Objectives To assess the effectiveness and safety of carnitine in the treatment of idiopathic asthenozoospermia. Methods The Cochrane Library, MEDLINE, EMbase, and CNKI were searched between Jan 1995 and Dec 2006. Both English and Chinese studies were included in the review if they were randomized controlled trials (RCTs) involving men with idopathic asthenozoospermia who were treated with carnitine. Trial screening, data extraction, and quality assessment of included trials were conducted by method recommended by Cochrane Collaboration. Statistical analysis was conducted using RevMan 4.2.10 software. Results Five RCTs involving 346 patients met the inclusion criteria, and 307 patients were included in the meta-analysis. The results showed that: after being treated with carnitine for 3 and 6 months, the difference of the patients’ partners’ spontaneous pregnancy rate between treatment group and control group was statistically significant with RR2.46 and 95% CI1.12 to 5.43 (Z=2.23, P=0.03). After being treated with carnitine for 3 and 6 months, the difference of forward motile sperm per ejaculate between treatment group and control group was not statistically significant with WMD 9.16 and 95%CI 0.14 to 18.18 (Z=1.99, P=0.05) and WMD 5.28 and 95%CI –4.45 to 15.01 (Z=1.06, P=0.29). After being treated with carnitine for 3 and 6 months, the difference of percentage of forward sperm motility between treatment group and control group was not statistically significant with WMD 14.56 and 95%CI –4.49 to 33.61( Z=1.50 ,P=0.13), and WMD 7.34 and 95%CI –5.93 to 20.61 (Z=1.08, P=0.28). After being treated with carnitine for 3 and 6 months, the difference of total motile sperm per ejaculate between treatment group and control group was not statistically significant with WMD 15.32 and 95%CI –1.34 to 31.98 (Z=1.80, P=0.07) and WMD 6.20, 95%CI –3.00 to 15.39 (Z=1.32, P=0.19).After being treated with carnitine for 3 and 6 months, the difference of percentage of total sperm motility between treatment group and control group was not statistically significant with WMD 2.97 and 95%CI –5.75 to 11.69 (Z=0.67, P=0.50) and WMD 4.48 and 95%CI-9.17 to18.14 (Z=0.64, P=0.52). After being treated with carnitine for 3 and 6 months, the difference of semen volume between treatment group and control group was not statistically significant with WMD –0.12 and 95%CI –0.55 to 0.30 (Z=0.57, P=0.57) and WMD 0.03 and 95%CI –0.38 to 0.45 (Z=0.16, P=0.87). After being treated with carnitine for 3 and 6 months, the difference of sperm concentration between treatment group and control group was not statistically significant with WMD 7.92 and 95%CI – 2.85 to18.68 (Z=1.44, P=0.15), and WMD 1.02 and 95%CI –5.09 to 7.14 (Z=0.33, P=0.74). Three RCTs reported that there were no serious side effects of carnitine during the treatment period. Conclusions The available evidence indicates that spontaneous pregnancy rate would increase with carnitine therapy, while it is short of improvement of semen parameters. There is no serious side effect of carnitine. Because of lack of evidence, we cannot conclude that carnitine is effective in improving the prognosis of infertile patients with idiopathic asthenozoospermia. More high quality trials with large sample are proposed.
Objective To establ ish an efficient and stable culture method of human umbil ical vein endothel ial cells (HUVECs) in vitro so as to provide good source of seed cells for tissue engineered vascular grafts and for precl inical research. Methods The umbil ical cords were harvested from full-term normal delivered neonates, which were perfused with0.1% collagenase II by self-made needle and were digested at 37 and 5% CO2 humidified incubator. The HUVECs were cultured in endothel ial culture medium (ECM) containing 5% fetal bovine serum (FBS) and 1% endothel ial cell growth factor (ECGS). HE staining of the umbil ical cords before and after digestion was used to observe the detachment of HUVECs, flow cytometry to detect the purity of primary HUVECs, and inverted phase contrast microscope to observe the morphology of the cultured HUVECs. The growth of the 3rd passage cells was measured by MTT assay; immunocytochemical technique and matrigelbased capillary-l ike tube formation assay were carried out to identify the function of HUVECs. Results After digestion of 0.1% collagenase II, marked HUVECs detachment was observed with complete digestion. The purity of the HUVECs was 99.56% by digestion of 0.1% collagenase II at 37 and 5% CO2 humidified incubator for 15 minutes. Primary HUVECs showed a cobblestone or pitching stone-l ike appearance in vitro, forming a confluent monolayer cells after 2-3 days of culture. MTT assay demonstrated that HUVECs showed the fastest growth speed at 3 to 4 days, and showed growth of cell fusion at about 5 days. Immunocytochemistry showed that HUVECs highly expressed endothel ial marker factor VIII. Matrigel based capillary-l ike tube formation assay showed that it could form endothel ial-l ike tube structures after 24 hours of culture. Conclusion Using improved method and ECM could obtain high quantity and high qual ity primary HUVECs, which might be a kind of promising seed cells for tissue engineering and precl inical research.