Comparison of two methods for detection of Chlamydia trachomatis and Ureaplasma urealyticum in male reproductive tract / 北京大学学报(医学版)

OBJECTIVE@#To investigate the value of clinical application of simultaneous amplification and testing of RNA (SAT-RNA) for detecting Chlamydia trachomatis (CT) and Ureaplasma urealyticum (UU) by comparing with the polymerase chain reaction testing of DNA (PCR-DNA) method.@*METHODS@#Specimens from both urethra swab and the first avoid urine which should be at least one hour after the previous urination were collected from 163 men who were scheduled for in vitro fertilization and embryo transfer (IVF-ET) treatment due to female factors at Center for Reproductive Medicine, Shengjing Hospital of China Medical University during the period of April 2016 to April 2017. Among the 163 men, 109 simultaneously provided semen that was collected after 3-7 days of sexual abstinence for the testing. Urine and semen specimens were detected for CT and UU with SAT-RNA, while urethra swab specimens were detected for CT and UU with standard PCR-DNA. Detection results of the SAT-RNA were compared with those of the PCR-DNA method.@*RESULTS@#The positive rate of UU in the urethra swab detected with PCR-DNA and that of UU in the urine with SAT-RNA were 47.24% and 47.85%, respectively, and the coincidence rate was 93.25%. In addition, the positive and negative coincidence rates were 93.51% and 93.02%, respectively, and the concordance between the two methods was very good (Kappa=0.865). On the other hand, the positive rate of CT in the swab specimen tested with PCR-DNA was 3.07% and that of CT in urine with SAT-RNA was 4.29%, and the coincidence rate was 97.55%. Moreover, the positive and negative coincidence rates were 80.00% and 98.10%, respectively, and the concordance between the two methods was good (Kappa=0.654). Regarding SAT-RNA detection of UU in the urine and semen specimen of the 109 patients, the positive rates of UU in the urine and semen specimens were 50.46% and 44.95%, respectively; and the coincidence rate between the two specimens was 88.99%. In addition, the positive coincidence rate and the negative coincidence rate was 93.88% and 85.00%, respectively, and the concordance between the two specimens was good (Kappa=0.780). Similarly, SAT-RNA detection of CT in the urine and semen specimens showed the positive rate was 5.50% and 3.67%, respectively; and the two specimens showed 98.17% coincidence rate. The positive and negative coincidence rates were 100.00% and 98.10%, respectively, and the concordance was also good (Kappa=0.791).@*CONCLUSION@#SAT-RNA detection of CT and UU in the urine specimen showed good concordance with the PCR-DNA detection of CT and UU in the urethra swab specimen. In addition, the concordance was also good between the urine and semen specimens detected with SAT-RNA. These results indicate that, as a less invasive and equally accurate procedure, SAT-RNA may be more suitable for clinical application.

Preliminary study on the psychological status of male patients with infertility / 中国实用妇科与产科杂志

OBJECTIVE: To evaluate mental status of the infertile men and explore the risk factors for the mental disorders.METHODS: Men with perceived male infertility were divided into two groups(mild or severe)according to their severity of semen quality from Aug. 2015 to Feb. 2016 in Shengjing Hospital of China Medical University.Their mental health was assessed with the symptom check list(SCL-90).Multiple Logistic regression analysis was performed to identify risk factors of the mental disorders.RESULTS: The SCL-90 total score,somatization factor score,depression factor score,anxiety factor score and psychoticism factor score of the poor semen quality group were significantly higher than those of the group with better semen quality(P<0.05).RESULTS: of the Logistic regression analysis showed that the general risk factors for mental disorders in infertile men were irregular daily life,irregular meals,lack of regular exercise,recent experience of significant adverse events and poor semen quality.Among them,poor semen quality was the risk factor for the anxiety factor,while the risk factors for depression were irregular daily life,lack of regular exercise and recent experience of significant adverse events.CONCLUSION: Men with perceived male infertility tend to have more severe psychological disorders when their semen quality is poor.Men who do not have regular daily life,meals or exercise,or who have recently experienced significant adverse events or who have poorer semen quality are more prone to mental disorders.

Semen expulsion under the ureterocystoscope / 中华男科学杂志

<p><b>OBJECTIVE</b>To determine the exact location of the opening of the ejaculatory duct in men and provide some basic anatomical evidence for seminal vesiculoscopy and the treatment of ejaculatory duct obstruction.</p><p><b>METHODS</b>We performed ureterocystoscopy for 21 male patients aged 26 - 47 years with hematuria (n = 12), hematospermia (n = 2), glandular cystitis (n = 6), and anejaculation after radical resection of rectal carcinoma (n = 1), and meanwhile, with the consent of the patients, massaged the prostate and ejaculatory duct and observed the outlet of the expelled fluid. Under the microscope, we described the fluid samples with sperm as the expulsion from the ejaculatory duct.</p><p><b>RESULTS</b>Ureterocystoscopy showed that the exact anatomical sites of the expulsion of prostatic fluid and semen in the patients were the side and lower side of the prostatic utricle opening above the verumontanum and the ventral side of the verumontanum. Quantities of sperm were found in the expulsion fluid of 13 of the patients, and no expulsion, including semen, was seen from the prostatic utricle opening.</p><p><b>CONCLUSION</b>Anatomically, the ejaculatory duct openings of males are located at the two sides of the verumontanum adjacent to the opening of the prostatic utricle, rather than in the prostatic utricle above the verumontanum.</p>

Oral tadalafil on alternate days for erectile dysfunction that fails to respond to on-demand sildenafil: a report of 15 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To sum up the experience in administering oral tadalafil on alternate days for the treatment of erectile dysfunction (ED) that fails to respond to on-demand medication.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 15 cases of ED treated with oral tadalafil on alternate days from September 2010 to March 2012. All the patients had failed to respond to on-demand medication of sildenafil previously.</p><p><b>RESULTS</b>After 4 weeks of tadalafil treatment, 11 (73.3%) of the cases were remarkably improved, with significant difference in IIEF-5 scores before and after treatment (P < 0.05). Transient adverse reactions were observed in the other 4 cases, including mild headache in 2, slight backache in 1, and facial flush in 1.</p><p><b>CONCLUSION</b>Oral tadalafil on alternate days is safe and effective in the treatment of ED that fails to respond to on-demand medication of sildenafil.</p>

Impact of male infertility on men's self-esteem and satisfaction with sexual relationship / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the impact of infertility on men's self-esteem, self-confidence, sexual satisfaction and overall relationship with their spouses.</p><p><b>METHODS</b>Using Self-Esteem and Relationship questionnaire (SEAR), we conducted an investigation among 253 infertile men and 52 fertile male controls. We divided the infertile men into four subgroups according to their perceived causes of infertility: male (M) factors, female (F) factors, both M and F factors, and unknown factors, and compared the SEAR scores among different groups.</p><p><b>RESULTS</b>In the infertile men, the total SEAR score was significantly higher in those with < 3 years than in those with > or = 3 years of infertility duration (75.50 +/- 17.05 vs 68.66 +/- 17.19, P < 0.05) and so was it in those with above-high-school than in those with high-school or lower education background (81.42 +/- 13.99 vs 67.61 +/- 17. 8, P < 0.01), but showed no significant difference between the > or = 30- and < 30-year-olds (71.77 +/- 17.42 vs 72.74 +/- 18.38, P > 0.05). The total SEAR scores in the M factor, M & F factor, unknown factor and F factor groups were 65.69 +/- 18.68, 68.52 +/- 17.68, 74.85 +/- 15.19 and 83.21 +/- 12.61, respectively, with significant differences between the first two and the latter two groups (P < 0.05), as well as between the unknown factor and F factor groups (P < 0.05). In the fertile male controls, the total SEAR score and subdomain scores on sexual relationship, self-confidence, self-esteem and overall relationship were 90.04 +/- 9.85, 88.40 +/- 10.74, 92.23 +/- 9.41, 91.95 +/- 10.67 and 90.38 +/- 14.14, respectively, all remarkably higher than in the M factor, M&F factor and unknown factor groups of the infertile men after adjustment of their infertility duration and education levels (P < 0.05).</p><p><b>CONCLUSION</b>Infertility reduces men's self-esteem, self-confidence, sexual satisfaction and relationship with their spouses, and the degree of its impact is correlated with the patients' infertility duration and education level.</p>

Impact of perceived male infertility factors on penile erectile function / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the impact of the factors of perceived male infertility on men's penile erectile function.</p><p><b>METHODS</b>Using the 5-item version of the International Index of Erectile Function (IIEF-5), we investigated the penile erectile function among 245 infertile men (infertility group) and another 52 males having physical checkup for planned conception (checkup group), the former further divided into four subgroups according to the factors of infertility: male factor, female factor, bilateral factor, and unknown factor. We compared the total and item scores of IIEF-5 among different groups.</p><p><b>RESULTS</b>Mild or mild-moderate ED was found in 50.61% of the infertile men, with a total IIEF-5 score of 21.24 +/- 2.58. The total and item scores of IIEF-5 were markedly higher in the male factor than in the female factor subgroup (P < 0.01), but with no significant difference between the male factor subgroup and the bilateral and unknown factor subgroups (P > 0.05), except the score on confidence. The scores were significantly lower in the bilateral and unknown factor subgroups than in the female factor subgroup (P < 0.05), with no remarkable difference between the former two. In the infertility group, the total and item scores of IIEF-5 were markedly higher in those with education above high school than in those with high school or lower education (P < 0.01), but not correlated with age and infertility duration. After adjustment for education background, the total IIEF-5 score and the scores on confidence and satisfaction were significantly lower in the infertility than in the checkup group (P < 0.05), and 15.38% of the men in the latter group had mild ED, dramatically lower than in the former (P < 0.01).</p><p><b>CONCLUSION</b>Perceived infertility may cause ED in males, and a higher incidence rate is associated with lower education background of the men.</p>

Outcomes of IVF-ET and percentage of morphologically normal sperm before and after swim-up treatment / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the relationship between sperm morphology and the outcomes of in vitro fertilization-embryo transfer (IVF-ET) before and after swim-up treatment of sperm on the day of oocyte retrieval.</p><p><b>METHODS</b>This study included 94 couples to be treated by IVF-ET for tubal factor infertility. Sperm samples were collected on the day of oocyte retrieval and sperm morphology evaluated according to the Kruger criteria before and after swim-up treatment. Based on the results of morphological evaluation, the sperm samples were divided into groups A1 (morphologically normal sperm > or = 10% after swim-up treatment), A2 (morphologically normal sperm < 10% after swim-up treatment), B1 (morphologically normal sperm > or = 10% before swim-up treatment) and B2 (morphologically normal sperm < 10% before swim-up treatment). The outcomes of IVF-ET treatment were compared between groups A1 and A2 as well as between B1 and B2.</p><p><b>RESULTS</b>After swim-up treatment, the rates of fertilization, cleavage, good quality embryo, clinical pregnancy and embryo implantation of group A1 were (72.72 +/- 3.35)%, (95.64 +/- 2.04)%, (24.39 +/- 4.57)%, 50.00% and 23.87%, respectively, while those of group A2 were (70.27 +/- 8.82)%, (94.82 +/- 4.94)%, (13.45 +/- 7.39)%, 9.52% and 6.25%, respectively, the latter three indexes remarkably higher in A1 than in A2 (P < 0.05), but the differences in the former two not statistically significant (P > 0.05). Before swim-up treatment, the above five indexes were (72.90 +/- 4.23)%, (95.20 +/- 2.61)%, (23.35 +/- 5.19)%, 39.58% and 18.35% in group B1, as compared with (71.33 +/- 5.10)%, (95.71 +/- 2.88)%, (20.18 +/- 6.15)%, 41.86% and 21.28% in group B2, with no statistically significant differences between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>The percentage of morphologically normal sperm after swim-up treatment on the day of oocyte retrieval may be a valuable predictor of the outcomes of IVF-ET.</p>

Detection of the mutation of all the exons of the CFTR gene in Chinese men with congenital bilateral absence of the vas deferens / 中华男科学杂志

<p><b>OBJECTIVE</b>To assess the necessity of detecting the gene of cystic fibrosis transmembrane conductance regulator factor (CFTR) in Chinese men with congenital bilateral absence of the vas deferens (CBAVD).</p><p><b>METHODS</b>We detected the mutation of all the 27 exons of the CFTR gene in 9 patients with CBAVD by DNA sequencing, and compared the results using NCBI and Cystic Fibrosis Mutation Database.</p><p><b>RESULTS</b>Four novel missense mutations/variants were found in the CFTR gene of the CBAVD patients, which were submitted and accepted in the Cystic Fibrosis Mutation Database.</p><p><b>CONCLUSION</b>There are mutations or variants in the CFTR gene in Chinese men with CBAVD, and the mutational distribution is different from that in Westerners.</p>

Alternate-day oral tadalafil for erectile dysfunction with no successful intercourse at the baseline / 中华男科学杂志

<p><b>OBJECTIVE</b>To summarize the experience in the treatment of erectile dysfunction (ED) with no successful intercourse at the baseline with tadalafil.</p><p><b>METHODS</b>We retrospectively analyzed 21 cases of ED with no successful intercourse at the baseline treated with tadalafil on alternate days combined with sex guidance.</p><p><b>RESULTS</b>After 4 weeks of tadalafil treatment, 19 of the patients achieved successful sexual intercourse, and the IIEF-5 score was remarkably improved as compared with pre-medication (3.24 +/- 1.55 vs 18.95 +/- 3.02, P<0.0001). Mild adverse reactions were observed in 6 cases, including 2 cases of mild headache and 4 cases of facial blush.</p><p><b>CONCLUSION</b>Tadalafil on alternate days combined with sex guidance can significantly improve ED with no successful intercourse at the baseline.</p>

Construction of eukaryotic vector of small hairpin interfering RNA against NYD-SP5 / 中华男科学杂志

<p><b>OBJECTIVE</b>NYD-SP5 is a newly cloned gene highly expressed in human testes, which consists of 3 598 nucleotides including a 1 027-amino acid open reading frame. It is a human-mouse homologous gene. The domain analysis indicated that the NYD-SP5 protein is a transmembrane protein. This study aimed to design and establish recombinant plasmids of small hairpin interfering RNA (shRNA) against NYD-SP5, and to pave the way for the analysis of the function of NYD-SP5 in the testis using the transgenic mouse model.</p><p><b>METHODS</b>Four sequences of oligonucleotides with the small hairpin structure were designed based on the NYD-SP5 mRNA sequence. Recombinant plasmids were constructed by cloning these oligonucleotides into pGPU6/GFP/Neo vectors. Interfering plasmids against GAPDH were established as positive controls and those targeting non-specific genes used as negative controls. The positive constructs were verified by enzyme digestion and sequencing.</p><p><b>RESULTS</b>Plasmid screening and sequencing showed the sequences of the recombinant plasmids to be the same as the shRNA transcribed sequences, which indicated the successful establishment of the recombinant vectors.</p><p><b>CONCLUSION</b>The shRNA expression vector targeting NYD-SP5 could be established successfully.</p>

Intracytoplasmic sperm injection for obstructive azoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To sum up the experience in the treatment of obstructive azoospermia by intracytoplasmic sperm injection (ICSI).</p><p><b>METHODS</b>We retrospectively analyzed 107 cases of obstructive azoospermia treated by ICSI in our center from Jan. 2006 to Dec. 2008, and compared the rates of fertilization, cleavage and pregnancy between the patients with congenital bilateral absence of vas deferens (CBAVD) and those with non-CBAVD.</p><p><b>RESULTS</b>A total of 949 oocytes were injected for the 107 patients undergoing ICSI, of which 678 (71.4%) were fertilized and 605 (89.2%) cleaved, with 44 pregnancies (41.4%). Of the 442 oocytes injected for the 49 patients with CBAVD, 308 (69.6%) were fertilized and 279 (90.6%) cleaved, with 27 pregnancies (55.1%), and of the 507 oocytes injected for the 58 cases induced by inflammation or surgery, 370 (72.9%) were fertilized and 326 (88.1%) cleaved, with 17 pregnancies (29.3%). The rate of pregnancy was significantly higher in the CBAVD than in the non-CBAVD group (P < 0.01), but there were no significant differences in the rates of fertilization and cleavage between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>PESA or TESE combined with ICSI is an effective approach to the treatment of male infertility induced by obstructive azoospermia, which may achieve a higher rate of pregnancy in patients with CBAVD than in those with non-CBAVD. Inflammation or surgery may not only cause the obstruction of the deferent duct, but also affect sperm quality, and consequently reduce the potentiality of embryonic development.</p>

Citation analysis of National Journal of Andrology and Asian Journal of Andrology / 中华男科学杂志

<p><b>OBJECTIVE</b>To analyze the distribution pattern of the references in National Journal of Andrology (NJA) and Asian Journal of Andrology (AJA), and evaluate the ability of information collection and the characteristics of literatures requested by scientists of andrology.</p><p><b>METHODS</b>The citation analysis was used to analyze the references cited by articles published on the two journals, including the number, type and publication year of references, and Price Index, self-citing rate of the two journals and top cited journals were analyzed individually.</p><p><b>RESULTS</b>The average numbers of references per article in AJA and NJA were 20.43 and 10.18 respectively, and the percentages of journals cited by the two journals were 95.84% and 93%. The Price indices were 38.50% and 55.01%, and self-citing rates were 6.20% and 5.82% for the two journals respectively. There were 358 and 725 journals cited by AJA and NJA, the top 12 of which provided 42.47% and 37.41% of all references respectively.</p><p><b>CONCLUSION</b>The main reference type was journal. NJA cited more disciplines than AJA did, and it cited more current publications. The result shows authors in NJA can use latest articles and keep abreast of progress in andrology. AJA had more references and relatively concentrated cited journal categories, and citing half-life of AJA was longer than that of NJA.</p>