Assessment of the health status of middle-aged and elderly men with head scale, SF-36, IIEF5, AMS, and IPSS.

BACKGROUND: Identifying practical and distinguished indicators and influencing factors of male aging may be useful in predicting subsequent aging trends, designing personalized prevention, and improving lifestyle and health. METHODS: A cross-sectional, population-based study was performed in Jiashan County, China in 2016. A total of 690 local male residents, aged 40 to 80 years, were eligible for recruitment. Demographic and lifestyle information was collected through structured interviews. A self-designed head scale, the Medical Outcomes Study 36-item Short Form (SF-36), International Index of Erectile Function (IIEF5), Aging Males' Symptoms (AMS), and International Prostate Symptom Score (IPSS) were used. Analysis of variance, local polynomial regression smoothing curves, multiple linear regression, and partial correlation analyses were performed. RESULTS: All the scales deteriorated with increasing age (P < 0.01), especially from the age of 60. The most significant changes between adjacent age groups were found in IIEF5 scores (16.7, 43.5 and 39.4%). Income, nutrition, personality and neighborhood relationship had an effect on SF-36 and AMS after adjusting for age (P < 0.01). Furthermore, neighborhood relationship modified the age effect on the head scale score and IIEF5 (P = 0.03); nutrition modified the relationship between age and SF-36 (P < 0.01). CONCLUSIONS: Recession of reproductive health may be a distinct predictor of male aging. The associations of social inequalities or personality and health offer potential interventions for men's health in aging. Self-reported scales may limit the precision and more physical fitness tests could be combined for a more precise assessment.

Body Mass Index Changes in Relation to Male Reproductive Hormones: Longitudinal Results From a Community-Based Cohort Study.

The objective of the current study was to explore the relationship between longitudinal change in body mass index (BMI) and reproductive hormones in middle-aged and elderly Chinese men. A cohort study was conducted in a rural area of China. Local male residents aged 40-80 years were recruited at baseline in 2012 and were followed up in 2016. Information about weight, height, waist circumference, sex hormones, smoking status, and medical history were obtained. The change in BMI reported no significant relationship with the change in total testosterone (TT), calculated free testosterone (cFT), and bioavailable testosterone (BioT) in Pearson correlation analyses. When the change in BMI was divided into three groups-"great loss," "normal fluctuation," and "great gain"-TT, cFT and BioT had the highest increase (or the lowest decrease) in men with "normal fluctuation" in BMI compared with the other two groups. The advantage of maintaining a stable BMI was more evident for those who were overweight, non-smoking, and disease-free. There was a tendency of a continuous increase in cFT and BioT with BMI increase in smoking and diseased populations. Maintaining a stable BMI is associated with maintaining normal levels of reproductive hormones, especially in overweight, non-smoking, and healthy men aged over 40 years.

Periconceptional Folic Acid Supplementation and the Risk of Spontaneous Abortion among Women Who Prepared to Conceive: Impact of Supplementation Initiation Timing.

It is unclear whether periconceptional folic acid (FA) supplementation decreases the risk of spontaneous abortion (SA). The impact of supplementation initiation timing has not been ascertained. This cohort study aimed to investigate the association between maternal periconceptional FA supplementation and risk of SA, with due consideration of the supplementation initiation timing. Through the National Free Pre-conception Health Examination Project (NFPHEP), we identified 65,643 pregnancies on FA supplementation in Chongqing, China between 2010 and 2015. After adjusting for covariates, maternal periconceptional FA supplementation was associated with a lower risk of SA (adjusted risk ratio [aRR]: 0.52; 95% confidence interval [CI]: 0.48-0.56). Pregnant women with FA supplementation initiated at least 3 months before conception had a 10% lower risk of SA (aRR: 0.46; 95% CI: 0.42-0.50) than those with FA supplementation initiated 1-2 months before conception (aRR: 0.56; 95% CI: 0.50-0.62) or after conception (aRR: 0.56; 95% CI: 0.51-0.61). These associations might not thoroughly account for FA supplementation, and to some extent our findings confirm the role of the utilization of healthcare in preventing SAs. Women who initiated healthcare, including taking FA earlier during the periconceptional period, could have a lower risk of SA.

Intended place of residence in old age of internal migrants aged 15-64 years: a citywide cross-sectional study in Shanghai, China.

OBJECTIVES: To explore the intentions of working-age internal migrants concerning their place of residence in old age and the relevant influencing factors. METHOD: A cross-sectional survey was conducted in the 17 districts of Shanghai, China in 2013. Through multi-stage stratified sampling with probability proportional to size, 7968 internal migrants (aged 15-64 years) were selected and interviewed individually face to face. The primary outcome concerned the intended place of residence in old age of internal migrants living in Shanghai. Information was collected on demographic characteristics, health insurance, economic condition and participation in social activities. Multinomial logistic regression was performed to analyse the factors influencing migrants' intentions concerning their place of residence in old age. RESULTS: A total of 7927 working-age migrants with complete data were analysed. Of these, 57.0% intended to live in their hometown in old age, 17.7% planned to remain in Shanghai and 25.3% were undecided. Those respondents who were male, less educated, from rural areas or Western China, living in rental houses or who had left family members behind in their hometowns were more likely to choose their hometown as their intended residence in old age (p<0.05). Engagement in business, longer residence duration, possession of social insurance and participation in social activities in Shanghai were identified as possible motivators for migrants who intended to remain in Shanghai in old age (p<0.05). CONCLUSIONS: Most of the migrants expressed an intention to remigrate to their hometowns in old age. Education, economic capacity and social insurance influenced internal migrants in their decision. Relevant authorities should monitor the remigration pattern of ageing migrants, strengthen the senior care system and prepare health service resources that are more adequate, especially in the provinces or cities whence the migrants came.

Longitudinal Trends of AMS and IIEF-5 Scores in Randomly-Selected Community Men 40 to 80 Years Old: Preliminary Results.

INTRODUCTION: Most of conclusions on the relationship between age and reproductive health in aging men relied on cross-sectional data. AIM: To better characterize the natural degradation trajectory of reproductive health of aging men based on longitudinal data. METHODS: A community cohort study was performed in randomly selected men 40 to 80 years old, initiated in 2012 and followed up in 2014 and 2016. Participants were investigated by face-to-face structured interview, including demographic information and International Index of Erectile Function (IIEF-5) and Aging Males' Symptoms (AMS) scales. MAIN OUTCOME MEASURES: The differences among the 3 assessments of IIEF-5 and AMS were analyzed, and progression trajectories were traced. RESULTS: The high degree of variability on AMS and IIEF-5 was evident across individual subjects, as was the variability within individuals. The average IIEF-5 score of 248 subjects decreased from 16.9 to 14.1 during the 4 years, and the total AMS score increased from 22.6-27.0 (P < .001). Longitudinal data, both of individuals and of groups, showed the more rapid increase or decrease on AMS or IIEF-5 scores over 4 years in the 61-70 age group than in other age groups. CLINICAL IMPLICATION: The evidence of the greatest changes on AMS and IIEF-5 scores in the 61-70 age group prompts the importance of early intervention to postpone the degradation of reproductive health. STRENGTH & LIMITATIONS: Compared with cross-sectional data, longitudinal data can provide a more natural progression trajectory of reproductive health of aging male individuals. The low follow-up rate might affect the parameter estimation to some extent. CONCLUSION: Cohort data over 4 years' follow-up showed more abrupt changes on AMS and IIEF-5 scores in the 61-70 age group than in other age groups. Zheng J-B, Liang Q-F, Li J-H, et al. Longitudinal Trends of AMS and IIEF-5 Scores in Randomly-Selected Community Men 40 to 80 Years Old: Preliminary Results. J Sex Med 2019;16:1567-1573.

[Clinical study of exercise rehabilitation and gait analysis during the perioperative period of lumbar percutaneous transforaminal endoscopic discectomy].

OBJECTIVE: To explore the clinical effect of exercise rehabilitation during perioperative period on residual pain, gait and activities of daily living (ADL) in patients with lumbar spinal stenosis (LSS) after lumbar percutaneous transforaminal endoscopic discectomy(PTED). METHODS: The clinical data of 48 patients with LSS underwent PTED from December 2015 to December 2016 were retrospectively analyzed. Patients were divided into observation group and control group according to different rehabilitation patterns, being 24 cases in each group. The patients of observation group received exercise rehabilitation and the patients of control group received conventional rehabilitation. Visual analogue scale(VAS), Oswestry Disability Index (ODI) and the ratio of supporting phase were recorded before operation and 12 days, 6 months after operation. The correlation between the ratio of supporting phase and VAS, ODI was analyzed. RESULTS: The ratio of supporting phase of observation group was significantly higher than that of control group at 12 days after operation(P<0.05). The VAS and ODI in observation group were significantly lower than that of control group at 6 months after operation(P<0.01). There was no correlation between the ratio of supporting phase and ODI or VAS in two groups (P>0.05). CONCLUSIONS: Lumbar percutaneous transforaminal endoscopic discectomy combined with exercise rehabilitation during the perioperative period can release or eliminate postoperative residual pain, improve gait balance, enable activities of daily living, and has a positive effect in patients with lumbar spinal stenosis.

The impact of age, BMI and sex hormone on aging males' symptoms and the international index of erectile function scores.

OBJECTIVE: To analyze the impact of age, BMI and sex hormone on aging males' symptoms (AMS) and the 5-item version of the international index of erectile function (IIEF-5) scores in middle-aged and elderly Chinese men. METHODS: A population-based cross-sectional study was conducted in Jiashan County. A total of 969 men, aged between 40 and 80 years old, were admitted. Physical examination and the sex hormones were measured, and AMS and IIEF-5 scores were assessed. RESULTS: The oneway ANOVA analysis indicated older age groups had higher AMS total-scores, somatic and sexual sub-scores, and lower IIEF5 scores (all p < .01). Pairwise correlation (rpairwise) analyses showed the significant associations between AMS and age or sex hormone (cFT, Bio-T, SHBG, and LH) levels, and similar for IIEF5. However, when age was adjusted, the correlation coefficients (rpartial) weakened, and correlation significance disappeared, except LH (for AMS: rpartial = 0.096, p = .009; for IIEF-5: rpartial = -0.140, p = .001). Multiple linear regressions confirmed the influence of increased age and LH on the AMS and IIEF5 scores. CONCLUSION: CFT, Bio-T and SHBG failed to yield any additional predicting information when age was adjusted. To improve the male reproductive health, future research should pay more attention on aging-related comorbidities and how to improve general wellness.

Single or double semen samples: the dilemma in epidemiological studies on semen quality.

STUDY QUESTION: Is it necessary to collect more than one semen sample from each individual in epidemiological studies? SUMMARY ANSWER: Single semen samples can be used in model construction as long as the model adjusts for major relevant covariates. WHAT IS KNOWN ALREADY: If a series of semen samples are taken from one individual at different times, significant intra-individual variation may exist. STUDY DESIGN, SIZE, DURATION: A population-based cross-sectional study was conducted from 1 December 2000 to 20 November 2002. A total of 1010 volunteers, aged between 20 and 60 years old, were recruited. PARTICIPANTS/MATERIALS, SETTING, METHODS: A total of 998 subjects were included for statistical analysis. Of these, 332 men provided single semen samples (group 1) and 666 men provided two samples (group 2). Semen parameters, including semen volume, sperm concentration, total sperm number, progressive motility, vitality, and sperm morphology, were analyzed with standardized methods according to the World Health Organization (WHO) laboratory manual for the examination of human semen and sperm-cervical mucus interaction (3rd edition). MAIN RESULTS AND THE ROLE OF CHANCE: Rapidly progressive motility of semen from group 1 was lower than that of group 2, but other parameters were not significantly different. The differences in mean values between the double samples were small on all semen parameters. The correlations between the two ejaculates were high, but the agreements were poor except for sperm vitality and normal morphology. Model selection and validation analysis supported the premise that the regression model from the first samples was applicable for the second samples. The large sample size with extensive quality control provides robust parameter estimation and promises good applicability for model selection and validation. LIMITATIONS, REASONS FOR CAUTION: The results are valid for healthy men in China, not for subfertile or infertile men. WIDER IMPLICATIONS OF THE FINDINGS: The overall semen quality of a given group of healthy men will not vary significantly in the short term. Single semen samples can be used in model building as long as major relevant covariates are considered. Utilizing multiple semen donations may actually cause the samples to be less representative. STUDY FUNDING/COMPETING INTERESTS: This research was supported by a grant from Shanghai Science and Technical Committee (02DJ14053) and a grant from Ministry of Science and Technology, China (9902). All authors have no competing interests.

Cancer risks in parents who had a child with a congenital malformation.

Cancer risk in parents may be related to congenital malformations (CMs) in their children if they share genetic susceptibility or environmental exposure that may be teratogenic and carcinogenic. We conducted a population-based cohort study based on Danish register data. We identified 795,607 mothers and 781,424 fathers who had all their children between 1977 and 2007 in Denmark. Information on CM was obtained from the Danish Hospital Registry and information on cancer was obtained from the Danish Cancer Registry. Parents were followed from the birth of their first child until the diagnosis of cancer, death, emigration, or December 31, 2007. We used Cox regression models to estimate hazard ratios (HRs) for cancer including cancer in specific organs in mothers and fathers. Overall, 75,701 (9.5%) mothers and 72,724 (9.3%) fathers had at least one child diagnosed with CMs within the first year of life. Neither mothers (HR=1.04; 95% CI: 0.99-1.04) nor fathers (HR=1.03; 95% CI: 0.98-1.09) who had a child with a CM had a higher overall risk of cancer. Mothers (HR=0.76, 95% CI: 0.58-1.00) or fathers (HR=0.89, 95% CI: 0.66-1.19) who had a child with a chromosomal malformation had a lower overall cancer risk. The findings also showed a higher risk for some specific types of cancer in parents who had children with a CM in the specific system. Some, or perhaps all, of these findings may be due to chance caused by multiple comparisons. We present all results on paper or online to provide clues for further research and to avoid publication bias.

Turning point of age for semen quality: a population-based study in Chinese men.

OBJECTIVE: To explore the relationship between age and semen quality in Chinese men. DESIGN: Population-based cross-sectional study. SETTING: The Department of Reproductive Epidemiology and Social Science, Shanghai Institute of Planned Parenthood Research, People's Republic of China. PATIENT(S): Healthy 20- to 60-year-old men. INTERVENTION(S): Standard World Health Organization procedures (3rd ed.) for semen analysis. MAIN OUTCOME MEASURE(S): Semen volume, sperm concentration, total sperm number, progressive motility, vitality, and sperm morphology. RESULT(S): Statistical analysis results of 998 subjects showed that age was negatively correlated with progressive motility, vitality, and percentage of normal sperm. No declining trend was found between age and parameters semen volume, sperm concentration, or total sperm number. Rapidly progressive motility and percentage of normal sperm began to decrease slowly at age 30 years, and progressive motility began to decrease at age 40 years. Compared with the 20- to 29-year age group, the values of the latter three parameters showed significant differences in men aged ≥35, ≥45, and ≥40 years. CONCLUSION(S): Increasing age mainly influences sperm motility, vitality, and normal morphology, but these parameters have turning points at different ages. Because of the large sample size, this information can be used to provide standard values for Chinese men, particularly in the age range 30-50 years. Further research would enroll a large sample of healthy 40- to 70-year olds to examine declining semen parameters in these age groups.

[Association between age and quality of semen in Chinese males with normal fertility].

OBJECTIVE: To explore the association between age and variables of semen in Chinese males with normal fertility. METHODS: The population size under study would consist of 946 fertile male volunteers from 6 provinces of China, aged between 20 and 59. Semen quality was analyzed by hand on site and background information was obtained through structured questionnaire. Trend chi-square test and multiple linear regression methods were used and 95%CI were calculated to serve as reference value of semen variables of different age group. RESULTS: The normal percent of motility and living sperm declined significantly while the ascending of age, they were 55.7% and 97.3% in age < 30 group when compared to 21.9% and 90.3% in the age 50 - 59 group respectively. Under control of confounding factors as for center and abstinence time, all semen variables except semen volume were significantly different among the age groups. Sperm concentration, percentage of sperm motility and normal morphology sperm decreased significantly after age 40 while percentage of living sperm decreased after age 50 - 59 group. Sperm concentration among the 50 - 59 year-old group appeared to be lower than the 40 - year-old group. CONCLUSION: The influence of age must be taken into account when evaluating the quality of semen.

Do reproductive hormones explain the association between body mass index and semen quality?

AIM: To examine whether reproductive hormones play a role in the association between body mass index (BMI) and semen quality. METHODS: Semen quality and testosterone (T), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and estradiol (E(2)) were evaluated in 990 fertile males with age 38.9 +/- 9.7 (mean +/- SD) years recruited from the Chinese general population in 2001 and 2002. RESULTS: Semen quality was reduced among underweight (BMI < 18.5) compared with normal (BMI 18.5-24.9) and overweight (BMI 25.0-29.9), but the associations were independent of reproductive hormones. After adjustment for the potential confounders, underweight men had reductions in sperm concentration (22.4 X 10(6)/mL), total sperm count (52.9 X 10(6)) and percentage of normal sperm forms (6.9%) compared with men with normal BMI. Being underweight may be a risk factor for low sperm concentration (OR: 4.68, 95% confidence intervals [CI]: 2.01-10.91). Otherwise, being overweight may be a protected factor for low sperm concentration (OR: 0.25; 95% CI: 0.08-0.83) and low total sperm count (OR: 0.37, 95% CI: 0.15-0.87). CONCLUSION: Low BMI was associated with reduced semen quality. The associations between BMI and semen quality were found statistically significant even after adjustment for reproductive hormones. Reproductive hormones cannot explain the association between BMI and semen quality.

Does exposure to computers affect the routine parameters of semen quality?

AIM: To assess whether exposure to computers harms the semen quality of healthy young men. METHODS: A total of 178 subjects were recruited from two maternity and children healthcare centers in Shanghai, 91 with a history of exposure to computers (i.e., exposure for 20 h or more per week in the last 2 years) and 87 persons to act as control (no or little exposure to computers). Data on the history of exposure to computers and other characteristics were obtained by means of a structured questionnaire interview. Semen samples were collected by masturbation in the place where the semen samples were analyzed. RESULTS: No differences in the distribution of the semen parameters (semen volume, sperm density, percentage of progressive sperm, sperm viability and percentage of normal form sperm) were found between the exposed group and the control group. Exposure to computers was not found to be a risk factor for inferior semen quality after adjusting for potential confounders, including abstinence days, testicle size, occupation, history of exposure to toxic substances. CONCLUSION: The present study did not find that healthy men exposed to computers had inferior semen quality.

[Effect of hydrogen sulfide, a new gaseous signal molecule, on pulmonary vascular smooth muscle cell apoptosis in rats].

OBJECTIVE: To explore the effects of hydrogen sulfide (H(2)S) on hypoxic pulmonary vascular smooth muscle cell (VSMC) apoptosis in rats. METHODS: Twenty-four Wistar rats were divided into 3 groups: control group (n=8), hypoxia group (n=8), and hypoxia +NaHS group (n=8). The plasma level of H(2)S was determined by methylene blue spectrophotometric method. VSMC apoptosis was measured by terminal deoxynucleotidyl transferase-biotin nick end labeling (TUNEL). The protein expressions of Bcl-2, Fas and caspase-3 in pulmonary arteries were detected by immunohistochemical technique. RESULTS: Compared with rats in the control group, the plasma level of H(2)S decreased by 36% in rats of hypoxic group. The apoptotic rate per area in VSMCs detected with TUNEL was significantly decreased by 52.9% in rats of hypoxic group. The expressing integral score of Bcl-2 of VSMCs was increased by 123.9% while Fas protein expression of VSMCs was decreased by 45% and caspase-3 protein expression of VSMCs was not significantly changed in rats of hypoxia group. But compared with rats in the hypoxia group, the plasma level of H(2)S increased by 65% in rats of hypoxia+NaHS group. The apoptotic rate in VSMCs of TUNEL was significantly increased by 62.5% in rats of hypoxia+NaHS group. The Bcl-2 protein expression of VSMCs was decreased by 36.4% in rats of hypoxia+NaHS group. The expressing integral scores of Fas and caspase-3 were significantly higher in rats of hypoxia+NaHS group than in those of hypoxia group. CONCLUSION: Hypoxia decreased the pulmonary artery smooth muscle cell apoptosis. H(2)S inhibited Bcl-2 protein expression of VSMCs and activated Fas and caspase-3 protein expressions of VSMCs, and therefore promoted the pulmonary artery smooth muscle cell apoptosis.

[Formation of the third phase and spectroscopic research of the loading organic phases in the gold extraction].

The formation of the third phase during the gold extraction from cyanide solution by quaternary ammonium, tetradecyldimethylbenzylammonium chloride (TDMBAC) was studied by 198Au tracer method. The microstructure of the organic phases was investigated by FTIR, 31P-NMR. With the increasing of gold concentration, aggregations were formed in the gold-loaded organic phase. With the further increasing of gold concentration, the organic phase turned into two layers. Gold, water, and tri-n-butyl phosphate (TBP) were mainly in the down organic phase. In the down layer, distinct O-H stretching vibration peak was found by FTIR; the frequency of P=O stretching vibration shifted to the low frequency; 31P-NMR chemical shift was markedly shifted to the high frequency field. The radius of aggregation was measured by the dynamic laser scattering (DLS) method.