Objectives:To evaluate the effect of modified prostate massage in the treatment of chronic pros-tatitis. Methods:There were totally 188 patients diagnosed as type III A prostatitis in the group from January to October in 2013.62 patients received oral tamsulosin hydrochloride sustained release tables (a table one night), levofloxacin lactate tables (twice a day,200mg once),qianliexiao suppository (a piece one night)by rectal admin-istration for 6 weeks.The other 126 patients were treated by modified prostate massage combined with medicines for 6 weeks.The NIH -Chronic Prostatitis Symptom Index (NIH -CPSI)and prostatic massage fluid (EPS)were per-formed before and after treatment.Changes were recorded and compared.Results:The demography and baseline data were similar in the two groups of patients.The subjective symptoms after treatment were significantly improved in CPSI (P <0.05).There were statistical differences between two groups in the decrease of CPSI (P <0.05). Conclusion:The symptoms of the patients with III A prostatitis can be largely alleviated by treatment with tamsulo-sin hydrochloride sustained release tables,levofloxacin lactate tablets and qianliexiao suppository.The treatment effect of oral medicines can be obviously enhanced with modified prostate massage.

目的：探讨抑制素B（InhibinB， InhB）用于预测精索静脉曲张（Varicocele， VC）手术后精液参数的改变情况。方法选取2012年2月至2013年10月上海交通大学医学院附属仁济医院泌尿男科门诊收治的VC型男性不育症患者92例。术前完成相关检测，包括完善病史登记，精液常规分析，卵泡刺激素（follicle-stimulating hormone，FSH）、睾酮（testosterone，T）和InhB检查等。所有患者均接受左侧精索静脉显微结扎术，术后12周随访精液常规分析、FSH、T、InhB。对术前、术后相关指标进行分析比较。结果根据术后12周精液参数改变情况将患者分为改善组（59例）和未改善组（33例），改善组术后12周精子浓度明显提高（P＜0.05），未改善组精子浓度变化差异无统计学意义（P＜0.05）；两组术后InhB水平均有明显提高，术前及术后12周InhB水平，改善组均明显高于未改善组（ P＜0.05）。根据术前InhB水平将患者分为低InhB组（38例）和高InhB组（54例），低InhB组治疗有效率低于高InhB组（P＜0.05）。结论 VC术前InhB水平的高低，与术后精液参数是否能得到明显改善有一定关系，可作为VC患者手术选择参考指标之一。

目的：明确无精子症精确诊断分型的临床应用情况。方法收集上海交通大学医学院附属仁济医院泌尿男科门诊就诊的无精子症患者356例。完成病史收集、体格检查、精液分析、性激素及抑制素B检测、染色体核型分析、AZF检测、超声检测等。依据2013版《中国男科疾病诊断治疗指南-男性不育诊疗指南》无精子症的精确诊断分型，将患者分为：梗阻性无精子症（ obstructive azoospermia ，OA）组（128例）、非梗阻性无精子症（ NOA non -obstructive azoospermia ， NOA ）组（166例）以及混合型无精子症（ combined azoospermia，CA）组（62例），针对不同分型采用不同治疗方法，观察治疗结果。结果 OA组中，先天性双侧输精管缺如（congenital bilateral absence of the vas deferens ， CBAVD）患者49例，均进行诊断性经皮附睾精子抽吸术（ percutaneous epididymal sperm aspiration ， PESA），找到精子后进行卵胞浆内单精子注射（ intracytolasmic sperm injection， ICSI）治疗；其余79例患者，63例选择生殖道重建术，16例选择直接PESA后ICSI治疗。 NOA组中，染色体异常40例，其中47， XYY克氏综合征23例、AZFa／b缺失12例，直接建议患者进行供精人工授精（ artifical insemination by dornor ， AID）治疗；5例为AZFc缺失，行睾丸活检后均未找到精子；其余126例患者为特发性NOA。26例患者选择接受精索内静脉显微结扎术联合睾丸活检术，选择经验性治疗61例，选择直接睾丸活检者44例。 CA组中，进行PESA 找到精子23例，睾丸精子抽吸术（ testicular sperm aspiration ， TESA）找到精子14例，TESA未找到精子者后续进行睾丸活检病理组织找到精子5例，其余20例睾丸活检也未能找到精子。结论按无精子症精确诊断分型，有助于避免过度诊断，加速临床诊断速度，提高诊断效率。根据分型进行治疗选择，有助于临床无精子症的诊治。

目的:回顾分析500例无精子症的临床诊治,为提高男性不育症规范化诊治水平提供参考.方法:回顾性分析2012年12月-2013年12月间收治的无精子症患者500例,根据中华医学会2013版《男科疾病诊治指南系列男性不育症诊疗指南》诊断为梗阻性、非梗阻性、混合性无精子症;分别提供附睾、输精管、射精管等精道重建手术、药物治疗、体外受精(IVF)/胞浆内单精子注射(ICSI)、供精人工授精(AID)及收养等方案供患者夫妇知情选择.结果:500例中梗阻性无精子症254例、非梗阻性无精子症187例、混合性无精子症40例,Y染色体AZFa或AZFb微缺失所致的无精子症19例.手术治疗的44例患者中,14例接受精囊镜射精管囊肿切开术、5例接受输精管-输精管吻合术、25例接受输精管-附睾吻合术;其中33例在术后3～12个月内行精液检查发现精子,2例在术后3～8个月女方自然妊娠;药物治疗的19例患者中,7例炎症性梗阻患者给予抗生素治疗1～3个月后,3例在3～6个月精液检查时发现精子,其中1例在治疗后5个月内女方自然妊娠,其余4例患者的生殖系统不适症状较前明显缓解;12例低促性腺激素患者给予卵泡刺激素(FSH)和(或)人绒毛膜促性腺激素(hCG)治疗,其中包括1例Kallmann综合征,9例患者经3～12个月随访,睾丸体积明显增大(＞4～8 mL),血清睾酮明显增高,其中5例在6～12个月内精液中出现精子;IVF/ICSI治疗组的376例患者12个月内成功妊娠者196例;其余61例选择AID或收养.结论:依据中华医学会《男科疾病诊治指南系列男性不育症诊疗指南》谨慎有创操作,倡导医患共同决策诊疗行为,对于临床上无精子症规范化与合理的诊治具有积极意义.

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。

Objectives To assess erectile function in middle-aged and older men with asexuality status and further analyze their specific reasons for this condition. Subjects and Methods Men who had regular sexual intercourse attempts (sex frequency≥1 time per month) were classified into mild erectile dysfunction (ED), moderate to severe ED and non-ED according to International Index of Erectile Function-5, and men having no sexual intercourse attempts for at least 6 months were defined as having an asexuality status. The risk factors associated with ED were collected in a sample of 1,531 Chinese men aged 40 to 80 years, and the self-report reasons for asexuality were recorded in asexual cohort individually. Comparative analyses and multivariate regression models were conducted among these groups. Results The prevalence rates of ED and asexuality status were 49.9% and 37.2%. The asexuality status group had higher risk factors than the moderate to severe ED group in terms of old age (age≥65, adjusted odds ratio (OR) 17.69 versus (Vs.) 7.19), diabetes (crude OR: 2.40 Vs. 2.36) and hypertension (crude OR: 1.78 Vs. 1.72). The specific reasons for the asexuality status were “erectile difficulty” (52.9%), “do not care about sexuality” (53.5%)”, “no longer necessary to have sexuality at this age” (47.7%), “severe stress” (44.4%), “severe fatigue” (26.3%) and “masturbation” (26.9%). Conclusions Men with an asexual status suffer from higher risk factors for ED than men with moderate to severe ED. The majority of this asexual status could be attributed to a full ED, although the reasons for this transient asexuality also involved sexual attitudes and interests, sexual partners and masturbation.

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.

control group (P<0.05). The sperm apoptosis rate was negatively correlated with the sperm concentration and (A+B) grade sperm percentage (P<0.01, P<0.05). The level of leptin in semen plasma was positively correlated with the sperm apoptosis rate (P<0.05). The increase of semen parameters were found in the patients after microsurgery (P<0.05). The level of leptin in semen plasma was decreased after microsurgery (P<0.05), while the sperm apoptosis rate was also decreased (P<0.05). Conclusion Varicocele might contribute to the high level of Leptin in seminal plasma and the sperm apoptosis, whereas, microsurgery will bring benefit for the condition. Leptin has significant correlation with the sperm apoptosis rate in both pre-and after microsurgery. So Leptin may be one of the pro-apoptotic factors to the sperm.

Objective To study the relationship between the level of prostate specific antigen (PSA)and levels of sex hormonessuch asfollicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), estradiol (E2)in aging males in the Shanghai. Methods Using multi-stage sampling method, 1 720 cases of 40 to 80-year-old male resident were recruitedfrom the general population of Shanghai The levels of serum prostate-specific antigen (PSA) and levels of four sex hormones (FSH, LH, T, E2) were respectively measured in the sampling population. Results Of 1 720 people, 1 489 were enrolled in the study due to their compliant and comprehensive data.Their average age was 61.88±10 years old, average level of PSA 1.29±1.06, levels of sex hormone FSH(7.97±6.35)mIU/ml, LH(4.39±.73)mIU/ml, T(4.47±2.58)ng/ml, and E2(9.99±16.51)pg/ml, there is no significant correlation between PSA and FSH levels (r = 0.002, P > 0.05); There were no significant correlations between PSA level and LH level (r=-0.008, P >0.05), between PSA level and T level (r =-0.008, P >0.05), between PSA level and E2 level (r =-0.019, P >0.05). Conclusion No relationship between PSA and four sex hormones was found in aging males.

OBJECTIVE:To explore the optimal treatment selection for treating varicocele (VC) male infertility patients accompanied with oligozoospermia or azoospermia of different Chinese medical syndrome types by comparing the efficacies of integrative medicine. METHODS:One hundred and twenty male infertility patients with VC accompanied with oligozoospermia or azoospermia were assigned to Chinese medical treatment group (A) and the surgical group (B), each consisting of three Chinese medical syndrome types, i.e., damp-heat stagnation syndrome (DHSS), Shen-deficiency blood stasis syndrome (SDBSS), and blood stasis stagnation syndrome (BSSS), 20 in each group. Corresponding Chinese medical treatment was administered to those in Group A, C, and E, while microscopic ligation of internal vena spermatic was administered to those in Group B, D, and F. The routine analysis of semen, biochemical analysis of seminal plasma, and serum sex hormones (prolactin, testosterone, follicle stimulating hormone, luteinizing hormone, and estradiol) were performed before treatment and by the end of the 24th week after treatment. RESULTS:Totally 18 patients' spouses were pregnant. Of them, 1 in Group A of DHSS (abbreviated as Group A), 3 in Group B of DHSS (abbreviated as Group B), 4 in Group A of SDB-SS (abbreviated as Group C), 5 in Group A of SDBSS (abbreviated as Group D), 1 in Group A of BSSS (abbreviated as Group E), and 4 in Group B of BSSS (abbreviated as Group F). After 24-week treatment, the sperm concentration, class a sperm percentage, class a + b sperm percentage, the motility rate, the seminal plasma of fructose density, and the seminal plasma neutral alpha-glucosidase were more significantly improved in Group B, C, D and F, when compared with the same group before treatment (P <0. 01, P <0. 05). There was no statistical difference in the aforesaid indices between before and after treatment in Group A and Group E (P >0.05). As for the improvement percentage of seminal routine indices, the difference of the seminal plasma of fructose density, and the difference of seminal plasma neutral alpha-glucosidase between before and after treatment in the same Chinese medical syndrome types, better effects were obtained in Group B than in Group A (P <0.01), and better effects were obtained in Group F than in Group E (P <0.01). There was no statistical difference between Group C and D (P >0.05). There was no statistical difference in the 5 items of sex hormones in each group between before and after treatment (P >0.05). CONCLUSIONS:Surgical treatment could effectively improve the semen quality for male infertility VC patients accompanied with oligozoospermia or azoospermia. Of them, Chinese medical treatment could be recommended to those of SDBSS who would not receive surgical treatment.

Objective To evaluate the vascular endothelial function of patients with erectile dysfunction using Peripheral Arterial Tone (PAT), and analyze the related factors to the vascular endothelial dysfunction. Methods The endothelial function of 87 ED patients was measured by EndoPAT2000. The test was carried out on two separate finger tips. The endothelial function was evaluated by PAT ratio of the finger tip. And ED patients were investigated by physical examination, lipid metabolism, fasting plasma glucose, sexual hormones (testosterone[T] 、estradiol[E2]、prolactin[P]) and International index of erectile function 5(IIEF-5). The clinical diagnostic criteria of metabolic syndrome (MS) was in accordance with the 2005 International Diabetes Federation (IDF2005) issued by the international academic community. Results Average age of 87 ED patients was 33.8±7.2 years-old, including 52 with endothelial dysfunction and 35 with normal endothelial function. Fasting plasma glucose (FPG), waist circumference and weight levels of patients in vascular endothelial dysfunction group were significantly higher than the patients in non-vascular endothelial dysfunction group (P<0.05), and total cholesterol(TC) and triglyceride (TG) were also significantly higher (P<0.01), while high density lipoprotein (HDL) was significantly lower ( P<0.05), but blood pressure, low density lipoprotein (LDL), T, E2 and PRL had no difference ( P>0.05). Secondly, the prevalence of MS in vascular endothelial dysfunction with ED group was 42.3%, which was significantly higher than 20% in non-vascular endothelial dysfunction with ED group (P<0.05). Secondly, compared with normal endothelial function, the patients with endothelial dysfunc-tion were much severer (P<0.05). Conclusion The prevalence of MS in ED patients with vascular endothelial dysfunction was significantly higher. Central obesity, hyperlipidemia and diabetes mellitus were the major risk fac-tors for endothelial dysfunction. And erectile function in patients with endothelial dysfunction might be even worse.

Objective To detect the microsurgery treatment effect for male infertility patients with varicocele including the sperm DNA fragmentation index (DFI) and the level of reactive oxygen species (ROS) in seminal plasma, moreover, explore their correlation. Methods One hundred and twenty left varicocele male infertility with oligospermia and asthenospermia were treated with microscopic ligation of internal spermatic vein in Renji hospital from January 2011 to December 2012. The number of subclinical varicocele (SVC), clinical varicocele I (VcI), clinical varicocele II(VcII) and clinical varicocele III(VcIII) were 30 respectively. Meanwhile, 30 semen samples with normal range of parameters were selected as the control group. Their spouse had been naturally conceived within one year. Semen routine parameters, the sperm DFI and the level of ROS in seminal plasma in each group were detected. Furthermore, the spouse pregnancy condition was followed-up. Results The level of ROS in SVC group had no difference with that of the control group (P>0.05), while the sperm DFI was increased (P<0.05), both of them in VcI group were higher than those of the control group (P<0.05)and in VcII and VcIII groups much significantly higher (P<0.01). The sperm DFI was positively correlated with the level of ROS in seminal plasma (r=0.683, P<0.01). The level of ROS and sperm DFI had no difference (P>0.05) in SVC group after microsurgery, whereas, the level of ROS in VcI group was lower (P<0.05) and sperm DFI was not changed (P<0.05). For VcII and VcIII groups, the levels of ROS were significantly decreased (P<0.01)after microsurgery, meanwhile, the sperm DFI in VcII group was declined after 3 months(P<0.05), that of VcIII group was 6 months. The level of ROS and sperm DFI in pregnancy group were lower than that of those whose spouses were not pregnant (P<0.05). Conclusion Vc II and Vc III might contribute to the high level of ROS in seminal plasma and the damage of sperm DNA, whereas, microsurgery will bring benefit for the condition. Furthermore, it had great importance for the examination of the sperm DFI to predict the pregnancy outcome.

Objective:To investigate the relationship between young men with erectile dysfunction and metabolic syndrome and to find the major risk factors affecting young ED patients. Methods:120 young ED patients and 40 males with normal sexual life were investigated by physical examination,lipid metabolism,fasting plasma glucose and International index of erectile function 5.The clinical diagnostic criteria of metabolic syndrome was according to the 2005 International Diabetes Federation issued by the international academic community.The ED patients with non-MS and MS also examined Audio visual sexual stimulation to assess the erectile function indicators. Results:The prevalence rate of MS in ED group was 35% which was significantly higher than 15% in non-ED group(P<0.01).The index central obesity(waist circumference,weight,body mass index) and triglyceride(TG) levels of patients in ED group were significantly higher than the patients in non-ED group(P<0.01),while high density lipoprotein(HDL) was significantly lower(P<0.01),total cholesterol(TC) and low density lipoprotein(LDL) was higher(P<0.05),but blood pressure and fasting plasma glucose(FPG) was no significant difference(P>0.05).Secondly,compared with the ED group with non-MS,the patients with MS were much severer(P<0.05),and IIEF-5 score reduced with the increase number of the risk factors of MS.Finally,AVSS indicators of ED patients with MS were inferior to the non-MS group(P<0.05). Conclusions:The prevalence of MS in young ED patients is significantly high and the severity of ED is positively correlated with the number of MS risk factors,in which central obesity and hyperlipidemia may be the major risk factors.

目的明确精索静脉曲张(varicocele, VC)男性不育患者通过显微外科手术治疗对于精浆活性氧(reactive oxygen spies, ROS)与精子DNA损伤指数(sperm DNA fragmentation index, DFI)的治疗效果并分析其相关性.方法选取2011年1月~2011年12月至上海交通大学医学院附属仁济医院泌尿男科就诊左VC伴少、弱精子症男性不育患者共120例进行显微外科精索内静脉结扎手术治疗,其中亚临床(s u b c l i n i c a l varicocele,SV C)、V CⅠ度(clinical varicocele,V cⅠ)、V CⅡ度(VcⅡ)、VCⅢ度(VcⅢ)患者各30例;另选取配偶于1年内自然受孕,且精液参数正常范围的精液标本30份作为对照组.检测各组精液常规参数,TBA法检测精浆ROS水平、精液吖啶橙试验检测精子DFI.观察比较各组VC患者术前、术后3月、术后6月女方怀孕情况、精液常规参数、精浆R O S 水平与精子D F I 情况,对数据进行统计学分析.结果 VC男性不育患者术前SVC组与对照组ROS水平无差异(P>0.05),精子DFI上升(P<0.05);VcI组ROS水平及精子DFI增高(P<0.05);VcII组及VcIII组ROS水平与精子DFI显著增高(P<0.01);精子DFI与精浆ROS水平呈正相关(r=0.683,P<0.01).SVC组术后精浆ROS水平与精子DFI较术前无差异(P>0.05);V cI组术后精浆ROS水平低于术前(P<0.05),精子DFI无差异(P>0.05);V cⅡ及VcⅢ组术后精浆ROS水平明显降低(P<0.01);VcII组术后3月精子DFI降低(P<0.05);VcⅢ组术后6月降低(P<0.05).手术后VC患者精浆ROS水平及精子DFI怀孕组低于未怀孕组(P<0.05).结论 VcⅡ及VcⅢ伴少、弱精子症男性不育患者精浆ROS水平上升且精子DFI较高,VC显微外科治疗可一定程度改善睾丸氧化应激环境及降低精子DNA损伤程度.其次,通过检测精子DFI对于预测妊娠结局具有重要意义.

OBJECTIVE:To determine the role of the sexual function inspection room in the treatment of patients with special penile insertion disorder.METHODS:This study included 6 couples received at the Andrology Clinic of Shanghai Renji Hospital from September, 2010 to February, 2011, who complained of being unable to accomplish sexual intercourse, all due to the husbands' abnormal penile erection. The couples had tried to make love 3 to 6 times after getting married, but never succeeded. Consequently the wives were planning to divorce, unwilling to attempt sexual activity again. We performed examinations and sexual education for the patients in the sexual function inspection room of Shanghai Institute of Andrology. The inspection room consisted of an inner and an outer section separated by a one-way transparent glass, through which what happened in the outer section could be observed from the inner section. The husband was given 20 mg of tadalafil to induce penile erection, followed by Doppler ultrasonographic determination of penile hemodynamics. Meanwhile, the wife was allowed to observe her husband's penile erection through the glass to get sensory stimuli and relieve the mental burden. In the end, the doctor advised the couple to try sexual intercourse.RESULTS:In nature, the 6 wives were all impatient, while their husbands were all introverted. Doppler ultrasonography displayed normal penile hemodynamics. After sensory stimulation, the wives gained confidence in their husbands' erectile function. A one month follow-up visit showed that all the 6 couples could perform sexual intercourse normally.CONCLUSION:This sexual function inspection room can help doctors and wives to observe the status of the patient's penile erection, and meanwhile disburden the mind of the wives by giving them sensory stimuli, which contributes much to successful attempt at sexual intercourse.

Objective To investigate the efficacy of huangmai mixture treating oligoathenospermia due to spleen and kidney yang deficiency.Methods Sixty-six male infertility patients were randomized into experimental group and control group,given with huangmai mixture and compound xuanju capsule,respectively.All patients recruited went through a treating period of 24 weeks and came for follow-up visits at the 4th,8th,12th,16th,20th and 24th weekend,receiving clinical examinations and safety evaluation.Observation items included semen analysis,sperm morphology analysis,antisperm antibody,seminal plasma biochemical analysis and serum sex hormone.Results After treatment for 24 weeks,the total effective rates of experimental group and control group were 63.33% and 53.33%,respectively.The total effective rates between groups were not statistically significant(P0.05).In total,6 patients' partners conceived during treating period(4 in experimental group and 2 in control group).Compared with those before treatment,the sperm density,sperm motility,a class sperm percentage,a+b class sperm percentage and sperm activity in the treated group and control group increased significantly(P0.05).Fructose density and α-glycosidase also increased,but the increasing degree showed no statistical significance.Serum sex hormone of two groups did not vary before and after treatment(P0.05).Statistical significance was not observed in percentage increased between groups(P0.01).Conclusion Huangmai mixture for treating oligoathenospermia due to spleen and kidney yang deficiency has the same efficacy and safety compared with compound xuanju capsule,with a relatively low cost,huangmai mixture is more suitable for clinical application.

Objective To investigate the differences of serum and seminal plasma leptin levels between those with idiopathic asthenospermia and with normal spermia, and further explore the relationship between leptin level and sperm motility. Methods Total of 54 men with idiopathic asthenospermia and 30 men with normal spermia were enrolled in this study. The semen specimens were analyzed by computer assisted semen analysis (CASA) after liquefaction. The levels of serum and semen leptin were measured by RIA. Results Neglecting a great difference in body mass index (BMI) between groups (P=0.346), there was no significant difference in the serum leptin levels between the patients with idiopathic asthenospermia and the control(P= 0.084). The seminal plasma leptin levels was significantly higher in those with idiopathic asthenospermia than that in the contol(P= 0.013). The seminal plasma leptin level in patients with idiopathic asthenospermia was negatively correlated with the total sperm motility and progressive motile sperm (r=-0.31, P=0.034 and r=-0.47, P=0.025), but there was no relativity between serum leptin level and the total sperm motility or progressive motile sperm (r=-0.213, P=0.249 and r=-0.167, P=0.154). Conelusion The level of seminal plasma leptin was significantly increased in those with idiopathic asthenospermia. Leptin might regulate the motility of sperm.

Objective: To study significance of the related biochemical indicator (Fasting blood-glucose, Triglyceride, Alanine aminotransferase, Creatinine) in aging males with ED. Methods: Total of 1591 men over 40 years old in Shanghai urban area, selected by multi-stage sampling methods, had been investigated by the questionnaire of erectile dysfunction and serum biochemical indicator assays. According to the score of International Index of Erectile Function (IIEF-5), 992 sexually active men in the overall population were divided into mild ED group, moderate ED grourp, severe ED group and normal group. The differences of the biochemical indictor levels among 4 groups, and the correlation between ED severity and levels of biochemical indicators were comparatively analyzed. Results: In 992 men, incidence of ED accounted for 78.83%, and no significant differences were found in the mean levels of ALT and Cr, between ED groups and the normal group, however a significant difference (P<0.01) in the mean level of FBG was found between severe/moderate ED group and mild ED/normal group. For the mean level of TG, there was a significant difference (P<0.01)between mild ED group and normal group, and there was also a significant difference(P<0.05) between moderate ED group and normal group. Moreover, the mean level of TG in mild ED goup was significantly lower (P<0.05) than moderate ED group, and the mean levels of TG in moderate ED group was significantly lower (P<0.05) than that of severe ED group. Conclusion: Hyperglycemia is an important risk factor for ocurrence of severe(moderate) ED in aging males. No correlation was found between hypertriglyceridemia and the morbidity of ED in aging males, but high level of serum TG in aging males with ED might aggravate the progression of ED.