中华男科学杂志最新文献

Objective: To explore the mechanism of Lingze Tablets (LZT) acting on BPH in rats based on the VEGFA/TNF/IL-6 signaling pathway.

Methods: We equally randomized 30 SPF SD male rats into five groups, normal control, BPH model control, low-dose LZT, medium-dose LZT and high-dose LZT, and established a BPH model in the latter four groups by induction with non-castrate testosterone propionate. After the modeling, we treated the rats in the normal and model groups by intragastrical administration of physiological saline, and those in the latter three groups with low-, medium-, and high-dose LZT respectively, all for 28 successive days. Then we collected the prostate tissue from the animals for observation of the changes in the prostatic indexes and histomorphology, detected the expressions of the proteins related to the VEGFA/TNF/IL-6 signaling pathway, and compared the data obtained among different groups.

Results: Compared with the normal controls, the rats in the model control group showed significant prostatic hyperplasia, markedly increased prostatic index (［0.84 ± 0.01］ g, P<0.05), thickness of the prostatic epithelia and infiltration of the luminal area, and dramatically up-regulated protein expressions of VEGFA (0.60 ± 0.02, P< 0.05), TNF (0.76 ± 0.02, P< 0.05) and IL-6 (0.64 ± 0.02, P< 0.05). In comparison with the model controls, the rats in the low-, medium- and high-dose LZT groups exhibited significantly decreased prostatic indexes (［0.76 ± 0.02］ g, ［0.58 ± 0.02］ g and ［0.52 0.01］ g, all P< 0.05), improved prostatic histomorphology, and down-regulated expressions of VEGFA (0.45 ± 0.01, 0.35 ± 0.01 and 0.31 ± 0.02, all P< 0.05), TNF (0.45 ± 0.01, 0.33 ± 0.01 and 0.27 ± 0.01, all P< 0.01) and IL-6 (0.44 ± 0.01, 0.36 ± 0.01 and 0.30 ± 0.01, all P< 0.01) in a dose-dependent manner.

Conclusion: LZT produces therapeutic effect on BPH by negatively regulating the VEGFA/TNF/IL-6 signaling pathway, reducing the expression levels of VEGFA, TNF and IL-6 proteins, and regulating cell proliferation, apoptosis and inflammatory response.

Objective: To investigate the effects of Xiongcan Yishen Formula (XYF) on ferroptosis in mouse TM3 Leydig cells after oxidative stress injury (OSI) induced by H2O2.　Methods: An oxidative stress injury model was established in mouse TM3 Leydig cells using H2O2 induction. The modeled TM3 cells were randomly divided into OSI group, XYF group, the ferroptosis inhibitor Ferrostatin-1 (F-1) group, and F-1+XYF group, which were respectively intervened with blank serum, 20% drug-containing serum, 2μmol/L F-1, and 2μmol/L F-1+ 20% drug-containing serum. A control group (normal TM3 cells + blank serum) was also set up. The morphology of cells in each group was observed, and the levels of testosterone, superoxide dismutase (SOD), reactive oxygen species (ROS), malondialdehyde (MDA), ferritin heavy chain 1 (FTH1), solute carrier family 7 member 11 (SLC7A11), glutathione (GSH), glutathione peroxidase 4 (GPX4), fatty acid CoA ligase 4 (FACL4), total iron ions, and ferrous ions were detected.

Results: Compared with the model group, the control group showed significantly decreased expression of ROS, MDA, FACL4, total iron, and ferrous ions (P<0.05), and significantly increased levels of testosterone, SOD, GSH, FTH1, SLC7A11, and GPX4 (P<0.05). The male silkworm kidney-tonifying formula group significantly promoted testosterone secretion by TM3 cells and upregulated the expression of FTH1, SLC7A11, GPX4, GSH, and SOD in TM3 cells (P<0.05), while significantly downregulating ROS, MDA, FACL4, total iron ions, and ferrous ions (P<0.05).

Conclusion: Following H2O2 exposure, oxidative stress can induce ferroptosis in mouse TM3 Leydig cells. XYF can antagonize OSI and ferroptosis in TM3 cells by activating the SLC7A11/GSH/GPX4 axis, which may underlie the mechanism of XYF in the treatment of male late-onset hypogonadism.

Objective: To compare the effects of transurethral resection of the prostate (TURP) and transurethral columnar balloon dilatation of the prostate (TUCBDP) in the treatment of BPH.

Methods: This study included 218 BPH patients treated in Qinhuangdao Workers' Hospital from July 2021 to November 2022, 109 by TURP and the other 109 by TUCBDP. We followed up the patients for 12 months, observed their postoperative recovery, complications, serum pain, inflammatory index, cytokine level, urodynamic index, symptom improvement and quality of life (QOL) and compared the data obtained between the two groups of patients.

Results: At 12 months after surgery, the total effectiveness rate was significantly higher in the TUCBDP than in the TURP group (93.58% vs 84.40%, P< 0.05), and the postoperative recovery was better in the former than in the latter (P< 0.05). Compared with the baseline, the levels of serum prostaglandin E2 (PGE2), substance P, tumor necrosis factor-alpha (TNF-α) and high sensitive C-reactive protein (hs-CRP) were remarkably increased in both of the groups on the first day after surgery (P< 0.05), more significantly in the TURP than in the TUCBDP group (P< 0.05), while the levels of serum PSA and E2 decreased and the T level elevated in all the patients at 3 months postoperatively (P< 0.05), more significantly in the TUCBDP than in the TURP group (P< 0.05). Before and at 3 and 12 months after operation, the postvoid residual urine volume (PVR) and NIH-CPSI, IPSS and QOL scores showed a decreasing trend, while the maximum urinary flow rate (Qmax), maximum cystometric capacity (MCC) and maximum urethral closure pressure (MUCP) exhibited an increasing trend in both of the two groups, even more significantly in the TUCBDP than in the TURP group (P< 0.05).

Conclusion: TUCBDP is advantageous over TURP in promoting postoperative recovery, improving QOL, reducing postoperative pain, inflammation and complications, regulating the levels of serum cytokines, and improving urodynamics and clinical symptoms in BPH patients. However, with the extension of postoperative time, the two strategies are basically comparable in improving the urodynamics, symptoms and QOL of the patients.

Objective: To investigate the clinical application value of injection of indocyanine green (ICG) via vasopuncture in fluorescence laparoscopic radical prostatectomy (FLRP).

Methods: We retrospectively analyzed the clinical data on 50 cases of PCa treated by injection of ICG via vasopuncture in FLRP. The patients were aged (70.60 ± 5.67) years old, with an average PSA value of (18.42 ± 2.69) μg/L. During the operation, we injected ICG at 0.5 ml by vasopuncture through the vas deferens at each side of the scrotum, observed the visualized images of the vas deferens and seminal vesicles using normal high-definition, black-and-white fluorescence, green fluorescence, and color fluorescence respectively, and then isolated the adherent seminal vesicles under the laparoscope.

Results: A total of 93 injections of ICG were completed, 86 bilaterally, 4 on the right and 3 on the left. The vas deferens and seminal vesicles were visualized in 41 cases (60 sides, 64.52%), 19 bilaterally, 7 on the right and 15 on the left. Spillage of the fluorescent agent occurred in 9 cases during the incision of the bladder neck and adhesion of the seminal vesicles was found intraoperatively in 10 cases, in which the seminal vesicles were all quickly located by fluorescence visualization. No rectal injury occurred during the surgery. Mild scrotal subcutaneous bruises were observed in 2 cases, with a postoperative pathological Gleason's score of 7.44 ± 0.88.

Conclusion: Injection of ICG by vasopuncture is minimally invasive and safe. ICG-mediated near-infrared imaging and real-time fluorescence imaging of the vas deferens and seminal vesicles can achieve precise positioning and removal of the seminal vesicles and prostate gland without causing rectal injury.

Objective: To observe the effect of auricular pressure beans (APN) combined with Compound Tung-Leaf Burn Oil (CTBO) on perioperative anxiety and pain in patients undergoing circumcision.

Methods: This study included 100 patients undergoing circumcision with the disposable circumcision anastomosis stapler in our hospital from August 2023 to November 2023, of whom 50 received routine circumcision nursing care (the control group) and other 50 APN combined with compound CTBO in addition (the observation group). We compared between the two groups the anxiety scores before any intervention, 30 minutes before and 24 hours and 10 days after operation, the pain scores 24 hours postoperatively and at the first change of wound dressing, the frequency of 3-day postoperative sleep awakenings, the incidence of complications, and the satisfaction of the patients.

Results: Totally, 94 patients completed the study, 46 in the observation and 48 in the control group. The anxiety scores exhibited no statistically significant difference between the two groups of patients before any intervention (P > 0.05), but were markedly lower in the observation than in the control group at 30 minutes before and 24 hours and 10 days after surgery (P<0.05), and so were the pain scores 24 hours after surgery and at the first change of wound dressing (P<0.05), and the frequency of 3-day postoperative sleep awakenings (P<0.05). The satisfaction rate of the patients was remarkably higher (P<0.05) while the incidence of complications significantly lower in the observation group than in the control (P<0.05).

Conclusion: Auricular pressure beans combined with Compound Tung-Leaf Burn Oil can effectively alleviate perioperative anxiety, reduce postoperative pain and improve satisfaction of the patients undergoing circumcision.

Objective: To investigate the effect of exosomes loaded with Lycium barbarum miRNA (Lb-miR2911) on spermatogenic function recovery in non-obstructive azoospermia (NOA) rats through cross-regulation of the Wnt/β-catenin signaling pathways.

Methods: We established an NOA model in 30 four-week-old male SD rats by intraperitoneal injection of busulfan. At 5 weeks after modeling, we equally randomized the rats into a model control group (MC，untreated), an Lb-miR2911EXO group (Lb-miR2911EXO ，treated by intratesticular injection of Lb-miR2911-loaded exosomes), and a sham group (Shame，treated by intratesticular injection of exosomes-empty drug), with another 10 male SD rats taken as normal controls（NC）. We observed the uptake and metabolic changes of Lb-miR2911 in the testis tissue of the rats by RNA FISH at 2 and 6 weeks after treatment, detected cell proliferation, spermatogenesis and gene expressions of the Wnt/β-catenin signaling pathways in the testis tissue by Transcriptome sequencing analysis combined with Western blot and RT-PCR at 12 weeks, evaluated the recovery of the spermatogenic function based on the testis tissue morphology and sperm quality, and assessed the organ toxicity of Lb-miR2911 in the tissue and organs of the rats based on histomorphological analysis and the levels of serum TNF-α, IL-1β, Aspartate aminotransferase (AST), Alanine aminotransferase (ALT) and other relevant indicators.

Results: After 12 weeks of treatment, histomorphological analysis showed regular arrangement of spermatogenic cells at all levels in the testis tissue, with a large number of mature sperm in the tubular lumen, and with significantly higher Johnsen scores, testis weight, testicular index, sperm concentration and sperm motility in the Lb-miR2911EXO than in the sham group (all P< 0.05). Compared with the model controls, the Lb-miR2911EXO group exhibited remarkably down-regulated gene expression of DACT3 (P< 0.05), up-regulated expressions of DVL2 and β-catenin (P< 0.05), elevated levels of p-DVL2 and β-catenin (nucleus) proteins (P< 0.05), increased expressions of cell proliferation-related genes CCND1, CCNE1 and CCNE2 (P< 0.05) and spermatogenesis-related genes DMC1, CCR6, JAM2 and KLC3 (P< 0.05). No pathological changes were observed in the lung, liver and kidney tissues of the rats, or in the levels of serum TNF-α, IL-1β, AST, ALT, creatinine and urea nitrogen in the rats treated with Lb-miR2911EXO compared with the normal controls (P > 0.05).

Conclusion: Lb-miR2911-loaded exosomes promote spermatogenic function recovery in NOA rats through cross-regulation of the DACT3, Wnt and β-catenin signaling pathways.

Sexual motivation refers to the intensity of willingness to have sex with or near a potential partner and is important for sexual health. At present, low sexual desire has become an increasingly prominent social problem, and there are no unified standards for its detection and evaluation. In this paper, we systematically sorted out the commonly used methods for detecting sexual motivation in male rats, including the three major categories of male-female mating, competitive selection and task acquisition, and discussed the relevant evaluation indexes and the advantages and disadvantages of various methods. We also explored the nature of sexual motivation, elaborated sexual contact behavior as a direct manifestation of sexual motivation, and proposed focusing relevant studies on contact behaviors and differentiating sexual proximity from social proximity.

Objective: To observe the effect and safety of the traditional Chinese medicine (TCM) Linggui Formula (LGF) in the treatment of asthenospermia with kidney deficiency and blood stasis.

Methods: This randomized controlled trial included 90 cases of asthenospermia with kidney deficiency and blood stasis treated in our hospital from September 2022 to September 2023, 45 by oral medication with LGF (the trial group) and the other 45 with oral levocarnitine solution (the control group), all for 12 weeks. We followed up the patients for 12 weeks, recorded the semen parameters, TCM syndrome scores, sexual hormone levels, pregnancy rates, and DNA fragmentation index (DFI) of the patients, and compared them between the two groups before and after treatment.

Results: Totally, 82 of the patients completed the study, 42 in the trial and 40 in the control group. After treatment, the patients in the trial group showed significant increases in the percentage of progressively motile sperm (PMS) (from ［19.25±3.08］% to ［38.57±4.99］%, P< 0.05), total sperm motility (from ［32.29±3.64］% to ［46.50±4.77］%, P< 0.05) and sperm concentration (from ［83.9±37.2］ to ［95.1±34.9］× 10⁶/ml ］, P< 0.05), and so did the controls in PMS (from ［19.75±4.28］% to ［34.46±5.07］%, P< 0.05), total sperm motility (from ［33.02±4.93］% to ［43.11±4.72］%, P< 0.05) and sperm concentration (from ［85.2±39.7］ to ［88.1±35.2］ × 10⁶/ml , P< 0.05), all even more significant in the trial than in the control group (P< 0.05). No statistically significant difference was observed in the semen volume either in the trial (from ［3.38±0.38］ to ［3.24±0.45］ ml, P> 0.05) or in the control group (from ［3.46±0.52］ to ［3.30±0.37］ ml, P> 0.05), or between the trial and control groups (P> 0.05), or in the sexual hormone levels, pregnancy rates, and sperm DFI between the two groups before and after treatment (P> 0.05). Both groups of patients had good safety profiles without serious adverse reactions.

Conclusion: Linggui Formula can improve the percentage of PMS in asthenospermia patients with kidney deficiency and blood stasis, potentially enhancing pregnancy rates and with a good safety.

Objective: To compare thulium laser enucleation of the prostate (ThuLEP) with plasma kinetic resection of the prostate (PKRP) in the treatment of BPH.

Methods: We retrospectively analyzed the medical records of 160 cases of BPH treated by ThuLEP (the observation group, n = 80) or PKRP (the control group, n = 80) in our hospital from January 2021 to December 2023. We recorded the operation time, bladder irrigation time, catheter retention time, hospitalization time, postoperative complications, and pre- and postoperative maximum urinary flow rate (Qmax), residual urine volume (PVR), prostate-specific antigen (PSA) and prostate volume, followed by comparison of the data obtained between the two groups of patients.

Results: Compared with the controls, the patients of the observation group showed significantly shorter operation time (［67.25 ± 7.24］ vs ［60.10 ± 5.15］ min, P< 0.05), bladder irrigation time (［46.90 ± 10.77］ vs ［43.24 ± 6.65］ h, P< 0.05), catheterization time (［5.60 ± 1.31］ vs ［5.03 ± 1.24］ d, P< 0.05) and hospitalization time (［7.31 ± 2.00］ vs ［6.55 ± 1.67］ d, P< 0.05), higher Qmax (［18.50 ± 1.24］ vs ［20.68 ± 1.45］ ml/s, P< 0.05), lower PVR (［12.10 ± 3.53］ vs ［10.82 ± 3.10］ ml, P< 0.05), PSA (［4.60 ± 0.78］ vs ［3.38 ± 0.40］ μg/L, P< 0.05) and prostate volume (［25.35 ± 6.46］ vs ［20.12 ± 5.13］ ml, P< 0.05) at 3 months after surgery, but no statistically significant difference in the total incidence of postoperative complications (7.50% ［6/80］ vs 5.00% ［4/80］, P > 0.05).

Conclusion: ThuLEP, with its advantages of notable effect, short operation and hospitalization time, significant improvement of urinary flow dynamics and prostate function, deserves clinical promotion for the treatment of BPH.

Objective: To investigate the risk factors affecting the prognosis of penile cancer after surgery.

Methods: We retrospectively analyzed the clinical data on 112 cases of penile cancer treated in Weifang People's Hospital from January 2013 to December 2023. Using the Kaplan-Meier survival curve, χ2 test, Fisher's exact test, and univariate and multivariate Cox risk regression analyses, we compared the clinical characteristics among different groups, and determined the independent prognostic risk factors for cancer-specific survival (CSS) of the patients.

Results: The 1-, 3- and 5-year CSS rates of the penile cancer patients were 78.2%, 66.1% and 63.7%, respectively. Kaplan-Meier analysis indicated a significant correlation of a higher neutrophil-to-lymphocyte ratio (NLR) with a lower CSS rate (P < 0.001). Multivariate Cox regression analysis showed high NLR (HR = 2.6; 95% CI: 1.031－6.558; P = 0.043) to be an independent risk factor for CSS.

Conclusion: Preoperative NLR is an independent risk factor for the prognosis of penile cancer. In addition, older age, farmer or worker occupation, lower education, preoperative lymphocyte-to-monocyte ratio (LMR)≤2.81, preoperative fibrinogen (FIB)≥3.41 g/L, advanced tumor stage and tumor differentiation are associated with the poor prognosis the malignancy.