Liang-Yun Zhao

Psychosexual adjustment and age factors in 130 men undergone hypospadias surgery in a Chinese hospital.

The study investigated the psychosexual status and sexual function in adults who had hypospadias surgery at different ages. A detailed questionnaire was mailed to 130 patients who underwent hypospadias surgery between January 1988 and December 2007, and 50 healthy males who served as the control group. The patients were divided into three groups based on their age at which surgery was completed: group A (n = 32; <10 years); group B (n = 45; 10–18 years); and group C (n = 53; >18 years). The Zung Self‐Rating Anxiety Scale and The Zung Self‐Rating Depression Scale were used to assess psychosexual status; a designed questionnaire and the International Index of Erectile Function‐5 were used to assess sexual function. The incidence of anxiety and depression was significantly higher in patients than that in controls (P < 0.001), and was correlated with the age at which surgery was completed. The length and circumference of penises in patients were shorter than those of control groups with statistically significant differences (P < 0.01). There were no significant differences between patients and controls regarding libido strength, overall sexual satisfaction and erectile function (P > 0.05). In conclusion, difference existed in certain aspects of psychosexual and penile development between patients and controls. Hypospadias surgery should be performed early.

Was Fine-Needle Vasography an Obsolete Diagnostic Method to Evaluate Ejaculatory Duct Obstruction? Report of 37 Cases

Objectives: Based on comparative analyses of the precision as well as reliability of the diagnostic results on fine-needle vasography (FNV) and transrectal ultrasonography (TRUS) in the diagnosis of patients who were suspected of having ejaculatory duct obstruction (EDO), this paper aims to demonstrate whether or not FNV techniques still constitute the backbone of diagnostic imaging used in obstructive azoospermia of EDO. Materials and Methods: From July 2005 to December 2008, opening fine-needle punctuation and vasography were performed under local anesthesia in 37 infertile male patients in our center, all of whom were suspected of having bilateral EDO. The diagnostic criteria of these infertile males included characteristic changes of TRUS and/or characteristic changes of semen analysis. Comparative analyses were made of the diagnostic results of the two methods. Results: In the 37 male patients, 19 (51.35%) had been confirmed with pathognomonic findings of both semen analyses and TRUS on complete EDO. Of the others, 18 patients (48.65%) testified with only pathognomonic findings of TRUS but not the typical characteristics on semen analyses. When compared with diagnostic results via FNV however, there were only 5 patients (13.51%) who could be confirmed as having bilateral EDO, 16/37 showed obstruction of the epididymis and proximal vas deferens, 7/37 showed bilateral vasal multiple obstruction, 2 showed unilateral EDO and multiple obstruction of the contralateral vas deferens, and the other 6 patients showed unilateral vasal multiple obstruction and obstruction on the contralateral epididymis and proximal vas deferens. Free flow of the contrast medium could be defined into the bladder by vasography in 23 patients. Of the 23 patients, 12 were suspected of having delayed evacuation based on more than 50% contrast medium remaining inside their seminal vesicles after exhaustion of urine. Conclusion: Our analyses suggest that despite its advantages of being non-invasive, the diagnostic effect of TRUS is limited by both accuracy and reliability. In contrast, although an invasive radiographic imaging method, FNV has been proven as being informative when providing preoperative details about obstruction and other symptoms. After 3 years of research we came to the conclusion that opening fine-needle punctuation and vasography have not become outdated, at least recently, and will remain a necessary and effective method to identify diseases and to provide a strictly defined morphology of the seminal vesicle and ductal system for more comprehensive diagnosis of obstructive azoospermia of EDO.

Screening and identification of a renal carcinoma specific peptide from a phage display peptide library

BackgroundSpecific peptide ligands to cell surface receptors have been extensively used in tumor research and clinical applications. Phage display technology is a powerful tool for the isolation of cell-specific peptide ligands. To screen and identify novel markers for renal cell carcinoma, we evaluated a peptide that had been identified by phage display technology.MethodsA renal carcinoma cell line A498 and a normal renal cell line HK-2 were used to carry out subtractive screening in vitro with a phage display peptide library. After three rounds of panning, there was an obvious enrichment for the phages specifically binding to the A498 cells, and the output/input ratio of phages increased about 100 fold. A group of peptides capable of binding specifically to the renal carcinoma cells were obtained, and the affinity of these peptides to the targeting cells and tissues was studied.ResultsThrough a cell-based ELISA, immunocytochemical staining, immunohistochemical staining, and immunofluorescence, the Phage ZT-2 and synthetic peptide ZT-2 were shown to specifically bind to the tumor cell surfaces of A498 and incision specimens, but not to normal renal tissue samples.ConclusionA peptide ZT-2, which binds specifically to the renal carcinoma cell line A498 was selected from phage display peptide libraries. Therefore, it provides a potential tool for early diagnosis of renal carcinoma or targeted drug delivery in chemotherapy.

Varicocele anatomy during subinguinal microsurgical varicocelectomy in Chinese men.

Knowledge of subinguinal microsurgical varicocelectomy is of fundamental importance to ensure that varicocele is resolved and testicular function is preserved. Our study aimed to describe the number of veins, arteries and lymphatics in the subinguinal spermatic cord and to clarify their differences between two sides, between patients with different complaints and between varicoceles with different clinical grades. A total of 102 consecutive patients underwent 162 primary subinguinal microsurgical varicocelectomies, during which the number of vessels with different diameters was recorded. A mean number of 12.9 internal spermatic veins, 0.9 external spermatic veins, 1.8 internal spermatic arteries and 2.9 lymphatics were identified per cord. 88.2% of the internal spermatic arteries were surrounded by a dense complex of adherent veins. The external spermatic vein or veins were found in 49.4% of the cases. The mean number of medium (1–3 mm in diameter) internal spermatic veins on the left was larger than that on the right (P < 0.001). The mean number of medium internal spermatic veins in grade III varicocele was larger than that in grade I or grade II (P < 0.015). There was no significant anatomical difference between the men presenting for infertility, chronic testicular pain and both the two complaints.

A modified single-armed technique for microsurgical vasoepididymostomy

This study is to evaluate the effectiveness of a modified single-armed suture technique for microsurgical vasoepididymostomy (VE) in patients with epididymal obstructive azoospermia. From September 2011 to December 2011, microsurgical two-suture longitudinal intussusception VEs were performed using our modified single-armed suture technique in 17 men with epididymal obstructive azoospermia at our hospital. Two of these patients underwent repeated VEs after previous failed VEs, and one patient underwent unilateral VE because of an occlusion of the left abdominal vas deferens. The presence of sperm in the semen sample at 3 months postoperation was used as the preliminary endpoint of this study. Each patient provided at least one semen sample at the 3-month time point, and the patency was assessed by the reappearance of sperm (>10(4) ml(-1)) in the semen. The mean operative time for the modified technique was 219 min. Patency was noted in 10 men (58.8%), including one patient who underwent repeated VE. The patient who underwent unilateral anastomosis manifested no sperm postoperatively in his semen. Sperm granulomas were not detected in this cohort. The results of this study demonstrate that our modified technique for microsurgical longitudinal intussusception VE is effective. We believe that it is a practical alternative that may reduce operation time and obviate the suture crossing.