不育男性双侧Ⅰ度精索静脉曲张对睾丸体积和生殖激素水平的影响

目的 评价不育男性双侧I度精索静脉曲张对睾丸体积和生殖激素水平的影响.方法 185例不育男性双侧I度精索静脉曲张(A组)和149例正常生育男性(B组),比较其睾丸体积、卵泡刺激素(FSH)、黄体生成素(LH)和睾酮(T)水平.结果 A组患者两侧睾丸体积均小于B组,但睾丸体积绝对差异和睾丸体积相对差异与B组比较,无统计学意义.A组患者血清FSH水平高于B组,而LH、T与B组相比,差异无统计学意义.结论 不育男性双侧I度精索静脉曲张可导致患者双侧睾丸体积减小,血清FSH水平升高.     

Study on changes of testicular AQP7mRNA and histology in varicocele rats

Experimental varicocele was created in male rats by partial lig-ation of left renal vein (VC) and control rats received a sham oper-ation (SO). Changes in AQP7mRNA expression and testicularfunction were observed. The results are as following: 1.AQP7mRNA expression in left testis of VC rats decreased signifi-cantly, while increased in the right, when compared with SO. 2.Weights of left testis in VC rats were significantly lower than thosein SO (P<0.05) and lower than those of the right (P>0.05);no difference was found between right testes in two groups. In VC,especially in left testes, there were sloughing spermatogenous cellsin slight and moderate atrophied seminiferous tubules, and edema inintestitial tissue as well. It suggests that left varicocele results indysfunction of spermatogenesis in rat testes, especially in the lefttestis. Obvious difference in AQP7mRNA expression suggestedchanges of water metabolism might be one of reasons for distur-bance of spermatogenesis, while active metabolism in righ     

精索静脉曲张患者精液质量及其不育患者手术前后精液变化的观察

目的观察精索静脉曲张（VC）患者的精液质量和精子形态学改变，以及VC不育患者手术前后精液的变化。方法121例VC患者精液按WHO标准常规分析并对精子形态学进行评价，23例健康男性精液检查结果作为对照。并对21例VC不育患者术前及术后的精液进行检测分析。结果121例VC患者的精子密度、（A＋B）级活动力精子（％）、活率、有效精子数、活动精子数、活力指数以及正常形态精子比例较对照组明显降低（P〈0．01）；畸形精子中小头、锥形头和无定形头精子数较对照组增多（P〈0．01）。21例VC不育患者手术后精子质量和精子形态学较术前明显改善。结论VC可以引起精液质量下降导致不育，精子形态学分析是判定VC患者精子受损的一个敏感指标，手术能有效地改善精液质量。     

Effects of aescin on testicular repairment in rats with experimentally induced varicocele

This study was conducted to investigate the effects of aescin treatment in a rodent model treated with an experimentally induced varicocele. Experimental varicocele was induced by partial ligation of the left renal vein of rats. Aescin administration was performed daily for 4 weeks after the varicocele induction. Seven weeks later, a contrast‐enhanced ultrasound was performed of the rats' testis to assess testicular blood flow. The animals were sacrificed, and H&E staining was then used to evaluate testicular pathological changes and polymorphonuclear leucocytes density. Cauda epididymal sperm counts and motility were evaluated. Blood was collected for the measurement of follicle‐stimulating hormone, luteinising hormone and testosterone. Contrast‐enhanced ultrasound showed that there were significant decreases in testicular blood flow in the aescin‐treated groups compared with those in control varicocele group. Testicular oedema was detected in those rats treated with a varicocele but without aescin, while no oedema was found in the experimental group. H&E staining showed dysfunctional spermatogenesis in both cohorts; however, polymorphonuclear leucocytes density was significantly reduced in aescin‐treated groups. There was an increase in sperm counts of the aescin‐treated groups. Our study demonstrated that aescin could exert therapeutical effects on reversal of testicular lesions in varicocele rats.     

Age is a significant predictor of early and late improvement in semen parameters after microsurgical varicocele repair

Accumulating evidence indicates that varicocele repair improves sperm quality. However, longitudinal changes in sperm parameters and predictors of improved semen characteristics after surgery have not been fully investigated. We retrospectively reviewed data from 100 men who underwent microsurgical subinguinal varicocele repair at a single centre. Follow‐up semen examinations were carried out at 3, 6 and 12 months post‐operatively. Logistic regression was used to identify predictors of early (3 months) and late (≥6 months) improvement in semen parameters after varicocele repair. At 3 months post‐operatively, 76.1% of the patients had improved total motile sperm counts, which continued to improve significantly up to 12 months post‐operatively (p = .016). When comparing changes in semen parameters between younger (<37 years) and older (≥37 years) men, post‐operative improvements in sperm concentration and motility were greater among younger men. Multivariate analysis showed that younger age was associated with early (p = .043) and late (p = .010) post‐operative improvement in total motile sperm count. Our findings indicate that early varicocele repair improved semen parameters after surgery.     

强精胶囊对精索静脉曲张大鼠附睾氧化/抗氧化系统的影响

目的:观察强精胶囊对精索静脉曲张大鼠附睾氧化/抗氧化系统的影响,探讨其促进附睾精子成熟的可能作用机理。方法:100只青春期雄性SD大鼠,随机抽取10只为假手术组,其余90只以缩窄左肾静脉建立精索静脉曲张大鼠模型。术后4周证实有72只大鼠造模成功,并随机分为模型组、强精胶囊高剂量组、强精胶囊中剂量组、强精胶囊低剂量组、五子衍宗胶囊组和少腹逐瘀胶囊组,每组12只。分别给予生理盐水和不同浓度的强精胶囊(0.216、0.108、0.054 g/ml)、五子衍宗胶囊(0.130 g/ml)、少腹逐瘀胶囊(0.146 g/ml)混悬液按10 ml/kg灌胃,每日1次,共4周,检测大鼠左侧附睾谷胱甘肽过氧化物酶(GPx)活性与丙二醛(MDA)含量。结果:与假手术组比较,模型组GPx活性降低,MDA含量升高;强精胶囊高剂量组GPx活性、MDA含量较模型组、中、低剂量组、五子衍宗胶囊组、少腹逐瘀胶囊组差异有统计学意义(P<0.01,或P<0.05)。结论:精索静脉曲张可致大鼠附睾GPx活性降低,MDA含量升高;强精胶囊能一定程度提高GPx活性,降低MDA含量;并可能通过此环节,改善附睾微环境及其调控功能,促进精子成熟,提高生育力。     

Proteomic profile of seminal plasma in adolescents and adults with treated and untreated varicocele

Varicocele, the most important treatable cause of male infertility, is present in 15% of adult males, 35% of men with primary infertility, and 80% of men with secondary infertility. On the other hand, 80% of these men will not present infertility. Therefore, there is a need to differentiate a varicocele that is exerting a deleterious effect that is treatable from a “silent” varicocele. Despite the growing evidence of the cellular effects of varicocele, its underlying molecular mechanisms are still eluding. Proteomics has become a promising area to determine the reproductive biology of semen as well as to improve diagnosis of male infertility. This review aims to discuss the state-of-art in seminal plasma proteomics in patients with varicocele to discuss the challenges in undertaking these studies, as well as the future outlook derived from the growing body of evidence on the seminal proteome.     

The effect of varicocele repair on testicular volume in children and adolescents with varicocele

PURPOSE: We investigated the effect of varicocele repair on testicular volume according to age in children and adolescents and review the long-term results of varicocele surgery. MATERIALS AND METHODS: The study included 39 boys 11 to 19 years old with clinical palpable varicocele who underwent varicocele surgery with at least 1 year of postoperative followup. Preoperative and postoperative testicular volumes were monitored and measured with an ellipsoid Prader orchidometer. Physical examination findings (testicular volumes and testicular consistency) in all boys, and serum hormone values and semen parameters in 16 adolescents were recorded and compared before and after surgery. RESULTS: Left unilateral varicocelectomy was done in 29 boys (74%) and bilateral varicocelectomy in 10 (26%). While no postoperative hematoma, infection or testicular atrophy was observed, 1 boy (2.5%) had varicocele recurrence and 2 boys (5.1%) had minimal hydroceles that required no intervention. Significant increases were observed in postoperative sperm concentration (p = 0.01), total motile sperm count (p = 0.009), testis volume (p = 0.000) and serum testosterone level (p = 0.014). All 15 boys with preoperative soft testis had normal testicular consistency postoperatively. Of the 19 boys with preoperative testicular atrophy 10 (53%) did regain normal testicular growth, while 9 (47%) retained testicular volume loss after surgery. When comparing preoperative to postoperative increase in testicular volume according to age in all boys, the mean was statistically significantly higher in boys younger than 14 years (left testis p = 0.037, right testis p = 0.000). CONCLUSIONS: Testicular consistency achieved normal firmness after varicocelectomy in all boys with preoperative soft testis. While there was catch-up growth in comparison to the contralateral testis, testicular consistency improved but testicular volumes may not increase significantly after varicocele repair at ages older than 14 years. However, in these adolescents postoperative semen parameters and serum hormone values may significantly improve regardless of testicular volume. Therefore, boys with varicocele and their families should be fully informed in light of these findings.     

Aquaporin-9 immunohistochemistry in varicocele testes as a consequence of hypoxia in the sperm production site

Aquaporin-9 (AQP-9) regulates tissue hydration by promoting transmembrane exchanges of both water and solutes, such as lactate. The latter is a key metabolite of primary spermatocytes and of maturing haploid germ cells (h-GCs). The present investigation was aimed at immunolocalising human AQP-9 in both normal and varicocele testes. Histology and immmunocytochemistry were investigated in archival biopsies from 20 varicocele testes and in eight unaffected ones. AQP-9 immunostaining was performed using a rabbit antibody, and either focal or diffuse cell membrane labelling was recorded. Varicocele testes showed disarranged tubular compartments, with sloughing h-GCs, tissue hyperhydration, spermiogenesis failure and fibrosis. AQP-9 immunohistology of the control testes showed a diffuse cell membrane staining of the primary spermatocytes and h-GCs, without any positive reaction of spermatogonia and Sertoli cells. AQP-9 cell expression in the varicocele testes was focal or lacking in both adluminal and sloughing GCs. AQP-9 expression occurs in normal human testis, at cell membrane of primary spermatocytes and h-GCs, suggesting a possible role of AQP-9 in the water and lactate transport from Sertoli cells to GCs. AQP-9 is focal or lacking in adolescent varicocele testes, and this suggests AQP-9 to be downregulated in such testicular disorder, leading to lactate deprivation with subsequent hypospermatogenesis.     

Roles of adrenomedullin and hypoxia‐inducible factor 1 alpha in patients with varicocele

This study aimed to assess any changes in the plasma concentrations of adrenomedullin (ADM) and hypoxia‐inducible factor 1 alpha (HIF 1a) in patients with varicocele (VC). Plasma concentrations of ADM and HIF 1a were measured in brachial vein (BV) and internal spermatic vein (ISV) of 30 fertile VC subjects and 35 untreated infertile VC patients. The results demonstrated that plasma levels of ADM and HIF 1a were significantly higher in ISV than those in BV in the fertile or infertile group respectively. The values of ADM and HIF 1a in BV or ISV of the infertile group were significantly higher than in BV or ISV of the fertile group respectively. Similar changes in values of reactive oxygen metabolites (ROM) were observed. Plasma HIF 1a concentration positively correlated with ROM levels. Plasma ADM concentration positively correlated with ROM values and HIF 1a levels in the two groups. Moreover, remarkable improvement in clinical sperm parameters was observed 3 months after surgery for the infertile patients. It is concluded that ADM may participate, along with HIF 1a, in mechanisms that aid spermatogenic cells in adapting to hypoxia. These predictors may have potential in infertility development in VC patients. Furthermore, early surgical repair is extremely important for infertile VC patients with poor semen quality.     

Effects of epidermal growth factor on sperm content and motility of rats with surgically induced varicoceles

Aim:To investigate the effect of epidermal growth factor(EGF)on the sperm content and motility of the varicocelizedrats.Methods:Forty-eight male Wistar rats were randomly divided into five groups.Experimental varicocele wasinduced by partial ligation of the left renal vein in the varicocele,the varicocele repair,the varicocele with EGF and thevaricocele repair with EGF groups,whereas the control group only received a sham induction of varicocele.Surgicalrepair of varicocele was performed 4 months later in the varicocele repair and varicocele repair with EGF groups.EGF administration was performed daily by s.c.injection in the varicocele with EGF and varicocele repair with EGFgroups at the dose of 10μg/(kg.day)from the next day of the second surgery.One month later,all animals werekilled and bilateral cauda epididymal sperm counts and motility were evaluated.Results:The mean sperm count andpercentage of motile spermatozoa were significantly higher bilaterally in the varicocele with EGF group than in thevaricocele group(P<0.05).They were also significantly higher bilaterally in the varicocele repair with EGF groupthan in the varicocele repair and the varicocele with EGF groups(P<0.05).Conclusion:EGF can improve bilateralepididymal sperm content and motility of the rat with surgically induced varicocele.The administration of EGF incombination with surgical repair is more effective than surgical repair or EGF administration alone.EGF might beuseful for the treatment of infertility induced by varicocele.(Asian JAndrol 2006 Nov;8:713-717)     

Effect of ethanol on the changes in testicular protein expression in adult male rats

Ethanol consumption is a major cause of male infertility, but the exact mechanism is still largely unknown. This study attempted to investigate the effect of ethanol on sperm morphology, acrosome reaction status and the alteration of the testicular protein expressions. Fourteen male rats were divided into control and ethanol groups (n = 7/each group). Ethanol-treated rats received ethanol (5 g/kg, 40% v/v) via oral gavage for consecutive 14 days. Testosterone hormone, sperm parameters, and testicular and epididymal histopathologies were evaluated. In addition, the expressions of testicular proteins including androgen receptor (AR), heat shock protein 70 (HSP70), steroidogenic acute regulatory protein (StAR) and tyrosine-phosphorylated (TyrPho) proteins were investigated. The results showed that ethanol significantly increased percentage of abnormal sperm morphology and acrosome-reacted spermatozoa. Some seminiferous and ductus epididymal histopathologies were observed in ethanol-treated rats. Significantly, ethanol reduced serum testosterone and expressions of testicular AR and TyrPho proteins. However, the overexpression of StAR and HSP70 proteins in ethanol testis was found. It was concluded that the changes in testicular protein expressions may be involved in mechanism of male infertility caused from ethanol consumption.     

中药治疗对大鼠坐骨神经损伤后mRNA^NGF表达的影响

目的研究中药党参、丹参、黄芪、生地和复方神肌再生冲剂对大鼠坐骨神经损伤后神经再生的影响。方法将大鼠分为党参组、丹参组、黄芪组、生地组、复方冲剂组和对照组，每组大鼠18只。麻醉下暴露右侧坐骨神经，在坐骨结节远侧0．8cm处造成坐骨神经挤压伤，根据分组，术后给予不同的中药喂养大鼠。术后不同时间，取紧邻挤压伤部位远侧神经干，应用原位杂交的方法和图像分析处理系统定量测定神经组织中神经生长因子mRNA（mRNA^NGF）的表达。结果丹参组和黄芪组大鼠坐骨神经挤压伤后第2周起，坐骨神经组织中mRNA^NGF表达明显增加，至伤后第4周达到高峰。党参治疗坐骨神经挤压伤，治疗后8周，mRNA^NGF表达较对照组明显增加，差异有显著性。在复方冲剂组，大鼠坐骨神经挤压伤后8周内，神经组织中mRNA^NGF表达始终处于高水平。各组大鼠坐骨神经mRNANG”表达与对照组之间的差异具有显著性（P〈0．05）。复方冲剂组大鼠坐骨神经mRNA^NGF表达与丹参和黄芪组之间的差异也具有显著性。结论中药党参、丹参和黄芪可以促进挤压伤后大鼠坐骨神经mRNA^NGF表达；这种作用在组成复方冲剂后，表现得更为明显。     

Smoking influence on sperm vitality,DNA fragmentation,reactive oxygen species and zinc in oligoasthenoteratozoospermic men with varicocele

This study aimed to assess the influence of smoking duration and intensity on sperm vitality, sperm DNA fragmentation, reactive oxygen species (ROS) and zinc (Zn) levels in oligoasthenoteratozoospermic (OAT) men with varicocele (Vx). A total of 246 men were investigated who were divided into OAT nonsmokers, OAT smokers, OAT nonsmokers and OAT smokers with Vx. They were subjected to history taking, clinical examination and semen analysis. In their semen, sperm hypo‐osmotic swelling (HOS) test, sperm DNA fragmentation test, seminal ROS and seminal Zn were assessed. The results demonstrated significantly decreased HOS test, seminal Zn level and significantly increased sperm DNA fragmentation, seminal ROS levels in OAT smokers with Vx more than OAT smokers compared with OAT nonsmokers. Smoking intensity, smoking duration and Vx grade demonstrated significant negative correlations with sperm motility, HOS test percentage and significant positive correlations with sperm DNA fragmentation, seminal ROS level. It is concluded that smoking has a negative impact on sperm progressive motility, HOS test, seminal Zn and positive impact on sperm DNA fragmentation, semen ROS level that are exaggerated if Vx is associated being correlated with smoking intensity, smoking duration and Vx grade.     

The effect of Chrysophyllum albidum fruit on testicular functions in rats

The prevalence of male infertility is a well‐known public health issue with majority of cases due to deficient sperm production of unknown origin. Studies have associated dietary habits with male factor infertility. Chrysophyllum albidum is a common plant that produces a popular fruit, widely consumed for its nutritional and medicinal values. This study investigates the effects of C. albidum fruit methanol extract on the reproductive functions of male Wistar rats. Ripe C. albidum fruit was extracted using methanol and subjected to phytochemical screening. Fifteen male Wistar rats (100–120 g) divided into three (n = 5) received distilled water (control), 1.0 and 6.4 g kg^?1 day^?1 extract, respectively, for 28 days via oral gavage. The sperm count, motility, percentage sperm aberration, histology of testes and epididymides were examined by microscopy. Serum levels of luteinising hormone (LH), follicle‐stimulating hormone (FSH) and testosterone were quantified using ELISA. Data were analysed using ANOVA at p < 0.05 significance. Sperm count significantly increased in 6.4 g kg^?1 day^?1 extract. Serum testosterone level decreased in 1.0 and 6.4 g kg^?1 day^?1 extract. The architecture of sections of testes and epididymides showed anomalies. C. albidum fruit adversely altered reproductive functions of male Wistar rat.     

Effects of experimental varicocele on mitochondria calcium and cytochrome C of epididymis in adolescent rats

Aim: To investigate the effect of experimental varicocele on mitochondrial calcium and cytochrome C of the epididymal cells in adolescent rats. Methods: Forty male adult Wistar rats were divided into two groups randomly: the varicocele group (VG) and the sham operated group (SOG). Varicocele was produced by partial ligation of the left renal vein. Bilateral epididymides were removed after ten weeks. The mitochondrial calcium and cytochrome C levels of the epididymal cells were determined. Results: The mi-tochondrial calcium was decreased (P<0.01) while the cytochrome C increased (P<0.05) markedly in the experimental group compared with the controls. Conclusion: Varicocele-induced calcium dyshomeostasis and mitochondrial damage of the epididymal cells may play an important role in causing subfertility.     

精索静脉曲张大鼠睾丸AQP7mRNA表达与组织学变化的研究

不全结扎大鼠左肾静脉诱发左侧精索静脉曲张,观察精索静脉曲张对ＡＱＰ７ｍＲＮＡ表达的影响以及睾丸结构和功能的变化。结果显示：（１）与对照线相比,精索静脉曲张组大鼠左侧睾丸ＡＱＰ７ｍＲＮＡ的表达强度减弱,而右侧睾丸ＡＱＰ７ｍＲＮＡ的表达强度则明显增强。（２）精索静脉曲张组大鼠睾丸曲细精管轻中度萎缩,细胞层次减少,生精细胞脱落,间质水肿。左侧睾丸的损害性变化较右侧严重;（３）精索静脉曲张大鼠睾丸ＡＱＰ７的表达减弱可能意味着在精子成熟的晚期,水代谢的变化可能成为精子成熟障碍。精细胞脱落的原因之一。右侧睾丸水通道表达增强可能是一种代偿反应,这种变化或许为精索静脉曲张治疗后生精功能的恢复提供可能。