Abstract:Objective The aim of this study is to provide the reference for the diagnosis and treatment of testicular germ cell tumors(TGCT).Methods A retrospective study of 12 patients with TGCT diagnosed from June 2021 to June 2024 at the Second Affiliated Hospital of Air Force Military Medical University was conducted with their clinical features,treatment methods and outcomes being discussed in conjunction with relevant literature.Results Among the 12 TGCT patients,there were 3 cases of seminoma and 9 cases of non-seminoma germ cell tumors(including 6 cases of mixed germ cell tumors,2 cases of embryonal carcinoma and a case of teratoma).All patients had unilateral lesions,and 6 cases(50％)had a history of cryp-torchidism.There were 7 cases in stage Ⅰ,3 cases in stage Ⅱ,1 case in stage Ⅲ,and 1 case in stage Ⅳ.The immunohisto-chemical results showed that all 6 cases of mixed germ cell tumors expressed CD117,SALL4,Ki-67 and OCT3/4.The serum tumor marker tests revealed that hCG and AFP were elevated to varying degrees in almost all tumors(11/12,92％),which was related to the histological composition of the tumors.All patients underwent surgery,and 5 cases received adjuvant conventional chemotherapy.The other patients had good outcomes after treatment(1 case of lung metastasis and 1 case lost to follow-up).Conclusion The pathological types of TGCT are diverse and judged by immunohistochemistry results.The type of tumor,stage,size and history of cryptorchidism all have varying degrees of impact on prognosis.Comprehensive and accurate pathologi-cal diagnosis is beneficial for the selection of treatment plans and the improvement of prognosis.

Abstract:In recent years,the incidence of male infertility has been on the rise,seriously threatening the reproductive health of people around the world.The causes of male infertility are complex.Recent relevant studies have shown that sperm mi-tochondria are closely related to male infertility.Previous studies have demonstrated that some Chinese herbal monomers and Chi-nese herbal compounds are helpful for the prevention and treatment of male infertility by protecting sperm mitochondria and thus improving sperm quality.This article will discuss the regulatory effects of TCM monomers and TCM combinations on sperm mito-chondrial function from the perspective of sperm mitochondrial dysfunction,and summarize the recent studies,with a view of rel-evant medications and their application in clinical practice.

Abstract:Seminal plasma exosomes(SE)are extracellular vesicles secreted by the epithelial cells of male gonads or ac-cessory gonads,which deliver various substances closely related to the maturation of sperm,such as proteins,RNA,lipids,and ions.Numerous studies have shown that SE plays an extremely important mediating role in a series of physiological processes such as sperm maturation,antioxidation,capacitation and fertilization.This article focuses on the latest research achievements of SE in the reproductive system,aiming to provide important theoretical references for the diagnosis,treatment of reproductive sys-tem diseases and the improvement of assisted reproductive technologies.

Abstract:Objective The aim of this study is to evaluate the clinical efficacy of Wendan Decoction in the treatment of erectile dysfunction(ED)with liver-qi stagnation pattern,and to explore its potential mechanisms and targets.Methods In this retrospective study,68 patients with ED of liver-qi stagnation pattern who attended the Andrology Department of Jiangsu Pro-vincial Hospital of Traditional Chinese Medicine from January 2024 to December 2024 were enrolled.The patients were assigned to the Wendan Decoction group(n=28)or the Chaihu Shugan San group(n=40),with a treatment duration of 8 weeks.The International Index of Erectile Function-5(IIEF-5),Erection Hardness Score(EHS)and Traditional Chinese Medicine syndrome score(TCMSS)were used to assess efficacy,and safety was monitored.Active components of Wendan Decoction and their puta-tive targets were obtained from public databases,and psychogenic-ED-related targets were collected.Common targets were identi-fied and subjected to enrichment analysis.After obtaining the targets of Chaihushugan Powder for psychogenic ED,Wendan-spe-cific targets were screened and analyzed.Molecular docking was performed to verify the binding of key components to key/com-mon and Wendan-specific targets.Brain-region enrichment of Wendan-specific targets was further conducted to predict the possi-bly modulated neural circuits.Results After treatment,IIEF-5,EHS and TCMSS were significantly improved in both groups compared with baseline(P＜0.01).The improvements in TCMSS(12.71±2.12 vs 14.15±3.88)and EHS(3.43±0.50 vs 3.02±0.76)were more significant in the observation group than those in the control group(both P＜0.01).No obvious adverse reactions were reported in either group.Network pharmacology suggested that core components of Wendan Decoction may act on key targets such as AKT1,TNF,TP53,IL6,IL1B,CASP3,ESR1,PTGS2,BCL2 and STAT3,thereby modulating PI3K-Akt,cGMP-PKG and other signaling pathways to exert anti-inflammatory,anti-apoptotic and antioxidative effects.Molecular docking showed stable binding between core components and these targets,with binding energies all＜-5 kcal/mol.Brain-region en-richment analysis indicated that the specific targets of Wendan Decoction were mainly distributed in key regions including the thalamus,basal ganglia,prefrontal and orbitofrontal cortices,hypothalamus,and cerebellum.Accordingly,Wendan Decoction may facilitate recovery from liver-qi stagnation-type ED by modulating the prefrontal-amygdala emotional circuit,the orbitofrontal-striatal reward circuit,and the frontoparietal attention network.Conclusion Wendan Decoction can effectively improve erectile function and accompanying symptoms in patients with ED of liver-qi stagnation pattern,with good safety.Its therapeutic effects may involve synergistic regulation of multiple components,multiple targets,multiple signaling pathways and multiple brain re-gions.

Abstract:Objective To explore the mechanism by which inhibition of integrin α5β1 in the context of hypertension downregulates the expression of RAS homolog gene family members(RhoA)/Rho-associated kinase(ROCK)signaling proteins in the penile corpus cavernosum tissue,and affects the erectile function of rats.Methods Fifteen 12-week-old spontaneously hypertensive rats(SHR)were randomly divided into the SHR group,SHR+LV-empty group(transfected with empty lentiviral vector)and SHR+LV-siRNA group(transfected with lentivirus carrying siRNA targeting integrin α5β1),with 5 rats in each group.Fifteen 12-week-old normotensive Wistar-Kyoto(WKY)rats were randomly divided into the WKY rat group,WKY+LV-empty group(transfected with empty lentiviral vector)and WKY+LV-siRNA group(transfected with lentivirus carrying siRNA targeting integrin α5β1),with 5 rats in each group.In the WKY group and SHR group,20 μL of normal saline was injected into the middle part of the penile corpus cavernosum.While in the SHR+LV-empty group and WKY+LV-empty group,20 μL of empty lentiviral vector(titer 1 × 108 TU/mL)was injected into the middle part of the penile corpus cavernosum.In the SHR+LV-siRNA group and WKY+LV-siRNA group,20 μL of lentivirus carrying integrin α5β1 interference(titer 1 × 108 TU/mL)was injected into the middle part of the penile corpus cavernosum.One week after transfection,the body weight,levels of serum testosterone,ratio of the maximum intracavernous pressure to the mean arterial pressure(ICPmax/MAP)of rats in each group,the expression of integrin α5β1,FAK,ROCK1,ROCK2,and eNOS in penile corpus cavernosum,as well as the content of ni-tric oxide(NO)were measured.Results There was no statistically significant difference in body weight and serum testosterone levels among the rats in each group(P＞0.05).Compared with the WKY group,the ICPmax/MAP in the SHR group was sig-nificantly lower(P＜0.05),and the expressions of integrin α5β1,FAK,ROCK1,and ROCK2 in the penile corpus caverno-sum of the SHR group were significantly higher(P＜0.05),while the expression of eNOS and the content of NO decreased sig-nificantly(P＜0.05).After successful transfection with integrin α5β1 interfering lentivirus,compared with the WKY+LV-empty group,there were no statistically significant differences in ICPmax/MAP,eNOS expression in the penile corpus caverno-sum,and NO content in the WKY+LV-siRNA group(P＞0.05),but the expressions of integrin α5β1,FAK,ROCK1,and ROCK2 were significantly decreased(P＜0.05).Compared with the SHR+LV-empty group,the ICPmax/MAP in the SHR+LV-siRNA group was significantly increased(P＜0.05).There were no statistically significant differences in eNOS expression in the penile corpus cavernosum and NO content(P＞0.05).While the expressions of integrin α5β1,FAK,ROCK1,and ROCK2 were significantly decreased(P＜0.05).Conclusion Hypertension upregulates the expression of integrin α5β1 in the penile corpus cavernosum,activates the RhoA/ROCK signaling pathway,and leads to penile erectile dysfunction.Inhibiting the expres-sion of integrin α5β1 in penile cavernous tissue of SHRs downregulates the RhoA/ROCK signaling pathway and improves the erectile function of SHRs.

Abstract:Sphingolipids are not only important components of cell membranes but also regulate key physiological processes such as apoptosis,autophagy,sperm capacitation,and acrosome reaction of spermatogenic cells through their metabolic prod-ucts.These processes are closely related to sperm production and normal fertilization.Exploring the relationship between sphin-golipid metabolism and male reproduction not only helps to reveal the pathological mechanisms of infertility but also may provide new targets for clinical treatment.This review systematically summarizes the role of sphingolipid metabolism in male reproduction and its potential mechanisms,covering the physiological and pathological mechanisms of sphingolipid metabolism and male repro-ductive function,the mechanisms by which sphingolipid metabolism is affected by physical and chemical factors on reproductive function,and the intervention of sphingolipid metabolism by traditional Chinese medicine and new drugs,aiming to provide new ideas for the diagnosis and treatment of male infertility.

Abstract:Objective To evaluate the safety and efficacy of transurethral oral mucosa graft in repairing external urethral orifice stricture.Methods The clinical data of 6 patients with external urethral stricture who underwent transurethral oral mu-cosa graft urethroplasty in the Department of Urology of the Second Affiliated Hospital of Zhejiang University from December 2023 to July 2024 were analyzed retrospectively.The age ranged from 17 to 69 years old,with an average of 57.3 years old.The course of the disease ranged from 6 months to 7 years,with an average of 3.1 years.Two cases had a history of benign prostatic hyperplasia,1 case had a history of indwelling catheterization,1 case had a history of recurrent glans urethritis caused by phimo-sis,1 case had a history of sclerosing lichen sclerosus of penis(lichen sclerosus,LS),and 1 case had no obvious inducement.The length of urethral stricture ranged from 0.5 to 2.0 cm,with an average of 1.1 cm.In 4 patients.The external orifice of ure-thra was cut longitudinally at 4 and 8 o'clock,and the narrow scar tissue was cut off by ophthalmology to form a fan-shaped wound,and the tongue mucosa of corresponding size was taken according to the size of the fan-shaped wound.One end of the double-headed 6-0PDS suture passed through the normal urethral mucosa of the fan-shaped apex of the oral mucosa and the apex of the urethral fan-shaped wound,then through the ventral skin of the penis,and the other end of the suture passed through the apex of the fan-shaped wound of the urinary tract from the abdominal skin of the penis.Tighten the knot suture outside the ventral skin of the penis.The margin of oral mucosa and urethral wound were sutured intermittently.In 2 cases,the tongue mucosa was replaced by the mucous membrane of the dorsal urethra.Results All the 6 patients completed the operation successfully.After the catheter was removed 2 weeks after operation,all the patiens had unobstructed urination,and there was no evidence of ische-mic necrosis in the transplanted tongue mucosa.All patients were satisfied with the appearance of the penile head.Postoperative follow-up ranged from 5 months to 11 months,with an average of 8.3 months.Half a year after operation,the maximum urinary flow rate was 11.2 mL/s urinary 22.0 mL/s,with an average of 15.9 mL/s.In one patient,the urine line became thinner 4 months after operation,and the adhesion of the external orifice of the urethra was found after revisit.The symptoms disappeared after urethral dilatation,and there were no obvious complications in the other patients.Conclusion Transurethral oral mucous membrane graft is an ideal surgical method for repairing external urethral orifice stricture.This operation not only has accurate effect and low recurrence rate of stenosis,but also takes into account the beauty of the head of the penis.

Abstract:Objective The aim of this study is to investigate the underlying molecular mechanisms of Tiandan Qiyang De-coction(TDQYD)in treating erectile dysfunction(ED)and to provide insights for further research.Methods Integrated strat-egies including network pharmacology,molecular docking and molecular dynamics simulations were employed to explore the ther-apeutic mechanisms of TDQYD for ED.Results A total of 140 active ingredients,1 143 associated target proteins,513 highly relevant ED-related disease targets,and 176 potential therapeutic targets were identified.The core targets such as AKT1,ESR1/2,IL-6,IL-1B,EGFR,VEGFA,and PTGS2 were identified by PPI analysis.KEGG pathway enrichment analysis revealed that the formulation primarily regulates key signaling pathways,including AGE-RAGE,Prolactin,EGFR,HIF-1,Prostate cancer,Endocrine resistance,Serotonergic synapse,Lipid and atherosclerosis,etc.Network and Sankey diagram analyses highlighted the seven most prominent active compounds:isoliquiritigenin 4-methylether,Isoliquiritigenin,3-deoxysappanchalcone,elenol-ide,micheliolide,bigelovin and 4-O-methylchinatin,while the most central core targets were EGFR,PTGS2,PIK3CA,GSK3B,and ESR1/2.Molecular docking simulations demonstrated strong binding affinities between the active components of TDQYD and the predicted therapeutic targets.Moreover,molecular dynamics simulations confirmed stable and robust interactions for the top-ranked complex pairs—ESR2_Bigelovin,ESR2_Micheliolide,EGFR_Isoliquiritigenin,and EGFR_4-O-Methylechina-tin—across multiple evaluation metrics.The ELISA results demonstrated that the serum EGFR levels in the control group,pre-treatment group,and posttreatment group were(244.12±57.16)pg/mL,(356.39±179.10)pg/mL and(263.01±122.08)pg/mL,respectively,showing a significant decrease after treatment(P＜0.05).The corresponding serum ER levels were(93.39±70.61)ng/L,(47.44±11.97)ng/L and(69.65±48.67)ng/L,respectively,indicating a significant in-crease following treatment(P＜0.01).Serum PTGS2 levels were measured as(3.55±1.58)ng/mL,(5.54±2.53)ng/mL and(3.84±1.61)ng/mL,respectively,and exhibited a significant reduction after treatment(P＜0.05).GSH-Px levels were(46.07±15.27)pmol/mL,(31.55±5.37)pmol/mL and(39.13±11.97)pmol/mL,respectively,and showed a significant elevation posttreatment(P＜0.01).Conclusion The core targets of TDQYD in the treatment of ED may be EGFR,PTGS2 and ER.This prescription acts on EGFR,HIF-1 and other pathways to improve ED by up-regulating ER,GSH-Px,and down-regulating EGFR,PTGS2 and other targets.

Abstract:Objective To mine and analyze the adverse drug reaction(ADR)signals of statin-induced male sexual dys-function based on the database of the FDA Adverse Event Reporting System(FAERS).Methods We searched the FAERS da-tabase for the case reports published from the first quarter of 2004 to the fourth quarter of 2023,in which statins were shown as the primary suspected drugs for sexual dysfunction ADRs in male patients,and subjected the reports to standardized processing according to the WHO Adverse Reaction Terminology.We detected the ADR signals using the reporting odds ratio(ROR),pro-portional reporting ratio(PRR),and Bayesian confidence propagation neural network(BCPNN).Results A total of 2 408 adverse event reports of male sexual dysfunction associated with statins as the primary suspected drug were extracted from the FAERS database,involving 2 173 patients(some patients reported multiple adverse events).The largest proportion of the pa-tients(47.22％[1 026/2 173])were aged 18-65 years old,primarily from the United States(n=897,41.28％),the lar-gest number of cases reported in 2010(n=183,8.42％),and atorvastatin ranking the first for intervention(n=990,41.11％),followed by rosuvastatin(n=639,26.54％)and simvastatin(n=502,20.85％).Totally,28 high-risk ADR signals for male sexual dysfunction were identified,among which,hypoesthesia was found related to 7 statins(atorvastatin,rosuvastatin,simvastatin,pravastatin,fluvastatin,lovastatin,and pitavastatin),and ED associated with 6(atorvastatin,rosuvastatin,simv-astatin,pravastatin,ezetimibe and lovastatin).Conclusion Sufficient medication evaluation is necessitated prior to clinical ap-plication of statins,especially for patients aged 18-65 years,with caution against the development of male sexual dysfunction within 30 days of administration.Clinicians should pay attention to ADR signals beyond those listed in the drug package inserts to ensure the safety of medication.

Abstract:Objective To investigate the relationship between the intravesical prostatic protrusion(IPP)with bladder and the prognosis of the patients with benign prostatic hyperplasia(BPH)treated with 12-point longitudinal urethral mucosa preservation of prostatic green laser vaporization.Methods A total of 212 BPH patients were retrospectively selected from March 2021 to October 2023.According to the length of the IPP,the patients were divided into a tripartite array from low to high:Group Ⅰ(IPP＜5 mm,n=65),Group Ⅱ(IPP:5 to＜10 mm,n=85),group Ⅲ(IPP ≥10 mm,n=62).They were then divided into good prognosis group(n=142)and bad prognosis group(n=70).Basic information and the results of laboratory test were collected.GAM was used to analyze the relationship between IPP and related factors.Multivariate Logistic regression analysis of factors influencing patient prognosis.And Bootstrap method was used to analyze the effects of IPP and uro-dynamics index on the prognosis of patients.Results There were significant differences in Pdet Qmax,Qmax,RUV and BOOI among the three groups of patients.There is a nonlinear correlation between IPP and PdetQmax,showing a significant line-ar negative correlation with Qmax and a significant linear positive correlation with RUV and BOOI.IPP and RUV are risk factors for poor prognosis of patients(β＞0,P＜0.05),while Pdet Qmax and Qmax are protective factors for poor prognosis of patients(β＜0,P＜0.05).IPP plays a mediating effect in the relationship between urodynamic index and patient prognosis.Conclusion IPP is significantly related to the prognosis of patients.And the greater the IPP is,the greater the risk of poor prognosis for patients.It can be used as an important indicator to evaluate the prognosis of patients in clinical studies.

Abstract:Objective To investigate the impact of GINS4 expression levels on prostate cell cancer viability,prolifera-tion,and migration capabilities.Methods We used public databases to perform bioinformaties analysis of GINS4 expression in human tumor and normal tissues.Prostate cancer cell lines with stable GINS4 knockdown were established through targeted gene silencing.Cellular viability was assessed via CCK-8 assay,proliferative capacity through colony formation assay,and migratory potential using scratch wound healing assays.Results GINS4 exhibited significantly elevated expression in urological tumor tis-sues relative to normal counterparts(P＜0.05).Silencing GINS4 expression resulted in concurrent downregulation of p-AKT.Functional assays demonstrated marked suppression of cellular viability,proliferative activity,and migratory capacity in GINS4-deficient prostate cancer cells(P＜0.05).Conclusion In vitro experimental evidence indicates that GINS4 inhibition sub-stantially attenuates prostate cancer cell viability,proliferation,and migration.Mechanistically,GINS4 may exert oncogenic effects through modulation of the PI3 K-AKT signaling pathway,suggesting its potential involvement in prostate carcinogenesis and progression.

Abstract:Objective To explore the application value of systemic immune inflammation index(SII)and neutrophil to lymphocyte ratio(NLR)in the diagnosis of prostate cancer.Methods The clinical data of 183 patients received first ultra-sound-guided transperineal prostate biopsies from November 2021 to March 2023 were retrospectively analyzed.The patients were divided into prostate cancer group and non-prostate cancer group according to the pathological results.Multivariate Logistic re-gression analysis was used to determine the independent risk factors for the incidence of prostate cancer.And the receiver operat-ing characteristic(ROC)curve was plotted to analyze the diagnostic performance of each independent risk factor and the new prediction model in prostate cancer.The positive rates of prostate biopsy at different levels of SII,NLR and PSA were compared.Results The age,and the levels of SII,PSA,NLR,platelet to lymphocyte ratio(PLR)and lymphocyte to monocyte ratio(LMR)were significantly higher than those in the non-prostate cancer group.SII,NLR,PLR and PSA all had high diagnostic efficacy for prostate cancer.The combination of SII,NLR,PLR and PSA had the better diagnostic efficacy for prostate cancer compared to single test index.Conclusion SII and NLR are of great significance in the clinical diagnosis of prostate cancer.The combined detection of SII,NLR,PLR and PSA can improve the detection rate for prostate cancer.

Abstract:Objective To investigate the effects of esketamine on postoperative analgesia,cognitive function,oxidative stress and safety in patients with electroprostatectomy.Methods One hundred and twenty patients who underwent electropros-tatectomy in Zaozhuang Municipal Hospital from October 2021 to May 2022 were selected and divided into experimental group and control group according to the different treatment,with 60 cases in each group.The patients in control group were treated with routine sufentanil during the operation.And esketamine hydrochloride was used in the experimental group at the dosage of 0.2 mg/kg 10 minutes before the end of the operation.VAS score and MMSE score were recorded at 0.5,2,4 and 12 h after surgery.The levels of oxidative stress indexes including NE and GSH-Px were compared between the two groups,and the postop-erative urinary tract irritation and adverse reactions were analyzed.Results There was significant difference in VAS score be-tween the two groups at 0.5 h and 2 h after surgery(P＜0.05),but no significant difference at 4 h and 12 h(P＞0.05).There was significant difference in MMSE score at 0.5 h after operation(P＜0.05).The scores of urethral irritation in the ex-perimental group were significantly lower than those in the control group at 0.5 h and 2 h after operation(P＜0.05),and the in-hibition effect on urethral irritation was significant.After anesthesia,the levels of NE and GSH-Px in experimental group showed a more dramatic improvement compared to control group(P＜0.05).There was no significant difference in the incidence of ad-verse reactions between the two groups(P＞0.05).Conclusion Esketamine has good postoperative analgesic effect in elderly patients undergoing transurethral resection of prostate with a temporary effect on early postoperative cognitive function,which al-leviates symptoms of urinary duct irritation and oxidative stress caused by surgery.

Abstract:Objective The aim of this study is to evaluate the effect of microporous membrane optimizer(MMO)on re-ducing sperm DNA fragmentation index(DFI).Methods The discarded semen of 60 infertile males were randomly selected.Swim-up method,density-gradient centrifugation techniques and MMO were used for sperm preparation.Then sperm concentra-tion,motility,sperm DNA fragmentation,intracellular H2 O2 and mitochondrial O2-level were measured respectively and com-pared with fresh semen.Results Compared with fresh semen,sperm motility and progressive motility prepared by swim-up,density gradient centrifugation and MMO were significantly increased,and DFI decreased significantly(P＜0.01).There was no significant difference in the H2O2 levels within the sperm cells prepared by the three methods(P＞0.05).However,the O2-level in the sperm mitochondria by density-gradient centrifugation significantly increased(P＜0.05),while the O2-level in the sperm mitochondria by MMO significantly decreased(P＜0.05).Conclusions For random samples,MMO is an effective method for selecting sperm with higher motility,lower sperm DNA fragmentation,and lower mitochondrial O2-levels.There are individual differences in sperm optimization methods among different semen samples.

Abstract:In different age stages of males,androgen levels exhibit unique changing patterns.During the fetal period,high levels of androgen promote sexual differentiation and initial development of male reproductive organs.In puberty,sustained and gradual androgen secretion drives the development of secondary sexual characteristics and maturation of the reproductive sys-tem.Adulthood is characterized by abundant androgen synthesis and secretion,which ensures sexual function and spermatogene-sis.As men enter middle and old age,the level of androgen continuously declines due to changes in testicular microenvironment,potentially leading to late-onset hypogonadism.These characteristic physiological fluctuations of androgen levels across different life stages serve as the primary driving force for male reproductive system development,secondary sexual characteristics,sper-matogenic function,and sexual function,while also being closely associated with musculoskeletal,metabolic,and cardiovascular systems.Testosterone replacement therapy and antioxidant therapy provide effective means to address androgen deficiency.This paper elaborates on androgen changes and their physiological significance across different male age stages,and explores clinical treatments and novel approaches for androgen deficiency.

Abstract:Objective To investigate the effects of selenoprotein and zinc transporter gene polymorphisms on selenium content of seminal plasma.Methods A total of 75 men who visited the Xingtai Meihe Reproductive and Genetic Hospital were selected as the research subjects.High-throughput sequencing technology was used to detect the SNP typing in 11 selenoprotein and 24 zinc transporter genes.The concentrations of selenium in serum and seminal plasma were measured by inductively cou-pled plasma emission spectrometry.Results The result of this study revealed that two SNPs(SLC39A14 rs1051708 and GPX3 rs8177412)were significantly associated with total selenium per ejaculate(P＜0.05).Additionally,ten SNPs(SLC30A2 rs4659404,rs2997452;SLC30A8 rs2466295,rs2466294;SLC39A9 rs61361699,rs1 1537776,rs1045301;SLC39A13 rs755555;SLC39A14 rs80097761;TXNRD2 rs2239893)showed significant correlations with seminal plasma selenium concen-tration(P＜0.05).In the analysis of different gene combinations,it was found that SLC30A2 and SLC30A8 gene combinations only affected seminal plasma selenium concentration(P＜0.05).SLC39A9,SLC39A13 andSLC39A14 gene combinations were related to seminal plasma selenium concentration and total selenium per ejaculate(P＜0.05),while GPX3 and TXNRD2 gene combinations were only related to total selenium per ejaculate(P＜0.05).Conclusion Selenoprotein and zinc transporter gene polymorphisms play an important role in seminal plasma selenium content.

Abstract:Objective To observe the clinical efficacy of low-and medium-frequency electrical stimulation desensitiza-tion therapy for premature ejaculation by analyzing the changes in intravaginal ejaculation latency time(IELT)data and prema-ture ejaculation symptom scores of patients with premature ejaculation.Methods A total of 139 patients with premature ejacula-tion were enrolled from June 2022 to June 2023,and divided into a drug treatment group(dapoxetine)and a combined treatment group(low-and medium-frequency electrical stimulation desensitization therapy combined with dapoxetine).A 4-week treatment was conducted in both of two groups.The intravaginal ejaculation latency time(IELT),Premature Ejaculation Diagnostic Tool(PEDT)score,and Chinese Index of Performance Evaluation in Patients with Premature Ejaculation(CIPE)score were evalua-ted before and after treatment in both of two groups.Results After 4 weeks of treatment,the IELT in both of two groups pro-longed significantly,with PEDT and CIPE scores being significantly improved as well.There was no significant difference in IELT between the two groups.However,the patients in combined treatment group showed more significant improvements in PEDT and CIPE scores.Conclusion Low-and medium-frequency electrical stimulation desensitization therapy improves symp-toms of premature ejaculation,which is worthy of clinical application.

Abstract:Objective The aim of this study is to evaluate the performance of 68Ga-PSMA PET/CT-guided transgluteal single-needle targeted biopsy(PSMA-TB)for detecting prostate cancer(PCa)and clinically significant prostate cancer(csPCa),in comparison with transrectal ultrasound-guided biopsy(TRUS-GB).Methods A retrospective analysis was conducted on 460 cases of suspected pros-tate cancer admitted to Nanjing First Hospital between January 2018 and June 2024.According to the biopsy method,the patients were di-vided into a TRUS-GB group(n=324)and a PSMA-TB group(n=136).Clinical,imaging,biopsy pathological,and postoperative pathological data after prostatectomy were collected for statistical analysis.Results There was no significant difference in age and SUVmax between the two groups(P＞0.05).PSA levels and PI-RADS scores were significantly higher in the PSMA-TB group than those of the TRUS-GB group(P＜0.05).The true positive rates of PSMA-TB for PCa and csPCa were higher than those of TRUS-GB(PCa:76.2％vs 38.0％,P＜0.01;csPCa:71.3％vs 28.4％,P＜0.01).Within the PSMA-TB group,the true positive rates for PCa and csPCa were high-er than the false negative rates(P＜0.01).The pathological consistency between PSMA-TB biopsy and postoperative prostatectomy speci-mens was higher than that of TRUS-GB(P=0.004 1).Conclusion PSMA-TB demonstrates higher diagnostic accuracy for both PCa and csPCa compared with TRUS-GB.Characterized by its minimal invasiveness and higher consistency with postoperative radical prostatectomy pathology,PSMA-TB represents an optimal approach for the precise diagnosis of suspected prostate lesions.

Abstract:Objective To investigate the clinical value of serum long non-coding RNA maternally expressed gene 3(lncRNA MEG3),microribonucleic acid-181b-5p(miR-181b-5p)and PSA in evaluating capsular invasion and prognosis of PCa after radical prostatectomy.Methods This study included 96 cases of PCa and 50 cases of BPH as controls treated in our hospital from August 2017 to August 2020.The serum levels of lncRNA MEG3,miR-181b-5p and PSA of the patients were ex-amined by RT-PCR and imumunochromatography,assessed the diagnostic value of serum lncRNA MEG3,miR-181b-5p and PSA alone or in combination for PCa using ROC curves,and analyzed the relationship of the lncRNA MEG3,miR-181b-5p and PSA levels with the clinicopathological characteristics of PCa.The correlation with capsular invasion in PCa patients by Spearman test.The factors influenced the prognosis of PCa after radical prostatectomy were analyzed using the Cox regression model.The 3-year overall survival of the patients with different levels of lncRNA MEG3,miR-181b-5p and PSA were analyzed using the Ka-plan Meier curve.Results Compared with the controls,the PCa patients showed significantly reduced serum lncRNA MEG3(P＜0.05)and increased miR-181b-5p and PSA(P＜0.05).The AUC values(95％CI)of serum lncRNA MEG3,miR-181 b-5p and PSA alone or in combination for the diagnosis of PCa were 0.723(0.635-0.815),0.764(0.675-0.852),0.811(0.739-0.891)and 0.920(0.870-0.974),respectively.Combined use of the three parameters achieved a signifi-cantly higher diagnostic efficiency than any one used alone(P＜0.05).The level of serum lncRNA MEG3 was remarkably low-er(P＜0.05)and those of miR-181b-5p and PSA markedly higher(P＜0.05)in the patients with Gleason score ≥ 7,clini-cal stage Ⅲ,lymph node metastasis,capsular invasion and low tissue differentiation than in those with Gleason score＜7,clini-cal stage Ⅰ+Ⅱ,no lymph node metastasis,no capsular invasion,and high tissue differentiation.Capsular invasion was corre-lated negatively with the level of serum lncRNA MEG3(P＜0.05)but positively with those of miR-181b-5p and PSA(P＜0.05)in the PCa patients.The 3-year overall survival rate of the patients was significantly lower in the low-level than in the high-level lncRNA MEG3 group(P＜0.05),and so was it in the high-level than in the low-level miR-181b-5p and PSA groups(P＜0.05).Significant risk factors for the prognosis of PCa after radical prostatectomy included decreased lncRNA MEG3,in-creased miR-181b-5p,elevated PSA,clinical stage Ⅲ,capsular invasion,and lymph node metastasis(P＜0.05).Conclusion The level of lncRNA MEG3 is decreased,while those of miR-181b-5p and PSA are increased in the serum of PCa patients,which are all correlated with capsule invasion and reduced 3-year overall survival of the patient,which may provide some guidance for the early diagnosis,severity evaluation and prognosis prediction of PCa.

Abstract:Objective To systematically evaluate the effectiveness and safety of kidney-tonifying prescriptions for the treatment of male infertility with sperm DNA fragmentation(SDF).Methods Randomized controlled trials(RCTs)on the improvement of SDF through kidney-tonifying prescriptions were retrieved from CNKI,VIP,Wanfang,PubMed,Cochrane Library,Embase,and Web of Science databases.The methodological quality of the retrieved literature was evaluated,and meta-analysis was conducted using RevMan 5.3.5 soft-ware.The outcome indicators were graded for quality using the GRADE system.Results A total of 17 RCT involving 2 164 male patients were included.Compared with conventional western medicine treatment,the prescription method significantly improved DNA fragmentation index(DFI)in male infertility patients(MD=-6.50,95％CI:-7.88,-5.11,P＜0.01),increased the spouse pregnancy rate(RR=2.11,95％CI:1.12,4.00,P=0.87),total sperm motility(MD=5.56,95％CI:4.39,6.74,P＜0.01),progressive motile sperm(MD=6.82,95％CI:5.62,8.03,P＜0.01),sperm concentration(MD=6.51,95％CI:3.81,9.21,P＜0.01),and per-centage of normal morphology sperm(MD=1.26,95％CI:0.45,2.06,P＜0.01).Additionally,kidney-tonifying prescriptions did not increase the likelihood of adverse reactions.Conclusion Low to moderate-quality evidence suggested that compared with conventional western medicine treatment,kidney-tonifying prescriptions have certain advantages in improving DFI,semen parameters,and spouse preg-nancy rates in male infertility patients,with good safety.