ObjectiveTo systematically evaluate the efficiency and safety of interventional embolization versus laparoscopic surgery in the treatment of varicocele. MethodsWe searched the Chinese Journal Full-text Database, Wanfang Medical Journal Database, and VIP Chinese Science and Technology Journal Full-text Database with such keywords as interventional therapy, embolization, laparoscope, and varicocele. For PubMed and Cochrane Library, MESH terms or keywords were interventional embolization, interventional therapy, embolization, laparoscope, laparoscopic surgery, and varicocele. All database were searched up to March 2015. Then we selected trials comparing interventional embolization versus laparoscopic surgery in the treatment of varicocele according to the including criteria. We assessed the quality of the included studies with the Newcastle-Ottawa Scale and conducted meta-analysis with revman 5.2 for the primary outcomes sperm improvement rate, recurrence rate, complication rate, pregnant rate, etc. ResultsWe included 7 trials comparing interventional embolization with laparoscopic surgery, including 1 prospective study and 6 retrospective studies, with a total of 349 patients receiving interventional therapy and 400 patients receiving laparoscopic surgery. Meta analysis of the included studies showed that there were no significant differences for sperm improvement rate[OR=1.17, 95%CI (0.70, 1.96), P=0.54], pregnant rate[OR=0.58, 95%CI (0.29, 1.13), P=0.11], recurrence rate[OR=0.84, 95CI% (0.40, 1.78), P=0.66] or complication rate[OR=0.68, 95%CI (0.34, 1.32), P=0.25] between the two groups. ConclusionPresent evidence shows that there is no significant difference between interventional embolization and laparoscopic surgery for varicocele.
Objective To explore the relationship between immune state and disease progression or severity of patients with hepatitis B virus (HBV). Methods A total of 332 patients infected with HBV diagnosed and treated from January 2012 to December 2013 were divided into acute hepatitis B (AHB) group (n=25), chronic hepatitis B (CHB) group (n=237) and cirrhosis group (n=70) according to disease progression. Moreover, CHB group was divided into mild (n=24), moderate (n=103), serious (n=72) and severe group (liver failure group,n=38) according to disease severity, while cirrhosis group was divided into hepatocellular carcinoma (HCC) group (n=13) and non-HCC group (n=57). The immune indexes including immunoglobulin (Ig), complement (C) and T-lymphocyte subsets were tested and compared. Results The immune indexes were not significantly different between AHB group and CHB group (P>0.05). Compared with AHB group and CHB group, cirrhosis group had higher levels of IgG and IgA, and lower levels of CD3+, CD4+ and CD8+ T cells count (P<0.05). Compared with non-HCC group, HCC group had more male patients without antiviral therapy, who had higher levels of C3 and C4 (P<0.05). As disease progressed, the levels of alanine fcell couaminotransferase, aspartate aminotransferase, total cholesterol, Fibroscan index, IgG, and IgA of CHB patients all gradually increased, while the levels of C3 and C4 and the counts of CD3+ and CD4+ T cells gradually declined. Conclusions The immune state of patients infected with HBV has a certain relationship with disease progression or severity, and immunoglobulin, complement and T cells count can partly reflect the severity of the disease. Cirrhosis patients accompanied with high levels of C3 and C4 should pay high attention to antiviral therapy and be vigilant on HCC.