Late-onset hypogonadism (LOH) is a syndrome in middle-aged and elderly men caused by age-related testosterone deficiency. Age-related change of total testosterone (TT) of Asian males is different from Caucasian population, suggesting difference for LOH identification in Asians. A nationwide cross-sectional study involving six centers in China was conducted. Totally 6296 men aged 40-79 were recruited. After exclusions 5980 men were left for analyses. The serum TT level, was neither decreased with aging nor correlated with most hypogonadal symptoms. Instead, ten hypogonadal symptoms were found to be significantly correlated with free testosterone and testosterone secretion index, thus were chosen to form a concise scale. Further analysis identified a level of free testosterone <210 pmol/L, testosterone secretion index <1.8, and the concise scale score ≧17 could be diagnosed as having significantly aggravated LOH. This study developed an evidence-based criteria for LOH identification in Chinese population and may be adopted in other Asians. It includes the impaired testosterone secretion ability and deficiency of bioavailable testosterone, which should be the main cause in LOH pathogenesis despite normal TT levels, as well as correlated multiple hypogonadal symptoms. Our results may guide the LOH treatment to increase testicular function of testosterone secretion and bioavailable testosterone.

Vasectomy is an efficient male contraceptive method, but the long-term effects of this technology in a large population are unclear. To investigate the influence of vasectomy on long-term health effects, we recruited 485 men with a vasectomy and 1940 men without vasectomy in China. After obtaining basic information from the Aging Males' Symptoms (AMS) scale and other questionnaires, peripheral blood was drawn to assess the hormone levels, prostate specific antigen (PSA) and blood biochemistry. Using multiple linear regression analysis, these factors had no relationship with vasectomy except for four factors including the Somatic score (0.31, 0.02 and 0.61) in AMS, SF-36 score (-18.8, -32.00 and -5.60), "Role emotional" (-6.28, -10.34 and -2.22) and "Mental health" (-1.55, -3.08 and -0.02). A stratified analysis showed that with increased age, smoking and drinking, residence in township or a higher level of education, the mental health of men was worse. Vasectomy had no long-term effect on the level of sexual hormones in men, and it did not increase the level of PSA. The impact of the vasectomy on quality of life in men were mainly reflected in psychological effects, which suggests that men with vasectomy groups many benefit from professional psychological counseling.

Circulating miRNAs have been shown to serve as diagnostic/prognostic biomarkers in cancers and other diseases. However, the role of plasma miRNAs in Late-onset hypogonadism (LOH) diagnosis is still unknown. Using Illumina HiSeq2000 sequencing at discovery phase, and then two-step validated by reverse transcriptase polymerase chain reaction (RT-PCR) assays in verification phases. We verified that the expression levels of miR-125a-5p, miR-361-5p and miR-133a-3p were significantly altered in LOH group compared to the control group. The area under the receiver operating characteristic (ROC) curve (AUC) is 0.682, 0.698 and 0.765, respectively. The combination of three miRNAs showed a larger AUC (0.835) that was more efficient for the diagnosis of LOH. Among three miRNAs, miR-133a-3p had the best diagnostic value for LOH with 68.2% sensitivity and 77.3% specificity. Regression analyses show that miR-133a-3p level was negatively associated with the ageing males’ symptoms (AMS) scale. However, miR-361-5p level was positively associated with serum testosterone concentrations. In summary, plasma miRNAs are differentially expressed between LOH and healthy controls. We validated three miRNAs that could act as novel biomarkers for diagnosis of LOH. These miRNAs may be involved in the development of LOH. However, further large and functional studies are warranted to confirm our findings.

Sperm DNA integrity is an essential factor for accurate transmission of genetic information. Human sperm DNA damage is a common cause of male infertility but the exact mechanism remains poorly understood. Considering the vital role of microRNA (miRNA) in multiple pathophysiological processes, we hypothesised that testicular miRNA is involved in sperm DNA damage during spermatogenesis. Infertile patients with high sperm DNA fragment index (DFI; n=94) were selected from 1090 infertile men and a total of 18 testis-specific seminal miRNAs previously identified from human seminal plasma were chosen and tested. miR-29c and miR-424 were downregulated in men with high DFI. The inhibition of these two miRNAs in mice confirmed the role of miR-424 (murine homologue miR-322) in sperm DNA damage during spermatogenesis; by contrast, miR-29c exhibited a negative result. Thus, miR-424/322 is involved in sperm DNA damage. Furthermore, the dysregulation of this miRNA can induce DNA double-strand breaks during spermatogenesis.

Objective To explore the prenatal diagnosis methods of spinocerebellar ataxia type 3 ( SCA3 )/Machado-Joseph disease ( MJD ) based on amniotic fluid cells culturing and fragment analysis with capillary electrophoresis.Methods The amniocentesis and aminotic cell culture were performed in a SCA3/MJD pregnant women at 20 weeks of gestation and 8 pregnant women at 16 -19 weeks of gestation.The MJD1 gene ( CAG ) n dynamic mutation were detected by capillary electrophoresis separation.Results The number of MJD1 gene ( CAG) n in fetal of SCA3/MJD patient was 22/78, the fragments of abnormal alleles was come from his mother.The fetus was diagnosed with SCA3/MJD.The number of MJD1 gene (CAG)n in fetal of 8 controls were 13-26, they were in normal range.Conclusions Amniotic fluid cells culturing and fragment analysis with capillary electrophoresis are very simple and precise methods.It worths to be recommended as a promising protocol for SCA3/MJD’s prenatal diagnosis and genetic consultation.

To determine the normal range of the inner diameters of the anatomical structures in the fetal cardiovascular system during the second trimester in Ningxia and to investigate their variation with gestational age. Routine echocardiography was performed for 1 247 normal fetuses during the second trimester (22~28 weeks) to determine the inner diameters of the atrium, ventricle, foramen ovale, aorta, pulmonary artery, left/right pulmonary artery, aortic isthmus, descending aorta, and ductus arteriosus. Measurement data were grouped by gestational age, and the correlation between the measurement data and gestational age was investigated. The inner diameters of the fetal atria, ventricles, and great vessels increased with gestational age and were significantly associated with gestational age (P < 0.05). In Ningxia, determining the normal range of fetal cardiovascular diameters during the second trimester allows the evaluation of fetal cardiovascular system development and provides an important basis for the accurate identification of fetal congenital heart disease.

Objective To evaluate the effect of vasectomy on serum lipids, renal and hepatic function in middle -aged and elderly men.Methods A total of 2 352 middle-aged and elderly men from Wuhan city Hubei province and Jinhu county Nanjing city Jiangsu province were enrolled for a reproductive health survey.Vasectomy condition of all subjects were surveyed, physical examination and laboratory measurement for serum lipids, renal/hepatic function and reproductive hormones were conducted as well.Results Vasectomy correlated positively with serum total bilirubin, direct bilirubin, total protein, albumin and globulin (β=0.057, 0.059, 0.085,0.071 and 0.067 respectively, P <0.01), the serum levels of aforementioned parameters were lower in men undergone vasectomy than those without vasectomy.Vasectomy was uncorrelated with serum lipids, hepatic function except the aforementioned parameters, urea nitrogen and creatinine (P>0.05).Conclusion Vasectomy has no harmful effect on serum lipids metabolism and renal function, but it may affect total/direct bilirubin, hepatic protein synthesis function which need further study to confirm.

Objective To investigate the influence of smoking, drinking and body mass index ( BMI ) on the aging males ’ symptoms scale ( AMS) score.Methods The ageing men were recruited and investigated by cross-section research and the influence of smoking, drinking and BMI on the AMS score was analyzed.Results 1 245 male participants were investigated and 1 197 male participants were involved in the final analysis, including 174 urban aging male, 790 village male in plain and 233 village male in mountain area.Statistical analysis found that the AMS score was not influenced by drinking and BMI.For aging men who have smoked no more than 10 years, the sexual symptoms score descend from 9.3 to 8.4, symptoms will be improved gradually;For aging men who have smoked more than 10 years, the sexual symptoms have the tendency of getting worse and the score raised up to 9.8; And the sexual symptoms score could raised to 10.6 even after stopping smoking which suggest that the sexual symptoms caused by smoking maybe irreversible.Conclusion The AMS score was influenced by smoking instead of body mass index or drinking and the sexual symptoms caused by long term smoking maybe irreversible.

Objective To investigate the long-term effects of vasectomy on gonadal function in middle-aged and elderly men . Methods 167 middle-aged and elderly men with a history of vasectomy were randomly chosen, according to the different vasectomy time, cases were divided into 10 years group (10~19 years ) , 20 years group (20~29 years ) , 30 years group (≥30 years ). 167 cases with reproductive history, non-ligation middle-aged and elderly men were selected as a control group.The total serum testosterone (TT), free serum testosterone (cFT), estradiol (E2), sex hormone binding globulin (SHBG), follicle -stimulating hormone (FSH), luteinizing hormone (LH) levels , Chinese version of the aging males’ symptoms scale (CN-AMS) score were compared between different groups.Results No significant differences were found in serum TT, cFT, E2, SHBG, FSH, LH levels and CN -AMS scores between the ligation group and the control group ( P >0.05 ) .No significant differences were found in all indicators between the 10 years group, the 20 years group and the control group(P>0.05).The cFT levels of the 30 years group were significantly lower than the control group (P<0.05), the other indicators had no significant difference(P>0.05).Conclusion The vasectomy has no long-term effect on gonadal function in middle-aged and elderly men.

Objective To analyze the suitability of insulin like factor 3( INSL3) for the clinical application in the diagnosis of male late onset hypogonadism ( LOH) .Methods The ageing men were recruited and sampled the fasting blood twice with one month interval, and the INSL3was tested for the blood samples to study it`s stability in blood.According the diagnosis criteria of LOH, the difference of INSL3 concentration between the LOH patient group and normal control group was analyzed.Results 44 aging males sampled the blood twice.The INSL3 concentration in serum is (1.86 ±0.64) ng/mL and the fluctuation with one month interval with no statistical significance (P>0.05);The INSL3 concentration in serum between two groups with statistical significance (P<0.05);The further study found that there is an association between the concentration correlation of INSL3 with LH and total testosterone( TT)&nbsp;and free testosterone( cFT) ( P <0.05); There is no association with male ligation, tobacco, alcohol, diabetes, hypertension, coronary heart disease, body mass index ( BMI) and aging males symptoms scale ( AMS) score( P>0.05 ) .Conclusion The study suggests that INSL3 has a clear-cut correlation with sexual performance and maybe adopted in the diagnosis of LOH.

Objective To explore the variation of serum total testosterone ( TT) and calculated serum free testosterone ( cFT) in male of different ages.Methods The subjects were divided into six groups according to age groups.The level of TT and sex hormone binding globulin ( SHBG) were detected.Then serum cFT was calculated.The relationship between levels of serum TT, cFT and age were analyzed.Results The differences in level of TT between 60~<70 group and 30~<40 group, 40~<50 group had statistical significance (P<0.05), no significant differences between other groups were found (P>0.05).The differences in level of cFT,&nbsp;SHBG between 20~<30 group and 30~<40 group had no statistical significance(P>0.05).The differences between other groups had statistical significance (P<0.05).TT and SHBG were positively correlated with age while cFT was negatively correlated with age (P<0.05).Conclusion The tendency of the level of TT increases slightly with ages, while the level of cFT has obviously declining trend in an adult >40.As the diagnostic criteria of hypogonadism in the middle-aged and elderly male, the level of cFT has better sensitivity.

Objective To explore the relationship of vasectomy and long-term cardiovascular disease risk factors in middle-age and elderly men.Methods Total of 2 352 middle -age and elderly men from Hubei province and Jiangsu province were recruited, who participated in a male reproductive health investigation.Physical exams and laboratory tests for cardiovascular disease risk factors were performed.The vasectomy status of participants were also investigated.Results Among age 50~<60 and 60~<70 group, the mean of fasting blood glucose of participants with vasectomy were lower than that of participants without vasectomy ( P<0.05).Among age 50 ~<60 group, The abnormal rates of fasting blood glucose and high density lipoprotein of participants with vasectomy were lower than that of participants without vasectomy ( P<0.05 ) .Among age≥70 group, The abnormal rate of fasting blood glucose of participants with vasectomy was lower than that of participants without vasectomy ( P <0.05 ) .Conclusion Vasectomy has no long-term effect on the cardiovascular disease risk factors, however, it may have some influence on fasting blood glucose which needs further study.

Objective To explore the effects of vasectomy on prostate symptoms and risk of prostate cancer in middle-aged and elderly.Methods A survey of 309 cases of middle-aged and elderly with vasectomy in Beijing, Hubei, Jiangsu was performed.618 age-matched non-vasectomy middle-aged and elderly were selected as a control with a proportion of 1:2.The international prostate symptom score( IPSS) of two groups were calculated by questionnaires, the peripheral blood samples were collected to detect prostate specific antigen ( PSA ) and free PSA.The differences between the two groups were compared.Results In the investigated population, IPSS score, level of PSA, free PSA and free PSA percentage between vasectomy group and non-vasectomy group had no significant difference after adjusted education factors.Conclusion Vasectomy does not affect the prostate symptoms or elevate the risk of prostate cancer.