The influence of male and female overweight/obesity on IVF outcomes: a cohort study based on registration in Western China

BACKGROUND

Overweight/obesity can affect fertility, increase the risk of pregnancy complications, and affect the outcome of assisted reproductive technology (ART). However, due to confounding factors, the accuracy and uniformity of published findings on IVF outcomes have been disputed. This study aimed to assess the effects of both male and female body mass index (BMI), individually and in combination, on IVF outcomes.

METHODS

This retrospective cohort study included 11,191 couples undergoing IVF. Per the Chinese BMI standard, the couples were divided into four groups: normal; female overweight/obesity; male overweight/obesity; and combined male and female overweight/obesity. The IVF outcomes of the four groups were compared and analysed.

RESULTS

Regarding the 6569 first fresh IVF-ET cycles, compared with the normal weight group, the female overweight/obesity and combined male/female overweight/obesity groups had much lower numbers of available embryos and high-quality embryos (p < 0.05); additionally, the fertilization (p < 0.001) and normal fertilization rates (p < 0.001) were significantly decreased in the female overweight/obesity group. The combined male/female overweight/obesity group had significant reductions in the available embryo (p = 0.002), high-quality embryo (p = 0.010), fertilization (p = 0.001) and normal fertilization rates (p < 0.001); however, neither male or female overweight/obesity nor their combination significantly affected the clinical pregnancy rate (CPR), live birth rate (LBR) or abortion rate (p > 0.05).

CONCLUSION

Our findings support the notion that overweight/obesity does not influence pregnancy success; however, we found that overweight/obesity affects the fertilization rate and embryo number and that there are sex differences.

Effect of glutathione S-transferase gene polymorphisms on semen quality in patients with idiopathic male infertility

OBJECTIVE

To investigate the relationship between glutathione S-transferase enzyme (GSTM1, T1, and P1) genetic variants and semen quality in men with idiopathic infertility.

METHODS

Sperm characteristics were measured using computer-assisted sperm analysis. The malondialdehyde (MDA), nitric oxide (NO), and total antioxidant capacity (TAC) activities were detected by spectroscopic analysis, and 8-hydroxy-2'-deoxyguanosine (8-OHdG) was detected by enzyme-linked immunosorbent assay.

RESULTS

This study included 246 idiopathic infertile men and 117 controls. The GSTM1(-), T1(-), and M1/T1(-/-) genotype frequencies significantly differed between the groups. The GSTM1(-) and T1(-) genotypes in idiopathic infertile men negatively correlated with sperm concentration, motility, mitochondrial membrane potential, and other parameters. However, these genotypes positively correlated with the amplitude of the lateral head displacement and NO and 8-OHdG levels. The GSTT1(-) genotype positively correlated with mean angular displacement and MDA activity. GSTM1(-) and T1(-) had a synergistic effect on semen quality. Sperm motility, normal morphology, straightness, and TAC were lower and amplitude of lateral head displacement and MDA were higher in the GSTP1(A/G + G/G) group than in the GSTP1(A/A) group among men with idiopathic infertility.

CONCLUSIONS

GSTM1, T1, and P1 genetic variants may be risk factors for infertility by affecting the semen quality men with idiopathic oligoasthenospermia.

Hypogonadotropic hypogonadism associated with another small supernumerary marker chromosome (sSMC) derived from chromosome 22, a case report

The idiopathic hypogonadotropic hypogonadism (IHH) is portrayed as missing or fragmented pubescence, cryptorchidism, small penis, and infertility. Clinically it is characterized by the low level of sex steroids and gonadotropins, normal radiographic findings of the hypothalamic-pituitary areas, and normal baseline and reserve testing of the rest of the hypothalamic-pituitary axes. Delay puberty and infertility result from an abnormal pattern of episodic GnRH secretion. Mutation in a wide range of genes can clarify ~40% of the reasons for IHH, with the majority remaining hereditarily uncharacterized. New and innovative molecular tools enhance our understanding of the molecular controls underlying pubertal development. In this report, we aim to present a 26-year-old male of IHH associated with a small supernumerary marker chromosome (sSMC) that originated from chromosome 22. The G-banding analysis revealed a karyotype of 47,XY,+mar. High-throughput DNA sequencing identified an 8.54 Mb duplication of 22q11.1-q11.23 encompassing all the region of 22q11 duplication syndrome. Pedigree analysis showed that his mother has carried a balanced reciprocal translocation between Chromosomes 22 and X[t(X;22)]. To the best of our knowledge, this is the second confirmed case of IHH with an sSMC deriving from chromosome 22. Based on our study, the duplicated chromosome fragment 22q11.1-q11.23 might be the reason for the phenotype of our case. Meanwhile, High-throughput DNA sequencing combined with cytogenetic analysis can provide a more accurate clinical diagnosis for patients carrying sSMCs.

Effects of testicular sperm aspiration upon first cycle ICSI-ET for type 2 diabetic male patients

Male diabetes mellitus (DM) can affect erectile function and sperm quality. In severe cases, DM can lead to retrograde or no ejaculation, so testicular sperm aspiration (TESA) is combined with intracytoplasmic sperm injection (ICSI) to treat subfertility and infertility for DM couples. However, the effect of TESA upon ICSI (TESA-ICSI) for DM patients remains unclear. This research investigated the effect of TESA-ICSI on first cycle ICSI-embryo transfer (ICSI-ET) for type 2 diabetic mellitus (T2DM) patients and the potential mechanisms. The subjects consisted of 1219 male patients with azoospermia or retrograde ejaculation who were treated with TESA-ICSI from 2015.01 to 2019.11. They were classified into two groups, the T2DM group (n = 54) and non-diabetic control group (n = 1165). Sperm selection for injection was performed using motile sperm organelle morphology examination criteria. The number of available embryos and the high-quality embryo rates following a single ET as well as cleavage, fertilization, implantation, clinical pregnancy and the abortion rates were noted. Compared with the non-diabetic group, the available embryo rate (75.20 ± 26.40% vs.78.36 ± 23.25%) and high-quality embryo rate (46.49 ± 30.37% vs. 47.55 ± 28.57%) in the T2DM group were lower and the abortion rate (20.83% vs. 8.88%) was higher, but these differences were not statistically significant. There were no significant differences in clinical pregnancy, implantation, normal fertilization, and cleavage rates between the two groups. The results show that TESA for male T2DM patients does not influence the effect of ICSI. For T2DM patients with severe oligozoospermia, asthenospermia, teratozoospermia, or retrograde ejaculation that do not meet ICSI criteria, TESA-ICSI may perhaps be considered for reproductive assistance.

ABBREVIATIONS

DM: diabetes mellitus; TESA: testicular sperm aspiration; ICSI: intracytoplasmic sperm injection; ICSI-ET; ICSI-embryo transfer; LH: luteinizing hormone; mL: milliliter; TES: testosterone; FSH: follicle-stimulating hormone; P: progesterone; HCG: human chorionic gonadotropin.

Adenomatoid tumor of epididymis-A case report

Adenomatoid tumors are rare benign mesothelial neoplasm involving the Para testicular region, mostly the tail of the epididymis. However, it may occur in some other parts of the genitourinary system. A definitive diagnosis of the tumor is very important because it is very difficult to differentiate it clinically and radiologically from the other intrascrotal tumors. Herein, we report a case of adenomatoid tumor of the epididymis in a 60-year old male patient, with its clinical data and review of the literature.

Common Variants in ALPL Gene Contribute to the Risk of Kidney Stones in the Han Chinese Population

OBJECTIVE

Kidney stone formation is a complex disorder that likely results from both dietary and genetic factors. A recent study identified an association between the risk of kidney stones and polymorphisms in the ALPL gene, but the study needs replication. To confirm whether the ALPL gene is universally associated with kidney stones, the present study further investigated polymorphisms of the ALPL gene in a Han Chinese population.

METHODS

A total of 331 kidney stone patients and 553 unrelated healthy controls were included in the present case-control study. We conducted genetic analyses to detect the association of 19 tagging single nucleotide polymorphisms (SNPs) with kidney stones. In addition, we examined the relations between targeted SNP(s) and several clinical characteristics of kidney stones in the patients.

RESULTS

Genetic association analyses using logistic regression models identified one ALPL SNP, rs1256328, which was significantly associated with the kidney stone disease status (OR = 1.52, p = 0.0009). No significant results were obtained through association tests between genotypes of this SNP and the various clinical characteristics of kidney stone patients.

CONCLUSION

The ALPL SNP, rs1256328, was identified as being significantly associated with kidney stone disease status in a large Chinese Han cohort. Our study replicated a previous genome-wide association study that was conducted in an Icelandic population.

[Risk factors of erectile dysfunction in patients with cardiovascular diseases]

OBJECTIVE

To investigate the penile erectile function of hospitalized male patients with cardiovascular diseases, the incidence of erectile dysfunction (ED) in this cohort, and the relationship of ED with cardiovascular diseases and its risk factors.

METHODS

Using a self-designed questionnaire, we conducted an investigation among the hospitalized patients in the Department of Cardiovascular Diseases of the First and Second Affiliated Hospitals of Xi'an Jiaotong University. We measured their body height, body mass index (BMI), waist circumference, hip circumference, and blood pressure, obtained their personal data, past history, metabolic indexes, and erectile function scores by IIEF-5, and analyzed the risk factors of ED using univariate and multivariate logistic regression and OR analyses.

RESULTS

Totally, 225 valid questionnaires were included in this investigation, which showed a 66.7% incidence of ED, 15.8% mild, 27.0% mild to moderate, 17.6% moderate, and 6.3% severe. The incident rates of ED in the 18-35 yr, 36-49 yr, 50-65 yr, and > 65 yr age groups were 13.6%, 39.1%, 89.2%, and 91.2%, respectively. Univariate logistic regression analysis manifested that the risk factors of ED in the patients with cardiovascular diseases included age (OR = 3.122, 95% CI 2.040-4.779), smoking (OR = 1.768, 95% CI 1.209-2.584), BMI (OR = 1.261, 95% CI 1.114-1.427), total cholesterol (OR = 1.77, 95% CI 1.339-2.340), TC/HDL (OR =1.715, 95% CI 1.349-2.181), hypertension (OR = 1.717, 95% CI 1.110-2.658), and coronary heart disease (OR = 2.235, 95% CI 1.169-4.275), while multivariate logistic regression analysis showed the risk factors to be age (OR = 4.99, 95% CI 2.264-10.998), financial condition, (OR = 2.804, 95% CI 1.127-6.976), smoking (OR = 2.109, 95% CI 1.179-3.772), BMI (OR = 1.414, 95% CI 1.136-1.760), and TC/HDL (OR = 2.001, 95% CI 1.016-3.943).

CONCLUSION

The incidence of ED is high in hospitalized patients with cardiovascular diseases and rises with the increase of age. Age, smoking, financial condition, BMI, and TC/HDL are the risk factors of both ED and cardiovascular diseases, and financial condition is closely associated with ED.

[Efficacy and tolerability of dapoxetine in the treatment of premature ejaculation]

OBJECTIVE

To investigate the efficacy and adverse effects of dapoxetine in the treatment of premature ejaculation.

METHODS

We randomly assigned outpatients with premature ejaculation in the proportion of 2:1 to receive 30 mg dapoxetine on demand (n =78) or 50 mg sertraline qd for one month (n = 39). Follow-up was accomplished in 95 cases, 63 in the dapoxetine group and 32 in the sertraline group. We recorded the intravaginal ejaculatory latency time (IELT), clinical global impression of change (CGIC) score, and adverse reactions of the patients and compared them between the two groups.

RESULTS

IELT was significantly increased in both the dapoxetine (from [0.87 ± 0.31] to [2.84 ± 0.68] min, P < 0.05) and the sertraline group (from [0.84 ± 0.28] to [2.71 ± 0.92] min, P < 0.05) after medication. Based on the CGIC scores in premature ejaculation, the rate of excellence or effectiveness was 36.5% in the dapoxetine and 37. 5% in the sertraline group, and the rate of improvement was 63.5% in the former and 71.9% in the latter. The incidence rates of dizziness, nausea, headache, and diarrhea were slightly higher (P > 0.05) while those of fatigue, somnolence, and dry mouth significantly higher (P < 0.05) in the sertraline than in the dapoxetine group.

CONCLUSION

On-demand oral medication of dapoxetine is effective and well-tolerated for the treatment of premature ejaculation.

Genetic polymorphisms of CYP2D6*10 and the effectiveness of combined tamoxifen citrate and testosterone undecanoate treatment in infertile men with idiopathic oligozoospermia

Tamoxifen citrate, as the first line of treatment for infertile men with idiopathic oligozoospermia, was proposed by the World Health Organization (WHO), and testosterone undecanoate has shown benefits in semen values. Our objective was to assess the effectiveness of treatment with tamoxifen citrate and testosterone undecanoate in infertile men with idiopathic oligozoospermia, and whether the results would be affected by polymorphisms of CYP2D6*10. A total of 230 infertile men and 147 controls were included in the study. Patients were treated with tamoxifen citrate and testosterone undecanoate. Sex hormone, sperm parameters, and incidence of spontaneous pregnancy were detected. There were no significant differences between the control and patient groups with respect to CYP2D6*10 genotype frequencies (P>0.05). The follicle-stimulation hormone (FSH), luteinizing hormone (LH), and testosterone (T) levels were raised, and sperm concentration and motility were increased at 3 months and became significant at 6 months, and they were higher in the wild-type allele (C/C) than in the heterozygous variant allele (C/T) or homozygous variant allele (T/T) subgroups (P<0.05). In addition, the percentage of normal morphology was raised at 6 months, and represented the highest percentage in the C/C subgroup (P<0.05). The incidence of spontaneous pregnancy in the C/C subgroup was higher than that in the C/T or T/T subgroups (P<0.01). This study showed that the CYP2D6*10 variant genotype demonstrated worse clinical effects in infertile men with idiopathic oligozoospermia.

Genetic polymorphisms of glutathione S-transferase M1, T1, and P1, and the assessment of oxidative damage in infertile men with varicoceles from northwestern China

Our objective was to investigate the genetic polymorphisms of the glutathione S-transferase M1, T1, and P1 genes (GSTM1, GSTT1, and GSTP1) and to assess the oxidative damage in infertile men with varicoceles from northwestern China. A total of 65 infertile men with varicoceles and 30 controls were included in the study. Multiplex polymerase chain reaction and polymerase chain reaction-restriction fragment length polymorphism analyses were used to identify the genotypes. Sperm DNA damage was assessed by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling (TUNEL). The levels of 8-hydroxy-2'-deoxyguanosine (8-OH-dG) were measured by high-performance liquid chromatography with electrochemical detection. The activities of malondialdehyde (MDA) and nitric oxide (NO), and the total antioxidant capacity (TAC) were detected by spectroscopic analysis, and sperm characteristics were measured using computer-assisted semen analysis. The frequencies of the GSTM1, GSTT1, and GSTP1 genotypes were not significantly different between the control and patient groups (P > .05). The percentage of TUNEL-positive sperm and the levels of 8-OH-dG, MDA, and NO were higher but the sperm concentration and motility and the TAC were lower in the patients with the GSTM1, GSTT1, and GSTM1/T1 null genotypes than those in the patients with the GSTM1, GSTT1, and GSTM1/T1 present genotypes (P < .05). However, no significant differences were observed between the GSTP1 A/A and A/G+G/G genotypes (P > .05). Our results suggest that the GSTM1 and GSTT1 null genotypes may predispose sperm to increased oxidative damage in infertile men with varicoceles; however, GSTP1 allelic variation was not significantly different between the patient and control groups in this study.

Variation in root-to-shoot translocation of cadmium and zinc among different accessions of the hyperaccumulators Thlaspi caerulescens and Thlaspi praecox

Efficient root-to-shoot translocation is a key trait of the zinc/cadmium hyperaccumulators Thlaspi caerulescens and Thlaspi praecox, but the extent of variation among different accessions and the underlying mechanisms remain unclear. Root-to-shoot translocation of Cd and Zn and apoplastic bypass flow were determined in 10 accessions of T. caerulescens and one of T. praecox, using radiolabels (109)Cd and (65)Zn. Two contrasting accessions (Pr and Ga) of T. caerulescens were further characterized for TcHMA4 expression and metal compartmentation in roots. Root-to-shoot translocation of (109)Cd and (65)Zn after 1 d exposure varied 4.4 to 5-fold among the 11 accessions, with a significant correlation between the two metals, but no significant correlation with uptake or the apoplastic bypass flow. The F(2) progeny from a cross between accessions from Prayon, Belgium (Pr) and Ganges, France (Ga) showed a continuous phenotype pattern and transgression. There was no significant difference in the TcHMA4 expression in roots between Pr and Ga. Compartmentation analysis showed a higher percentage of (109)Cd sequestered in the root vacuoles of Ga than Pr, the former being less efficient in translocation than the latter. Substantial natural variation exists in the root-to-shoot translocation of Cd and Zn, and root vacuolar sequestration may be an important factor related to this variation.

[Genetic polymorphism of glutathione S-transferase T1 associated with idiopathic azoospermia and oligospermia]

OBJECTIVE

To investigate the association of glutathioneS-transferase T (GSTT1) gene polymorphism with azoospermia and oligospermia.

METHODS

Semen samples from 34 patients with idiopathic azoospermia, 40 patients with idiopathic oligospermia and 53 healthy controls with normal sperm concentration and motility were assessed according to the standards of WHO. The GSTT1 genotypes were identified by multiplex polymerase chain reaction (PCR) with peripheral blood DNA samples.

RESULTS

The frequencies of null GSTTI genotypes in the patients with idiopathic azoospermia, idiopathic oligospermia and the healthy controls were 76.5%, 72.5% and 49.1%, respectively. There was a significant association between the null alleles of GSTT1 and idiopathic azoospermia (odds ratio 3.13, 95% CI 1.20-8.16, P = 0.020) and idiopathic oligospermia (odds radio 2.53, 95% CI 1.06-6.11, P = 0.038).

CONCLUSION

The null alleles of GSTTI are a strong predisposing risk factor for idiopathic azoospermia and oligospermia.

Polymorphism analysis of Y-chromosomal haplotypes in the Chinese Han population living in the Shaanxi province of China

POPULATION

Chinese Han population living in the Shaanxi Province of China.

[Effect of oxidative damage to human sperm in vitro on mitochondrial tRNa LeuUUR gene]

OBJECTIVE

To study the oxidative damage to human sperm mitochondrial tRNA LeuUUR gene by reactive oxygen species (ROS) in vitro.

METHODS

Spermatozoa of normal physiological function selected from semen samples by Percoll gradient centrifugation technique were used as normal sperm models, which were divided into two groups of 20 cases each, a damage group and a control group, the former treated with hypoxanthine xanthine oxidase system and the latter left untreated, both incubated at 37 degrees C in aerobic environment for 60 minutes. Sperm DAN was extracted, and digestion by the enzymes fpg and ligation-mediated PCR ( LM-PCR) was performed to map the damage to mitochondrial tRNA LeuUUR gene. The spermatozoa were labeled with specific fluorescent probe of Rhodamine 123 to measure mitochondrial membrane potential ( MMP) by flow cytometry and observe sperm function.

RESULTS

Compared with the control group, after the normal spermatozoa were incubated with ROS, MMP of the spermatozoa significantly decreased ( 116. 27+/-11.72 vs 64.00+/-4. 88) , P <0.05. Digestion by the enzymes fpg and LM-PCR showed damage to mitochondrial tRNA LeuUUR, gene.

CONCLUSION

Reactive oxygen species may inflict oxidative damage on sperm mitochondrial tRNA LeuUUR gene and thus affect sperm function ( as shown by significant decrease in MMP), resulting in infertility.

[Papillary cystadenocarcinoma in a Müllerian duct cyst: report of a case with literature review]

OBJECTIVE

To study the diagnosis and treatment of Müllerian duct cysts and their involvement with malignancy.

METHODS

A 44-year-old male patient with papillary cystadenocarcinoma involving a Müllerian duct cyst was presented. The presentation treatment, and pathological and radiological appearances were retrospectively analysed and discussed with literature review. The main manifestation was intermittent episode of hemospermia accompanying terminal hematuria and infertility for 15 years. Final diagnosis was determined by the findings of transrectal ultrasound scan, CT scan, MRI imaging, cystoscopic examination and biopsy.

RESULTS

Exploratory laparotomy was performed through a suprapubic retrovesical approach. The finding that a duct-like wedge of tumor tissue passed through the prostate near cyst neck to the posterior urethra without affecting the adjacent prostatic tissue during tylectomy confirmed that it arises from Müllerian duct system. Pathohistologic examination disclosed a papillary cystadenocarcinoma and it infiltrated the wall of the cyst. Both seminal vesicles and ejaculatory duct had no carcinoma invasion.

CONCLUSION

Müllerian duct cyst involving with malignancy is exceedingly rare, the diagnosis is based on the findings of transrectal ultrasound scan, CT scan, MRI imaging, cystoscopic examination. The final diagnosis depends on the pathohistologic examination. Lumpectomy is effective and have a good outcome.

[Expression and effect of hCGRP recombinant adeno-associated virus in primary cultured corporal cavernosum smooth muscle cells of the rat in vitro]

OBJECTIVE

To observe the expression and effect of human calcitonin gene-related peptide (hCGRP) gene mediated by recombinant adeno-associated virus (rAAV) in primary cultured corporal cavernosum smooth muscle cells of the rat and explore the possibility of using CGRP gene for gene therapy in erectile dysfunction.

METHODS

The primary cultured corporal cavernosum smooth muscle cells of the rat were randomly divided into 4 groups and infected with recombinant virus VssHGCMV-hCGRP, VssHGCMV, VssC-MV-GFP and the untreated, respectively. CGRP-like immunoreactivity was measured by protein dot blot assay in the 24 h-culture medium, and intracellular cAMP and cGMP levels in the cultured cells were also determined using radioimmunoassay to ascertain bioactivity of transduced CGRP.

RESULTS

The exogenous gene was transferred into primary corporal cavernosum smooth muscle cells by VssHGCMV-hCGRP infection and efficiently expressed. Compared with the control group, intracellular cAMP level in the cell infected by VssHGCMV-hCGRP was significantly increased (48.7 +/- 1.1 nmol/L vs 7.8 +/- 1.4 nmol/L, P < 0.01), whereas cGMP level remained unchanged in two groups, and CGRP-like immunoreactivity was also detected in the culture medium infected by VssHGCMV- hCGRP.

CONCLUSION

The system of secretory expressing bioactive peptide rAAV mediated gene transfer may be used to express efficiently exogenous gene in corporal cavernosum smooth muscle cells and affect cAMP level in the corporal cavernosum smooth muscle cells of the rat.

[Effect of secretory human calcitonin gene-related peptide recombinant AAV on penile erection in streptozotocin-induced diabetic rat]

OBJECTIVE

To determine whether recombinant adeno-associated virus-mediated overexpression of hCGRP in the corpus cavernosum can affect the continuous production of hCGRP in the penile tissue and enhance erectile responses in STZ-induced diabetic rats.

METHODS

Diabetes mellitus was induced by a single intraperitoneal injection of 60 mg/kg streptozotocin in male SD rats. VssHGCMV-hCGRP, VssCMV-GFP and rAAV solution were injected into the corporal cavernosum of STZ-induced diabetic rats, respectively. The corporal tissue was obtained from groups of 8 rats on day 5 post-injection, and the expressions of CGRP and GFP in cavernosal tissue were detected using immunohistochemistry and laser scanning confocal microscopy, respectively. Cavemosal tissue cAMP and cGMP levels were measured using radioimmunoassay. On day 5 post-injection, intracavernous pressure induced by electrostimulation of penile dorsal nerves was measured and recorded with a biological signal processing system in each group rat.

RESULTS

rAAV transduction efficiency of GFP reporter gene was measured by laser scanning confocal microscopy and was observed in the penile tissue, especially in the corporal cavernosum and the vessel 5 days after transfection with VssCMV-GFP. Immunohistochemistry showed that the CGRP increased in the corporal cavernosum. In addition, both cAMP and cGMP levels in the corpora cavernosa transfected with VssHGCMV-hCGRP were significantly increased, compared with controls [(48.4 +/- 6.5) nmol/L and (21.2 +/- 13.6) nmol/L vs (16.7 +/- 2.5) nmol/L and (0.42 +/- 0.12) nmol/L, respectively]. More importantly, 5 days after administration of VssHGCMV-hCGRP,a significant increase was observed in the erectile response to penile dorsal nerve stimulation in the diabetic rat [(60.5 +/- 4.5) mm Hg vs (22. 3 +/- 1.3) mm Hg].

CONCLUSIONS

This results demonstrate that rAAV-mediated transfer of the CGRP gene can increase production of endogenous CGRP, cAMP and cGMP in corpora cavernosa of STZ-induced diabetic rats. Moreover, overexpression of CGRP enhances ICP and the erectile response to penile dorsal nerve stimulation in the diabetic rat.

[Intracavernous pressure responses induced by electrical stimulation of penile dorsal nerves and intracavernosal drug injection in rats]

OBJECTIVE

To evaluate the application of intracavernous pressure (ICP) monitoring in the electrophysiologic and pharmacologic induction of penile erection.

METHODS

The penile dorsal nerves (DN) of 8 anesthetized adult male rats were isolated and the corpora cavernosa exposed. A heparinized 25-gauge angiocath (intravenous catheter) was inserted into the right corpus cavernosum to monitor the ICP and a 30-gauge needle was inserted into the left corpus cavernosum for intracavernosal drug administration. Penile erection was induced by electrical stimulation of the dorsal nerve (16 Hz frequency, 0.5 ms pulse width, 20 s duration, 4 volts) and intracavernous papaverine hydrochloride injection (0.4 mg). ICP was recorded with the SMUP-PC biological signal process system.

RESULTS

In the anesthetized rats, the baseline level of ICP was (12.3 +/- 3.1) mm Hg and the electrical stimulation of the DN significantly increased ICP[(36.4 +/- 2.3) mm Hg, P < 0.05], which slowly returned to baseline pressure after termination of the electrical stimulation. The intravavernosal administration of papaverine also induced a significant increase in ICP [(28.4 +/- 6.1) mm Hg, P < 0.05].

CONCLUSION

ICP monitoring in rats provides a useful scientific tool for in vivo studies of penile erection in experimental rat models. It is of great significance for further studying the physiology of penile erection and the pathogenesis of erectile dysfunction as well as for evaluating the efficacy of novel therapies for erectile dysfunction.

[Etiology and treatment of bladder spasm associated with benign prostatic hyperplasia]

OBJECTIVE

To investigate the etiology and treatment of bladder spasm associated with benign prostatic hyperplasia (BPH).

METHODS

Urodynamic tests were performed in 102 cases of BPH before operation. The correlation of bladder spasm with aging, international prostate symptom score (IPSS), quality of life, prostatic volume, operation methods and urodynamic indexes was studied by t and chi2 tests.

RESULTS

The incidences of bladder spasm in the lower compliant bladder and unstable bladder were 32.1% (9/28) and 42.5% (13/20), and those after suprapubic prostatectomy and transurethral resection of the prostate (TURP) were 50.9% (26/51) and 23.3% (12/51). There was significant difference between operation methods (P < 0.05).

CONCLUSION

Bladder spasm easily develops in the lower compliant bladder and unstable bladder, especially after suprapubic prostatectomy. TURP might decrease the incidence of bladder spasm after BPH operation.

[Analysis of Yq microdeletions in idiopathic infertile males with azoospermia and oligospermia in Shaanxi Province]

OBJECTIVE

To evaluate the frequency of microdeletions in the long arm of Y chromosome of idiopathic infertile males with azoospermia and oligospermia in Shaanxi province in China and to investigate the relevance of sperm count to Y microdeletion frequencies.

METHODS

According to the sequence of sequence-tagged sits (STS) AZFa, AZFb, AZFc and SRY, 4 of the azoospermic factor regions on Y chromosome long-term supplied by GenBank, 5 sets of primers were synthesized. The Y microdeletions in AZF regions were screened by polymerase chain reaction (PCR) in 64 idiopathic cases of azoospermia and oligospermia and 20 men of known fertility.

RESULTS

No microdeletion was detected in the 20 normospermic subjects. Deletion of the AZFc/DAZ was detected in 11 individuals and one patient had both AZFb and AZFc deletion; no deletion of AZFa and SRY region was found. The frequency of Y microdeletions in the subgroups with different sperm count showed the highest value among azoospermic men (3 cases, 21.4%). The percentage progressively decreased with the deletion frequency (20.0%, 17.9% and 8.3%) in the subgroups with sperm counts of < 1 x 10(6)/ml, < (1-5) x 10(6)/ml and < (1 to approximately 10) x 10(6)/ml, respectively.

CONCLUSION

Y chromosome microdeletions are specifically associated with severe spermatogenic failure. The rate of deletion involving AZF region of the Y-chromosome is higher in infertile men with azoospermia and oligospermia. PCR amplification of AZF locus is useful for the diagnosis of microdeletions in the Y-chromosome.

[Role of ionic channels in the regulation of cavernous smooth muscle tone]

The regulation of vascular and trabecular smooth muscle relaxation or contraction in the penis, that is, the physiology of corporal smooth muscle tone, determines penile erection or flaccidity. There is considerable evidence that the potassium channel and calcium channel, like many other vascular tissues, are the major modulators of smooth muscle tone in the corpora. Moreover, data on cultured corporal smooth muscle cells and isolated corporal tissue strips have demonstrated that the neurotransmitters participating in erection modulate corporal smooth muscle tone largely through their effects on ionic channels and transmembrane ionic flux.

[Advances in the study of signal transduction in cavernous smooth muscle]

The signal transduction pathways within corporal smooth muscle cells are the intracellular molecular mechanisms of corporal smooth muscle tone regulation. Various neurotransmitters activate the membrane receptor proteins or intracellular enzyme pathways and result in the production of extracellular chemical signals. Second messenger molecules and ions transmit and amplify the signals, and subsequently induce the relaxation of smooth muscle cells and penile erection. Therefore, the study of signal transduction in cavernous smooth muscle play an important role in understanding the physiology of erection and the pathophysiology of erectile dysfunction as well as in developing new selective drugs for the treatment of erectile dysfunction.