Dexamethasone protects the glycocalyx on the kidney microvascular endothelium during severe acute pancreatitis / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

OBJECTIVE@#This study demonstrated that dexamethasone (DEX) protects the endothelial glycocalyx from damage induced by the inflammatory stimulus tumor necrosis factor-α (TNF-α) during severe acute pancreatitis (SAP), and improves the renal microcirculation.@*METHODS@#Ninety mice were evenly divided into 3 groups (Sham, SAP, and SAP+DEX). The SAP mice model was established by ligature of pancreatic duct and intraperitoneal injection of cerulein. Renal perfusion and function, and morphological changes of the glycocalyx were evaluated by laser Doppler velocimetry, electron microscopy, and histopathology (hematoxylin and eosin (H&E) staining), respectively. Serum levels of syndecan-1 and TNF-α were assessed by enzyme-linked immunosorbent assay (ELISA). The protective effects of dexamethasone on the glycocalyx and renal microcirculation were evaluated.@*RESULTS@#Significantly high levels of serum TNF-α were detected 3 h after the onset of SAP. These levels might induce degradation of the glycocalyx and kidney hypoperfusion, resulting in kidney microcirculation dysfunction. The application of dexamethasone reduced the degradation of the glycocalyx and improved perfusion of kidney.@*CONCLUSIONS@#Dexamethasone protects the endothelial glycocalyx from inflammatory degradation possibly initiated by TNF-α during SAP. This is might be a significant discovery that helps to prevent tissue edema and hypoperfusion in the future.

Clinical application of cross microsurgical vasovasostomy in scrotum for atypical obstructive azoospermia / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Seminal duct obstruction may result in obstructive azoospermia (OA) and severe oligoasthenoteratozoospermia (OAT) (<0.5 million/mL) (Nordhoff et al., 2015). Cases of partial OA and OAT can be treated effectively by microsurgical anastomosis (Goldstein and Kim, 2013) to obtain successful surgical reversal. However, microsurgical vasovasostomy (VV) (Dickey et al., 2015) and vasoepididymostomy (VE) (Peng et al., 2017) are not suitable for patients with atypical OA and poor epididymis conditions or unpredictable obstruction of the distal vas deferens. For those patients, cross anastomosis may be applied instead of routine VE or VV. A single-center, retrospective, comparison study was conducted, which assessed the usefulness of the cross VV (CVV) in the scrotum for indication and efficacy. A total of 77 cases with OA or OAT were included, and 20 cases implemented cross anastomosis, including unilateral CVV (UCVV) in 4 cases, unilateral VE plus CVV (UVE+CVV) in 11 cases, and unilateral VV-based CVV (UVV+CVV) in 5 cases. The other 57 cases received no cross-matching anastomosis. The patency and natural pregnancy rates in one year were 75.0% and 50.0%, respectively, in the UCVV group; 54.5% and 27.3%, respectively, in the UVE+CVV group; and 60.0% and 40.0%, respectively, in the UVV+CVV group. The CVV in the scrotum in the selected patients with OA and severe OAT could yield good results. We regard the CVV in the scrotum as an efficacious operation with a lower risk of injury in cases of atypical OA.

Microsurgical treatment of obstructive azoospermia: a report of 76 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the clinical effect of microsurgical vasoepididymostomy and/or vasovasostomy in the treatment of obstructive azoospermia.</p><p><b>METHODS</b>This study included 76 patients with obstructive azoospermia, 53 treated by bilateral vasoepididymostomy (8 involving the epididymal head, 18 involving the epididymal body, 5 involving the epididymal tail, and 22 involving the epididymal head, body and tail), 14 by unilateral vasoepididymostomy, and the other 9 by unilateral vasoepididymostomy + unilateral vasovasostomy (including cross anastomosis). We followed up the patients for 2 to 16 months for the patency rate, routine semen parameters, and pregnancy outcomes.</p><p><b>RESULTS</b>The success rate of bilateral vasoepididymostomy, unilateral vasoepididymostomy, and unilateral vasoepididymostomy + unilateral vasovasostomy (including cross anastomosis) were 62.26% (33/53), 35.71% (5/14), and 77.78% (7/9), respectively. The average sperm concentrations in the three groups of patients were (27.9 +/- 5.74), (11.8 +/- 8.33), and (19.9 +/- 7.53) x 10(6)/ml, the average total sperm counts were (65.6 +/- 13.71), (28.0 +/- 15.86), and (69.2 +/- 28.59) x 10(6), and the mean rates of progressively motile sperm were (22.3 +/- 3.18), (11.0 +/- 9.77), and (15.8 +/- 5.05)%, respectively. The success rates of bilateral vasoepididymostomy that involved the epididymal head, body, tail, and all the three parts were 62.5, 72.22, 60, and 54.55%, respectively. Natural pregnancy was achieved in 8 (10.53%) of the total number of cases.</p><p><b>CONCLUSION</b>Microsurgery is effective for the treatment obstructive azoospermia. Unilateral vasoepididymostomy + unilateral vasovasostomy is superior to the other procedures, followed by bilateral vasoepididymostomy. Bilateral vasoepididymostomy involving the epididymal body may achieve a slightly better effect than that involving the other epididymal parts.</p>

Albumin resuscitation protects against traumatic/hemorrhagic shock-induced lung apoptosis in rats / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To determine the effects of albumin administration on lung injury and apoptosis in traumatic/hemorrhagic shock (T/HS) rats.</p><p><b>METHODS</b>Studies were performed on an in vivo model of spontaneously breathing rats with induced T/HS; the rats were subjected to femur fracture, ischemia for 30 min, and reperfusion for 20 min with Ringer's lactate solution (RS) or 5% (w/v) albumin (ALB), and the left lower lobes of the lungs were resected.</p><p><b>RESULTS</b>Albumin administered during reperfusion markedly attenuated injury of the lung and decreased the concentration of lactic acid and the number of in situ TdT-mediated dUTP nick-end labelling (TUNEL)-positive cells. Moreover, immunohistochemistry performed 24 h after reperfusion revealed increases in the level of nuclear factor kappaB (NF-kappaB), and phosphorylated p38 mitogen-activated protein kinase (MAPK) in the albumin-untreated group was down-regulated by albumin treatment when compared with the sham rats.</p><p><b>CONCLUSION</b>Resuscitation with albumin attenuates tissue injury and inhibits T/HS-induced apoptosis in the lung via the p38 MAPK signal transduction pathway that functions to stimulate the activation of NF-kappaB.</p>

Diagnosis and treatment of priapism due to neoplasma of penis / 中华男科学杂志

<p><b>OBJECTIVE</b>To improve the clinician's ability for emergency treatment of priapism.</p><p><b>METHODS</b>Both cases received 2 mg to 8 mg of metaraminol injection at the root of cavernous body, and perfusion of heparinized saline at glans and root of cavernous body of the penis by contrecoup, but they had not good response to the above therapy. At last surgery was performed.</p><p><b>RESULTS</b>Total penectomy was performed for both cases. One case was diagnosed of penile sarcoma, and another was metastatic transitional cell carcinoma.</p><p><b>CONCLUSION</b>Priapism due to neoplasma is infrequent, it should not be misdiagnosed in case of emergency.</p>

Clinical study of recombinant human growth hormone for male climacteric syndrome / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the effect and safety of the recombinant human growth hormone (rhGH) in the treatment of male climacteric syndrome and to investigate the specificity and sensitivity of insulin-like growth factor-1 (IGF-1) and serum total testosterone as the curative effect index.</p><p><b>METHODS</b>Forty patients aged 40-75 with male climacteric syndrome were divided into two groups randomly and injected with rhGH 4 IU (Group A) or 8 IU (Group B). The patients were followed up for about 12 weeks after 12-week treatment and then asked the questions of the assessed index of male climacteric syndrome at the 4th, 8th and 12th week of the treatment and 12 weeks after the treatment. The serum IGF-1, total testosterone (TT) and prostatic specific antigen(PSA) were measured before and after the treatment. The data were analysed by the software of SPSS 12.0 for Windows.</p><p><b>RESULTS</b>The scores of the 4th, 8th and 12th week and the follow-up significantly declined compared with the baseline (P < 0.01), but did not differ significantly between Groups A and B (P > 0.05). After the treatment, serum total testosterone, PSA and prostate volume had no obvious change (P > 0.05), and the IGF-1 level was markedly higher than the baseline and the normal public. No obvious side effect was found during the treatment and follow-up.</p><p><b>CONCLUSION</b>Small dosage of rhGH(4 IU/week) for 12 weeks can effectively treat male climacteric syndrome. The value of IGF-1 was parallel with the treatment effects. Short-time and small-dosage treatment with rhGH is safe and has little side effect.</p>