Relationship between aryl hydrocarbon receptor and spermatogenic dysfunction in male patients with varicocele

The main purpose of this project is to verify whether there is a difference in the expression of aryl hydrocarbon receptor (AhR) between varicocele (VC) and normal male semen, and determine whether there is a connection with the parameters of semen analysis. The risk factors of infertility in patients with VC were also studied. Semen samples were collected for semen analysis and Western blot. Logistic regression was used to investigate the risk factors associated with infertility in patients with VC. Men with VC had lower AhR expression compared to healthy men; correlation analysis results showed that: AhR expression in patients with VC group was significantly positively correlated with sperm concentration and sperm motility; significantly negatively correlated with the diameter of spermatic veins during Valsalva and the percentage of abnormal sperm morphology; the research results of related risk factors show that the risk of infertility of patients with grade III is 1.67 times that of patients with grades I and II. For each unit of abnormal sperm morphology, the risk of infertility increases 1.04 times. Sperm concentration, total sperm viability and each unit the expression of AhR protein decreases the risk of infertility by 3%, 9% and 11% respectively.     

Autophagy Gene Polymorphism is Associated with Susceptibility to Leprosy by Affecting Inflammatory Cytokines

Autophagy and inflammation closely interact with each other, and together, they play critical roles in bacterial infection. Leprosy is caused by the infection of Mycobacterium leprae (M. leprae). The objective of the study was to investigate the association between polymorphisms in IRGM, an autophagy gene, and susceptibility to leprosy, and identify possible functions of the polymorphism in the infection of M. leprae. Two polymorphisms in IRGM, rs4958842 and rs13361189, were tested in 412 leprosy cases and 432 healthy controls. Levels of inflammatory cytokines including interleukin 1 beta, IL-4, IL-6, and interferon gamma (INF-γ) were measured after the infection of M. leprae in the peripheral blood mononuclear cell (PBMC) of subjects with different genotypes of rs13361189. Data showed that prevalence of rs13361189TC and CC genotypes were significantly higher in leprosy patients than in healthy controls (odds ratio (OR)?=?1.49, 95 % confidence interval (CI) 1.09–2.04, P?=?0.012; OR?=?2.58, 95 % CI 1.65–4.05, P?<?0.001; respectively). Furthermore, the frequency of rs13361189CC genotype was increased in patients with complications than those without complications (P?=?0.011). When analyzing the effect of rs13361189 polymorphism on M. leprae infection, we identified that M. leprae-infected PBMC with rs13361189CC genotype expressed significantly elevated levels of INF-γ and IL-4 than those with TT genotype. Our results suggested autophagy gene polymorphism was associated with the increased risk of leprosy by affecting inflammatory cytokines.     

持续性高眼压青光眼手术治疗的临床观察

目的 观察持续性高眼压青光眼的手术疗效。方法 对２０例２２眼持续性高眼压青光眼患者采用复合式小梁切除术联合后巩膜隧道切开引流，缓慢降低眼压后完成手术。术后随访３￣１４月。结果 术后平均眼压为１４．５７ｍｍＨｇ，比术前平均眼压降低３６．０５ｍｍＨｇ，手术成功率为９１％。全部病例无严重并发症。结论 复合式小梁切除术联合后巩膜隧道切开引流降低眼压的术式，可有效地控制眼压，减少并发症，提高一次手术成功率。     

超声对引起原位肝移植术后黄疸相关因素的分析

目的探讨超声对于提示引起原位肝移植术后黄疸相关因素的价值。方法28例实施肝移植术后临床拟诊黄疸的患者，以二维超声检查移植肝内外胆管及肝周情况，以彩色多普勒超声（CDI）评估移植肝动、静脉血流情况，并结合临床资料、肝穿刺活检病理诊断结果和内镜逆行胰胆管造影（ERCP）综合分析。结果22例患者术后出现胆道并发症，其中5例CDI提示有肝动脉并发症，超声检出胆漏者4例，胆道梗阻者18例；其余6例肝穿刺活检证实有排斥反应。结论多普勒超声显像可以较好地提示引起原位肝移植术后黄疸的相关因素，有利于临床医师作出正确的病情判断及确定相应的治疗方案。     

甲巯咪唑片引起重度粒细胞缺乏症1例并文献分析

目的　分析甲巯咪唑片致重度粒细胞缺乏症的一般规律和临床特点。方法　基于1例甲巯咪唑片致重度粒细胞缺乏症的病例,检索中国知网、万方数据库和Pubmed数据库建库至2022年2月公开发表的文献,分析甲巯咪唑致重度粒细胞缺乏症的一般规律及临床特点。结果　共纳入文献44篇,包含患者49例,其中男性7例（14.3%）,女性42例（85.7%）,年龄（39.3±15.5）岁,日剂量为（29.9±11.9）mg,重度粒细胞缺乏症多发生于用药后1～3个月内,常有高热、咽痛等症状,大部分患者经积极治疗可好转,但仍有部分患者因感染性休克、呼吸衰竭而死亡。结论　甲巯咪唑可导致罕见的重度粒细胞缺乏症,临床医生应注意合理用药,以减少和避免重度粒细胞缺乏症的发生。     

改良氩激光周边虹膜成形术后前房角的改变

目的 探讨采用改良氩激光周边虹膜成形术后中晚期闭角型青光眼前房角的改变及疗效。方法 对20例34眼前房角关闭270°～360°,虹膜膨隆型及高褶虹膜型的中晚期闭角型青光眼,采用大光斑、低能量的曲线形、斜照、略模糊光斑光凝的改良氩激光周边虹膜成形术式。 结果 术后随访6～24个月,平均10.8 个月,其中1年以上者14例26眼。15例26眼眼压控制≤21 mmHg(76.47％);28眼周边前房加深,房角粘连范闱减轻或重新开放(82.35%) 全部治疗眼的周边虹膜皱缩,堆积现象缓解,并发症少,有效地保护了患者仅存的视功能。结论 改良氩激光周边虹膜成形术是治疗中、晚期闭角型青光眼的有效方法之一     

联合激光手术治疗中晚期闭角型青光眼

目的：评价联合激光手术治疗中，晚期闭角型青光眼的临床效果及应用价值。方法：采用随机对照临床研究方法，将52例（78眼）中，晚期慢性闭角型青光眼患者分为两组。联合激光手术组（氩激光周边虹膜成形术联合氩激光加Nd:YAG激光周边虹膜切除术）32例（46眼），小梁切除术组20例（32眼），其中8例为同一患者左右眼对照。结果：两组比较，联合激光手术组，术后早期眼压控制率为95．65％（P＜0．05），术后视力提高迅速而且稳定（P＜0．05），术后并发症轻而少（P＜0．05），术后无需加用抗青光眼药物治疗的患者明显增多（P＜0．05），结论：联合激光手术安全有效，可作为中，晚期闭角型青光眼一种可行的治疗方法。     

Heterozygote of TAP1 Codon637 decreases susceptibility to HPV infection but increases susceptibility to esophageal cancer among the Kazakh populations

Background

The role of human papillomavirus (HPV) may be involved in the development of esophageal cancer (EC) and the polymorphic immune response gene transporter associated with antigen processing (TAP) may be involved in HPV persistence and subsequent cancer carcinogenesis. The current study aims to provide association evidence for HPV with EC, to investigate TAP1 polymorphisms in EC and assess its association with HPV statuses and EC in Kazakhs.

Methods

The HPV genotypes in 361 patients with EC and 66 controls selected from Kazakh population were evaluated using PCR. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was performed to detect two SNPs of TAP1 in 150 cases comprised of 75 HPV⁺ and 75 HPV^- patients and 283 pure ethnic population of Kazakh and evaluate their associations with susceptibility to EC. A case-to-case comparison based on the genotyping results was conducted to address the function of TAP1 variants in the involvement of HPV.

Results

The presence of four HPV genotypes in EC tissues ― including HPV 16, 18, 31, 45 ― was significantly higher at 64.6 % than those in controls at 18.2 % (P < 0.001). Such presence was strongly associated with increased risk of EC (OR 8.196; 95 % CI 4.280–15.964). The infection of HPV16, and multi-infection of 16 and 18 significantly increase the risk for developing EC (OR 4.616, 95 % CI 2.099–10.151; and OR 6.029, 95 % CI 1.395–26.057 respectively). Heterozygote of TAP1 D637G had a significantly higher risk for developing EC (OR 1.626; 95 % CI 1.080–2.449). The odds ratio for HPV infection was significantly lower among carriers of TAP1 D637G polymorphism (OR 0.281; 95 % CI 0.144–0.551).

Conclusions

HPV infection exhibits a strong positive association with the risk of EC in Kazakhs. Heterozygote of TAP1 D637G decreases susceptibility to HPV infection in patients with EC but increases susceptibility to EC among the Kazakh populations.     

保留股骨颈型人工全髋关节置换术92例

目的探讨保留股骨颈型人工全髋关节置换术的疗效。方法 2000年9月—2010年9月,我科开展保留股骨颈型人工全髋关节置换术92例(104髋),其中男50例,女42例,年龄20～65岁。结果本组经过0.5～10年随访,92例人工全髋关节置换术后,髋关节功能良好。影像学检查显示人工髋关节位置良好,假体无松动和下沉。结论保留股骨颈型人工全髋关节置换符合股骨近端生理顺应性,能防止股骨近端骨质疏松引起假体松动和下沉。