Micro-dissection testicular sperm extraction for non-obstructive azoospermia patients with the history of secondary testicular injury / 中华男科学杂志

<p><b>Objective</b>To investigate the value of micro- dissection testicular sperm extraction (micro-TESE) in the treatment of non-obstructive azoospermia (NOA) in patients with the history of secondary testicular injury.</p><p><b>METHODS</b>Totally, 121 NOA patients with the history of secondary testicular injury underwent micro-TESE in our hospital from September 2014 to December 2017. We analyzed the correlation of the sperm retrieval rate with the causes of testicular injury and compared the outcomes of the ICSI cycles with the sperm retrieved from the NOA males by micro-TESE (the micro-TESE group) and those with the sperm ejaculated from severe oligospermia patients (sperm concentration <1×10⁶/ml, the ejaculate group). Comparisons were also made between the two groups in the female age, two-pronucleus (2PN) fertilization rate, transferrable embryos on day 3 (D3), D3 high- quality embryos, D14 blood HCG positive rate, embryo implantation rate, and clinical pregnancy rate.</p><p><b>RESULTS</b>Testicular sperm were successfully retrieved by micro-TESE in 86.0% of the patients (104/121), of whom 98.4% had the history of orchitis, 75.5% had been treated surgically for cryptorchidism, and 63.6% had received chemo- or radiotherapy. No statistically significant differences were observed between the micro-TESE and ejaculate groups in the 2PN fertilization rate (59.4% vs 69.3%, P > 0.05), D14 blood HCG positive rate (44.6% vs 57.9%, P > 0.05), embryo implantation rate (31.8 %% vs 32.6%, P > 0.05) and clinical pregnancy rate (41.5% vs 48.7%, P > 0.05). However, the rate D3 transferrable embryos was significantly lower in the micro-TESE than in the ejaculate group (40.5% vs 52.2%,P < 0.05), and so was that of D3 high-quality embryos (32.5% vs 42.1%, P < 0.05).</p><p><b>CONCLUSIONS</b>Micro-TESE can be applied as the first choice for NOA patients with the history of secondary testicular injury, but more effective strategies are to be explored for the improvement of ICSI outcomes with the sperm retrieved by micro- TESE.</p>

Epidemiological characteristics and clinical phenotype of sporadic retinitis pigmentosa / 中华实验眼科杂志

BackgroundRetinitis pigmentosa (RP)is a group of progressive monogenic inheritance disease.Seldom epidemiology is performed to summarize the varied clinical phenotypes,especially some sporadic cases with untypical genetic history.ObjectiveThe aim of this survey was to investigate the clinical epidemiological characteristics and phenotype of sporadic RP.MethodsA prospective cohort study was designed.A survey of a series of clinically diagnosed sporadic primary RP patients was conducted at the Southwest Eye Hospital from July 2010 to November 2011.A total of 130 patients that matched the inclusion criteria were enrolled in this survey.Clinical ocular examinations and questionnaire surveys were given,including ophthalmoscopic examination,best corrective visual acuity( BCVA ),perimetry and Ganzfield electroretinogram (ERG)and color fundus photo.RP with different phenotypes were classified. ResultsA total of 130 sporadic RP patients were collected in this survey.Of them,66 were male and 64 were female with a mean age of (36.9±14.4) years.The average onset age of these subjects was (21.2±18.4) years.Seven (5.38％) patients had consanguineous marriage history,and 13 ( 10.00％ )patients had systemic disease.Forty-four (33.85％) patients had outdoor jobs,and 86 (66.15％ ) worked indoor.Eighty-nine patients had typical RP ( 68.5％ ),and the number of patients that developed central RP and sine pigmento RP were 16 ( 12.3％ ) and 16( 12.3％ ),respectively.An absence of a- and b-waves in full-field ERG wasdetected in 99 (76.15％ ) cases.The longest duration of night blindness was identified in typical RP patients and the lowest BCVA in central RP patients.ConclusionsThe age at first onset is early in sporadic RP.There are wide variations in different types of RP,but the ERG outcome is specific for all RP types.

Study on the value assessment of various screening programs regarding cervical cancer screening strategy in the rural areas of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the application value and feasibility of various cervical screening methods and to explore a rapid and efficient cervical cancer screening program for the women in the rural areas of China.</p><p><b>METHODS</b>We sequentially conducted human papillomavirus (HPV) DNA test by hybrid capture-2 (hc2) with cervical cells, liquid-based thinprep cytology test (TCT), visual inspection with acetic acid (VIA), visual inspection with iodine (VILI), colposcopy respectively for the 2499 married women between 30 and 49 years from Xiushui county of Jiangxi province. All the detection methods were performed independently under double-blind design. Women who were diagnosed positive for having any VIA,VILI and colposcopy inspection or for those women who were diagnosed negative for VIA, VILI and colposcopy but with positive result of HPV or TCT test underwent cervical biopsy directly and endocervical curettage (ECC)when necessary. We performed cervical biopsy endocervical curettage within two weeks to observe the sensitive (SE), specificity (SP), negative predict value (NPV) and positive predict value (PPV) of these detection methods when used alone or combined each other, including HPV test, TCT inspection, VIA, VILI, and colposcopy, the pathological diagnosises of cervical tissue were confirmed by IARC (International Agency for Research on Cancer) while the cytological findings were underegone through the updated program of TBS (The Bethesda System) in 2001.</p><p><b>RESULTS</b>A total of 2499 women underwent the screening and found 443 women who were diagnosed as HPV positive, 337 women with abnormal cervical cytology and 27 women with ASC-H, 157 cases with ASCUS; 103 cases with HSIL, 49 cases with LSIL and 1 cervical cancer. According to the pathological findings. There were 181 women diagnosed as cervical intraepithelial neoplasia (CIN) or cervical cancer, including 81 cases with CIN1 37 cases with CIN2,60 case cervical cancer. The sensitivity rates of HPV, TCT, HPV+ TCT, VIA, VILI, VIA+VILI and colposcopy were 96.67%, 89.47%, 97.98%, 56.57%, 36.36%, 63.64% and 39.39%, and the specificity rates were 85.00%, 96.91%, 86.97%, 94.60%, 96.23%, 92.97% and 98.14% respectively.</p><p><b>CONCLUSION</b>HPV + TCT seemed to be more sensitive than other screening methods in the cervical cancer screening program.</p>

Clinical analysis of intracytoplasmic sperm injection in patients with previous fertilization failure after conventional IVF / 中华男科学杂志

<p><b>OBJECTIVE</b>To analyze the clinical outcome of intracytoplasmic sperm injection (ICSI) in patients with previous fertilization failure after conventional IVF.</p><p><b>METHODS</b>Data from 20 ICSI cases (22 ICSI cycles) with previous complete failure of fertilization or with fertilization rate < or = 20% between January 2002 and December 2004 were retrospectively analyzed. The control group consisted of 100 consecutive ICSI cycles for male factor infertility in the same period.</p><p><b>RESULTS</b>The fertilization rate dramatically increased from 5.4% after conventional IVF to 76.9% after ICSI treatment (chi-squared = 264.66, P < 0.001). However, the fertilization rate in the subgroup with previous low fertilization was significantly lower than those in the control and in the subgroup without previous fertilization (67.9% vs 77.5%, 67.9% vs 84.2%). Compared with the control group, the subgroup without previous fertilization had a higher pregnancy rate and implantation rate, but only the difference in the implantation rate was statistically significant (40.5% vs 18.9%).</p><p><b>CONCLUSION</b>ICSI can overcome previous fertilization failure with conventional in vitro fertilization and thus improve the clinical outcome.</p>

Sperm sex chromosome analysis and preimplantation genetic diagnosis of patients with sex chromosome anomalies / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the constitution of abnormal spermatozoa from patients with sex chromosome anomalies.</p><p><b>METHODS</b>Triple color fluorescence in situ hybridization (FISH) was used to determine the sex chromosome constitution of spermatozoa from three patients with sex chromosome anomalies (case 1:46,XY/47,XXY, case 2:45,XO/46,X,Yqh-, case 3:47,XXY). The preimplantation genetic diagnosis (PGD) was performed to case 2.</p><p><b>RESULTS</b>An increased ratio (2.05 vs 1) of X-bearing to Y-bearing spermatozoa was only observed in case 2, who also had an increased incidence of total abnormal spermatozoa (29.71%). An increased incidence of total abnormal spermatozoa (4.91%) was also observed in case 3. Among the constitution of abnormal spermatozoa, case 2 had the increased proportions of XY18 disomy, O18 monosomy and XO monosomy, while case 3 had an increase proportion of XY18 disomy (1.87%). PGD was performed to case 2 and one embryo with XX1818 was selected for implanting.</p><p><b>CONCLUSION</b>Using FISH to detect the sperm sex chromosomes in patients with sex chromosome anomalies can provide the useful information to evaluate the risk of sex chromosome anomalies in preimplantation embryos.</p>

Effects of eicosapentaenoic acid on metabolic abnormalities and renal pathologic changes in KKA~y/Ta mice / 上海第二医科大学学报

Objective To elucidate the effects of eicosapentaenoic acid(EPA)on the metabolic abnormalities and renal pathologic changes during the early stage of diabetic nephropathy in KKAy/Ta mice.Methods Sixteen KKAy/Ta mice(7 weeks of age)were randomly divided into two groups(n=8).Since 12 weeks of age,EPA group were injected with EPA at 1 g?kg-1?d-1 intraperitoneally for 8 weeks,and the control group were injected with 0.9% saline.The levels of serum fatty acids were detected at 20 weeks of age by gas chromatography.The phenotypic characterizations were measured at 12,16 and 20 weeks of age.Renal morphological examinations were performed after 8 weeks of treatment.Results Serum EPA levels in KKAy/Ta mice treated with EPA [(125.8?15.5)?g/mL] were significantly higher than those in control group [(69.2?7.8)?g/mL] at 20 weeks of age(P

Outcome of repeated epididymal sperm aspiration or testicular sperm extraction in azoospermic patients / 中华男科学杂志

<p><b>OBJECTIVE</b>To review the outcome of repeated percutaneous sperm aspiration (PESA) and testicular sperm extraction (TESE) for intracytoplasmic sperm injection (ICSI).</p><p><b>METHODS</b>Forty-three cycles of 31 cases of azoospermic patients which underwent at least two PESA or TESE for ICSI from January 2001 to December 2002 were collected. The sperm retrieval, fertilization, implantation and clinical pregnancy were analyzed.</p><p><b>RESULTS</b>Twenty-four cases underwent PESA and 7 cases underwent TESE. There were not any complications in these patients. Compared with the first cycle of 154 cases, the fertilization rate, implantation rate and clinical pregnancy rate were 78.39% vs 73.64%, 19.68% vs 18.38% and 34.88% vs 37.91%, respectively(P > 0.05).</p><p><b>CONCLUSIONS</b>Repeated PESA or TESE is safe and well tolerated in azoospermic patients. Compared with the first cycle, the differences of repeated PESA or TESE cycles in fertilization rate, implantation rate and clinical pregnancy rate were not statistically significant.</p>

Preimplantation genetic diagnosis for beta-thalassemia using whole genome amplification / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To achieve pregnancy with unaffected embryo using in vitro fertilization and embryo transfer (IVF-ET) and preimplantation genetic diagnosis(PGD) for the couples at risk of having children with beta-thalassemia.</p><p><b>METHODS</b>A couple carrying different thalassemia mutations of codon 41/42 and codon IVS2 position 654 received standard IVF treatment and intracytoplasmic sperm injection, embryo biopsy, single cell polymerase chain reaction and DNA analyses, and only the unaffected or carrier embryos were transferred to uterus. Pregnancy confirmation, and prenatal diagnosis were done at 20 week's gestation.</p><p><b>RESULTS</b>A total of 13 embryos were analyzed in the IVF cycle. PGD indicated that 2 were normal 18.1 , 3 were affected 27.3 , and 6 were carriers 54.5 ; diagnosis was not possible in 2. Three embryos were transferred to uterus on the third day after oocyte retrieval. Ultrasonography showed twin pregnancy with one blighted ovum. The prenatal diagnoses revealed that both fetuses were unaffected, one normal baby and one carrier were born.</p><p><b>CONCLUSION</b>These studies represent the successful application of PGD for beta-thalassemia in China.</p>

Sex determination of human preimplantation embryo using nested polymerase chain reaction / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>Using nested polymerase chain reaction (PCR) to perform preimplantation gender diagnosis.</p><p><b>METHODS</b>One (or two) lymphocyte and blastomere (n=50/group) were collected and prepared under the following conditions: (1) water only (H(2)O); (2) freeze-thaw liquid nitrogen, then boiling; (3) potassium hydroxide/dithiotheriol, heated to 65 degree centigrade, followed by acid neutralization (KOH). Cells were analyzed by PCR using nested primers amplification with amelogenin gene.</p><p><b>RESULTS</b>The amplification rate and allele dropout (ADO) rate for male lymphocytes by the three methods were 83%, 94%, 95% and 24%, 12%, 4%, respectively. Using two cells per reaction did not increase the amplification rate for the KOH method.</p><p><b>CONCLUSION</b>The KOH method for DNA preparation is superior to the other methods evaluated. Dual blastomere biopsy and independent blastomere analysis may improve preimplantation diagnostic reliability.</p>

Sperm retrieval methods and pregnancy outcome of 100 azoospermia patients / 中华男科学杂志

<p><b>OBJECTIVES</b>To review the retrospective treatment results of the azoospermia patients during January 2001 to January 2002 in the fertility center.</p><p><b>METHODS</b>One hundred males attempted intracytoplasmic sperm injection (ICSI) cycle for treatment of azoospermia. All patients were undergone sperm retrieval by percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE) while their wives received conventional ovarian hyperstimulation. The hormone levels, testicular histology, the rates of sperm retrieval, fertilization, implantation and pregnancy were analysed and evaluated.</p><p><b>RESULTS</b>Sperm were retrieved by PESA in 76 of 100 (76%) and by TESE in 23 of 100 (23%) men of azoospermia. The fertilization rate, implantation rate and clinical pregnancy rate were 71.3%, 20.35% and 42.11% respectively in PESA group, and 75.18%, 22.05% and 41.60% respectively in TESA group. Thirty-two clinical pregnancies were achieved with 15 ongoing pregnancies and subsequent live delivery for 15 cases in PESA group, and 2 cases of miscarriage, while 10 clinical pregnancies were achieved with 6 ongoing pregnancies, 2 cases of live delivery and 2 cases of miscarriage in TESA group. One case failed to retrieve sperm by TESE and canceled.</p><p><b>CONCLUSIONS</b>Hormonal levels and testicular histology are unable to predict which men with azoospermia will have sperm retrieved by PESA and TESE. PESA and TESE with ICSI are effective methods to treat azoospermia. There were no significant differences in fertilization, implantation and clinical pregnancy rate between two groups.</p>