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ObjectiveTo observe the clinical efficacy of herb-partitioned moxibustion on the navel combined with Yishen Tongluo prescription in the treatment of infertility induced by idiopathic asthenozoospermia （iAZS） with kidney-Yang deficiency and collateral obstruction syndrome and its effect on sperm DNA damage and superoxide dismutase （SOD） in the seminal plasma. MethodsA total of 112 eligible patients who met the inclusion criteria were randomly divided into an observation group （56 cases） and a control group （56 cases）. The patients in the observation group were treated with herb-partitioned moxibustion on the navel combined with Yishen Tongluo prescription，while those in the control group received levocarnitine oral liquid. The primary observation indicators included spouse pregnancy rate，progressive motility （PR），and total sperm motility，and the secondary observation indicators included sperm DNA fragmentation index （DFI），SOD in the seminal plasma， and improvement of TCM syndromes. The treatment cycle was 12 weeks. Before and after treatment，the PR，total sperm motility，sperm DFI，SOD in the seminal plasma， and TCM syndrome scores were recorded. The patients were followed up for 12 weeks and the pregnancy status of spouses within 24 weeks （half a year） was recorded. The clinical efficacy of the two groups was evaluated. ResultThe pregnancy rate of spouses in the observation group was 15.69% （8/51）， higher than 3.85% （2/52） in the control group （χ2=4.118，P<0.05）. The total effective rate of the observation group was 88.24%（45/51）， superior to 69.23% （36/52）in the control group （Z=-3.402，P<0.01）. After treatment， PR， total sperm motility，sperm DFI， SOD in the seminal plasma， and TCM syndromes of the two groups were improved compared with those before treatment （P<0.05）， and the observation group was superior to the control group （P<0.05）. ConclusionHerb-partitioned moxibustion on the navel combined with Yishen Tongluo prescription in the treatment of iAZS-induced infertility patients with kidney-Yang deficiency and collateral obstruction syndrome can increase PR，total sperm motility， and SOD level in the seminal plasma， reduce sperm DFI，improve the TCM symptoms of patients， and improve the pregnancy rate of spouses. The mechanism may be attributed to the fact that this treatment can increase the SOD level in the seminal plasma of patients，enhance the body's antioxidant function，protect sperm from oxidative stress damage，and reduce sperm DFI.
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【Objective】 To predict the expression of human epidermal growth factor receptor 2 (HER2) in urothelial bladder carcinoma based on normalized apparent diffusion coefficient (ADC). 【Methods】 The preoperative pelvic 3.0T magnetic resonance imaging (MRI) images of 127 patients with urothelial bladder carcinoma were retrospectively studied, the ADC was measured, and the HER2 expression in postoperative tissue specimens was determined with immunohistochemistry (IHC). The differences in normalized ADC were analyzed among different HER2 expressions and among different expression divisions. Correlation between normalized ADC and HER2 expression was analyzed. The optimal diagnostic threshold for distinguishing different expression divisions were determined with receiver operating characteristic (ROC) curve. 【Results】 Normalized ADC was negatively correlated with HER2 expression (tau-b=-0.180, P=0.008). Normalized ADC of HER2 overexpression group (IHC 2+, 3+) was lower than that of HER2 negative group (IHC 0, 1+) (P=0.081). Normalized ADC of HER2 expression group (IHC 1+, 2+, 3+) was significantly lower than that of HER2 zero-expression group (IHC 0) (P=0.020). Normalized ADC of HER2 strong positive group (IHC 3+) was significantly lower than that of HER2 non-strong positive group (IHC 0, 1+, 2+) (P=0.024). The optimal diagnostic threshold of HER2 strong positive group was 0.849; the sensitivity, specificity and accuracy were 0.621, 0.909 and 0.765, respectively. The optimal diagnostic threshold of HER2 overexpression group was 0.909; the sensitivity, specificity and accuracy were 0.547, 0.667 and 0.607, respectively. 【Conclusion】 Normalized ADC is negatively correlated with HER2 expression. ADC may be a potential marker for predicting HER2 expression.
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ObjectiveTo observe the clinical effect of governor meridian moxibustion combined with modified Youguiwan in treating erectile dysfunction of kidney Yang deficiency type and its influence on the level of sex hormones and penile hemodynamics. MethodA total of 120 patients were randomized into the control group （60 cases in total， 3 dropouts/lost to follow-ups， 57 finally included） and treatment group （60 cases in total， 2 dropouts/lost to follow-ups， 58 finally included） with the random number table method. Both groups received governor meridian moxibustion （1 time/w， a total of 4 times）. In addition， the control group took oral compound Xuanju capsule （3 capsules/time， 3 times/d）， and the treatment group was given Jiawei Youguiwan （Chinese medicine decoction， 1 dose/d）. The administration lasted 4 weeks for both groups. The scores of 5th edition international index of erectile function （IIEF-5）， erection quality scale （EQS）， and erectile hardness score （EHS）， traditional Chinese medicine （TCM） syndrome score， levels of sex hormones ［testosterone （T）， follicle-stimulating hormone （FSH）， luteinizing hormone （LH）， prolactin （PRL）］， and parameters of penile hemodynamics ［peak systolic velocity （PSV）， end-diastolic volume （EDV）， and resistance index （RI）］ were recorded. ResultAfter treatment， the total effective rate was 87.93% （51/58） in the treatment group， higher than the 71.93% （41/57） in the control group （χ2=4.600 3， P<0.05）. After treatment， compared with before treatment，the treatment group registered increase in the scores of IIEF-5， EQS， and EHS （P<0.01）， decrease in TCM syndrome score （P<0.01）， rise of serum T level （P<0.05）， reduction in the levels of FSH， LH， and PRL （P<0.05）， increase in the levels of PSV and RI （P<0.05）， and down-regulation of EDV level （P<0.05）. ConclusionGovernor meridian moxibustion combined with modified Youguiwan can effectively improve the penile erectile function， erectile hardness， and erection quality， and relieve the clinical symptoms of erectile dysfunction patients of kidney Yang deficiency type.
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Objective To compare prospectively the features and effects of combined operation(splenorenal shunt plus portal-azygous devascularization) and portal-azygous devascularization only(PCDV)on portal(hypertension)(PH).Methods We summarized 360 cases of PH admitted from 1984 to 2004.All patients were randomly divided into two groups,one was combined operative group(250 patients) and the other was PCDV group(110 patients).The therapeutic effects and changes of portal hemodynamics were studied with doppler flowmeter(DCFI),free portal pressure(FPP) and digital subtraction angiography(DSA) pre-and post-operatively,and were measured directly during the course of the procedure.Results(1)Postoperative bleeding:Of all the patients who underwent combined operation,no case of rebleeding occurred in the short period after operation,and the rebleeding rate was 8.0% in the long period of follow-up.In the patients who underwent PCDV,the rebleeding rate was 5.5% in the short period after operation,and 17.6% at long-term follow up(P0.05).(3)There was a significant decrease in the diameter of portal vein,and FPP postoperatively in the combined operation group compared to PCDV group.There was a significant decreases of PVF in the PCDV group.But the decrease of PVF in the two groups had no significant difference.Conclusions The combined procedure has merits of greater decrease of FPP,and alleviation of the condition of hyperdynamic blood flow in the portal vein.The clinical effect is also better than that of portal-azygous devascularization only.
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Objective To investigate the hemodynamic changes during the progression of portal hypertension(PHT) by establishing a model of liver cirrhosis in rats.Methods Totally 100 healthy male SD rats were assigned to 5 groups randomly(1 control group and 4 experimental groups with 20 rats in each group).Animal model of cirrhosis was established by subcutaneous injection of carbon tetrachloride(CCl4) and drinking alcohol.Rats in control group were given water and forage.The changes in the portal hemodynamics during the pathological process of liver tissues were observed after 2,4,7 and 10 weeks.Results During the formation of experimental cirrhosis,the hepatocytes of rats underwent 4 processes: degeneration,necrosis,fibrosis and pseudolobular proliferation.The hemodynamic changes were observed: the mean arterial pressure declined gradually after injection,but the portal venous pressure,the inferior vena cava pressure and the portal vascular resistance increased slowly.The portal venous flow reduced after ascending whereas the splanchnic vascular resistance increased after descending.Conclusion This method can establish a stable cirrhosis PHT model,which can be made in large quantities.During the progression of PHT,there are significant changes in portal vein hemodynamics and pathology,which can be used in related research on PHT.