate whether different frequencies of heat exposure cause different degrees of damage to spermatogenesis. Two groups of volunteers (10 per group) received testicular warming in a 43°C water bath 10 times, for 30 min each time: group 1: 10 consecutive days; group 2: once every 3 days. Sperm parameters, epididymis and accessory sex gland function, semen plasma oxidative stress and serum sex hormones were tested before treatment and in the 16-week recovery period after treatment. At last, we found an obvious reversible decrease in sperm concentration (P = 0.005 for Group 1 and P= 0.008 for Group 2 when the minimums were compared with baseline levels, the same below), motility (P = 0.009 and 0.021, respectively), the hypoosmotic swelling test score (P = 0.007 and 0.008, respectively), total acrosin activity (P = 0.018 and 0.009, respectively), and an increase in the seminal plasma malondialdehyde concentration (P = 0.005 and 0.017, respectively). The decrease of sperm concentration was greater for Group 2 than for Group 1 (P = 0.031). We concluded that transient scrotal hyperthermia seriously, but reversibly, negatively affected the spermatogenesis, oxidative stress may be involved in this process. In addition, intermittent heat exposure more seriously suppresses the spermatogenesis compared to consecutive heat exposure. This may be indicative for clinical infertility etiology analysis and the design of contraceptive methods based on heat stress.     

超声心动图对继发性三尖瓣反流术疗效的评价

【摘要】〓目的〓通过超声心动图比较继发性三尖瓣反流患者行三尖瓣缝线成形术和成形环成形术的早期和中期效果,评价两种三尖瓣成形方法的疗效。方法〓回顾性分析我院2008年1月~2013年6月行三尖瓣成形术治疗的,并能追踪到而且进行了随访的继发性三尖瓣反流患者 175 例,根据成形方法分成两组:缝线成形术组 143例(82%),使用成形环成形术组 32 例(18%),分别于术前、术后一个月、术后一年通过超声心动图测量左室射血分数(LVEF)、三尖瓣反流束面积(TRA)、三尖瓣反流分数(TRF)、右室前后径(RVD)、右房上下径(RAD1)及右房左右径(RAD2),比较术前、术后半个月及术后1年时各参数的变化。结果〓两组患者,与术前相比,所有患者术后一个月TRA、TRF及RVD、RAD1及RAD2均显著降低(P<0.05),LVEF无显著变化(P>0.05);术后1年,缝线成形术组的患者TRF较术后一个月显著增加(P<0.05),其余指标无明显变化(P>0.05);而使用成形环组术后一年,所有指标较术后一个月无显著变化(P>0.05)。结论〓三尖瓣成形环成形术治疗三尖瓣反流,在术后中期仍可维持良好的疗效。超声心动图对三尖瓣反流的程度可提供半定量信息,在术前及术后随访中有着重要的应用价值。     

单侧通道椎体后凸成形术治疗骨质疏松脊柱压缩性骨折

目的探讨单侧通道椎体后凸成形术治疗骨质疏松脊柱压缩性骨折的临床效果。方法选择2012-01—2012-12间收治的骨质疏松脊柱压缩性骨折患者42例,行单侧通道椎体后凸成形术,观察患者的治疗效果及疼痛评分等指标。结果患者治疗后椎体高度(26.94±12.35)mm,显著优于治疗前(15.23±5.32)mm,差异有统计学意义(P<0.05);治疗后疼痛评分(1.01±0.21)分,明显低于治疗前(7.64±1.34)分,差异有统计学意义(P<0.05)。患者出院后随访6~12个月,平均8.7个月,42例患者未发生感染及血管栓塞等并发症,术后3 d下床活动,7 d后出院。1 a后复查,患者骨水泥充盈良好。结论骨质疏松脊柱压缩性骨折采用单侧通道椎体后凸成形术治疗,疗效可靠,值得临床推广。     

Thioredoxin-Interacting Protein Deficiency Protects against Diabetic Nephropathy

Expression of thioredoxin-interacting protein (TxNIP), an endogenous inhibitor of the thiol oxidoreductase thioredoxin, is augmented by high glucose (HG) and promotes oxidative stress. We previously reported that TxNIP-deficient mesangial cells showed protection from HG-induced reactive oxygen species, mitogen-activated protein kinase phosphorylation, and collagen expression. Here, we investigated the potential role of TxNIP in the pathogenesis of diabetic nephropathy (DN) in vivo. Wild-type (WT) control, TxNIP^−/−, and TxNIP^+/− mice were rendered equally diabetic with low-dose streptozotocin. In contrast to effects in WT mice, diabetes did not increase albuminuria, proteinuria, serum cystatin C, or serum creatinine levels in TxNIP^−/− mice. Whereas morphometric studies of kidneys revealed a thickened glomerular basement membrane and effaced podocytes in the diabetic WT mice, these changes were absent in the diabetic TxNIP^−/− mice. Immunohistochemical analysis revealed significant increases in the levels of glomerular TGF-β1, collagen IV, and fibrosis only in WT diabetic mice. Additionally, only WT diabetic mice showed significant increases in oxidative stress (nitrotyrosine, urinary 8-hydroxy-2-deoxy-guanosine) and inflammation (IL-1β mRNA, F4/80 immunohistochemistry). Expression levels of Nox4-encoded mRNA and protein increased only in the diabetic WT animals. A significant loss of podocytes, assessed by Wilms’ tumor 1 and nephrin staining and urinary nephrin concentration, was found in diabetic WT but not TxNIP^−/− mice. Furthermore, in cultured human podocytes exposed to HG, TxNIP knockdown with siRNA abolished the increased mitochondrial O₂⁻ generation and apoptosis. These data indicate that TxNIP has a critical role in the progression of DN and may be a promising therapeutic target.     

Deficiency of Fibroblast Growth Factor-Inducible 14 (Fn14) Preserves the Filtration Barrier and Ameliorates Lupus Nephritis

TNF ligand superfamily member 12, also known as TNF-related weak inducer of apoptosis (TWEAK), acts through its receptor, fibroblast growth factor-inducible 14 (Fn14), to mediate several key pathologic processes involved in tissue injury relating to lupus nephritis. To explore the potential for renal protection in lupus nephritis by targeting this pathway, we introduced the Fn14 null allele into the MRL-lpr/lpr lupus mouse strain. At 26–38 weeks of age, female Fn14-knockout MRL-lpr/lpr mice had significantly lower levels of proteinuria compared with female wild-type MRL-lpr/lpr mice. Furthermore, Fn14-knockout mice had significantly improved renal histopathology accompanied by attenuated glomerular and tubulointerstitial inflammation. There was a significant reduction in glomerular Ig deposition in Fn14-knockout mice, despite no detectable differences in either serum levels of antibodies or splenic immune cell subsets. Notably, we found that the Fn14-knockout mice displayed substantial preservation of podocytes in glomeruli and that TWEAK signaling directly damaged barrier function and increased filtration through podocyte and glomerular endothelial cell monolayers. Our results show that deficiency of the Fn14 receptor significantly improves renal disease in a spontaneous lupus nephritis model through prevention of the direct injurious effects of TWEAK on the filtration barrier and/or modulation of cytokine production by resident kidney cells. Thus, blocking the TWEAK/Fn14 axis may be a novel therapeutic intervention in immune-mediated proliferative GN.     

地佐辛联合舒芬太尼用于全麻术后患者静脉自控镇痛的临床效果及安全性:Meta分析

目的 系统评价地佐辛联合舒芬太尼与单独舒芬太尼用于术后患者自控静脉镇痛(patient controlled intravenous analgesia,PCIA)的临床效果及副作用.方法 计算机检索Cochrane Library、PubMed、Embase、CBM、Ovid、ScienceDirect、ProQuest、Springer、CNKI、万方和维普等数据库从建库至2014年6月文献,在按纳入和排除标准进行资料提取和文献质量评价后,采用RevMan 5.1版软件进行Meta分析.结果 共纳入6个随机对照实验,共计患者477例.Meta分析结果显示:地佐辛联合舒芬太尼与单独舒芬太尼分别用于PCIA后,患者术后4、8、12、24 h视觉模拟评分(visual analogue scales,VAS)比较,差异无统计学意义(P＞0.05),术后48 h VAS[加权均数差(weighted mean difference,WMD)=-0.36,95％置信区间(confidence interval,CI)(-0.69,-0.04)]差异有统计学意义(P＜0.05);副作用总发生率差异有统计学意义[比值比(odds ratio,OR)=0.36,95％CI(0.26,0.50)](P＜0.05);术后24、48 h白细胞介素(interleukin,IL)-6及IL-10水平差异有统计学意义(P＜0.05).结论 地佐辛联合舒芬太尼镇痛效果明显且副作用少,能在一定程度上改善免疫功能.     

去细胞化肝脏生物支架的应用进展

肝脏替代治疗是目前终末期肝病最有效的治疗措施,而去细胞化肝脏生物支架拓宽了肝脏替代治疗的研究领域.目前普遍的支架制备过程是在一定的物理条件下,经灌注设备将化学试剂(去垢剂、消化酶等)注入肝脏自身的脉管结构中,达到去除细胞成分,保留支架内ECM和超微脉管结构的目的.再将种子细胞注入到去细胞化肝脏生物支架,获得再细胞化肝脏,模拟机体内肝脏生物环境进行体外或体内培养,观察种子细胞附着情况,检测肝脏代谢功能,评估肝脏替代效果.目前,种子细胞的选取、再细胞化流程、再细胞化肝脏移植等问题仍处于探索阶段.笔者围绕去细胞化肝脏生物支架的制备与评价、检测和应用作一综述,为进一步应用于实验研究和临床实践提供参考.     

微创经皮肾镜碎石术对肾内型肾盂结石的治疗评价

目的评价微创经皮肾镜碎石术对肾内型肾盂结石的治疗效果。方法回顾性分析肇庆市第二人民医院2013年1月1日至2013年12月31日由同一术者完成的微创经皮肾镜碎石术187例,其中肾内型肾盂肾结石58例,非肾内型肾盂肾结石129例,比较二者之间的一期结石清除率、二期结石清除率、一期手术时间、手术中取石通道个数、二期体外冲击波碎石例数、输血率、胸膜损伤发生率。结果肾内型肾盂结石病例一期结石清除率低于非肾内型肾盂结石病例,而一期手术时间、双通道取石率均高于后者(P<0.05)。二期结石清除率、术后体外冲击波碎石例数、输血率、胸膜损伤发生率均无统计学差异(P>0.05)。结论微创经皮肾镜碎石术对肾内型肾盂合并结石的治疗安全有效。     

局麻微创经皮肾镜对全身炎症反应及肾功能损害的影响

目的通过对局麻微创经皮肾镜治疗肾结石及输尿管上段结石导致的全身炎症反应、肾功能损害等临床资料进行分析,评估局麻微创经皮肾镜的安全性、有效性、可行性、经济效益及其临床推广应用价值。方法东莞市大朗医院泌尿外科在2012年8月至2014年8月将经皮肾镜患者随机分成观察组及对照组(各40例),观察组行局麻,对照组行腰硬联合麻醉。对比两组术前晨、手术结束时及术后一周血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、β2-微球蛋白(β2-MG)、C-反应蛋白(CRP)、肌酐(Cr)及尿素氮(BUN)的表达水平;同时对比两种麻醉状态对患者心率(HR)、血氧饱和度(SPO2)及平均动脉压(MAP)的影响;并比较两组间手术时间、术中出血量、住院时间、住院费用及残石率的差异。结果两组患者术前晨血BUN、Cr、β2-MG、IL-6、TNF-α及CRP组间比较差异无统计学意义(P>0.05),两组各项参考指标在手术结束时明显高于术前。对照组术后一周血清IL-6、TNF-α、CRP含量高于观察组,两组术后一周血清BUN、Cr、β2-MG低于术前,差异有统计学意义(P<0.05)。观察组及对照组MAP、HR、SPO2在手术开始前、手术中与麻醉前比较差异有统计学意义(P<0.05)。两组间手术时间、术中出血量及残石率比较无统计学差别(P>0.05),观察组住院时间及住院费用明显低于对照组,差异有统计学意义(P<0.05)。结论局麻微创经皮肾镜治疗肾结石及输尿管上段结石引起的全身炎症反应较轻,总费用及住院时间明显低于腰硬联合麻醉组,两组患者肾功能损伤差别无统计学意义。