Zhongyi Sun

Clinical analysis of the characterization of magnetic resonance imaging in 102 cases of refractory haematospermia

To analyze the pathogenesis of persistent and refractory haematospermia and to evaluate the aetiological diagnostic value of magnetic resonance imaging (MRI) for this type of haematospermia. Clinical data from 102 patients with persistent and refractory haematospermia was retrospectively analysed. Data collected included history, symptoms, as well as ultrasound and MRI of the morphological features of the bilateral seminal vesicles (SV) and ejaculatory duct (ED) areas. Criteria for inclusion were haematospermia symptoms that occurred more than six times, that lasted more than 6 months, and that did not improve after >1 month of conservative treatment. Patients underwent seminal vesiculoscopy with a post‐surgery follow‐up of 3–48 months [average (18.1 ± 10.3) months]. Of the 102 patients that underwent MRI examination, data from 88 patients (86.3%) showed typical and characteristic changes in the ED area, including the signal intensity changes in 60 (58.8%), SV volume changes in 32(31.4%), the formation of cysts such as prostatic utricular cysts in 27 (26.5%), Müllerian cysts in 4 (3.9%), ED cysts in 5 (4.9%) and a SV cyst in 1(1.0%). The MRI findings were confirmed by seminal vesiculoscopy and all patients received appropriate treatment. In 14 patients (13.7%), no obvious abnormal changes were observed with MRIs, however, these patients were diagnosed and successfully managed using seminal vesiculoscopy. Some degrees of ED obstruction was usually found during surgery. The symptoms of haematospermia disappeared 1–2 months after surgery in all patients. Two patients had a recurrence of haematospermia, underwent the same treatment, and recovered during the follow‐up period. The aetiology of the most cases of the refractory haematospermia can be distinguished using the three‐dimensional MRI. Typical abnormalities observed on MR images are signal intensity, SV volume changes and cyst formation. MRI has significant etiological diagnostic value and provides reliable information for the subsequent treatment of patients with persistent and refractory haematospermia.

ORIGINAL ARTICLE: Immunocontraceptive Effect of DNA Vaccine Targeting Fertilin β in Male Mice

Citation Sun Z, Jin F, Li Y, Zhang J. Immunocontraceptive effect of DNA vaccine targeting fertilin β in male mice. Am J Reprod Immunol 2010; 63: 282–290

Immunocontraceptive effect of DNA vaccine targeting fertilin beta in male mice.

Citation Sun Z, Jin F, Li Y, Zhang J. Immunocontraceptive effect of DNA vaccine targeting fertilin β in male mice. Am J Reprod Immunol 2010; 63: 282–290

Reduction of fertility in male mice immunised with pSG.SS.C3d3.YL.Bin1b recombinant vaccine

Abstract Objectives To study the anti-fertility effect of a DNA vaccine using Bin1b as the target antigen in male mice. Methods A novel recombinant eukaryotic vector containing a fusion gene sequence of mouse Bin1b in tandem with three copies of C3d fragment (C3d3) was used to construct pSG.SS.C3d3.YL.Bin1b. The correct expression of the Bin1b-C3d3 protein was confirmed in transfected HEK293 cells by indirect immunofluorescence and western blot analysis. The fertility of immunised mice was determined by a mating experiment and sperm motility test. Anti-Bin1b antibody titres in sera were examined by ELISA assays. Binding activity of C3d3 fragment of the fusion protein was verified in C3d receptor-expressing Raji cells and flow cytometric analysis. Results Immunisation of pSG.SS.C3d3.YL.Bin1b recombinant DNA vaccine significantly decreased sperm motility and compromised fertility in male mice. ELISA results showed that the titres of anti-Bin1b IgG in sera of immunised mice increased markedly with the immunisation process. Further, the anti-fertility effect of pSG.SS.C3d3.YL.Bin1b was significantly better than that of pSG.SS.YL.Bin1b DNA vaccine and generated higher titres of anti-Bin1b antibody. Conclusions Our results show that recombinant DNA vaccine targeting Bin1b can markedly reduce fertility in male mice, providing an alternative approach for birth control. Chinese Abstract 摘要 目的研究以Bin1b作为雄性小鼠靶抗原的DNA疫苗的抗生育作用。 方法使用包含小鼠Bin1b与三拷贝C3d片段（C3d3）融合基因序列的新型重组真核载体构建pSG.SS.C3d3.YL.Bin1b。间接免疫荧光和蛋白印迹分析证实Bin1b-C3d3蛋白在转染HEK293细胞中正确表达。交配试验和精子运动试验来确定免疫小鼠的生育能力。ELISA 检测血清中的抗Bin1b抗体滴度。C3d受体表达Raji细胞和流式细胞分析验证融合蛋白中C3d3片段的结合活性。 结果免疫接种pSG.SS.C3d3.YL.Bin1b重组NDZ疫苗显著降低雄性小鼠的精子运动力，损害其生育能力。ELISA 结果表明，免疫过程中雄性小鼠抗Bin1b抗体IgG的血清滴度显著降低。而且，pSG.SS.C3d3.YL.Bin1b产生较高的抗Bin1b抗体滴度，其抗生育效应明显优于pSG.SS.YL.Bin1b DNA疫苗的抗生育效应。 结论我们的研究结果表明，以Bin1b为靶抗原的重组DNA疫苗能够显著降低雄性小鼠的生育能力，为生育控制提供了一种新的方法。 关键词 抗生育能力，Bin1b，C3d，重组载体疫苗

1091 IMAGING DIAGNOSIS, TRANSURETHRAL ENDOSCOPIC OBSERVATION AND MANAGEMENT OF 43 CASES OF PERSISTENT AND REFRACTORY HEMATOSPERMIA

The goal of this study was to explore minimally invasive transurethral imaging and surgery for the treatment of severe, persistent hematospermia in cases that were refractory to conservative treatments. The study included 43 patients (aged 22-77 years; average, 44.6 years) with long-lasting, severe hematospermia, accompanied by discomfort or pain in the lumbosacral or perineal region, dysuria, frequent micturition, decreased semen volume, and/or azoospermia. Patient symptoms had persisted for 1 to 10 years (average, 5.3 years). Computed tomography or magnetic resonance imaging of each patient was evaluated, and transurethral surgery was performed. The causes of hematospermia were identified in all 43 patients, and their ejaculatory duct obstruction or seminal vesiculitis was successfully treated. No serious intraoperative or postoperative complications occurred. Pathologic analyses revealed that all of the resected or biopsied seminal vesicle tissues had chronic nonspecific inflammation in the seminal vesicle wall, and no tumors were identified. Preoperative symptomology of hematospermia disappeared in all patients followed up for 2 to 30 months (average, 16 months). A single patient experienced recurrence at 11 months and had a second minimally invasive surgery that was curative. A total of 95.3% (41 of 43) of the patients experienced normal orgasmic intensity after surgery. Magnetic resonance imaging is a valuable and accurate diagnostic method for the identification of causative factors underlying hematospermia. Transurethral dilation of ejaculatory ducts, incision of the verumontanum or the distal end of the ejaculatory ducts, and incision or resection of the relevant cysts represent simple, safe, and reliable approaches for the management of refractory cases of hematospermia that do not respond to conservative treatments.

ORIGINAL ARTICLE: Immunocontraceptive Effect of DNA Vaccine Targeting Fertilin β in Male Mice: DNA VACCINE TARGETING FERTILIN β

Citation Sun Z, Jin F, Li Y, Zhang J. Immunocontraceptive effect of DNA vaccine targeting fertilin β in male mice. Am J Reprod Immunol 2010; 63: 282–290