Leptin level in azoospermic patients and its clinical value / 中华男科学杂志

<p><b>OBJECTIVE</b>To detect the levels of seminal plasma leptin (SPL) and serum leptin (SL) in patients with azoospermia, and to explore the methods of using SPL and SL alone or the combination of SPL, SL and follicle stimulating hormone (FSH) for the differential diagnosis of obstructive azoospermia (OA) and non-obstructive azoospermia (NOA).</p><p><b>METHODS</b>We enrolled in this study 45 patients with diagnosed OA, 41 with unexplained NOA and 30 men with normal semen parameters as controls. The azoospermia patients underwent percutaneous aspiration from the epididymis (PESA) or aspiration/extraction from the testis (TESA/TESE), and all the subjects were detected for the levels of serum FSH, SPL and SL. Individual and multiple indexes were evaluated by Fisher's discriminant analysis combined with ROC curve analysis.</p><p><b>RESULTS</b>There were no significant differences in the body mass index (BMI) among the three groups. Compared with the normal control, the OA patients showed an obviously elevated level of SPL (P = 0.048), and the NOA patients remarkably increased levels of FSH (P = 0.000), SL (P = 0.000) and SPL (P = 0.000). In comparison with the OA group, the levels of FSH (P = 0.000), SL (P = 0.006) and SPL (P = 0.033) were significantly increased in the NOA group. For the differential diagnosis of OA and NOA, the areas under the ROC curve of SPL and SL were 0.658 (P = 0.014) and 0.702 (P = 0.002) , respectively, both significantly greater than 0.5, while that of the combination of SPL, SL and FSH was the greatest (0.953). In addition, with 0.026 x SPL +0.05 x SL +0.106 x FSH -2.197 as the combined indicator value and -0.289 as the cut-off value (> or = cut-off value for NOA), the sensitivity and specificity of the combination were 0.878 and 0.902, respectively, both reached the maximum.</p><p><b>CONCLUSION</b>Both the levels of SPL and SL are valuable for the differential diagnosis of OA and NOA, but the joint consideration of SPL, SL and FSH may provide better indicators.</p>

Jinleng method is effective and safe for the treatment of oligospermia and asthenospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>The Jinleng method is based on the principle of lowered temperature and diathermic action on the testis. The aim of this study is to investigate the effect and safety of the Jinleng method on oligospermia and asthenospermia.</p><p><b>METHODS</b>We treated 39 infertile males with oligospermia or asthenospermia with Jinleng underpants (Jinleng method) bid for 3 months, observed the changes in the sperm parameters of the patients after the treatment and recorded the pregnancy outcomes of their wives.</p><p><b>RESULTS</b>Of the 36 patients who accomplished the treatment, 31 showed significantly improvement in semen volume, sperm concentration, forward sperm motility, total sperm motility, total sperm count and total motile sperm count (P < 0.05), with an effectiveness rate of 86.1%. Five of the patients wives achieved pregnancy in the 2-month follow-up. Adverse effects were found in none of the patients.</p><p><b>CONCLUSION</b>Jinleng method is effective and safe for the treatment of infertile males with oligospermia and asthenospermia.</p>

Sexual and reproductive health service needs of university/college students: updates from a survey in Shanghai, China / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To promote the provision of reproductive health services to young people by exploring the attitudes and perceptions of university students in Shanghai, China, toward reproductive health.</p><p><b>METHODS</b>From July 2004 to May 2006, 5 243 students from 14 universities in Shanghai took part in our survey. Topics covered the demands of reproductive health-care services, attitudes towards and experience with sex, exposure to pornographic material, and knowledge on sexual health and sexually transmitted infections (STIs)/AIDS.</p><p><b>RESULTS</b>Of the 5 067 students who provided valid answer sheets, 50.05% were female and 49.95% were male, 14.86% were medical students, and 85.14% had non-medical backgrounds. A total of 38.4% of respondents had received reproductive health education previously. The majority of students supported school-based reproductive health education, and also acquired information about sex predominantly from books, schoolmates, and the Internet. Premarital sexual behavior was opposed by 17.7% of survey participants, and 37.5% could identify all the three types of STIs listed in the questionnaire. Although 83.7% knew how HIV is transmitted, only 55.7% knew when to use a condom and 57.8% knew that the use of condoms could reduce the risk of HIV infection.</p><p><b>CONCLUSION</b>The reproductive health service is lagging behind current attitudes and demands of university students. Although students' attitudes towards sexual matters are liberal, their knowledge about reproductive health and STIs/AIDS is still limited. It is therefore necessary to provide effective and confidential reproductive health services to young people.</p>

The feeder layer of human embryonic fibroblasts supports the growth of human spermatogonial stem cells / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the methods and conditions for the isolation, purification and culture of human spermatogonial stem cells (SSCs) on the feeder layer cells of human embryonic fibroblasts (hEFs).</p><p><b>METHODS</b>SSCs isolated and purified from normal human fetal testicular tissues by sequential two-step enzyme digestion and Percoll uncontinuous density gradient centrifugation were cultured on the feeder layer cells of hEFs isolated from 5-9 weeks old human embryos. The surface markers SSEA-1 and OCT4 of the SSCs were detected by immunohistochemistry; the alkaline phosphatase (AKP) activity of the SSC clones measured; and the expressions of the SSC-related genes determined by RT-PCR.</p><p><b>RESULTS</b>SSCs survived, proliferated and formed colonies on the feeder layers, and the colonies were highly positive for SSEA-1 and OCT4, with strong AKP activity and high expressions of the SSC-related genes.</p><p><b>CONCLUSION</b>The feeder layer of hEFs supports the growth of human spermatogonial stem cells.</p>

IIEF-5 cannot be used as a tool for differential diagnosis of vasculogenic erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the 5-item version of the international index of erectile function (IIEF-5) as a method to differentiate the causes of vasculogenic erectile dysfunction (ED).</p><p><b>METHODS</b>In all, 103 ED patients (mean age 46.8 +/- 18.7) were reviewed by IIEF-5. Penile blood flow was also assessed in each patient after an intracavernosal injection (ICI) and audio-visual sex stimulation by duplex Doppler ultrasonography. The 99mTc-(113m)In dual radioisotope test was performed to confirm specific vascular causes in the vasculogenic ED cases. Kruskal-Wallis TEST was employed to compare the scores of IIEF-5 with the results of ICI, duplex Doppler ultrasonography and the 99mTC-(113m)In dual radioisotope test.</p><p><b>RESULTS</b>Of the total number of ED cases, 37 (37/103, 35.9%) were nonvasculogenic, 18 (18/103, 17.5%) arteriogenic, 35 (35/103, 34.0%) venogenic and 13 (13/103, 12.6%) combined vasculogenic. There was no significant difference in the IIEF-5 scores either between the vasculogenic group and the non-vasculogenic one (P = 0.253) or among different groups of the vasculogenic ED patients.</p><p><b>CONCLUSION</b>IIEF-5 cannot be used as a tool for differential diagnosis of vasculogenic ED, or to compare its specific vascular causes, nor can the scores of IIEF-5 reflect penile vascular conditions.</p>

Update of PDE5 inhibitors as treatment of ED / 中华男科学杂志

Erectile dysfunction is a common ailment in middle-aged and old men. The management of ED has entered a new stage since sildenafil was used to treat ED in 1998. Sildenafil became the first-line treatment for its efficacy and safety. In recent years, new PDE5 inhibitors--vardenafil and tadalafil came into market in succession, providing more options available for oral therapy. This review is about the development of preclinical and clinical medicine research on the three PDE5 inhibitors, and provide information for clinical choices.