Strategies of preserving urinary continence in transurethral plasmakinetic enucleation of the prostate for benign prostate hyperplasia / 中华男科学杂志

Objective@#To explore the strategies of preserving urinary continence in transurethral plasmakinetic enucleation of the prostate (PKEP) for benign prostate hyperplasia (BPH).@*METHODS@#We treated 65 BPH patients by PKEP with preservation of urinary continence (UC-PKEP), which involved protection of the external urethral sphincter in the beginning of surgery, proper preservation of the anterior lobe of the prostate to protect the internal urethral sphincter in the middle, and preservation of the integrity of the bladder neck towards the end. We compared the postoperative status of urinary continence of the patients with that of the 54 BPH cases treated by complete plasmakinetic enucleation of the prostate (Com-PKEP).@*RESULTS@#All the operations were performed successfully with the urinary catheters removed at 5 days after surgery. In comparison with Com-PKEP, UC-PKEP achieved evidently lower incidence rates of urinary incontinence at 24 hours (31.49% vs 13.85%, P 0.05), and 3 months (3.70% vs 0%, P >0.05) after catheter removal. Compared with the baseline, the maximum urinary flow rate (Qmax) was significantly improved postoperatively in both the Com-PKEP (［7.43 ± 3.26］ vs ［20.58 ± 3.22］ ml, P <0.05) and the UC-PKEP group (［8.04 ± 2.28］ vs ［20.66 ± 3.08］ ml, P <0.05).@*CONCLUSIONS@#Transurethral PKEP is a safe and effective method for the management of BPH, during which the strategies of avoiding blunt or sharp damage to the external urethral sphincter in the beginning, properly preserving the anterior lobe of the prostate in the middle and preserving the integrity of the bladder neck towards the end may help to achieve rapid recovery of urinary continence.

Clinical Observation of 654-2 Acupoint Injection at Zusanli Combined with Shiatsu at Neiguan Acupoint for Colonoscopy Analgesia / 中国中医药信息杂志

Objective To investigate the effects of 654-2 acupoint injection at Zusanli combined with shiatsu at Neiguan acupoint for colonoscopy analgesia. Methods Totally 140 patients underwent colonoscopy were divided into observation group and control group according to the random number table method, with 70 cases in each group. The observation group were given 654-2 acupoint injection at Zusanli (5 mg each side) combined with shiatsu at Neiguan acupoint (the patient to feel the acid, swelling, hemp began to check, until colonoscopy to return to the ileocecum, stop pressing), and the control group were given 654-2 muscle injection (10 mg) 10 min before colonoscopy. The pain scores, checking time and patients'' satisfaction degree of the two groups were compared, and serum beta-endorphin (β-EP) and substance P (SP) level of the two groups before and after examination were compared. Results The pain degrees during colonlscope inserting and passing the sigmoid, splenic flexure of colon of the observation group were significantly lower than those of the control group (P<0.001); testing time was less than that of the control group (P<0.001); patient satisfaction scores were higher than those of the control group (P<0.001); serum β-EP level after examination was higher than that of the control group (P<0.001); SP level was lower than that of the control group (P<0.001). Conclusion 654-2 acupoint injection at Zusanli combined with shiatsu at Neiguan acupoint for colonoscopy analgesia can adjust the serum levels of β-EP and SP, with obvious analgesic effect, which can shorten the testing time.

Follow-up of children born after intracytoplasmic sperm injection with epididymal and testicular spermatozoa / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>To evaluate the safety of intracytoplasmic sperm injection (ICSI) with epididymal or testicular sperm, this study compared children born after ICSI treatment with epididymal or testicular sperm with children conceived after ICSI with ejaculated sperm.</p><p><b>METHODS</b>This retrospective study included 317 children born after ICSI with percutaneous epididymal sperm aspiration (PESA), 103 children born after ICSI with testicular sperm aspiration (TESA), and a control group of 1008 children born after ICSI with ejaculated sperm. All of the patients received their assisted reproductive treatment in the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2004 to December 2011. Data, such as the rate of stillbirths, perinatal mortality, gestational age, birth weight, and the rate of congenital malformations of the three groups, were compared.</p><p><b>RESULTS</b>PESA and TESA children were not different from ICSI children in the rate of stillbirths, perinatal mortality, infant mortality rate, gestational age, the rate of prematurity, and the rate of malformations (P > 0.05). A slight increase in birth defects was reported in the TESA group compared with those in the control group, but there was no significant difference between the groups (P > 0.05).</p><p><b>CONCLUSION</b>ICSI with epididymal or testicular sperm does not lead to more stillbirths or congenital malformations compared with ICSI using ejaculated sperm.</p>

Efficacy observation on infiltrative exophthalmos treated with acupuncture and acupoint massage / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical efficacy of acupuncture combined with massage on infiltrative exophthalmos so as to provide a more effective treatment for infiltrative exophthalmos in hyperthyroidism.</p><p><b>METHODS</b>Forty-five cases of infiltrative exophthalmos were randomly divided into an acupuncture massage group (25 cases) and a western medicine group (20 cases). In acupuncture massage group, acupuncture was applied mainly at Jingming (BL 1), Qiuhou (EX-HN 7), Chengqi (ST 1) and Shangming (Extra); and massage was applied in combination on the back of the neck and the local points around the orbit. In western medicine group, Dexamethasone and Methotrexate were used for intravenous infusion, and Prednisone was for oral administration. The exophthalmos extent and clinical efficacy were compared between two groups.</p><p><b>RESULTS</b>Before and after the treatment, the exophthalmos extents were (20.27 +/- 1.22) mm and (18.11 +/- 0.87) mm in acupuncture massage group and were (20.34 +/- 1.20) mm and (19.47 +/- 1.11) mm in western medicine group separately, indicating remarkable improvement in two groups (both P < 0.01). The improvement in acupuncture massage group was superior remarkably to that in western medicine group (P < 0.01). The total effective rate (83.3%, 40/48) in acupuncture massage group was superior to that (53.8%, 21/39) in western medicine group, and with less adverse reaction.</p><p><b>CONCLUSION</b>Acupuncture combined with acupoint massage is an advanced therapy and has definite efficacy on infiltrative exophthalmos, which is superior to the conventional treatment in western medicine.</p>

Clinical application of oocyte vitrification in failed testicular sperm extraction cycles: report of 8 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical application value of oocyte vitrification in failed testicular sperm extraction cycles in non-obstructive azoospermia (NOA) patients.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 8 women undergoing oocyte frozen-thawing cycles by vitrification because of failed testicular sperm extraction from their NOA husbands and no banked donor sperm on the day of oocyte retrieval. The oocytes were cryopreserved by vitrification with cryotop and thawed 2 months later. The surviving metaphase II (MII) oocytes were injected with the banked donor sperm of the same blood type as the husbands by intracytoplasmic sperm injection (ICSI) for fertilization. The rates of oocyte survival, fertilization, cleavage, good embryos and pregnancy were evaluated.</p><p><b>RESULTS</b>Sixty oocytes were vitrified and 47 (78.3%) survived after thawing, of which 41 MII oocytes underwent ICSI and 33 (80.5%) of them were fertilized. The rates of cleavage and good embryos were 81.8% (27/33) and 59.3% (16/27) respectively. Fifteen of the embryos were transferred to the 8 patients, with 1.9 +/- 0.8 per cycle, of which 5 (33.3%) were confirmed by ultrasound to have been implanted and 5 resulted in clinical pregnancy (62.5%), all singleton without miscarriage. Three normal boys and 1 normal girl were already born, with the pregnancy time of (39 + 4 +/- 0.4) wk and newborn body weight of (3787.5 +/- 513.7) g, respectively.</p><p><b>CONCLUSION</b>Vitrification of oocytes in failed testicular sperm extraction cycles is a promising technique for preserving female fertility, which, with ICSI of banked donor sperm, may result in satisfactory clinical outcomes.</p>

Outcomes of ICSI with microamount frozen-thawed sperm obtained by PESA or TESA in the treatment of azoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effects and clinical pregnancy outcomes of intracytoplasmic sperm insemination (ICSI) with microamount frozen-thawed sperm obtained by percutaneous epididymal sperm aspiration (PESA) or testicular sperm aspiration (TESA) in azoospermia patients.</p><p><b>METHODS</b>We divided 365 azoospermia patients treated by ICSI into an experimental group (n = 123) and a control group (n = 242) , the former with microamount frozen-thawed sperm, and the latter fresh sperm obtained by PESA or TESA. The rates of fertilization, good embryos, clinical pregnancy, miscarriage, ectopic pregnancy and multiple pregnancy were analyzed and compared between the two groups.</p><p><b>RESULTS</b>With PESA, the experimental group showed no statistically significant differences from the control group in the rates of fertilization (75.67% vs 76.49%), good embryos (64.96% vs 66.09%), clinical pregnancy (55.21% vs 57.22%), clinical miscarriage (13.21% vs 12.61%), ectopic pregnancy (3. 77% vs 5.41%) and multiple pregnancy (37.74% vs 37.84%) (P > 0.05); nor with TESA (74.41% vs 76.43%, 64.63% vs 66.35%, 46.81% vs 53.39%, 18.18% vs 14.55%, 4.55% vs 1.82%, 37.74% vs 37.84%, P > 0.05). The revival rate of the frozen-thawed sperm from PESA was 70.07%, not significantly different from that of TESA (62.67%) (P > 0.05).</p><p><b>CONCLUSION</b>ICSI with frozen-thawed micro-amount sperm obtained by PESA or TESA is a safe, economic and effective method for the treatment of azoospermia. The techniques for reviving frozen sperm from PESA or TESA remain to be optimized, and whether these techniques may result in long-term genetic risks in the offspring deserves further investigation.</p>

Differences of Angiotensin II receptor expression between systemic and pulmonary circulation in children with left-to-right shunt congenital cardiac lesions / 中国当代儿科杂志

<p><b>OBJECTIVE</b>It has been shown that angiotensin converting enzyme inhibitors (ACEI) can reduce the ratio of pulmonary and systemic circulation blood flow (Qp/Qs) and thus decrease the blood flow of left-to-right shunt in children with left-to-right shunt congenital cardiac lesions. This suggests that there are differences in the expression of Angiotensin II receptors between systemic and pulmonary circulation. This study aimed to explore the differences of Angiotensin II receptors type 1 and type 2 (AT1 and AT2 receptors) expression between systemic and pulmonary circulation in children with left-to-right shunt congenital cardiac lesions.</p><p><b>METHODS</b>Lung and skeletal muscular tissues were obtained from 20 children with left-to-right shunt congenital cardiac lesions by biopsy during operation. The specimens were stained by immunohistochemistry techniques for AT1 and AT2 receptors. The technique of morphometric analysis was used to measure the immunoreactivity of AT1 and AT2 receptors (expressed by IOD values) of pulmonary, skeletal muscular and pleural small vascular wall the diameter of which was 15-100 microm.</p><p><b>RESULTS</b>The immunoreactivities of AT1 and AT2 receptors of pulmonary small vascular walls [(124 +/- 95)x10(3) and (85 +/- 62)x10(3) respectively] were significantly lower than those of skeletal muscular [(219 +/- 156)x10(3) and (155 +/- 139)x10(3) respectively] and those of pleural small vascular walls [(279 +/- 191)x10(3) and (175 +/- 128)x10(3) respectively] in children with left-to-right shunt congenital cardiac lesions (P < 0.05).</p><p><b>CONCLUSIONS</b>The expression of AT1 and AT2 receptors in small vascular walls of systemic circulation was higher than that of pulmonary circulation in children with left-to-right shunt congenital cardiac lesions.</p>