Influence of the sperm DNA fragmentation index on the outcome of rescue ICSI and the clinical value of rescue ICSI / 中南大学学报(医学版)

OBJECTIVES@#As a remedy for the failure of in vitro fertilization (IVF), rescue intracytoplasmic sperm injection (R-ICSI) has been widely carried out, but it has failed to significantly improve the fertilization rate and clinical pregnancy rate. Sperm DNA fragmentation index (DFI) was highly correlated with pregnancy outcome of artificial assisted reproduction. This study aims to investigate the effect of the sperm DFI on the outcome of R-ICSI and the clinical value of R-ICSI.@*METHODS@#This retrospective analysis was conducted among 140 infertile couples receiving R-ICSI in from January 2014 to December 2019. The subjects were assigned into a total fertilization failure (TFF)+low DFI group (R-ICSI after TFF and DFI<30%) (n=63), a TFF+high DFI group (R-ICSI after TFF and DFI≥30%) (n=16), a partial fertilization failure (PFF)+low DFI group (R-ICSI after PFF and DFI<30%) (n=52), a PFF+high DFI group (R-ICSI after PFF and DFI≥30%) (n=9). All transferred embryos were come from R-ICSI. The general clinical data [infertility duration, male age, female age, basal serum level of follicle stimulating hormone (FSH), basal serum level of luteinizing hormone (LH), antral follicle count, endometrial thickness of human chorionic gonadotropin (HCG) day, and eggs] and R-ICSI cycle outcomes (fertilization rate, normal fertilization rate, cleavage rate, good embryo rate, implantation rate, clinical pregnancy rate and live birth rate) were analyzed. In addition, the effect of R-ICSI on the fertilization outcome of conventional IVF total fertilization failure and partial fertilization failure was explored.@*RESULTS@#There was no significant difference in the general clinical data and R-ICSI cycle outcome between the TFF+low DFI group and the TFF+high DFI group (all P>0.05). There was no significant difference in the general clinical data between the PFF+low DFI group and the PFF+high DFI group (all P>0.05). The fertilization rate and normal fertilization rate in the PFF+low DFI group were significantly higher than those in the PFF+high DFI group (85.40% vs 72.41%, 71.90% vs 58.62%, respectively; both P<0.05). However, there was no significant difference in cleavage rate, good embryo rate, implantation rate, clinical pregnancy rate, and live birth rate between the 2 groups (all P>0.05). The R-ICSI cycle of TFF: A total of 79 fresh cycles, 57 fresh transplant cycles, a total of 761 unfertilized oocytes, and 584 M II oocytes were treated with R-ICSI, the fertilization rate was 83.22%, the normal fertilization rate was 75.51%, the cleavage rate was 98.15%, the good embryo rate was 40.74%, the implantation rate was 30.56%, and the clinical pregnancy rate was 43.86%; 29 live births were obtained. The R-ICSI cycle of PFF: A total of 61 fresh cycles, 31 fresh transplant cycles, a total of 721 unfertilized oocytes, and 546 M II oocytes were treated with R-ICSI; the fertilization rate was 83.33%, the normal fertilization rate was 69.78%, the cleavage rate was 97.36%, the good embryo rate was 44.39%, the implantation rate was 25.42%, and the clinical pregnancy rate was 45.16%; 12 live births were obtained.@*CONCLUSIONS@#In the case of partial fertilization failure of IVF, the sperm DFI affects the fertilization rate and normal fertilization rate of R-ICSI; whether it is a TFF of IVF or PFF of IVF, ICSI can be used as an effective remedy way.

Impact of sperm DNA and acrosome integrity and acrosome reaction rate on outcomes of rescue intracytoplasmic sperm injection / 南方医科大学学报

<p><b>UNLABELLED</b>Objective To explore the effects of sperm DNA integrity rate, acrosome integrity rate and acrosome reaction rate on the outcomes of rescue intracytoplasmic sperm injection (ICSI).</p><p><b>METHODS</b>This retrospective analysis was conducted among 97 infertile couples receiving rescue ICSI due to failure of in vitro fertilization procedures in our Reproductive Medicine Center. Of these 97 women, 41 had clinical pregnancy and 56 did not, and the effects of sperm DNA integrity rate (estimated by DNA fragmentation index, DFI), acrosome integrity rate and acrosome reaction rate on rescue ICSI outcomes were analyzed.</p><p><b>RESULTS</b>No significant difference was found in paternal age, testosterone value, testicular volume, FSH, female patient' age or the number of eggs retrieved between the two groups (P>0.05), but the infertility years was significantly shorter in the pregnancy group than in the non-pregnancy group (P<0.05). The fertilization rate and cleavage rate were similar between the two groups (P>0.05), but the good embryo rate was significantly higher in the pregnancy group (P<0.05). The sperm DNA integrity or acrosome reaction rate did not differ significantly between the two groups (P>0.05), but the acrosome integrity rate was significantly higher in the pregnancy group (P<0.05). The sperm DNA integrity rate, acrosome integrity or acrosome reaction rate were not correlated with the fertilization rate, cleavage rate or good embryo rate (P>0.05). The pregnancy rate, twin and single fetus rates were 42.3%, 10.3% and 32.0% in this cohort after recue ICSI, respectively.</p><p><b>CONCLUSION</b>Rescue ICSI is an effective treatment after failed in vitro fertilization procedure, and sperm acrosome integrity rate is associated with the outcome of rescue ICSI.</p>

Testicular and epididymal sperm comparison of DNA integrity rate and ICSI outcome / 重庆医学

Objective To comparative analysis the intracytoplasmic sperm injection (ICSI)result and rate of sperm DNA in-tegrity (DNA fragmentation index,DFI)about testicular and epididymis sperm.Methods Totally 183 obstructed azoospermia pa-tients were choosed to use ICSI.80 cycles by PESA and 103 cycles by TESA,compared two groups of sperm DNA integrity rate and ICSI outcome.Results Sperm DNA integrity rate,fertilization rate,cleavage rate,good-qualityembryo rate and pregnancy rate com-pared with no difference by ICSI(P >0.05).Conclusion DNA integrity rate and ICSI outcomes of the testis and epididymis sperm have no significant differences,clinicians can be based on personal experiences or patients,wills to select sperm for ICSI.

Influencing factors of radial artery spasm in digital subtraction angiography of transradial approach in patients with ischemic cerebrovascular disease / 国际脑血管病杂志

Objective To investigate the risk factors and their prevention and treatment approaches for occurring radial artery spasm (RAS) during the brain digital subtraction angiography (DSA) with transradial catheterization in patients with ischemic cerebrovascular disease.Methods The patients who underwent DSA of transradial approach because of ischemic cerebrovascular disease were enrolled.Their clinical data,surgical complications,and radial artery spasm were collected.The data of occurring RAS or not during DSA of transradial approach in patients were compared.Multivariate logistic regression analysis was used to analyze the risk factors for occurring RAS during DSA of transradial approach.Results A total of 100 patients with ischemic cerebrovascular disease who underwent DSA of transradial approach (74 ischemic stroke,26 transient ischemic attack) were enrolled,of which 21 (21％) had RAS.Of the 21 patients with RAS,4 suspended their operations and completed their DSA after spasm relief; another 17 were treated with intrathecal cocktail (heparin 2500 U,nitroglycerin 0.5 mg,verapamil 1.25 mg) and completed their DSA after spasm relief.There were significant differences in the proportions of radial artery diameter (1.89 ±0.28 mm vs.2.12 ± 0.17 mm; t =1.582,P =0.041),duration of operation (12.3 ± 3.1 min vs.9.8 ±2.7 min; t =1.264,P =0.038),and radial artery diameter ＞2 mm (9.52％ vs.65.82％ ;x2 =9.624,P =0.002),radial artery anatomy variation (23.81％ vs.0.27％; x2 =14.185,P＜ 0.001),and the first successful puncture (42.86％ vs.78.48 ％ ;x2 =5.335,P =0.021) in patients between RAS group and the non-RAS group.Multivariate logistic regression analysis showed that the radial artery anatomy variation (odds ratio [OR] 1.940,95 ％ confidence interval [CI] 1.372-2.241; P=0.023) was an independent risk factor for the occurrence of RAS.Radial artery diameter ＞2 mm (OR 0.752,95％ CI 0.352-0.847;P=0.043) and the first successful puncture (OR 0.843,95％ CI 0.367-0.941; P=0.045) were the independent protective factors for RAS.Conclusions RAS is a common complication of DSA of transradial approach.Repeated puncture,radial artery diameter,and radial artery anatomy variation are its most important influencing factors.

Risk factors for carotid sinus reactions during carotid artery stenting: a retrospective case series / 国际脑血管病杂志

Objective To investigate the risk factors for carotid sinus reactions (CSR) during internal carotid artery stenting (CAS).Methods The clinical data of 36 patients treated with CAS were enrolled retrospectively.The patients were divided into either a CSR group or a non-CSR group according to whether they had CSR or not.The risk factors for CSR during procedure were analyzed using univariate and multivariate logistic regression analysis.Results Of the 36 patients,25 had CRS (7 simple hypotension,4 simple bradycardia,and 14 both co-existence).The constituent ratios of the patients of the age ≥ 75 years (64.00％ vs.27.27％ ;x2 =2.384,P =0.028),degree of CAS 70％ to 99％ (76.00％ vs.36.36％ ; x2 =4.430,P =0.035),symptomatic stenosis (72.00％ vs.36.36％ ; x2 =4.082,P =0.043),calcified plaque (76.00％ vs.36.36％ ;x2 =4.430,P =0.035),distance from stenosis to bifurcation ≤ 10 mm (72.00％ vs.27.27％ ;x2 =5.029,P =0.025) and balloon expansion (64.00％ vs.18.18％ ;x2 =44.483,P =0.000) in the CSR group were significantly higher than those in the non-CSR group.Multivariate logistic regression analysis showed that age ≥ 75 years (odds ratio [OR] 1.520,95％ confidence interval [CI] 1.376-4.369; P =0.034),distance from stenosis to bifurcation ≤ 10 wm (OR 2.432,95％ CI 2.423-3.421; P =0.041) and balloon expansion (OR 3.631,95％ CI 1.764-4.738; P=0.003) were the independent risk factors for occurring CSR during CAS.Conclusions CSR is a common perforrance during CAS.Advanced age,distance from stenosis to bifurcation ≤ 10 mm and balloon expansion are the independent risk factors for occurring CSR.

High ligation of varicocele improves sperm DNA integrity in patients with asthenospermia / 中南大学学报(医学版)

OBJECTIVE@#To assess how high ligation of varicocele improves sperm DNA integrity in patients with asthenospermia.@*METHODS@#The DNA fragmentation index (DFI) and semen analysis were conducted in 30 subjects with normal sperm samples, and the parameters were used as references. Fifty-six patients from the Department of Urology of the Second Affiliated Hospital of Chongqing Medical University from April 2009 to April 2011 all signed the informed consent. Semen was collected 1 week before the high ligation of varicocele and 3 months after the surgery. We compared the change of the integrity of sperm DNA and semen.@*RESULTS@#Three months after the high ligation of varicocele, DFI and semen indexes significantly improved (P0.05). Six months later, 27 spouses were pregnant out of the 53 surgical patients (50.9%). DFI of the pregnancy group and the non-pregnancy group was (13.90±9.70)% and (20.10±10.27)%, with significant different (P<0.05).@*CONCLUSION@#Varicocelectomy can improve the sperm DNA integrity in patients with asthenospermia, whose effect is not related to surgical approach, unilateral or bilateral varicocele or varicocele grade.

Correlation between the dynanic changes of serum high-sensitivity Creactive protein and restenosis after internal carotid artery stenting / 国际脑血管病杂志

Objective To investigate the dynamic change of serum high sensitive C-reactive protein (hsCRP) after carotid artery stenting (CAS) and its correlation with in-stent restenosis.Methods The serum hsCRP levels were determined before procedure,at 12 hours,7 days,3 and 6 months after procedure in patients who underwent CAS in the Department of Neurology,Jinling Hospital,Nanjing Their cerebral angiography was reexamined and whether there was in-stent restenosis after 6 months was observed.Results Eighty-four patients treated with CAS were included in the study.Fifteen (24％) had in-stent restenosis after CAS.The stenosis in 3 of them was ＞ 50％,and the stenosis m 12 of them was 30％ to 50％.The serum hs-CRP levels in all patients after procedure were significantly higher than those before treatment (all P ＜ 0.01 ),and they were significantly lower at 6 months after procedure than before treatment (all P ＜0.01).Univariate analysis showed that the proportion of diabetes in the restenosis group was significantly higher than that in the non-restenosis group (P＜0.01).At 7 days (8.83 ± 1.94 mg/L vs.6.77 ± 1.63 mg/L,t =14.398,P=0.044),3 months after procedure (8.26 ± 1.32 mg/L vs.4.58 ± 1.45 mg/L,t =17.569,P =0.008) and 6 months after procedure (7.04 ± i.07 mg/L vs.3.12 ± 1.28 mg/L,t =21.867,P =0.003),the serum hs-CRP levels in the restenosis group were significantly higher than those in the non-restenosis group,and the difference of the serum hs-CRP level (△ hs-CRP) before procedure and at 6 month after procedure was significantly lower than that in the nonrestenosis group (0.85 ± 0.13 mg/L vs.4.89 ± 0.94 mg/L,t =16.987,P =0.000).Multivariate logistic regression analysis showed that /hs-CRP (odds ratio [ OR] 2.392,95％ confidence interval [ CI] 1.538 -3.513; P =0.009) and diabetes (OR 1.840,95％ CI 1.372 -2.241; P =0.023) were the risk factors for instent restenosis.Conclusions The serum hs-CRP level increased significantly at 12 hours after CAS procedure,and then decreased continuously.At 6 months after procedure,the more decrease of the serum hs-CRP level,the lower risk of occurring in-stent restenosis was.

The effect of Compound Xuanju Capsule and Prednisone on male infertility / 国际中医中药杂志

Objective To observe the curative effect of the combined action of Compound Xuanju Capsule and Prednisone on oligospermatism and antisperm antibody due to yang deficiency of kidney. Methods 136 patients were randomly divided into two groups: a treated group, which was taken Compound Xuanju Capsule and Prednisone, and a control group, which was taken Prednisone and Tamoxifen Citrate Tablet. Both groups received a 3-month therapy. The conditions of semen and antisperm antibody between the two groups were observed before and after the treatment. Results The total effective rate of the treated group was 90.94% (61 in 67 cases), and in which 11 cases were pregnant (16.41%). While the total effective rate of the control group was 63.07% (41 in 65 cases), and in which 2 cases were pregnant (3.08%).The clinical efficacy of the treated group was better than that of the control group. (P＜0.05) After the treatment, sperm density and motility of two groups were both evidently increased, (P＜0.05, P＜0.01) and the treated group increased much more obviously (P＜0.05). Conclusion The combined action of Compound Xuanju Capsule and Prednisone can improve the curative effect on the treatment for male infertility from oligospermatism and antisperm antibody due to yang deficiency of kidney.

Survival after pulmonary metastasectomy: experience in 26 patients / 中国肺癌杂志

<p><b>BACKGROUND</b>Surgical resection becomes standard treatment for pulmonary metastatic tumor with operative indication. The aim of this study is to analyze the indication and surgical efficacy of pulmonary metastasectomy.</p><p><b>METHODS</b>From November 1991 to May 2003, a total of 26 patients with pulmonary metastatic tumors were treated surgically in our hospital, 12 cases were males and 14 females, with an average age of 50 years old. The metastatic tumors came from different organs and tissues, 5 cases accompanied by metastatic tumors of liver or brain.</p><p><b>RESULTS</b>Four cases underwent pneumonectomy, 8 lobectomy, and 14 wedge resection (in which 8 cases underwent mildly invasive operation using video-assisted thoracic surgery). No operative death occurred. 5-year survival rate was 27.3% (3/11), 2-year survival rate 42.9% (9/21) and 1-year survival rate 69.2% (18/26).</p><p><b>CONCLUSIONS</b>Pulmonary metastasectomy is recommended in pulmonary metastases with operative indication, and is still effective in cases accompanied by resectable metastatic tumors of liver or brain. Mildly invasive operation using video-assisted thoracic surgery might be chosen for some cases with single metastatic locus.</p>

Study on ?_2-adrenergic receptor genetic polymorphisms in asthmatics / 中国实用内科杂志

0.05).Conclusion these results suggest that ?_2-AR 16、27 locus genetic polymorphism is not correlated with asthma.