[目的]分析男科门诊早泄(PE)患者的临床特征及影响因素.[方法]收集2020年1月至2022年5月医院男科门诊20～60岁男性患者,详细记录一般人口学资料、病史、性生活史等,对符合要求的患者行早泄诊断量表(PEDT)、自我评估阴道内射精潜伏期(IELT)、国际勃起功能问卷-5(IIEF-5)、勃起硬度评分(EHS)、广泛性焦虑障碍量表(GAD-7)和健康问卷抑郁量表等量表评估.采用多元线性回归及Logistic回归分析PE的相关因素及独立危险因子.[结果]共纳入男科门诊患者973例,其中PE组445例(31.12±6.72)岁,非PE组528例(32.78±7.95)岁.两组间年龄、PEDT、IELT、IIEF-5、EHS、GAD-7及PHQ-9的差异均存在统计学意义(P<0.05).回归分析校正后,PEDT与年龄(b=-0.11,P=0.001)、IIEF-5(b=-0.17,P<0.001)及PHQ-9(b=0.19,P<0.001)存在显著相关性.多因素校正后,年龄≤30岁、勃起功能障碍及抑郁状态三个变量有统计学意义(P<0.01),其OR(95％CI)值分别为1.63(1.23,2.16)、2.05(1.45,2.92)、1.90(1.37,2.65).[结论]PE与年龄、勃起功能评分、焦虑及抑郁评分等因素密切相关.年龄≤30岁、勃起功能障碍及抑郁状态是PE的独立危险因子.

Objective To explore the clinical value of audiovisual sexual stimulation (AVSS) test in the diagnosis of erectile dysfunction.Methods All the cases were derived from AVSS test database in our andrologic center from 2012 to 2016.Clinical data of the patients including demographic data,Rigiscan Plus data and cavernous artery Color Doppler duplex ultrasound (CDDU) parameters were comparatively analyzed.The patients in erectile dysfunction (ED) group was confirmed according to the International Index of Erectile Function-5 (IIEF-5) scores and the vasculogenic ED was diagnosed by corpus cavernosum parameters.The diagnostic value of effective erection rigidity and duration of AVSS test were evaluated by analyzing ED and non-ED group.Results A total of 396 eligible subjects were included in the analysis,with an average age of 32.3±7.2 years.According to the diagnostic criteria of IIEF-5 score,there were 373 ED patients and 23 cases without ED.The tip rigidity ≥60％ with duration 9.25 min (sensitivity:73.3％;specificity:73.5％) or base rigidity ≥60％ with duration 19.75 min (sensitivity:66.7％;specificity:69.8％) showed the highest diagnostic value.There were 97 cases of vasculogenic ED and 299 cases of non-vasculogenicED.No significant differences were found in term of AVSS test parameters between the two groups.Conclusion AVSS is a rapid,practical and objective method for screening ED.The tip rigidity ≥ 60％ with duration more than 9 min or base rigidity ≥ 60％ with duration more than 19 min presented highest diagnostic value for ED.

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Objective To investigate the levels of seminal Leptin, ROS, as well as sperm parameters in leukocytospermia patients tretaed with anti-inflammatory therapyand explore their correlation. Methods Total of 80 male infertility patients with leukocytospermia (WBC group) were enrolled in the study, and 40 normal sperm samples were taken as the control. The sperm parameters were detected by computer assisted sperm analysis (CASA). The levels of semen plasma Leptin and ROS were measured using RIA and TBA kits respectively. Results The sperm concentration and viability in WBC group before treatment were lower than those of the control group (P<0.05,P<0.01), whereas, the levels of semen plasma Leptin and ROS were higher than those of the control group (P<0.05, P<0.01). The level of Leptin in semen plasma was positively correlated with the ROS level (r=0.695, P<0.05). After treatment, the increase of semen viability and decrease of Leptin and ROS level were found in WBC group. Conclusion Increased levels of seminal Leptin and ROS were founded in WBC group. Positive relationship between seminal Leptin and ROS indicated that Leptin might involve in oxidative stress and result in the decrease of sperm concentration and viability.

Objective To study the association between body mass index and semen parameters, gonadotropic and sex hormone, Inhibin B levels in infertile men. Methods 317 infertile men visited outpatient clinic for reproductive treatment and preconception counseling in Renji hospital from January 2012 to December 2012. BMI was assessed and the subjects stratified into subgroups according to BMI, normal-weight:18.5~23.9, overweight:24~27.9 and obese:≥28. The sperm parameters were detected by computer assisted sperm analysis (CASA) and a morning blood sample was taken to assess the levels of serum FSH, LH, testosterone, estradiol and Inhibin B. Results Overweight group had significant decrease in sperm concentration, total sperm count, total motile sperm count, the percentage of immotility type C, serum T level, Inhibin B level and T/E2 ratio compared with normal-weight group, while increase in the percentage of immotility type D and serum E2 level. Obese group had significant decrease in sperm concentration, total sperm count, sperm motility, total motile sperm count, the percentage of progressive motility type A+B, the percentage of immotility type C, serum T level, Inhibin B level, T/E2 ratio compared with normal-weight group, while increase in the percentage of immotility type D and serum E2 level. BMI was significant positively associated with age, serum E2 level and significant negatively associated with sperm concentration, total sperm count, the percentage of immotility type C, serum T level, Inhibin B level, T/E2 ratio. Conclusion The association explored between BMI and some semen characteristics and sexual hormones, as well as different patterns of this association between overweight and obsess infertile men, will be of help to broaden our understanding of the effect of obesity on some male reproductive physiologic characteristics among infertile men.

抑制素B（Inhibin B）在男性体内主要由睾丸支持细胞（Sertoli细胞）分泌，是一种糖蛋白激素。由于血清抑制素B的水平能够较准确地评价男性睾丸的生精功能，如今它已逐渐有趋势成为男科临床检测的一个重要指标[1]。本文通过检测550例男性的精液参数以及其血清抑制素B含量，探讨男性血清抑制素B水平与精子浓度、总数以及活力之间的关系，并比较分析其在梗阻性无精子证（OA）与非梗阻性无精子症（NOA）患者中的水平。

Objective To explore the correlation of the serum Leptin level of obsen male and semen parameters, as well as endocrine hormones level related to male sterility. Methods Total of 30 patients (the obesity group) and 10 healthy men (the control group) were enrolled in the study. The CASA was used to analyze semen quality of the patients. The levels of serum endocrine hormone were measured by Chemiluminescence, and the level of serum Leptin was detected by ELISA. Results The sperm concentration and a+b grade sperm motility percentage in the control group were significantly higher than that in the obesity group (P<0.01). Levels of FSH, LH and T in the control group were significantly lower than those in the obesity group(P<0.05). The level of serum Leptin in the control group was significantly higher than that in the obesity group(P<0.01). The level of serum Leptin was significantly negatively correlated with sperm concentration and the levels of FSH、LH and T. Conclusion There are significant correlation between serum Leptin level and sperm parameters, as well as endocrine hormones level. Leptin may inhibit endocrine hormones and affect sperm production, then resulting in the decline of sperm number and motility.

Objective To detect the seminal Leptin level, sperm parameters and sperm apoptosis rate of leukocytospermia patients before and after treatment, and explore their correlation. Methods Total of 80 leukocytospermia patients(WBC group)were randomly recruited in the study and their sperm samples were collected before and after treatment. Other 40 normal sperm samples were collected as the controls. The sperm parameters were detected by computer assisted sperm analysis (CASA). The level of semen plasma Leptin was measured by RIA and the sperm apoptosis rate were assessed by AnnexinV/PI staining-FACS. Results Sperm concentration and viability in WBC group before treatment were all obviously lower than those of the control (P<0.05,P<0.01), whereas the apoptosis rate was significantly higher(P<0.01). The level of semen plasma Leptin was higher than that of the control (P<0.05), moreover itwas positively correlated with sperm apoptosis rate (r=0.678,P<0.05). After treatment, semen activity was increased and sperm apoptosis rate and Leptin level were decreased in WBC group. Conclusion Increase inseminal Leptin level and sperm apoptosis rate were founded in WBC group, which may be contributed to the decrease of sperm concentration and viability. Positive relationship between seminal Leptin and sperm apoptosis was found, implyingthat Leptin might play a role in sperm apoptosis by increasing seminal leukocyte.

Objective: To investigate the contraceptive knowledge, the attitude toward, and the related determinants of contraception and induced abortion among early pregnant women who underwent induced abortion, and accordingly to explore how to improve the concerned reproductive health conditions. Methods: A cross-section study was carried out through personal questionnaires among 646 early pregnant women who consented and accepted induced abortion. Results: The main causes of accidental pregnancy were intercourse without contracep-tion (478, 74%) and failure or misuse of contraceptive methods. Women’s age, contraceptive and sexual knowledge, and educational status were main and significant factors affecting induced abortion rate. Conclusion: It is highly recommended to promote public reproductive health education for young women and youngsters so as to reduce unwanted pregnancies and induced abortion.

The assisted reproductive techniques in China have witnessed rapid development in the past two decades.However,it also brings up issues of ethics and laws,especially the urgent regulation and reinforcement of the procedure of informed consent.This article begins with an explanation of the procedure of informed consent.Then it discusses the decision of the content,major and difficult points of informed consent in assisted reproductive technology services based on the practice in this field.Finally,it discusses the challenges to informed consent.To well enforce an informed consent process,we should first ensure the contents are reasonable and just;second,clinicians should have a scientific understanding of the importance of informed consent and establish normative procedure of informed consent;third,we must work according to relative ethic demands.Last but not least,respecting patients is the key to the principle of ethics.