人工诱导大鼠精索静脉曲张对睾丸、附睾的组织学影响

采用左侧精索静脉主干结扎和左肾静脉部分结扎诱导SD 大鼠精索静脉曲张,并对其睾丸、附睾的组织学进行了研究。结果表明:精索静脉曲张所致睾丸曲细精管病变为双侧性,病变曲细精管与正常曲细精管成片交错存在,呈典型的“斑点样“表现。最主要的病变是精子成熟障碍,其次为精子细胞及精母细胞提前释放入管腔;睾丸病变程度与静脉曲张程度无相关关系(P>0.05);左右睾丸病变程度也无显著差异(P>0.05);精索静脉主干结扎与肾静脉部分结扎所致睾丸病变相同(P>0.05),且两者分别与对照组比较有显著差异。(P<0.01)。光镜下附睾上皮无明显异常。     

精索静脉曲张大鼠附睾功能变化的观察

目的:探讨实验性精索静脉曲张导致大鼠附睾功能降低的病理生理机制。方法:雄性Wister大鼠建立左侧精索静脉曲张模型,为实验组(n=11)并以假手术为对照组(n=9),免疫组化法检测附睾上皮p53的表达,DTNB法检测附睾中肉毒碱的含量,以5-甲基苯二酚法检测附睾中唾液酸的含量。结果:大鼠精索静脉曲张模型建立后的d28,实验组左侧附睾上皮p53表达显著高于对照组(P<0.05);实验组附睾中唾液酸、肉毒碱含量显著低于对照组(P<0.05)。结论:p53在精索静脉曲张后附睾功能降低的过程中起重要作用。     

精索静脉曲张大鼠睾丸线粒体病变活性氧机制的探讨

目的 :从细胞水平探讨精索静脉曲张大鼠睾丸线粒体损害的活性氧 (ROS)机制。方法 :将精索静脉曲张模型组 (VG)和假手术组 (SOG) Wistar大鼠于术后 3个月 ,取双侧睾丸 ,制作超薄切片和分离线粒体 ,各指标测定按试剂盒说明书进行。结果 :VG左、右侧睾丸线粒体丙二醛 (MDA)含量分别高于 SOG(P<0 .0 1 ) ,Na+ - K+ - ATPase、Ca2 + - ATPase、GSH- Px活力分别低于 SOG(P<0 .0 1 ,P<0 .0 5 ) ,SOD活力两组间无显著性差异 (P>0 .0 5 )。相关检验显示 VG左侧睾丸线粒体的MDA含量分别与其 Na+ - K+ - ATPase、Ca2 + - ATPase、GSH- Px活力呈负相关 (r=- 0 .71 8,r=- 0 .6 5 6 ,r=- 0 .6 3 6 ,P<0 .0 5 )。电镜发现 :精索静脉曲张大鼠双侧睾丸均有不同程度的病变 ,以线粒体改变为主要特征 ,且静脉结扎侧较重。结论 :静索静脉曲张时线粒体 ROS产生增加、清除发生障碍 ,线粒体结构、功能改变将导致睾丸功能紊乱 ,进而造成不育     

男性不育症睾丸曲细精管界膜厚度分析

<正>睾丸曲细精管界膜的组织学观察是评价男性生育力的重要内容.我们观察了50例男性不育症睾丸曲细精管的病理组织学变化,对睾丸生精障碍进行分级诊断,测量其界膜厚度、并测定血清生殖激素水平,研究界膜厚度与生殖激素和生精障碍之间的关系.为男性不育症的诊断、治疗及预后提供依据.材料和方法一、睾丸活检标本收集我院门诊1991～1996年间50例男性不育症睾丸活检标本.患者年龄20～35岁,平均27.5岁.不育龄1～13年,均为原发不育,其中无精症32例、少精症18例.粗针穿刺取睾丸组织.对照组取8例已育尸检睾丸标本,年齿24～43岁,平均29.9岁.全部标本用10%福尔马林固定,石蜡包埋,切片厚7～8μm,HE和     

精浆肉毒硷和α-糖苷酶的测定在男性学中的应用

本文测定了80例无精症精浆肉毒碱,29例无精症精(?)α-糖苷酶,其值与正常生育力组存在明显差异。测定了12例明确诊断为严重睾丸病变引起的分泌性无精症,10例由排出障碍引起的阻塞性无精症,两者相比,差异十分明显,阻塞性无精症精浆肉毒碱低于100nmol/ml,因此100nmol/ml精浆肉毒碱可作为阻塞性无精症的诊断标准。测定90例精索静脉曲张不育症,精浆肉毒碱也有明显降低,表明附睾功能受到了影响,在用中西医结合方法治疗后,精浆肉毒碱上升,精子活动度改善。     

Ⅱ型糖尿病雄性大鼠血清、生殖器官生物化学及组织学变化的实验研究

目的 :观察和探讨 型糖尿病雄性大鼠血清、睾丸、附睾和阴茎中 NO、NOS、SOD和 MDA含量的变化和相互关系 ,及其对雄性大鼠生殖器官的影响。方法 :4～ 6月龄 Wistar雄性大鼠 30只 ,随机分为 型糖尿病模型组 2 0只和对照组 1 0只。饲以高糖 -高脂饲料后 ,取血清及组织 ,光镜下观察各组织的病理改变 ,并测定各指标的变化。结果 : 型糖尿病大鼠模型制备成功 ;糖尿病大鼠与正常比较 ,显示睾丸曲细精管数量减少 ,管壁呈纤维样变 ;睾丸间质小血管内皮细胞增生 ,管壁纤维组织增生显著 ;附睾管腔内精子数量减少或缺如 ;阴茎海绵体平滑肌数量减少 ,纤维结缔组织增生。糖尿病大鼠血清及生殖器官中 NO含量和 NOS、SOD活性均显著低于对照组 ,MDA浓度明显高于对照组。相关分析表明 ,睾丸中 SOD活性与 MDA含量呈负相关 ,NO含量与 NOS活性呈正相关。结论 :II型糖尿病时睾丸、附睾及阴茎组织均受到不同程度的损害 ;糖尿病时自由基产生增加及清除障碍导致血清及生殖器官中 MDA、SOD与 NO、NOS发生变化 ,且这些变化可导致睾丸、附睾和阴茎功能紊乱 ,进而造成男性不育     

抗精子抗体介导不育的再认识

男、女性体内抗精子抗体(ASA)可以降低生育力,导致不育。但ASA介导免疫不育的关系非常复杂,目前认识仍有限。本文基于笔者30多年ASA的检测实践及以往文献审读,围绕ASA检测、ASA对睾丸精子发生、精索静脉曲张、流产的影响,以及宫腔内人工授精(IUI)、体外受精(IVF)、卵胞质内精子注射(ICSI)治疗ASA不育患者的疗效进行了评价;并针对当前ASA的阳性率、抗体水平、一般治疗效果等问题提出看法,以期增进ASA与生殖效应相互关系的深入认识。     

大鼠精索静脉曲张对睾丸氧自由基和LPO浓度的影响

应用成年Ｗｉｓｔａｒ大鼠制作精索静脉曲张动物模型，术后３月，处死动物取出睾丸。以电子自旋共振（ＥＳＲ）法测试睾丸组织的氧自由基相对自旋浓度，ＴＢＡ法和化学发光法分别检测过氧化脂质（ＬＰＯ）含量、超氧化物歧化酶（ＳＯＤ）水平。实验结果表明，精索静脉曲张组（ＶＧ）左、右睾丸氧自由基自旋浓度明显高于假手术对照组（ＣＧ）（Ｐ＜Ｏ．０５）；ＶＧ双睾ＬＰＯ含量显著高于ＣＧ（Ｐ＜０．０１）；睾丸氧自由基相对自旋浓度和ＬＰＯ含量呈明显正相关（ｒ＝０．５４，Ｐ＜０．０５）；．ＶＧ双睾ＳＯＤ水平均显著低于ＣＧ（Ｐ＜０．０１）；睾丸ＳＯＤ水平与氧自由基自旋浓度呈显著负相关（ｒ＝－０．９１，Ｐ＜０．０１）。上述结果提示：精索静脉曲张大鼠睾丸组织中含有大量的氧自由基和ＬＰＯ，损伤睾丸细胞及其各级生物膜，会导致睾丸生精功能紊乱造成不育，而睾丸氧自由基清除障碍可能是氧自由基浓度增高继之ＬＰＯ含量增多的重要机制之一。     

影响精子DNA损伤因素研究进展

精子DNA损伤是引起不育的原因之一,同时可以增加遗传缺陷风险,因此对精子DNA损伤的研究已成为生殖医学的热点之一。精子DNA检测在评价男性不育患者时越来越受到重视。精子中的DNA包括核DNA和线粒体DNA,它们均易受损伤,损伤机制可能有氧化应激、精子染色质组装缺陷、异常凋亡。精子DNA损伤与很多因素有关,如化学治疗和放射治疗、高龄和生活方式、睾丸温度升高、吸烟与生殖道炎症、环境毒素、精索静脉曲张、激素等,它是多因素共同作用的结果。     

男性不育症患者睾丸超微结构的病理学研究

本文对25例男性不育症患者的睾丸活检组织进行了超微结构观察。结果表明不育症患者睾丸曲细精管界膜有显著变化,主要为界膜增厚、界膜纤维化、基膜样物质沉积、肌样细胞变性及肥大细胞增多。间质中可见结缔组织增生或小血管内皮细胞肿胀。支持细胞有空泡变性,支持细胞综合症患者的支持细胞呈未成熟型,支持细胞间未形成复合连接,而在其它病例,则有血睾屏障存在。     

In vitro fertilizing ability of testicular, epididymal, and ejaculated rabbit spermatozoa

The fertilizing ability of testicular, epididymal, and ejaculated rabbit spermatozoa was evaluated in vitro following in vitro capacitation by high ionic strength treatment. Fewer than 11% of inseminated ova were apparently fertilized (i.e., in pronuclear, two-, and four-cell stages as determined by light microscopy) when testicular sperm treated with caffeine, caput epididymal, or corpus epididymal sperm samples were tested. A greater fertilizing ability, reflected by the percentage of ova fertilized and more normal progression of embryonic development, was exhibited by cauda epididymal sperm. Of 93 ova, 68 (73.1%) were fertilized by cauda sperm, whereas ejaculated sperm from the same 10 bucks fertilized 34 (36.6%) of 93 ova (P is less than 0.005). Ultrastructural examination of selected ova apparently fertilized by sperm from levels of the male reproductive tract proximal to the cauda epididymidis revealed abnormal activation. Authentic fertilization occurred when ova were inseminated with cauda epididymal and ejaculated sperm. An unusual and infrequent form of activation involving failure of cortical granule breakdown in ova penetrated by cauda epididymal and ejaculated sperm was seen. A comparison of fertilizing ability of sperm from first, second, and third ejaculates revealed a significant decrease with the third ejaculate (P is less than 0.01).     

Testicular function in rats following immobilization stress

Stress is believed to influence male reproductive activity. Male rats were subjected to immobilization stress for 2 h/day for 30 days to assess the effects of stress on testicular function. Net mass of the testes, epididymes and the seminal vesicles, sperm morphology, number of epididymal sperms and percent progressive motility of the sperms were determined. Adrenal weights were significantly increased (P less than 0.05) in the stressed animals. There was no significant difference between the control and the stressed animals with respect to testicular and epididymal weight, level of sperm production, progressive motility, seminal vesicular weight and abnormal forms. Histological examination also revealed a similarity in the structure of seminiferous tubules, adequacy of cell types of developing germ cells, structure of Leydig cells and epididymal lumina in both the groups. This study demonstrated a lack of significant effect of immobilization stress on testicular function in rats.     

What is the incidence of varicocele in a fertile population?

One hundred men with proven fertility who presented for vasectomy consultation were examined for testicular size and presence of a varicocele, including examination with the Doppler stethoscope for the presence of subclinical varicocele. A diagnosis of varicocele was established in 61%. In 17 patients, the varicocele was evident clinically, whereas in 44 patients it was subclinical (8 bilateral). There was a discrepancy in testicular size in 22 patients, but this group included 8 men without varicoceles and 7 with subclinical varicoceles. It is apparent that varicoceles, especially subclinical varicoceles, are an extremely common finding, even in a group of fertile men. The results suggest that subclinical varicoceles have no role in male infertility.     

用Apizym方法测定人精浆酶活性的初步报告

本文用Apizym半定量比色微量法测定正常生育力男子精浆,精索静脉曲张不育患者精浆和注射鱼肝油酸钠后精浆中的酶。用本法测得正常人精浆中有14种酶,其中以α-葡糖苷酶等9种酶活性最高。精索静脉曲张不育患者和注射鱼肝油酸钠后精浆中的酶种类和活性基本同正常生育力组,但α-葡糖苷酶有很大差异。     

Etiological factors of male infertility in Africa.

Of the 595 infertile African males studied, 192 (30.8%) were azoospermic and 413 (69.40%) had oligospermia. Azoospermia was caused by obstruction to the vas and/or epididymis in 44% of cases and testicular lesions in the remaining 56% of cases, whilst the oligospermia was probably caused by obstruction in 4.7% of cases and testicular lesions in 85.3%. Bilateral testicular biopsies were performed on 302 patients. A variety of pathological conditions were observed; the most prevalent was hypospermatogenesis, in 12% of cases. A significant portion (37.2%) of patients without testicular biopsies had clinically detectable testicular or epididymal abnormalities. There was a higher incidence (12%) of inflammatory testicular or prostatic conditions in this study as compared with those found in Europeans, suggesting that inflammatory conditions contribute more to male infertility in Africa. Only a single case of chromosomal abnormality was detected.     

睾丸活检和病理学检查对梗阻性无精子症患者睾丸精子检出率初探

目的:初步评估国内目前睾丸活检手术和睾丸病理对梗阻性无精子症的诊断价值。方法:对曾接受过睾丸活检经本次临床诊断为梗阻性无精子症的84例梗阻性无精子症患者进行梗阻病因分析,对病理报告无精子者重新进行经皮细针附睾或睾丸穿刺(PESA或TEFNA)检查,并对先前的睾丸病理报告进行分析。结果:84例均诊断出明确的梗阻病因,其中先天性梗阻56例(66.67%);炎症性梗阻26例(30.95%);另2例为双侧疝气术史。对33例递交的病理报告为无精子者中的29例重新进行PESA或TEFNA手术,均获取了附睾或睾丸精子。84例中的57例行ICSI62个周期,周期妊娠率为46.8%。结论:本组患者的病因主要为先天性或炎症性梗阻,目前国内睾丸病理学对梗阻性无精子症睾丸内是否存在精子的诊断欠准确。对梗阻性无精子症患者可应用损伤小的PESA或TEFNA进行诊断,有利于患者的后续治疗。     

Measurement of human testicular consistency by tonometry

A tonometer was used for objective assessment of testicular consistency in a group of 83 men. Testicular measurements in three dimensions were also obtained using calipers. The testicular tonometry value was found to be significantly correlated with the clinical impression of testicular consistency and with testicular size. The testicular tonometry value for the right testicle was significantly larger than the tonometry value for the left testicle in all men except those with azoospermia. The difference in tonometry values between the right and left testicles was most significant in the group of men with left varicocele. The men with varicoceles also had left testicles which were significantly smaller than the paired right testicle in two of three dimensions. In the group with varicocele there was a significant positive correlation between the tonometry value and sperm concentration in the semen. In men with no history of varicocele there was a significant positive correlation between the tonometry value and the percentage of oval sperm.     

Right varicocele and hypoxia, crucial factors in male infertility: fluid mechanics analysis of the impaired testicular drainage system

Varicocele is considered a predominantly unilateral left-sided disease. However, since male fertility is preserved with only one healthy testis, infertility perforce represents bilateral testicular dysfunction. It was hypothesized that: (i) right varicocele cannot be diagnosed by palpation and therefore has not been treated in the past by the traditional treatment, and (ii) right varicocele causes impaired oxygen supply in the right testicular microcirculation, leading to germ cell degeneration. This study performed venographies of both right and left internal spermatic veins during the treatment of 840 infertile men with varicocele and analysed the results using tools of fluid mechanics. Histopathology of the right testis revealed stagnation of blood flow and degenerative changes attributed to lack of adequate oxygenation in all testicular cell types. Right varicocele was found in the vast majority of the patients. We found that due to the destruction of one-way valves, pathologic hydrostatic pressure is produced in the testicular venous microcirculatory system about five times higher than normal, exceeding arteriolar pressure. The pressure gradient between the arterioles and venules in the testicular tissue is therefore reversed, leading to persistent hypoxia. Right varicocele, although undetected, is prevalent in infertile men with varicocele, hence only bilateral occlusion of the internal spermatic veins, including the associated bypasses, eliminating the pathologic hydrostatic pressure will lead to resumption of arterial blood flow in the testicular microcirculation.     

Necrospermia and chronic spinal cord injury

OBJECTIVE: To determine whether improvement in quality of semen over 4 consecutive days of electroejaculation in men with chronic spinal cord injury (SCI) was consistent with epididymal necrospermia. DESIGN: Prospective study of a random sample of men with SCI. SETTING: A southeastern Australian SCI management center in collaboration with the specialist andrology service of a university-based department of obstetrics and gynecology in a tertiary referral hospital. PATIENT(S): Nine men with chronic spinal cord injury. INTERVENTION(S): Semen samples were obtained by using electroejaculation, and testicular biopsy samples were obtained by using fine-needle tissue aspiration. MAIN OUTCOME MEASURE(S): Semen analysis was performed according to World Health Organization criteria. Testicular biopsy and electron microscopy were done by using standard techniques. RESULT(S): During up to 4 days of consecutive-day electroejaculation, sperm motility and viability in semen obtained from men with chronic SCI increased by an average of 23% on days 2 and 3. The severity of the degenerative changes and the numbers of spermatozoa affected on day 1 became less marked by day 4. The changes were not present in late spermatids obtained from testicular biopsies. CONCLUSION(S): The asthenospermia of chronic SCI is similar to epididymal necrospermia and can be improved by consecutive-day electroejaculation.     

Hysterophlebography in patients with intrauterine devices

A method for the radiological examination of the uterus, used to study the behavior of the uterus in the presence of a foreign body, such as an IUD, is described. A total of 44 patients were studied, of which 26 wore IUDs. A much higher incidence of varicocele was found among patients with IUDs (13 out of 26 cases, as compared with 5 out of 13 cases in the control group). The report is followed by a discussion, of the question of whether the higher incidence of varicocele may be related to the use of IUDs. It is suggested that a new study should be conducted, using the same patients as controls and examining them for a long period of time to detect the development of changes in their pelvic vascular system.