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显微镜下单针法纵向套叠输精管附睾吻合术后附睾管-输精管精道复通的影响因素
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作者 王璐瑶 吕坤龙 +3 位作者 张天标 郑涛 南永浩 王瑞 《现代泌尿外科杂志》 CAS 2024年第11期964-968,共5页
目的分析显微镜下单针法纵向套叠输精管附睾吻合术治疗附睾梗阻性无精子症术后附睾管-输精管精道复通的影响因素,为临床提高复通率提供参考。方法回顾性分析郑州大学第一附属医院男科于2020年9月—2023年1月行显微镜下单针法纵向套叠输... 目的分析显微镜下单针法纵向套叠输精管附睾吻合术治疗附睾梗阻性无精子症术后附睾管-输精管精道复通的影响因素,为临床提高复通率提供参考。方法回顾性分析郑州大学第一附属医院男科于2020年9月—2023年1月行显微镜下单针法纵向套叠输精管附睾吻合术的82例附睾梗阻性无精子症患者的临床资料,术后门诊和/或电话随访患者术后复通情况及配偶受孕情况。分析患者年龄、病程、身体质量指数(BMI)、既往病史(附睾炎、手术史、无)、术前精浆弹性蛋白酶(SPE)水平、吻合部位、吻合侧别、附睾液镜检精子质量、手术时长及住院时间对术后复通率的影响。结果82例患者的手术均成功实施,随访率95.12%(78/82),78例随访患者中已婚73例,复通率78.21%(61/78),61例复通患者中已婚56例,已婚患者配偶自然受孕率45.21%(33/73)。单因素分析结果显示年龄<30岁、病程<2年、术前SPE水平<290 ng/mL、双侧吻合、体尾部吻合及附睾液镜检有活动精子的患者有更高的术后复通率(P<0.05);BMI、既往病史、附睾液镜检活动精子数量、手术时间及住院时间对术后复通的影响无显著相关性(P>0.05)。多因素logistic回归分析结果显示患者术前SPE水平(OR=0.998,95%CI:0.997~1.000,P=0.008)、吻合部位(OR=10.724,95%CI:2.243~51.283,P=0.003)与术后复通显著相关。结论术前SPE水平和吻合部位是显微镜下输精管附睾吻合术后复通的显著影响因素。年龄<30岁、病程<2年、术前SPE水平<290 ng/mL、双侧吻合、体尾部吻合及附睾液镜检有活动精子的患者术后复通率较高。 展开更多
关键词 显微输管附睾吻合 梗阻性无子精症 附睾梗阻 影响因素 男性不育 浆弹性蛋白酶
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A TOP6BL mutation abolishes meiotic DNA double-strand break formation and causes human infertility 被引量:3
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作者 Yuying Jiao Suixing Fan +23 位作者 Nazish Jabeen Huan Zhang Ranjha Khan Ghulam Murtaza Hanwei Jiang Asim Ali Yang Li Jianqiang Bao Beibei Zhang Jianze Xu Bo Xu Hafiz Muhammad Jafar Hussain Qumar Zaman Ihsan Khan Ihtisham Bukhari Furhan Iqbal Ayesha Yousaf Sobia Dil Manan Khan Niaz Ahmad Hui Ma Xiaohua Jiang Yuanwei Zhang Qinghua Shi 《Science Bulletin》 SCIE EI CSCD 2020年第24期2120-2129,M0006,共11页
Meiosis is pivotal for sexual reproduction and fertility. Meiotic programmed DNA double-strand breaks(DSBs) initiate homologous recombination, ensuring faithful chromosome segregation and generation of gametes. Howeve... Meiosis is pivotal for sexual reproduction and fertility. Meiotic programmed DNA double-strand breaks(DSBs) initiate homologous recombination, ensuring faithful chromosome segregation and generation of gametes. However, few studies have focused on meiotic DSB formation in human reproduction.Here, we report four infertile siblings born to a consanguineous marriage, with three brothers suffering from non-obstructive azoospermia and one sister suffering from unexplained infertility with normal menstrual cycles and normal ovary sizes with follicular activity. An autosomal recessive mutation in TOP6BL was found co-segregating with infertility in this family. Investigation of one male patient revealed failure in programmed meiotic DSB formation and meiotic arrest prior to pachytene stage of prophase I.Mouse models carrying similar mutations to that in patients recapitulated the spermatogenic abnormalities of the patient. Pathogenicity of the mutation in the female patient was supported by observations in mice that meiotic programmed DSBs failed to form in mutant oocytes and oocyte maturation failure due to absence of meiotic recombination. Our study thus illustrates the phenotypical characteristics and the genotype-phenotype correlations of meiotic DSB formation failure in humans. 展开更多
关键词 Programmed meiotic DNA double-strand breaks TOP6BL mutation Meiotic DSB formation failure Human infertility Oocyte maturation failure Meiotic arrest
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