Serine-arginine protein kinase 1 (SRPK1) is a major protein kinase involved in mRNA splicing, cell cycle, and endothelial function. Recent studies have highlighted a close relationship between palmitic acid (PA) and endothelial cell ferroptosis. Here, we demonstrate that PA promotes the ubiquitination-dependent degradation of SRPK1 mediated by the E3 ubiquitin ligase mindbomb 1 (MIB1) at lysine 494. Moreover, SRPK1 S-palmitoylation is catalyzed by zinc-finger DHHC S-acyltransferase 24 (ZDHHC24) at cysteines 188/502/647 and deacylated by acyl protein thioesterase 1 (APT1). The dynamic S-palmitoylation of SRPK1 can strengthen SRPK1-MIB1 interaction, facilitate its ubiquitination, and thereby affect protein stability. Furthermore, SRPK1 modulates the phosphorylation of p53 tumor suppressor protein (p53) at serine 15, which may promote its nuclear translocation and activation under PA stimulation or in high-fat-diet-fed animal models. The crucial effect of SRPK1 on p53 activation contributes to the suppression of endothelial cell ferroptosis in the context of lipid accumulation. Additionally, in silico screening reveals that 4'-O-Methylochnaflavone interacts with SRPK1, which effectively stabilizes SRPK1 and alleviates PA-induced ferroptosis. Collectively, these findings underscore the critical role of PA in regulating endothelial cell ferroptosis via SRPK1 S-palmitoylation and p53 activation, providing potential therapeutic strategies for dyslipidemia-related erectile dysfunction.

BACKGROUND:Premature ejaculation is a prevalent male sexual dysfunction, yet real-world clinical practices in China remain poorly characterized. OBJECTIVES:To evaluate current premature ejaculation management practices among Chinese physicians. MATERIALS AND METHODS:A nationwide cross-sectional survey of 1000 physicians was conducted using a structured, self-administered questionnaire exploring diagnostic practices, treatment modalities, and perceived therapeutic effectiveness. Associations between physician characteristics and treatment choices were analyzed using chi-square tests. RESULTS:Diagnostic reliance on clinical history (67.4%) exceeded that on standardized tools (32.6%). Around 46.5% of physicians reported treating intravaginal ejaculation latency time < 1 min without distress, while 32.6% reported treating intravaginal ejaculation latency time > 10 min with distress. Oral dapoxetine (59.7%) and psychotherapy (92.1%) were preferred first-line therapies, followed by long-acting selective serotonin reuptake inhibitors (13.7%). Prescriptions for long-acting selective serotonin reuptake inhibitors were primarily driven by guideline adherence (25.95%), anxiety/depression comorbidity (17.56%), dapoxetine inefficacy (6.11%), and clinician experience (6.11%). Combination therapy was common (52.1%), whereas surgical interventions remained rare (14.7%) but more prevalent among andrologists than among non-andrologists (p < 0.001). Compared with non-andrologists, andrologists demonstrated greater use of behavioral therapy (p = 0.001) and topical agents (p = 0.006) than non-andrologists. Drug selection (54.5%) and psychological factors (16.6%) were identified as key efficacy determinants. DISCUSSION AND CONCLUSION:Chinese physicians commonly use combined pharmacological and psychological approaches for premature ejaculation treatment, but significant challenges persist, including inappropriate treatment of non-premature ejaculation cases, unwarranted surgical interventions, and insufficient utilization of evidence-based selective serotonin reuptake inhibitors, highlighting the need for standardized diagnostic criteria and enhanced physician education on guideline-recommended therapies.

Background:Erectile dysfunction (ED) is a significant health issue affecting the global male population, with a complex and multifaceted etiology. High-fat diet (HFD) is known to impair endothelial function and promote the development of ED. Hinokiflavone (HINO), a naturally occurring biflavonoid, has garnered attention for its notable antioxidant and anti-inflammatory activities, suggesting its potential therapeutic role in treating ED. Aim:This study aims to investigate the therapeutic effects and underlying mechanisms of HINO in HFD-induced ED. Methods:Network pharmacology and molecular dynamics simulation were employed to predict relevant targets and analyze their binding kinetics. Rat corpus cavernosum endothelial cells (RCCECs) were treated with palmitic acid in vitro to induce metabolic dysfunction. The ED model was established in vivo by feeding male rats an HFD (60 kcal% fat). Outcomes:The primary outcomes were the target genes and pathways associated with HINO and the evaluation of its therapeutic potential in HFD-induced ED. Results:Bioinformatics analyses identified the epidermal growth factor receptor (EGFR) and protein kinase B (Akt) as key molecular targets of HINO. Treatment with HINO promoted RCCEC proliferation, enhanced antioxidant activities, and increased nitric oxide production. The administration of HINO ameliorated erectile dysfunction, improved serum lipid profiles, and reduced oxidative stress in HFD-fed rats. The protective effects of HINO against endothelial dysfunction and impaired cell viability were mediated through modulation of the EGFR/PI3K/Akt/eNOS signaling pathway. Clinical Translation:The results provide a strong rationale for further investigation of HINO as a novel therapeutic agent for ED, with promising implications for future clinical applications. Strengths and Limitations:In this study, we found that HINO could mitigate HFD-induced ED. Limitations of the study include that the alternative mechanisms of HINO were not fully explored in these settings. Conclusions:Our findings underscore the pharmacological properties of HINO in the management of ED, particularly through the modulation of critical targets such as EGFR.

BACKGROUND:Microsurgical vasoepididymostomy (MVE) is the standard treatment for epididymal obstructive azoospermia (EOA). However, existing studies report inconsistent pregnancy and patency rates. OBJECTIVES:To comprehensively review the therapeutic effects of various MVE techniques on EOA, address prior research controversies, and identify factors influencing MVE efficacy. MATERIALS AND METHODS:Eligible studies focused on MVE outcomes, such as patency, pregnancy, or natural pregnancy rates. Relative pregnancy rate refers to natural pregnancies occurring in partners of patients with post-operative patency. Meta-analyses were performed using the "meta" R package. Heterogeneity was assessed with Q and I2 tests. RESULTS:A total of 56 studies involving 3204 patients were included. End-to-end/end-to-side (EE/ES) techniques were associated with patency, pregnancy, and relative pregnancy rates of 65.0%, 23.0%, and 38.0%, respectively, whereas longitudinal intussusception vasoepididymostomy (LIVE) technique demonstrated slightly higher rates (68.0%, 27.0%, 40.0%). However these differences were not statistically significant (all p > 0.05). Compared with the 2-suture TIVE (72.0%) and LIVE (58.0%; p < 0.01) techniques, the 3-suture transverse intussusception vasoepididymostomy (TIVE) technique demonstrated significantly higher patency rates (89.0%). Pregnancy rates (33.0% vs. 26.0% vs. 28.0%) and relative pregnancy rates (38.0% vs. 33.0% vs. 42.0%) did not significantly differ among the three techniques (p > 0.05). Single-armed LIVE (SA-LIVE) demonstrated numerically higher patency (69.0% vs. 64.0%), pregnancy (31.0% vs. 26.0%), and relative pregnancy rates (46.0% vs. 39.0%) compared with double-armed LIVE (DA-LIVE). However, these differences were not statistically significant (all p > 0.05). Vessel-sparing SA-LIVE demonstrated superior patency (83.0%) compared with classical SA-LIVE (67.0%; p < 0.01), whereas pregnancy (38.0% vs. 31.0%) and relative pregnancy rates (both 47.0%) were not significantly different (p > 0.05). Bilateral MVE, genital infections, and the presence of motile spermatozoa were associated with increased patency rates. The overall late failure rate was 23.0%, with significantly higher rates for the EE/ES techniques (32.0%) than the IVE technique (15.0%; p = 0.03). CONCLUSION:This meta-analysis confirms the efficacy of MVE for EOA. IVE has supplanted ES/EE, likely owing to its technical superiority and reduced rate of late failures, with LIVE emerging as the dominant approach. SA-LIVE and DA-LIVE yield comparable outcomes, and both should be recommended. Bilateral cases, infectious etiology, and motile epididymal spermatozoa predict increased patency rate. The relative pregnancy rate may better reflect effectiveness.

PURPOSE:The purpose of this meta-analysis is to study the impact of varicocele repair in the largest cohort of infertile males with clinical varicocele by including all available studies, with no language restrictions, comparing intra-person conventional semen parameters before and after the repair of varicoceles.MATERIALS AND METHODS:The meta-analysis was performed according to PRISMA-P and MOOSE guidelines. A systematic search was performed in Scopus, PubMed, Cochrane, and Embase databases. Eligible studies were selected according to the PICOS model (Population: infertile male patients with clinical varicocele; Intervention: varicocele repair; Comparison: intra-person before-after varicocele repair; Outcome: conventional semen parameters; Study type: randomized controlled trials [RCTs], observational and case-control studies).RESULTS:Out of 1,632 screened abstracts, 351 articles (23 RCTs, 292 observational, and 36 case-control studies) were included in the quantitative analysis. The before-and-after analysis showed significant improvements in all semen parameters after varicocele repair (except sperm vitality); semen volume: standardized mean difference (SMD) 0.203, 95% CI: 0.129-0.278; p<0.001; I²=83.62%, Egger's p=0.3329; sperm concentration: SMD 1.590, 95% CI: 1.474-1.706; p<0.001; I²=97.86%, Egger's p<0.0001; total sperm count: SMD 1.824, 95% CI: 1.526-2.121; p<0.001; I²=97.88%, Egger's p=0.0063; total motile sperm count: SMD 1.643, 95% CI: 1.318-1.968; p<0.001; I²=98.65%, Egger's p=0.0003; progressive sperm motility: SMD 1.845, 95% CI: 1.537%-2.153%; p<0.001; I²=98.97%, Egger's p<0.0001; total sperm motility: SMD 1.613, 95% CI 1.467%-1.759%; p<0.001; l2=97.98%, Egger's p<0.001; sperm morphology: SMD 1.066, 95% CI 0.992%-1.211%; p<0.001; I²=97.87%, Egger's p=0.1864.CONCLUSIONS:The current meta-analysis is the largest to date using paired analysis on varicocele patients. In the current meta-analysis, almost all conventional semen parameters improved significantly following varicocele repair in infertile patients with clinical varicocele.

Male infertility (MI) and male sexual dysfunction (MSD) can often coexist together due to various interplay factors such as psychosexual, sociocultural and relationship dynamics. The presence of each form of MSD can adversely impact male reproduction and treatment strategies will need to be individualized based on patients' factors, local expertise, and geographical socioeconomic status. The Asia Pacific Society of Sexual Medicine (APSSM) and the Asian Society of Men's Health and Aging (ASMHA) aim to provide a consensus statement and practical set of clinical recommendations based on current evidence to guide clinicians in the management of MI and MSD within the Asia-Pacific (AP) region. A comprehensive, narrative review of the literature was performed to identify the various forms of MSD and their association with MI. MEDLINE and EMBASE databases were searched for the following English language articles under the following terms: "low libido", "erectile dysfunction", "ejaculatory dysfunction", "premature ejaculation", "retrograde ejaculation", "delayed ejaculation", "anejaculation", and "orgasmic dysfunction" between January 2001 to June 2022 with emphasis on published guidelines endorsed by various organizations. This APSSM consensus committee panel evaluated and provided evidence-based recommendations on MI and clinically relevant MSD areas using a modified Delphi method by the panel and specific emphasis on locoregional socio-economic-cultural issues relevant to the AP region. While variations exist in treatment strategies for managing MI and MSD due to geographical expertise, locoregional resources, and sociocultural factors, the panel agreed that comprehensive fertility evaluation with a multidisciplinary management approach to each MSD domain is recommended. It is important to address individual MI issues with an emphasis on improving spermatogenesis and facilitating reproductive avenues while at the same time, managing various MSD conditions with evidence-based treatments. All therapeutic options should be discussed and implemented based on the patient's individual needs, beliefs and preferences while incorporating locoregional expertise and available resources.

Introduction:Penile fracture is an uncommon urological emergency resulting from tunica albuginea rupture during penile erection. It is a rare condition requiring urgent surgery. Despite immediate surgical repair, the patients' erectile functions may still be impacted by penile fracture. This study aims to investigate the efficacy of surgical repair in penile fractures and its impact on erectile function. Methods:Our cohort was composed of patients diagnosed with penile fractures and received surgical repair from September 2014 to August 2022 in Peking University First Hospital. Penile color Doppler ultrasound confirmed the diagnosis. Surgical exploration was conducted, and postoperative complications were evaluated during follow-up. Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5) score. Univariate analysis was conducted employing the chi-square test, t-test, and Mann-Whitney U test to identify factors that may impact postoperative erectile function. Furthermore, multivariate analysis was conducted using logistic regression and linear regression to determine the independent risk factors influencing postoperative erectile function. Results:A total of 58 patients were enrolled in our study. The majority of injuries (69.0 %, 40/58) resulted from vigorous sexual intercourse. Most of the patients (69.0 %, 40/58) presented within 24 h. Sixteen patients (27.6 %) presented with concomitant urethral injury. The median size of the tunical tear was 1.5 (IQR, 1.0-2.0) cm. Presentation delay correlated significantly with the difference in IIEF-5 score before and after surgery, with corresponding p values of 0.028. Urethral injury correlated significantly with postoperative erectile dysfunction (ED), postoperative IIEF-5 score, and the difference in IIEF-5 score before and after surgery, with corresponding p values of 0.002, 0.004, and 0.002, respectively. Conclusions:To conclude, surgical repair of penile fracture provides good functional results with few morbidities and urethral injury may adversely affect postoperative erectile function after penile fracture repair.

PURPOSE:To examine the role and mechanism of thrombospondin-1 (TSP1) in the development of fibrosis in diabetes mellitus-induced erectile dysfunction (DMED). MATERIALS AND METHODS:DMED was induced by intraperitoneal streptozotocin injection. All rats were categorized into three groups: control group (n=8), DMED group (n=8) and DMED+Leu-Ser-Lys-Leu (LSKL) group (n=8). After eight weeks following the induction of diabetes mellitus, the DMED+LSKL group was subjected to intraperitoneal injections of LSKL twice weekly for four weeks. To measure intracavernous pressure (ICP), a 25-gauge needle connected to a PE tube containing heparin was inserted into the corpus cavernosum (CC). Additionally, a needle was inserted into the carotid artery to measure mean arterial pressure (MAP). Sirius red staining and Masson trichrome staining were utilized to assess CC fibrosis. Moreover, high glucose (HG)-induced CC smooth muscle cells (CCSMCs) and CC fibroblasts (CCFs) were treated with or without LSKL. Western blotting and immunofluorescence were utilized to assess the phosphorylation and expression of related proteins. RESULTS:Compared with those in the control group, the ratio of the maximum ICP to the MAP markedly decreased in the DMED group, as did the ratio of smooth muscle to collagen and the ratio of collagen I to collagen III. These ratios were greater in the DMED+LSKL group than in the DMED group. TSP1 was highly expressed in the CC of DMED rats. In vitro experiments indicated that TSP1 expression significantly increased in the medium of CCSMCs and CCFs cultured in HG media and that the TGF-β pathway was activated in CCSMCs. Collagen IV was overexpressed in CCSMCs, indicating severe fibrosis was severe. Adding LSKL or knocking TSP1 down can prevent the activation of TGF-β signaling, as well as the overexpression of collagen IV in CCSMCs promoted by TSP1 secreted from CCSMCs itself or CCFs. CONCLUSIONS:TSP1 expression is increased in the CC of DMED rats. HG-induced TSP1 secretion via autocrine signaling from CCSMCs and/or paracrine signaling from CCFs to accelerate penile fibrosis. LSKL, an antagonist of TSP1, could improve erectile dysfunction by inhibiting the TGF-β/SMAD pathway.

Background Palmitic acid (PA) has a lipotoxic effect on blood vessels, leading to endothelial dysfunction and cell death. The underlying mechanisms are not yet fully understood.Aim We sought to investigate the effects of PA on endothelial cells, with an emphasis on ferroptosis.Methods Rat corpus cavernosum endothelial cells (RCCECs) and human umbilical vein endothelial cells (HUVECs) were treated with PA to induce a pattern of cell death, as evidenced by the evaluation of cell viability. The differentially expressed genes were measured via RNA sequencing to reveal potential mechanisms. The intracellular levels of glutathione (GSH), malondialdehyde (MDA), ferrous ion (Fe2+), and reactive oxygen species (ROS) were evaluated using commercial kits. Western blot was performed to determine the expressions of relative proteins.Outcomes At the end of the study period, the evaluated outcomes were cell viability, transcriptome profiles, the expressions of glutathione peroxidase 4 (GPX4) and solute carrier family 7 member 11 (SLC7A11), as well as levels of GSH, MDA, Fe2+, and ROS.Results PA-induced cell death of RCCECs and HUVECs was demonstrated in a dose- and time-dependent manner. Based on the findings of RNA-sequencing (RNA-seq), enrichment of many biological processes associated with cell cycle and response to stimulus occurred. More importantly, ferroptosis was highlighted in the bioinformatic analysis of both endothelial cells. The levels of intracellular Fe2+, MDA, and ROS were significantly increased following PA exposure while GSH was decreased, suggesting excessive iron accumulation, development of lipid peroxidation, and imbalanced redox homeostasis. Mechanistically, PA decreased the protein expression levels of GPX4 and SLC7A11 in endothelial cells, both of which played crucial roles in ferroptotic cell death.Clinical Translation This study suggests that ferroptosis may be a useful target for novel therapeutic interventions for endothelial dysfunction and cell death in vascular diseases such as erectile dysfunction.Strengths and Limitations In this study, we found that ferroptosis could participate in PA-induced endothelial dysfunction and cell death. A limitation of the study is that it did not shed light on the overall mechanisms of this process. Therefore, further research on the intricate networks of regulating ferroptosis is needed.Conclusion Overall, the occurrence of ferroptosis was demonstrated in the PA-treated HUVECs and RCCECs in this study.

射精管不完全梗阻(partial ejaculatory duct obstruc-tion,PEDO)是指因射精管内、管外或其他因素,使射精管不完全闭塞,导致精液排出时受阻,可引起少精、弱精或死精子症,约占男性不育病因的 4％ [1]. PEDO分为单侧PEDO或双侧PEDO. 近些年来,随着辅助检查技术的完善,临床上PEDO患者的检出率有了很大提高. 本文综述了PEDO相关的胚胎和解剖学、病理生理学、临床表现及近年来的诊治进展.

Purpose Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes. The aim of this study was to explore global practice patterns on the management of varicocele in the context of male infertility. Materials and Methods Sixty practicing urologists/andrologists from 23 countries contributed 382 multiple-choice-questions pertaining to varicocele management. These were condensed into an online questionnaire that was forwarded to clinicians involved in male infertility management through direct invitation. The results were analyzed for disagreement and agreement in practice patterns and, compared with the latest guidelines of international professional societies (American Urological Association [AUA], American Society for Reproductive Medicine [ASRM], and European Association of Urology [EAU]), and with evidence emerging from recent systematic reviews and meta-analyses. Additionally, an expert opinion on each topic was provided based on the consensus of 16 experts in the field. Results The questionnaire was answered by 574 clinicians from 59 countries. The majority of respondents were urologists/uro-andrologists. A wide diversity of opinion was seen in every aspect of varicocele diagnosis, indications for repair, choice of technique, management of sub-clinical varicocele and the role of VR in azoospermia. A significant proportion of the responses were at odds with the recommendations of AUA, ASRM, and EAU. A large number of clinical situations were identified where no guidelines are available. Conclusions This study is the largest global survey performed to date on the clinical management of varicocele for male infertility. It demonstrates: 1) a wide disagreement in the approach to varicocele management, 2) large gaps in the clinical practice guidelines from professional societies, and 3) the need for further studies on several aspects of varicocele management in infertile men.

Background: Endothelial dysfunction is commonly accompanied by a reduced capacity for nitric oxide (NO) production and decreased NO sensitivity, playing a central role in numerous vascular diseases. Saturated free fatty acids are known to reduce NO production and then induce endothelial dysfunction. Alternative splicing participates in the regulation of cellular and tissular homeostasis and is highly regulated by serine-arginine protein kinase (SRPK1). The role of SRPK1 in the biology of endothelial cells remains elusive. Icariside Ⅱ (ICA Ⅱ) has been reported to have protective effects on endothelial function. However, the specific molecular mechanisms are still unknown. The purpose of this study is to explore the role of SRPK1 in the biology of endothelial cells and the underlying mechanism of ICA Ⅱ on palmitic acid (PA) induced endothelial dysfunction. Methods: Endothelial dysfunction was induced using PA in human umbilical vein endothelial cells (HUVECs). The expression and phosphorylation of related proteins in the SRPK1-Akt-eNOS signaling pathway were detected by Western Blot. Cell Counting Kit-8 assay and Ki-67 immunofluorescence were used to estimate cell viability. Endothelial cell function was assessed by detecting NO production using DAF-FM DA. Interaction between ICA Ⅱ and SRPK1 was demonstrated by a biotinylated protein interaction pull-down assay. Results: The expressions of eNOS, Akt, and SRPK1 were down-regulated in the endothelial dysfunction stimulated by PA. SRPK1 inhibitor SPHINX31 restrained endothelial cell viability in a dose-dependent manner. Moreover, inhibition of SRPK1 using SPHINX31 and knockdown of SRPK1 by shRNA also showed a down-regulation of the proteins associated with the SRPK1-Akt-eNOS signaling pathway. Biotinylated protein interaction pull-down assay revealed that ICA Ⅱ could be directly bound with SRPK1. On the other hand, ICA Ⅱ could attenuate the PA-induced endothelial dysfunction and restore cell viability through the SRPK1-Akt-eNOS pathway. Conclusions: ICA Ⅱ, bound with SRPK1, could attenuate the endothelial dysfunction induced by the PA in HUVECs via the SRPK1-Akt-eNOS signaling pathway.

Purpose To assess the diverse cell populations of human corpus cavernosum in patients with severe erectile dysfunction (ED) at the single-cell level. Methods Penile tissues collected from three patients were subjected to single-cell RNA sequencing using the BD Rhapsody™ platform. Common bioinformatics tools were used to analyze cellular heterogeneity and gene expression profiles from generated raw data, including the packages Seurat, Monocle, and CellPhoneDB. Results Disease-related heterogeneity of cell types was determined in the cavernous tissue such as endothelial cells (ECs), smooth muscle cells, fibroblasts, and immune cells. Reclustering analysis of ECs identified an arteriole ECs subcluster and another one with gene signatures of fibroblasts. The proportion of fibroblasts was higher than the other cell populations and had the most significant cellular heterogeneity, in which a distinct subcluster co-expressed endothelial markers. The transition trajectory of differentiation from smooth muscle cells into fibroblasts was depicted using the pseudotime analysis, suggesting that the expansion of corpus cavernosum is possibly compromised as a result of fibrosis. Cell-cell communications among ECs, smooth muscle cells, fibroblasts, and macrophages were robust, which indicated that inflammation may also have a crucial role in the development of ED. Conclusions Our study has demonstrated a comprehensive single-cell atlas of cellular components in human corpus cavernosum of ED, providing in-depth insights into the pathogenesis. Future research is warranted to explore disease-specific alterations for individualized treatment of ED.

OBJECTIVE:To investigate the effect of biflavonoid 4'-O-methylochnaflavone (MF) on palmitic acid-induced endothelial dysfunction in rat cavernous endothelial cells (RCECs).METHODS:The isolated RCECs were commercially available and randomly divided into four groups: normal+BSA group (NC group), palmitic acid (PA) group, MF group, and icariside Ⅱ (ICA Ⅱ) group. The protein expression levels of protein kinase B (PKB/AKT) and endothelial nitric oxide synthase (eNOS) in each group were evaluated via Western blotting. The differences in the intracellular nitric oxide of RCECs treated by MF or ICA Ⅱ were detected by DAF-FM DA that served as a nitric oxide fluorescent probe. Effects of MF and ICA Ⅱ on cell proliferation of PA-stimulated RCECs were determined via CCK-8 assay.RESULTS:The content of nitric oxide in RCECs was significantly increased after the treatment of MF and ICA Ⅱ in comparison with the NC group (P < 0.05). Moreover, compared with ICA Ⅱ group, MF demonstrated a more obvious effect in promoting nitric oxide production (P < 0.05). Compared with the NC group, the expression levels of eNOS and AKT in the PA group were significantly decreased, indicating that a model for simulating the high-fat environment in vitro was successfully constructed (P < 0.05). Meanwhile, the intervention of MF and ICA Ⅱ could effectively increase the expression of eNOS and AKT, suggesting that MF and ICA Ⅱ could promote the recovery of endothelial dysfunction caused by high levels of free fatty acids (P < 0.05). The results of CCK-8 assays showed that PA could significantly reduce the proli-feration ability of RCECs (P < 0.05). Furthermore, the decreased cell viability induced by PA was significantly elevated by treatment with ICA Ⅱ and MF (P < 0.05).CONCLUSION:In RCECs, MF and ICA Ⅱ could effectively increase the content of nitric oxide. The down-regulation of the expression of proteins associated with the AKT/eNOS pathway after PA treatment revealed that this pathway was involved in the development of endothelial dysfunction, which could be effectively reversed by MF and ICA Ⅱ. In addition, the cell proliferation ability was significantly decreased following PA treatment, but MF and ICA Ⅱ could restore the above changes. Overall, biflavonoid MF has an obvious repairing effect on PA-stimulated endothelial dysfunction.

OBJECTIVE:To assess the accuracy and value of ultrasonography in the diagnosis of ruptured tunica albuginea (RTA) of the corpus cavernosum penis. Factors affecting prognosis were analyzed.METHODS:This retrospective study included 57 cases of RTA of the corpus cavernosum penis ultrasonographically diagnosed and surgically treated in Peking University First Hospital from 2013 to 2021. We analyzed the location, size and number of ruptures and the presence or absence of urethral injury, and compared the intraoperative with the ultrasonographic findings.RESULTS:Of the 57 cases of RTA of the corpus cavernosum penis diagnosed by ultrasonography, 54 (94.7%) were confirmed by surgery. Preoperative ultrasonography indicated 2 cases of bilateral RTA and 6 cases of urethral injury, while surgery revealed 7 cases of bilateral RTA and 13 cases of combined urethral injury. Those with urethral injury developed no urethral stricture or urinary fistula after one-stage urethral repair. And no severe or moderate ED was found in any of the patients during the 12-month follow-up.CONCLUSION:Ultrasonography has a high accuracy in the diagnosis of ruptured tunica albuginea of the corpus cavernosum penis, and contributes to the determination of the site of surgical incision.

早泄是最常见的男性性功能障碍之一,发生率为21％～33％[1-2].早泄严重影响男性的自信、性生活满意度、伴侣关系以及对男性和伴侣的整体生活质量产生负性影响[3-5]. 早泄的病理生理机制还不完全清楚,但生理和心理因素可能都与早泄有关.精神药理学研究提示早泄可能与控制射精的 5 羟色胺神经递质减少有关[6-7].用于治疗抑郁症和其他精神疾病的选择性5 羟色胺再摄取抑制剂(SSRI),由于有延长射精的作用而越来越多地用来治疗早泄[8-9].SSRI治疗早泄的机制与抑制5 羟色胺地摄取和随后的5 羟色胺活性有关.但是,SSRI 治疗早泄属于非适应证用药.