The association between body mass index and varicocele: A meta-analysis

ABSTRACT Objective: Recently, several studies have found that obesity had a protective effect against varicocele, but no meta-analysis has confirmed this finding. Therefore, we conducted this meta-analysis to investigate the association between body mass index (BMI) and varicocele. Material and Methods: We searched for studies in PubMed, Science Direct and the Cochrane Library from inception until February 2018. The association between BMI and varicocele was assessed by pooling the odds ratios (ORs). Results: Eleven eligible studies with a total study population of 1.376.658 participants were included in our analysis. According to BMI, the subjects were defined as belonging to the obese, overweight and underweight groups. Our results showed that the obese group had a lower risk of varicocele when compared with the normal weight group (odds ratio [OR] 0.46, 95% confidence intervals [CIs] 0.37-0.58). Additionally, an overweight BMI had a protective effect against varicocele (OR 0.70, 95% CIs, 0.56-0.86). However, underweight patients had a more than 30% higher risk of varicocele (OR 1.31, 95% CI, 1.04-1.64). Furthermore, there was no publication bias in any of the analyses. Conclusions: Our study demonstrates that BMI is negatively associated with the presence of varicocele.

A novel robust nomogram based on peripheral monocyte counts for predicting lymph node metastasis of prostate cancer / 亚洲男科学杂志(英文版)

Accurate methods for identifying pelvic lymph node metastasis (LNM) of prostate cancer (PCa) prior to surgery are still lacking. We aimed to investigate the predictive value of peripheral monocyte count (PMC) for LNM of PCa in this study. Two hundred and ninety-eight patients from three centers were divided into a training set (n = 125) and a validation set (n = 173). In the training set, the independent predictors of LNM were analyzed using univariate and multivariate logistic regression analyses, and the optimal cutoff value was calculated by the receiver operating characteristic (ROC) curve. The sensitivity and specificity of the optimal cutoff were authenticated in the validation cohort. Finally, a nomogram based on the PMC was constructed for predicting LNM. Multivariate analyses of the training cohort demonstrated that clinical T stage, preoperative Gleason score, and PMC were independent risk factors for LNM. The subsequent ROC analysis showed that the optimal cutoff value of PMC for diagnosing LNM was 0.405 × 109 l

Protective effect of bone marrow mesenchymal stem cell-derived exosomes against the reproductive toxicity of cyclophosphamide is associated with the p38MAPK/ERK and AKT signaling pathways / 亚洲男科学杂志(英文版)

Spermatogenic dysfunction caused by cyclophosphamide (CP) chemotherapy has seriously influenced the life quality of patients. Unfortunately, treatments for CP-induced testicular spermatogenic dysfunction are limited, and the molecular mechanisms are not fully understood. For the first time, here, we explored the effects of bone marrow mesenchymal stem cell-derived exosomes (BMSC-exos) on CP-induced testicular spermatogenic dysfunction in vitro and in vivo. BMSC-exos could be taken up by spermatogonia (GC1-spg cells). CP-injured GC1-spg cells and BMSC-exos were cocultured at various doses, and then, cell proliferation was measured using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay. In addition, photophosphorylation of extracellular-regulated kinase (ERK), p38 mitogen-activated protein kinase (p38MAPK), and protein kinase B (AKT) proteins was evaluated by western blotting as well as apoptosis in GC1-spg cells measured using flow cytometry. Treatment with BMSC-exos enhanced cell proliferation and reduced apoptosis of CP-injured GCI-spg cells. Phosphorylated levels of ERK, AKT, and p38MAPK proteins were reduced in CP-injured spermatogonia when co-treated with BMSC-exos, indicating that BMSC-exos acted against the reproductive toxicity of CP via the p38MAPK/ERK and AKT signaling pathways. In experiments in vivo, CP-treated rats received BMSC-exos by injection into the tail vein, and testis morphology was compared between treated and control groups. Histology showed that transfusion of BMSC-exos inhibited the pathological changes in CP-injured testes. Thus, BMSC-exos could counteract the reproductive toxicity of CP via the p38MAPK/ERK and AKT signaling pathways. The findings provide a potential treatment for CP-induced male spermatogenic dysfunction using BMSC-exos.

Ultracentrifugation, ExoPerfectTM-MU and PEG6000 for the extraction and identification of seminal plasma exosomes: A comparative study / 医学研究生学报

Objective　No studies have been reported on the comparison of ultracentrifugation, ExoPerfectTM-MU and PEG6000 in extracting seminal plasma exosomes. This article aimed to compare the three methods for the extraction and identification of seminal plasma exosomes. Methods　Semen samples were obtained from 30 healthy donors and randomly divided into three portions, followed by extraction of exosomes from the seminal plasma by ultracentrifugation, ExoPerfectTM-MU, and 8%PEG6000, respectively. The size of the extracted exosomes was measured with the nanoparticle tracking analyzer (NTA), their morphology observed under the transmission electron microscope (TEM), and their protein biomarkers detected by Western blot.　Results　Significantly higher expressions of CD63 and TSG101 were found in the exosomes extracted by ultracentrifugation than in those extracted by ExoPerfectTM-MU and 8%PEG6000 (P0.05). Compared with the 8%PEG6000 group, the ultracentrifugation and ExoPerfectTM-MU groups showed significantly higher concentrations ([11.90±1.78] vs [21.20±0.98] and [19.74±1.45]×108/mL, P<0.01) and numbers of seminal plasma exosomes under TEM (4.7±1.7 vs 7.0±1.6 and 6.0±1.6, P< 0.01).　Conclusion　Ultracentrifugation, ExoPerfectTM-MU and 8%PEG6000 are all capable of successful extraction and identification of seminal plasma exosomes, but the former two yield more exosomes, the latter one gives a higher purity, and ExoPerfectTM-MU is simple and convenient in operation.

Changed percentage of myeloid-derived suppressor cells in the peripheral blood of prostate cancer patients and its clinical implication / 中华男科学杂志

<p><b>Objective</b>To investigate the changes in the percentage of myeloid-derived suppressor cells (MDSCs) in the peripheral blood of prostate cancer (PCa) patients and explore the correlation of MDSCs and their subsets with the prognosis of PCa.</p><p><b>METHODS</b>Using flow cytometry, we determined the percentage of MDSCs and the levels of Arg-1, iNOS and PD-L1 in the peripheral blood of 32 PCa patients and 25 healthy controls, detected the distribution of CD14+ Mo-MDSC and CD15+ PMN-MDSC subsets, and analyzed the correlation between the obtained parameters and the prognosis of PCa.</p><p><b>RESULTS</b>Compared with the healthy controls, the PCa patients showed significant increases in the percentage of MDSCs (P<0.01) and levels of Arg-1, iNOS and PD-L1 in the peripheral blood. Statistically significant differences were observed in the distribution of the CD14+ Mo-MDSC and CD15+ PMN-MDSC subsets between the two groups（60.4% vs 72.2%, 29.5% vs 18.8%） (P<0.05). The percentages of MDSCs and Mo-MDSCs were remarkably correlated with the total survival rate of the PCa patients (P=0.025 and 0.017).</p><p><b>CONCLUSIONS</b>The percentages of MDSCs and CD14+ Mo-MDSCs in the peripheral blood were correlated with the prognosis of PCa, which may provide a target or some evidence for the clinical treatment of PCa.</p>

Application value of real-time contrast-enhanced ultrasound in transrectal prostate biopsy / 中华男科学杂志

<p><b>Objective</b>To explore the application value of real-time contrast-enhanced ultrasound (RTCEU) in improving the detection rate of transrectal ultrasound-guided prostate biopsy.</p><p><b>METHODS</b>This prospective study included 91 male patients with abnormally high PSA (4－20 μg/L) or abnormalities in DRE or MRI, who underwent 12+X prostate biopsy following conventional transrectal ultrasonography (TRUS) and RTCEU examination. We compared the numbers of suspected prostatic nodules before and after RTCEU as well as the detection rates of prostate cancer between conventional TRUS-guided 12PBx and 12PBx plus lesion-targeted biopsy procedures.</p><p><b>RESULTS</b>Totally, 57 of the 86 suspected lesions on TRUS (66.3%), and 108 of the 118 abnormal nodules on RTCEU (91.5%) were confirmed to be prostate cancer. RTCEU achieved a significantly higher detection rate than TRUS (P<0.01). A total of 39 cases of prostate cancer (42.8%) were detected by RTCEU, while only 28 (30.7%) by TRUS, with statistically significant difference in the detection rate between the two procedures (P=0.033).</p><p><b>CONCLUSIONS</b>Real-time contrast-enhanced ultrasound can significantly improve the detection rate of prostate cancer and provide a valuable guide to targeted prostate biopsy.</p>

Extraction and identification of semen-derived exosomes using PEG6000 / 南方医科大学学报

<p><b>OBJECTIVE</b>To extract and identify semen-derived exosome using PEG6000.</p><p><b>METHODS</b>Exosomes were extracted from semen specimens from 6 healthy volunteers with step-by-step centrifugations and ultracentrifugation prior to 8% PEG6000 enrichment. The extracted exosomes were characterized by transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA) and Western blotting.</p><p><b>RESULTS</b>The pellets obtained were round or elliptic membrane vesicles 30 to 150 nm in diameter with intact double membranes and contained low electron density material. The pellets expressed CD63, ALIX and TSG101 molecules but not calnexin that was expressed in sperm cells.</p><p><b>CONCLUSION</b>The PEG6000-based method for extraction of exosomes from semen samples facilitates future studies of seminal exosomes.</p>

Efficacy of compound xuanju capsule combined with bromocriptine on hyperprolactinemia-induced erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effect of Compound Xuanju Capsule (CXC) combined with bromocriptine on hyperprolactinemia-induced erectile dysfunction (ED).</p><p><b>METHODS</b>We randomly assigned 46 patients with hyperprolactinemia-induced ED to receive bromocriptine (trial group, n = 23) and bromocriptine plus CXC (control group, n = 23), respectively, both for 12 weeks. Then we compared the two groups of patients in erectile function and the levels of serum prolactin and testosterone.</p><p><b>RESULTS</b>After 12 weeks of treatment, the IIEF-5 scores were significantly improved in both the trial and the control groups as compared with the baseline (19.5 +/- 4.1 vs 13.0 +/- 3.8 and 16.4 +/- 3.7 vs 13.7 +/- 3.5, P<0.05), the level of serum prolactin was remarkably decreased ([156.07 +/- 26.31] vs [478.35 +/- 62.28] mIU/L and [164.73 +/- 28.58] vs [445.26 +/- 57.83] mIU/L, P<0.05), while the level of serum testosterone was markedly increased ([15.34 +/- 5.27] vs [3.80 +/- 1.09] nmol/L and [12.02 +/- 2.36] vs [4.07 +/- 1.25] nmol/L, P<0.05). Post-treatment erectile function was significantly better in the trial than in the control group (P<0.05), and the post-treatment serum testosterone level remarkably higher in the former than in the latter (P<0.05), but there was no significant difference in the serum prolactin level after treatment between the two groups (P>0.05).</p><p><b>CONCLUSION</b>The combination of Compound Xuanju Capsule and bromocriptine is highly effective in the treatment of hyperprolactinemia-induced ED, and its effect is even better than that of bromocriptine alone.</p>

B-ultrasound guided aspiration and sclerotherapy with 2% iodophor for renal cysts / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the efficacy of B-ultrasound-guided aspiration and sclerotherapy with 2% iodophor for treatment of renal cysts.</p><p><b>METHODS</b>Twenty-eight cases of sympotomatic renal cysts were treated with B-ultrasound-guided aspiration followed by sclerotherapy with 2% iodopher, which was maintained for 20 min. After extraction of iodopher, another injection of 2% iodopher (5-10 ml) into the cysts was given. The patients were followed up for 6 months to 18 months.</p><p><b>RESULTS</b>Full recovery was achieved in 25 cases and improvement in 2 cases. Recurrence was found in 1 case after the treatment.</p><p><b>CONCLUSIONS</b>B-ultrasound-guided aspiration and sclerotherapy with 2% iodophor is safe, minimally invasive, and highly effective for treatment of symptomatic renal cysts.</p>

Efficacy of low-dose tadalafil on ED assessed by Self-Esteem and Relationship Questionnaire / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the effects of low-dose oral tadalafil on self-esteem, confidence and sexual relationship in ED patients.</p><p><b>METHODS</b>We treated 17 ED patients with oral tadalafil at the low dose of 5 mg once daily for 12 weeks, and used the paired t test to compare their scores on The Self-Esteem and Relationship Questionnaire (SEAR) and IIEF-5 and the results of nocturnal penile tumescence (NPT) obtained by nocturnal electrobioimpedance volumetric assessment (NEVA) before and after the medication.</p><p><b>RESULTS</b>The scores on SEAR and IIEF-5 were significantly increased (P < 0.01) and NPT markedly improved (P < 0.05) after tadalafil treatment as compared with the baseline.</p><p><b>CONCLUSION</b>Low-dose oral tadalafil once daily can significantly improve the self-esteem, confidence, sexual relationship satisfaction and NPT of ED patients.</p>

Correlation of aging with psychological and organic ED: nocturnal electrobioimpedance volumetric assessment of 83 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>The ratio of psychological to organic ED changes with aging. This study aimed to analyze the results of nocturnal electrobioimpedance volumetric assessment (NEVA) for ED patients of different age groups and their significance in the diagnosis of ED.</p><p><b>METHODS</b>A total of 83 ED patients were divided into 4 age groups (< or = 29 yr, 30 -39 yr, 40 -49 yr and > or = 50 yr) and detected for nocturnal penile tumescence (NPT) by NEVA.</p><p><b>RESULTS</b>Thirty-four of the cases were diagnosed as organic ED, and the other 49 as psychological ED. With the increase of age, the former was increased from 30.3% in the < or = 29 yr group to 60.0% in the > or = 50 yr group, while the latter decreased from 69.7% to 40.0%.</p><p><b>CONCLUSION</b>The percentage of organic ED tends to grow with the increase of age, while that of psychological ED is just the opposite.</p>

Single- and two-layer gradient centrifugation in sperm separation: comparison and appraisal / 中华男科学杂志

<p><b>OBJECTIVE</b>To appraise the effect of single- and two-layer Percoll density gradient centrifugation in sperm separation.</p><p><b>METHODS</b>Twenty semen specimens underwent single-(50%) and two-layer (90% and 45%) density gradient centrifugation, respectively. The sperm class analyzer (SCA) was used to analyze sperm density, motility and dynamic parameters and round cell density before and after the treatment.</p><p><b>RESULTS</b>After separation, the sperm recovery rate of the single-layer method was (65.5 +/- 12.8)%, significantly higher than that of the two-layer method (P < 0.01). The percentages of grade a sperm of the single- and two-layer method were significantly higher than pre-treatment (P < 0.05, P < 0.01), that of the single-layer was significantly lower than that of the two-layer method (P < 0.05), but the percentage of grade c sperm of the former was significantly higher than that of the latter (P < 0.05). Compared with pre-treatment, the percentage of grade a + b sperm of the two-layer method was significantly higher (P < 0.05), while that of the single-layer method showed no significant difference (P > 0.05), and the round cell density of both the methods was significantly lower (P < 0.05, P < 0.01), with no significant differences between the two methods (P > 0.05).</p><p><b>CONCLUSION</b>The single-layer method yields a higher rate of sperm recovery and causes little change in the sperm motility, while the two-layer method effects a lower rate and significantly improves sperm motility. Both the methods can efficiently separate sperm from round cells, and each has its own advantages and its application value in in vitro treatment of sperm.</p>