目的 应用慢性前列腺炎临床分型系统(UPOINT(S))观察宁泌泰胶囊对慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)各表型患者的临床疗效.方法 根据UPOINT(S)系统诊断标准,对44例CP/CPPS患者进行临床表型分类,采用口服宁泌泰胶囊连续治疗8周,分别在治疗前、治疗4周和治疗8周时,进行美国国立卫生研究院慢性前列腺炎症状评分(NIH-CPSI),分析比较宁泌泰胶囊对具有不同表型患者的临床疗效.结果 44例CP/CPPS患者根据UP-OINT(S)系统分型,所有患者至少具有2种临床表型,其中,93.18％的患者同时具有3种及以上表型.患者经宁泌泰胶囊治疗4周后,NIH-CPSI疼痛评分、生活质量评分以及总评分显著低于治疗前(P<0.05),总分由23.51±6.36降至19.58±8.02;治疗8周后评分持续下降,总分降至17.47±9.05.进一步分层分析结果显示,具有U、P、O、N、T或S表型的患者治疗4周和治疗8周时,NIH-CPSI总评分均显著降低(P<0.05).此外,经宁泌泰胶囊治疗8周,O型患者前列腺按摩液(EPS)白细胞阳性率和卵磷脂小体异常率分别由58.62％和89.66％降至35.29％和70.59％.结论 宁泌泰胶囊在治疗4周内即可显著改善CP/CPPS患者疼痛症状,提高生活质量,且对UPOINT(S)表型分类系统中的U、P、O、N、T和S 6种表型均具有显著的临床疗效,治疗8周疗效进一步增强.

男性性功能障碍一般认为分为四大类,即性欲障碍(主要是性欲低下)、勃起功能障碍、射精障碍、高潮缺乏,无论性功能障碍原因是什么,都可以影响夫妻间性生活满意度,加重夫妇间已有的或产生新的情感分离和痛苦,最终影响夫妇整体生活质量.近二十年来,关于男性勃起功能障碍和射精功能障碍受到医患双方的高度重视,基础和临床研究有较大发展,而有关性欲障碍(主要是性欲低下)的相关研究进展缓慢.对于男性来说,性欲是性生活的起点,性欲低下或缺乏对性生活和整体生活质量影响不言而喻.

得知江鱼教授过世的消息,心情久久不能平静,一幕幕往事涌上心头. 江鱼教授是一位敢于克服困难的人.记得一年冬天,我承担的一项课题需要早晨在老年冬泳队抽空腹血,我觉得这件事很难做:冬天,露天游泳池,寒风刺骨,七、八十岁的老人,想想这些,困难应该不小吧?当我向您说明后,您告诉我:小戴,这不难,我来帮你联系上海交通大学游泳池、许昌路游泳池,如果样本不够,还可以到嘉定,这里都有老年冬泳队.还记得,我和您一同骑车到上海交通大学游泳池,发放问卷,回收问卷,向老人们宣传此次研究的科学意义;还记得,清晨我从杏花楼买好点心,赶到交大游泳池,您已骑车等在那里,您带头跳进游泳池、您第一个伸出冰冷的手臂招呼我:小戴,来抽血;您向抽完血的冬泳队老人分发早餐.从上海交通大学游泳池到许昌路游泳池,从嘉定区冬泳队到密云路养老院,您鼓励我认认真真完成第一个自主申请的科研课题.

Introduction: Obstructive sleep apnea (OSA) has been linked with erectile dysfunction (ED), but the relatively independent polysomnography (PSG) outcomes of apnea and nocturnal hypoxia may not effectively assess the physiological impairment of OSA well. Aim: To propose a new calculation method, the blood oxygen accumulation distribution area index (BOADAI), for evaluating the association between OSA and ED. Methods: In this study, 502 male participants with suspected OSA were enrolled. Clinical questionnaire, physical measurements, and PSG outcomes were obtained by 2 respiratory physicians. ED was assessed by a urologist using the International Index of Erectile Function-5 (IIEF-5). Whole pulse oxygen saturation curves during the sleep time were compressed into a fixed scale image, and the distribution area of oxygen saturation curves was outlined. We then calculated the value of the outlined area and normalized it by total sleep time. The least absolute shrinkage and selection operator logistic regression model was used for selecting the optimal variable associated with ED and model construction. The clinical net benefit of the BOADAI and its related modules was estimated and compared by decision curve analysis. Main Outcome Measure: ED and OSA were assessed using the IIEF-5, clinical questionnaire, physical measurements, and PSG outcomes. Results: The frequency of ED in patients with OSA was significantly greater than that in the no-OSA group. Meanwhile, the new BOADAI was negatively correlated with the IIEF-5 score (r = -0.2525, P = .0000). Moreover, the least absolute shrinkage and selection operator method retained BOADAI but not the other PSG parameters such as respiratory disorder index and lowest SaO2. Finally, logistic regression analysis revealed that older age, lips with cyanochroia, systemic hypertension, and BOADAI were independently associated with ED, and decision curve analysis indicated the clinical usefulness of the BOADAI module. Conclusion: This study revealed novel evidence that OSA is a risk factor for ED. Meanwhile, the BOADAI could act as a potential clinical characteristic to evaluate ED in patients with OSA and to provide clinical treatment recommendations. Copyright (C) 2020, International Society for Sexual Medicine. Published by Elsevier Inc.

Objective To observe the efficacy and safety of LiShenBao (uFSH) in the treatment of severe oligoasthenospermia. Methods Using a multi-centered, open and self-controlled clinical trial, we treated 43 patients with severe oligoasthenospermia with LiShenBao 75 IU/3d, i.m, for 24 weeks, and evaluated the the semen parameters including sperm concentration and the percentage of progressive motile sperm, reproductive hormone, adverse reaction and pregnancy condition of their spouse at 8, 16 and 24 weeks. Results Compared with baseline, the sperm concentration was increased by 334%, 258% and 460% respectively at 8, 16 and 24 weeks, elevating from the baseline of (1.39±1.58)×106/mL to(7.79±8.44)×106/mL at 24 weeks. The percentage of progressive motile sperm was significantly improved (increased by 71%, 135% and 143% respectively at 8, 16 and 24 weeks). There was also an increase in terms of sperm motility and total number, and serum FSH, while no significant changes were observed in sperm volume, LH and T. One patient with severe oligoasthenospermia has pregnancy during the treatment. Conclusion LiShenBao can evidently improve the seminal quality of oligoasthenospermic patients with no obvious adverse events.

Nonobstructive azoospermia (NOA) or testicular failure is the most severe form of male infertility. A variety of conditions, both acquired and congenital, can cause azoospermia. However, in a large number of azoospermia patients who are classified as idiopathic cases, the etiology remains poorly understand mainly due to the lack of knowledge of all the genetic causes and molecular mechanisms responsible for spermatogenesis failure. Identification of the key gene modules and pathways-related spermatogenesis failure might help to reveal the mechanisms of idiopathic azoospermia. Therefore, the expression patterns of spermatogenesis-associated genes in NOA were analyzed by weighted gene coexpression network analysis (WGCNA) based on two public microarray data sets (GSE45885 and GSE45887), which included 51 samples and 32,321 genes. We identified a module (turquoise) that was significantly related to the Johnsen score of the testicular samples. In addition, the results of function and pathway enrichment analyses based on the online bioinformatics database Metascape revealed that genes in the turquoise module were mainly related to the process of spermatogenesis and spermatid development. To further identify spermatogenesis-associated genes, a microarray data set (GSE926) of murine testis at different developmental time points was analyzed by WGCNA. The blue module in GSE926 was significantly related to the time of murine testis development. The overlap study and k-core analysis based on protein-protein interaction network revealed that spermatogenesis- and spermatid development-associated genes, including glyceraldehyde-3-phosphate dehydrogenase, ADAM metallopeptidase domain 2, transition protein 1, testis-specific serine kinase 2, transition protein 2, and germ cell-associated 1 (GSG1), were further identified in the selected modules. The expression profile of GSG1 in human testis was chosen for further study using immunochemistry staining. Taken together, these screened gene modules and pathways provided a more detailed genetic and molecular mechanism underlying spermatogenesis failure occurrence and holds promise as potential diagnosis biomarkers and therapeutic targets.

Penile hypersensitivity plays an important role in premature ejaculation (PE), but differences in penile sensitivity among subtypes of PE are unknown. Therefore, we compared penile sensory thresholds in PE subtypes of lifelong and acquired PE, PE with and without erectile dysfunction (ED), PE with an intravaginal ejaculation latency time ≤1 min and >1 min, and PE with and without orgasmic pleasure perceptual dysfunction. During August 2014 to January 2016, 136 patients with PE were included. Penile warm, cold, and vibratory thresholds were measured. Data of clinical characteristics, sexual life, Premature Ejaculation Diagnostic Tool (PEDT) score, and the 5-item version of the International Index of Erectile Function (IIEF-5) score were collected. Vibratory thresholds of the PE with ED group were higher in the right coronal sulcus (median amplitude: 4.92 vs 3.65 μ m, P = 0.02) and the right penile shaft (median amplitude: 3.87 vs 3.30 μ m, P = 0.03), while differences in penile sensory thresholds between other subtypes were not significant. The median PEDT score was lower in the PE without ED group (12 vs 14, P < 0.001). The IIEF-5 and PEDT scores were negatively correlated (r = -0.29, P < 0.001). Patients with orgasmic pleasure perceptual dysfunction had a lower median IIEF-5 score (20 vs 21, P = 0.02). Patients with PE and ED had lower penile sensitivity, and ED was associated with more severe symptoms and weaker orgasmic pleasure perception. In men with PE, management of comorbid ED is necessary. In case of side effects in erectile function, topical anesthetics should be cautiously used in men with PE and ED.

OBJECTIVE:To investigate the effects of the compound preparation Jinghuosu on oligospermia and asthenospermia.METHODS:This multi-centered clinical study included 120 cases of mild to moderate idiopathic oligospermia or asthenospermia, all treated with oral Jinghuosu once a bag, bid, for 3 successive months. Before and at 1, 2 and 3 months after treatment, we detected sperm concentration, total sperm motility, progressive sperm motility and normal sperm morphology of each ejaculate, and recorded whether the patients had any adverse reactions.RESULTS:After 3 months of treatment, all the patients showed obvious improvement in semen parameters, most significantly in sperm concentration, total sperm motility, and the percentages of progressive motile sperm and morphologically normal sperm (P <0.05). No significant adverse reactions were observed during the 3 months of medication.CONCLUSIONS:Jinghuosu has a significant efficacy and no obvious adverse effect in the treatment of mild to moderate oligospermia and asthenospermia.

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia I1 Apr 2016PD20-09 THE ROLE OF INFLAMMATORY CYTOKINES AND MAPK SIGNALING IN CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME WITH RELATED MENTAL HEALTH DISORDERS Chao Hu, Hualan Yang, Yanfang Zhao, Xiang Chen, Yinying Dong, Yehao Dong, Jiefeng Cui, Tongyu Zhu, Ping Zheng, Ching-Shwun Lin, and Jican Dai Chao HuChao Hu More articles by this author , Hualan YangHualan Yang More articles by this author , Yanfang ZhaoYanfang Zhao More articles by this author , Xiang ChenXiang Chen More articles by this author , Yinying DongYinying Dong More articles by this author , Yehao DongYehao Dong More articles by this author , Jiefeng CuiJiefeng Cui More articles by this author , Tongyu ZhuTongyu Zhu More articles by this author , Ping ZhengPing Zheng More articles by this author , Ching-Shwun LinChing-Shwun Lin More articles by this author , and Jican DaiJican Dai More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1422AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Mental health disorders (MHD) in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have been widely studied. Among these MHD, depression has been identified in 78% of patients with CP/CPPS and even anxious symptoms have been observed in CP/CPPS patients. However, the underlying role of inflammatory cytokines and their associated signaling pathways has not been investigated. Recently, neuroscience research has identified the dysfunction of specific brain areas, such as the basolateral amygdala, nucleus accumbens, hippocampus, and caudate nucleus, are related to anxiety, depression, and spatial and associative memory. Here, we report the potential role of cytokines and associated signaling pathways in CP/CPPS patients with MHD and in a CP/CPPS animal model. METHODS Clinically, CP/CPPS patients (n=810) and control subjects (n=992) were enrolled in this case-control multicenter study with assessment of NIH-CPSI, anxiety and depression. The serum cytokine levels were measured by microarray. Male Sprague-Dawley rats received multiple intracutaneous injections of an immuno-agent along with a pertussis-diphtheria-tetanus triple vaccine for autoimmune CP/CPPS development. The evaluation of rodent animal behavior were performed by elevated plus maze test, open field test, Y maze test and shuttle box passive avoidance test. The levels of cytokines in serum and prostates were detected by ELISA and RT-PCR, and the levels of phospho-MAPK (Erk1/2) in specific brain areas were measured by western blot. All statistical analyses were performed on SAS for Windows 8.0. Statistical significance was considered at a p<0.05 level for all parameters. RESULTS The results revealed that, in CP/CPPS patients with significant MHD, elevated IL-1α, IL-1β, IL-4, IL-13, and TNF-α serum levels were observed. The above five cytokines in CP/CPPS rats were significantly elevated in prostate tissue (p<0.05), and IL-1β levels were elevated in serum and CSF. In behavioral tests, CP/CPPS rats showed anxiety- and depression-like symptoms, and impaired spatial and associative memory performance (p<0.05). In the CP/CPPS group ERK1/2 phosphorylation levels were increased in the amygdala and nucleus accumbens, and decreased in the hippocampus and caudate nucleus. CONCLUSIONS Thus, prostate-derived cytokines, especially IL-1β, cross the blood brain barrier and may lead to enhanced ERK1/2 signaling in several brain areas, possibly underlying induction of CP/CPPS-related MHD. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e454 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Chao Hu More articles by this author Hualan Yang More articles by this author Yanfang Zhao More articles by this author Xiang Chen More articles by this author Yinying Dong More articles by this author Yehao Dong More articles by this author Jiefeng Cui More articles by this author Tongyu Zhu More articles by this author Ping Zheng More articles by this author Ching-Shwun Lin More articles by this author Jican Dai More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

勃起功能障碍（Erectile dysfunction, ED）和早泄（Premature ejaculation, PE）都是常见的性功能障碍。ED合并PE在临床上也很常见，两者可同时发生或者前后发生，并在发生、发展过程中可能互为因果，互相影响，形成恶性循环。勃起和射精是性生理中两个先后发生、密切关联的过程，但相比ED，多数PE患者还可以勉强完成性生活，使人们缺乏把PE作为一种疾病的意识。而且由于勃起在射精之前医患更容易关注勃起而忽略了射精问题，加之既往缺少特异性PE治疗药物，从而使医生忽略或轻视了ED合并PE的诊治[1]。因此，专家组制定出ED合并PE的诊疗共识，以期有助于帮助快速发现、诊断和治疗ED合并PE，并提高诊治水平和临床疗效。

Objective To explore the therapeutic effects of scrotal cooling patch combined with Vitamin E on infertile males with varicocele.Methods From July 2015 to June 2016, there were 76 infertile males with varicocele enrolled in the research,they were divided randomly into two groups and recept treatments in three hospitals. 40 patients in Group one took Vitamin E, at the same time using scrotal cooling patch nocturnally. 36 patients in Group two only took Vitamin E. Scrotal temperature and semen analysis were performed before and 4,8,12 weeks after treatment. 39 normozoospermiaic males without varicocele were enrolled as control group.Results Compared with control group, 76 infertile males with varicocele showed higher scrotal temperature(35.2℃vs control group 33.5℃,P<0.05 ) and deteriorated semen quality. Patients in group one showed the same level of scrotal temperature and semen parameters compared with that of group two before treatment. Patients in group one showed decreased scrotal temperature and increased semen parameters monthly. After 12-week treatment, the average scrotal temperature of patients in group one was statistically lower than that in group two (34.2℃vs35.0℃), the average sperm density and progressive motile sperm percentage in group one were higher than that in group two(26.8×106/mL vs22.5×106/mL, 34.5% vs 28.8%,P<0.05).Conclusion Consecutively scrotal and testicular cooling is able to improve semen quality in infertile males with varicocele.

早泄（Premature Ejaculation，PE）是最常见的男性性功能障碍，国外有报道18~59岁男性PE患病率达31%[1]，国内学者调查早泄的发病率达到25.8%[2]。然而，全球性态度和性行为调查显示，78%认为有性功能障碍的男性没有寻求专业医生的治疗[3]；早泄患病率和态度调查显示只有9%自我报告的PE男性会咨询医生[4]。目前我国早泄患者在初诊时，也以非PE主诉居多，临床上容易出现对PE的漏治。自从2013年达泊西汀在中国上市用于PE治疗以来，临床证实有效延长患者阴道内射精潜伏期[5]，但PE治疗较为复杂，由于治疗方法不妥、缺少沟通而造成无效的病例已引起医师重视[6]。因此，如何正确选择PE的治疗方法，为PE患者制定最佳的诊疗方案是临床医师面临的重要课题。

Mental health disorders(MHD) in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) have been widely studied. However, the underlying role of inflammatory cytokines and their associated signaling pathways have not been investigated. Here, we report the potential role of cytokines and associated signaling pathways in CP/CPPS patients with MHD and in a CP/CPPS animal model. CP/CPPS patients (n = 810) and control subjects (n = 992) were enrolled in this case-control multicenter study, and serum cytokine levels were measured. Male Sprague-Dawley rats received multiple intracutaneous injections of an immuno-agent along with a pertussis-diphtheria-tetanus triple vaccine for autoimmune CP/CPPS development. The results revealed that, in CP/CPPS patients with significant MHD, elevated IL-1α, IL-1β, IL-4, IL-13, and TNF-α serum levels were observed. The above five cytokines in CP/CPPS rats were significantly elevated in prostate tissue (p < 0.05), and IL-1β levels were elevated in serum and cerebrospinal fluid. In behavioral tests, CP/CPPS rats showed anxiety- and depression-like symptoms, and impaired spatial and associative memory performance (p < 0.05). In the CP/CPPS group, ERK1/2 phosphorylation levels were increased in the amygdala and nucleus accumbens, and decreased in the hippocampus, but not caudate nucleus. Thus, prostate-derived cytokines, especially IL-1β, cross the blood brain barrier and may lead to enhanced ERK1/2 signaling in several brain areas, possibly underlying induction of CP/CPPS-related MHD.

慢性前列腺炎（Chronic prostatitis，CP）和早泄（Premature ejaculation,PE），均属于泌尿男科门诊常见疾病，两者可同时或前后发生，并在发生、发展过程中可能互为因果，互相影响。CP合并PE患者，由于其PE 的隐匿性较强，容易漏诊。因此，专家组制定出CP合并PE的诊疗共识，以期有助于指导医生从CP中发现PE，规范CP合并PE的治疗。

阴茎勃起功能障碍（Erectile Dysfunction，简称ED）是影响男性性生活质量的常见疾病，国、内外流行病学资料显示[1,2]，在有性生活人群中，ED的发生率高达39.4%，且随伴发疾病以及年龄而增加。因此，随着我国逐步进入老龄化社会，ED患病人数呈现上升态势。

ObjectiveHigh prevalence of erectile dysfunction (ED) was observed in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, it is still unknown whether CP/CPPS is a risk factor of ED. This systematic review and meta-analysis was conducted to evaluate the relationship between CP/CPPS and ED.