中华男科学杂志最新文献

According to the theory of traditional Chinese medicine (TCM), benign prostatic hyperplasia (BPH) belongs to the category of "Jing Long". Clinical management of BPH in TCM is root-aimed and kidney-targeted, in combination with the treatment of other viscera based on the syndrome differentiation of zang-fu organs. The neuro-endocrine-immune network of modern medicine is similar to the holistic concept of TCM. Based on the study of the neuro-endocrine-immune network, with kidney deficiency as the root of pathogenesis, and starting from the classification of viscera, this review elucidates the etiologic mechanisms of BHP from the perspective of Chinese and Western medicine and provides some reference for medication.

Necrozoospermia is a special type of asthenospermia, in which mass sperm death is commonly seen, with an incidence rate of 0.2%－0.4%. Studies on necrospermia are rarely reported. Its etiology is complicated, and its diagnosis and treatment are very difficult. This article focuses on the main etiological factors, pathophysiological mechanism, diagnostic methods and treatment strategies of necrospermia, aiming to provide some reference for andrologists and reproduction physicians, as well as a theoretical guidance for intracytoplasmic sperm injection (ICSI) in the treatment of the patients with necrospermia.

Objective: To investigate the effects of visualized precision electrophysiological diagnosis and transcutaneous low-frequency electrical stimulation (TES) on hypoxia-induced ED in high-altitude areas.

Methods: This study included 152 ED patients from high-altitude hypoxic areas treated by TES based on the parameters obtained from visualized precision electrophysiological diagnosis. We followed up the patients for 1 to 3 months and compared their IIEF-5 scores, nocturnal penile tumescence and rigidity (NPTR) and infrared thermal metabolic technology (TMT)-based temperature of the whole body and diseased parts before and after treatment.

Results: All the patients successfully completed 1 to 3 courses of TES. There were no statistically significant differences in the IIEF-5 scores (P<0.05) and penile tip optimal erection rigidity and duration (P<0.01) of the patients before and after treatment. TMT images indicated a temperature change of >1.5 ℃ in the penis and bilateral inguinal regions after treatment, suggesting the effectiveness of electrical stimulation. No recurrence was observed during the follow-up.

Conclusion: TES based on the parameters obtained from visualized precision electrophysiological diagnosis has a definite effect on hypoxia-induced ED by enhancing oxygen supply to the penile corpus cavernosum and improving its function and structure.

Objective: To study the effect of cluster nursing care based on 10S continuous quality improvement (CQI) on the incidence of postoperative delirium in patients with BPH.

Methods: This study included 96 BPH patients undergoing transurethral resection of the prostate (TURP) in our department from August 2021 to February 2023. We randomly divided the patients into two groups of equal number to receive routine postoperative nursing care (the control group) and postoperative cluster nursing care based on the 10S DQI mode (the observation group), respectively. We recorded and compared the delirium scores of the patients at 2, 6, 12 and 24 hours after operation, their status of recovery, scores on Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and quality of life (QOL), and incidence of complications between the two groups.

Results: Compared with the controls, the patients in the observation group showed significantly lower delirium scores at 2 h (12.72±3.54 vs 10.65±2.87, P<0.05), 6 h (20.17±4.92 vs 14.19±4.64, P<0.01), 12 h (16.82±4.24 vs 10.69±3.18, P<0.01) and 24 h (13.61±2.86 vs 9.13±2.12, P<0.01) after operation, and shorter time to ambulation (［3.65±1.41］ vs ［2.84±0.83］ d, P<0.01) and time of postoperative catheterization (［6.28±1.65］ vs ［4.28±1.14］ d, P<0.01), bladder irrigation (［3.41±1.08］ vs ［2.25±0.71］ d, P<0.01) and hospitalization (［10.33±2.41］ vs ［7.82±2.06］ d, P<0.01). No statistically significant differences were observed between the two groups in either the SAS and SDS scores (P >0.05) or the QOL scores before operation (P >0.05), but the former two were dramatically decreased (P<0.01) while the latter one increased in the observation group postoperatively (P<0.01). Postoperative complications included delirium, bladder spasm, urethral pain, and secondary bleeding, with a significantly lower total incidence rate in the observation than in the control group (12.50% vs 52.08%, P<0.01).

Conclusion: Cluster nursing care based on 10S CQI can promote the postoperative recovery of BPH patients, improve their psychological status and quality of life, and reduce the incidence of delirium and complications.

This paper discusses the study contents, theoretical basis, treatment methods and research tasks of andrology of traditional Chinese medicine (ATCM). It clarifies the connotation, explores the extension and reflects on the direction and content of disciplinary construction of ATCM, aiming to contribute to the development of ATCM in the new era and further improvement of male health.

Objective: To systematically evaluate the methodological quality and reporting quality of randomized controlled trials (RCT) on the treatment of BPH with traditional Chinese medicine (TCM), in order to provide some methodological reference for clinical practice and research.

Methods: We searched CNKI, VIP, Wanfang Data and PubMed for RCTs on the treatment of BPH with TCM published in China from January 2013 to November 2023. Two researchers screened the literature separately, and evaluated the methodological and reporting quality of the RCTs based on the Cochrane bias risk assessment tool and CONSORT TCM compound.

Results: Totally, 88 RCTs were included in this study. In terms of methodological quality, according to the Cochrane bias risk assessment tool, 27 biases in the process of randomization were identified as of low-risk and the other 61 of a certain risk. Among the allocation-related biases deviating from the established interventions, 76 were of low risk, 10 of a certain risk and 2 of high risk; among the compliance-related biases deviating from the established interventions, 76 were of low risk and 12 of a certain risk; among the biases due to missing outcome data, 86 were of low risk and 2 of a certain risk, while all the biases due to outcome measurement were of low risk; and among the biases from selective reporting, 65 were of low-risk, 2 of a certain risk and 21 of high-risk. In terms of reporting quality, according to the evaluation criteria of consort TCM compound, appropriate key words were used in 1 RCT (0.01%), the random assignment sequence method described in 27 (30.68%), the details of assignment limitation given in 5 (5.68%), assignment concealment mentioned in 3 (3.41%), the blind method and assignment concealment employed in 3 (3.41%), fall-offs recorded in 10 (11.36%), adverse events reported in 38 (43.18%), and limitations of the trials analyzed in 18 (20.45%). All the RCTs lacked complete intervention measures, subject flow chart, clinical trial registration and research schemes.

Conclusion: At present, the methodological quality and reporting quality of RCTs on the treatment of BPH with TCM are generally low, with the main problems of incomplete experimental designs, lack of detailed description of randomized and blind methods, and insufficient TCM symptom evaluation of outcome indicators. Researchers should be cautious in adopting and applying the results reported, follow the CONSORT statement in design, registration, implement and reporting of the scheme, fully consider the clinical characteristics of TCM in the treatment of BPH, and reasonably design and report the evaluation indicators.

Objective: To investigate the effect of miR-199b-5p knockout on the expression of the CREM gene in the semen and testis of mice.

Methods: We selected 8 miR-199b-5p knockout (KO) male mice (the KO group) and another 8 wild-type (WT) C57BL/6 male mice (the WT group), and observed the changes in their body weight, testicular index, testis structure and sperm morphology. We detected sperm concentration under the microscope, determined the mRNA and protein expression levels of CREM in the semen and testis by RT-qPCR and Western blot respectively, and predicted the targeting relationship between CREM and miR-199b-5p using the online database.

Results: There were no significant changes in the body weight and testicular index in either of the two groups. Compared with the WT mice, the animals in the KO group showed a slight reduction in both the count and concentration of sperm (P>0.05). Testis pathology exhibited a lower testis volume in the KO than in the WT mice, but no obvious abnormalities in the testis tissue, spermatogenic and supporting cells in the seminiferous tubules, boundary membrane or diameter of the seminiferous tubule. Online database prediction indicated that CREM was the target gene of miR-199b-5p. Both the mRNA and protein expressions of CREM in the semen and testis of the mice were significantly decreased in the KO group compared with those in the WT group (both P<0.05). A six-month follow-up showed a remarkably lower rate of male births in the KO than in the WT mice (P<0.05).

Conclusion: The expression of the CREM gene is down-regulated in the semen and testis of miR-199b-5p knockout male mice, and miR-199b-5p may affect the fertility of male mice by targeting CREM.

Objective: To investigate the effects of resveratrol (RSV) on ovarian morphology, plasma anti-Müllerian hormone (AMH) and insulin-like growth factor 1 levels (IGF-1), and oxidative stress parameters in rats with polycystic ovary syndrome (PCOS).

Methods: Forty-six rats were randomly divided into a normal control (n = 12), a PCOS model control (n = 12), a rosiglitazone (RSG, n = 11), and an RSV group (n = 11). The PCOS model was established in the latter three groups by rejection of epidehydroandrosterone. The rats in the normal control and PCOS model control groups were treated by gavage of normal saline and those in the RSG and RSV groups by intragastric administration of RSG at 10 mg/(kg·d) and RSV at 3.0 mg/(kg·d), respectively. After 4 weeks of treatment, the ovarian histology was observed under the light microscope, the levels of plasma AMH and IGF-1 measured by ELISA, and the activities of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and catalase (CAT) in the ovarian tissue detected using the Ellman, Sun and AEBI methods, respectively.

Results: After a 4-week treatment, statistically significant differences were observed in the above indicators between the normal control and PCOS model control groups (P<0.05). The rats treated with RSG and RSV also showed significant differences in these parameters from the model controls (P<0.05).

Conclusion: RSV can enhance the local antioxidant capacity of the ovary, reduce the levels of AMH and IGF-1, and improve the morphology of the ovarian tissue in rats with PCOS, indicating its potential value in the treatment of PCOS.

Objective： To explore the influence of environment temperature on the incidence of testicular torsion.

Methods: We collected the clinical data on 172 cases of testicular torsion diagnosed in the Second Hospital of Hebei Medical University from December 2013 to December 2020. According to the local environment temperature on the day of onset, we divided the patients into groups A (below 0℃), B (0－10℃), C (10－20℃) and D (above 20℃), and compared the incidence rates of testicular torsion among the four groups, followed by correlation analysis.

Results: The incidence rate of testicular torsion was 12.8% (n = 22) in group A, 35.5% (n = 61) in B, 34.9% (n = 60) in C and 16.9% (n = 29) in D, the highest at 0－10℃ in group B, with statistically significant difference among the four groups (χ2 = 29.07, P <0.001). Spearman correlation analysis indicated that the incidence of testicular torsion was negatively correlated with the environment temperature (r = －0.261, P <0.01), with no statistically significant difference among different seasons (χ2 = 5.349, P >0.05), but higher in autumn and winter than in the other two seasons.

Conclusion: The incidence of testicular torsion is negatively correlated with the environment temperature, elevated when the temperature decreases, but has no statistically significant difference among different seasons, though relatively higher in autumn and winter.

Objective: To explore the effect of tanshinone on the invasion of PCa cells induced by androgen-deprivation therapy (ADT) and its possible action mechanism.

Methods: We treated human PCa LNCaP cells with tanshinone at 0 nmol/L (the control group), 5 nmol/L (tanshinone group 1), 10 nmol/L (tanshinone group 2) and 20 nmol/L (tanshinone group 3), respectively. Then we detected their cloning, angiogenesis and invasion abilities by plate cloning assay, tube-formation assay and Transwell chamber assay, respectively, examined their apoptosis using the AnnexinV-FITC/PI double staining method, and determined the protein expressions of phosphatidylinositol 3-kinase (PI3K), p-PI3K, protein kinase B (AKT) and p-AKT by Western blot.

Results: Compared with the control group, the PCa LNCaP cells in the tanshinone groups 1, 2 and 3 showed significant dose-dependent decreases in the clone formation rate (［25.14 ± 5.19］% vs ［19.33 ± 4.12］% vs ［14.69 ± 4.71］% vs ［9.35 ± 2.37］%, P<0.05), number of cellular lumens (［23.20 ± 4.85］ vs ［19.80 ± 5.12］ vs ［14.40 ± 4.16］ vs ［10.20 ± 3.21］ per microscopic field, P<0.05) and count of transmembrane cells (［62.80 ± 8.97］ vs ［50.40 ± 7.62］ vs ［38.60 ± 5.16］ vs ［27.40 ± 4.91］ per microscopic field, P<0.05), increase in the rate of cell apoptosis (［3.58 ± 0.74］% vs ［8.97 ± 1.36］% vs ［14.64 ± 4.10］% vs ［21.17 ± 5.37］%, P<0.05), and down-regulation of the expressions of p-PI3K, PI3K, p-AKT and AKT (P<0.05).

Conclusion: Tanshinone can reverse ADT-induced invasion of PCa cells, reduce their clone formation and angiogenesis, promote their apoptosis, and inhibit the activity of PI3K and AKT signaling pathways.