高压氧下调精索静脉曲张大鼠睾丸组织NOS和NO表达的研究

目的:探讨精索静脉曲张(varicocele,VC)大鼠睾丸组织一氧化氮合酶(NOS)和一氧化氮(NO)含量的变化及高压氧(HBO)的干预效果。方法:选取50只7周龄雄性SD大鼠,随机抽取10只为假手术对照组(A组),其余40只部分结扎左肾静脉建立VC模型,8周后再将40只大鼠随机分为VC模型组(B组)和HBO干预的VC模型组(C组),C组用HBO对VC大鼠进行干预。实验结束后分别测定三组大鼠睾丸组织NOS及NO的含量。结果:B组左侧睾丸NOS、NO含量显著高于A组,C组左侧睾丸NOS、NO含量下降明显(P0.01);三组右侧睾丸NOS、NO含量比较,差异无统计学意义(P0.05)。结论:VC时睾丸NOS和NO含量的变化是造成睾丸损伤、生精障碍的原因之一,高压氧可能通过下调NOS、NO的表达来改善VC所致的生精功能障碍。     

实验性精索静脉曲张大鼠睾丸组织IL-1和NO的变化

目的 :研究精索静脉曲张 (VC)对大鼠睾丸组织中IL 1和NO含量的影响。　方法 :采用部分结扎左肾静脉及左髂总静脉之间的交通支 ,制备Wistar大鼠VC模型。将大鼠随机分为手术结扎组 (VC组 ,n =30 )和假手术组 (n =2 0 ) ,分别测定 2组大鼠睾丸组织中IL 1和NO的含量 ,并加以比较。　结果 :①IL 1、NO含量在左侧睾丸组织中VC组均显著高于假手术组 (P <0 .0 1) ,而在右侧睾丸组织中 2组比较差异无显著性 (P >0 .0 5 ) ;②IL 1与NO呈正相关关系 (r =0 .5 72 ,P <0 .0 1)。　结论 :VC时睾丸组织IL 1和NO的变化 ,可能是造成睾丸损伤、精子发生障碍甚至不育的原因     

一氧化氮合酶对精索静脉曲张患者精子功能的影响

为探讨一氧化氮、一氧化氮合酶对精索静脉曲张（VC）患者精子功能的影响,本文测定15例VC不育患者外周静脉血清、精索静脉血清和精浆中一氧化氮（NO）及一氧化氮合酶（NOS）,并与12例有生育能力的对照组进行了对比研究。结果显示VC组精索静脉血清和精浆中NO含量及NOS活性,不仅高于其外周静脉血清（P＜0．01）,而且高于对照组（P＜0．01）,但两组外周静脉血清中两项指标无显著性差异（P＞0．05）。提示VC时可能是由于曲张精索静脉血和精浆中NOS的产生增加导致精子生成障碍或（和）精子活力下降,从而导致不育症。     

大鼠精索静脉曲张模型的制作及变异分析

目的:观察大鼠睾丸-精索静脉脉管系统解剖及变异情况,探索大鼠精索静脉曲张(varicocele,VC)模型的制作。方法:采用左肾静脉部分结扎法制作80只SD大鼠的VC模型,对模型组及对照组大鼠的睾丸-精索静脉脉管系统进行解剖并绘制图谱。结果:64只成功制成左侧VC模型,平均静脉直径从术前的0.16mm增加到1.3mm。SD大鼠左侧精索静脉走行存在多种类型的变异情况。VC大鼠的睾丸血流由常规的经精索静脉流入下腔静脉变为经3～4个静脉侧枝经膀胱前列腺周围静脉丛流入髂静脉。结论:大鼠VC模型的制作需要考虑多种静脉变异情况,VC使得睾丸静脉血回流通路发生改变。     

N-硝基-L-精氨酸甲酯对大鼠精索静脉曲张生精细胞Caspase-3酶及bcl-2基因的影响

目的 探讨精索静脉曲张大鼠睾丸组织中一氧化氮(NO)与生精细胞凋亡之间的关系并研究其机制.方法 实验分3组:对照组(假手术组)、曲张组(精索静脉曲张组)和药物组,每组10只大鼠.(45±5)d的SD雄性大鼠复制左侧曲张模型.药物组为术后8周起腹腔注射N-硝基-L-精氨酸甲酯(L-NAME),剂量:50mg/lg·d-1),每组10只大鼠.术后10周用流式细胞仪检测睾丸生精细胞凋亡,分光光度法检测Caspase3活性,用硝酸还原酶法测定睾丸组织NO含量和NOS活性.逆转录.聚合酶链反应(RT-PCR)检测bcl-2基因mRNA的表达.结果 与对照组对应侧相比较,曲张组大鼠双侧睾丸组织NO含量增加,NOS活性显著升高(P＜0.01),流式细胞仪枪测生精细胞凋亡率显著增加(P＜0.01),生精细胞Caspase-3酶的活性显著升高(P＜0.01),bcl.2基因mRNA表达明显减少(P＜0.01).药物组较曲张组大鼠对应侧睾丸组织NO含量、生精细胞凋亡显著减少(P＜0.01),生精细胞Caspase-3酶的活性显著降低(P＜0.01),bcl-2基因mRNA表达明显增加(P＜0.01).结论 精索静脉曲张明显诱导大鼠睾丸组织生精细胞凋亡.其机制可能与NO含量增加,NOS活性升高,生精细胞中Caspase-3酶的活性升高及bcl-2基因表达下调有关.L-NAME对曲张大鼠乍殖细胞有保护作用.曲张对睾丸的影响是是双侧性的.     

一氧化氮、一氧化氮合酶与伴精索静脉曲张不育患者精液参数的关系

目的:探讨一氧化氮(NO)、一氧化氮合酶(NOS)与伴精索静脉曲张(VC)不育患者精液参数之间的关系。方法:根据体格检查和彩色多普勒超声检查选择伴VC的不育患者(组1,n=53),其中临床型和亚临床型分别为21例和32例;同时选择非VC少弱精子症患者(组2,n=29)和正常生育者(组3,n=28)作对照组。采用硝酸还原法分别测定外周血和精浆中NO含量和NOS活性。用计算机辅助精液分析仪测定VC组患者精子密度、活动精子(a+b级精子)和快速前向运动精子百分率。结果:①组1外周血清NO含量和NOS活性与组2及组3相比差异无显著性(P>0.05),但精浆中NO含量和NOS活性组1明显高于其他两组,差异有显著性(P<0.01和P<0.05)。②组1中,随着曲张的精索静脉内径的增加,外周血清和精浆中NO含量和NOS活性均有所上升,但只有精浆中临床型和亚临床型之间相比差异有显著性(P<0.05)。③组1中,随着精子密度和精子活力的下降,外周血清和精浆中NO含量和NOS活性均有上升趋势,且精子密度≥20×106/ml和≤10×106/ml之间,精子活力≥50%和≤25%之间差异有显著性(P均<0.05)。结论:在VC诊断中精浆中NO含量和NOS活性测定较外周血清中更有意义。早期测定精浆NO含量和NOS活性对VC的诊断和治疗具有重要的临床价值。     

大鼠精索静脉曲张模型及其高位结扎术后睾丸生精细胞凋亡及其IL-1和NO含量的变化

目的:研究大鼠左侧精索静脉曲张(VC)模型及其高位结扎术后睾丸生精细胞凋亡及白细胞介素-1(IL-1)和一氧化氮(NO)含量的变化。方法:选用雄性SD大鼠60只,均选择左侧精索静脉作为研究对象,建立VC模型。将大鼠随机分为3组:假手术组(SO)15只,VC后高位结扎组(VCT)组15只和VC模型对照组30只。模型对照组中随机选取15只大鼠作为VC1组,余下15只大鼠作为VC2组,分别测定VC1组和SO组、VC2组和VCT组大鼠精液质量及睾丸组织中IL-1和NO的含量并加以比较,采用TUNEL检测睾丸生精细胞凋亡情况。结果:所有大鼠均建模成功,VC1组精子浓度[(1.54±1.16)×10~6/ml]和精子活力[(44.23±15.46)%]均显著低于SO组[2.80±1.62)×10~6/ml、(72.34±12.62)%](P0.05),VCT组精子浓度[1.82±1.34)×10~6/ml]和精子活力[(51.21±12.62)%]较VC2组有显著提高[(1.04±1.21)×10~6/ml、(39.23±13.21)%](P0.05)。大鼠左侧睾丸NO[(0.172±0.030)ng/ml]、IL-1[(1.468±0.080)mg/ml]含量VC1组明显高于SO组[(0.134±0.021)ng/ml、(0.782±0.079)mg/ml](P0.05),VC2组左侧睾丸NO[(0.198±0.020)ng/ml]、IL-1[(1.994±0.090)mg/ml]含量明显高于VCT组[(0.141±0.010)ng/ml、(0.781±0.036)mg/ml](P0.05),而右侧睾丸2组比较差异无显著性(P0.05),而且NO与IL-1含量之间呈正相关关系(r=0.492,P0.01)。VC1组大鼠双侧睾丸生精细胞大量凋亡,左、右侧睾丸生精细胞凋亡指数差异有统计学意义(P0.05),SO组左、右侧睾丸生精细胞凋亡指数无明显差异(P0.05),2组间同侧睾丸生精细胞凋亡指数差异显著,均有统计学意义(P0.01);VCT组大鼠左、右侧睾丸生精细胞凋亡指数差异有统计学意义(P0.05);VC2组左、右侧睾丸生精细胞凋亡指数无明显差异(P0.05);2组间同侧睾丸生精细胞凋亡指数差异显著,均有统计学意义(P0.01)。VC2组、VCT组组内同侧睾丸生精细胞凋亡指数无明显差异(P0.05),但VC2组、VCT组2组间同侧睾丸生精细胞凋亡指数差异显著,均有统计学意义(P0.01)。结论:VC致睾丸组织中NO和IL-1含量升高,并加重睾丸生精细胞凋亡,可能是其致睾丸损伤、影响睾丸生精功能障碍的原因之一。     

精索静脉曲张大鼠睾丸组织HIF-1α、VEGF、iNOS的表达及意义

目的:检测HIF-1α、VEGF及iNOS在实验性精索静脉曲张(VC)大鼠睾丸组织中的表达,探讨精索静脉曲张导致男性生育力低下的病理生理学机制。方法:用SD雄鼠制造VC模型。36只SD雄性大鼠分为对照组(n=10)、假手术组(n=11)和VC组(n=15),造模后30天行左侧睾丸切除,用免疫组织化学方法检测睾丸组织中低氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)及诱导型一氧化氮合酶(iNOS)的表达。结果:HIF-1α、VEGF和iNOS在VC组睾丸组织中的表达均上调,明显高于对照组和假手术组(P<0.05)。结论:青春期实验性VC大鼠的左侧睾丸组织存在低氧。低氧引起HIF表达并激活其下游基因表达,是精索静脉曲张一系列病理生理学改变的可能基础。NO表达上调与间质细胞中iNOS的激活有关。     

Ν-硝基-L-精氨酸甲酯对大鼠隐睾生殖细胞凋亡的保护作用

目的 :探讨一氧化氮合酶 (NOS)抑制剂N 硝基 L 精氨酸甲酯 (L NAME)对大鼠隐睾生殖细胞凋亡的保护作用。　方法 :用 2 2dSD雄性大鼠复制单侧隐睾模型。实验分假手术组、隐睾组、隐睾 +L NAME组 [术后腹腔注射L NAME ,10mg/(kg·d) ],每组大鼠各 10只。术后 7d ,用生物素 dUTP/酶标亲和素测定法检测睾丸生殖细胞凋亡 ,用硝酸还原酶法测定睾丸组织中N0含量 ,用化学比色法测定睾丸组织中NOS活性。　结果 :术后第 7d ,与假手术组睾丸相比 ,隐睾组睾丸发生凋亡的生殖细胞数显著增加 ,隐睾 +L NAME组睾丸发生凋亡的生殖细胞数比隐睾组显著减少 (P <0 .0 1) ,隐睾 +L NAME组睾丸组织中NO含量及NOS活性与隐睾组相比显著降低 (P<0 .0 1)。　结论 :隐睾组织中NO和NOS升高是隐睾生殖细胞凋亡增加的病理机制之一 ,L NAME通过抑制NOS活性、减少NO的产生来降低睾丸组织生殖细胞的凋亡发挥其保护作用。     

精索静脉曲张不育与微量元素锌和镉关系的研究

本研究应用原子吸收光谱法 (AAS)测定 18例精索静脉曲张 (VC)不育患者和 14例正常生育的斜疝和或鞘膜积液患者外周静脉血、精索静脉血、精浆中的锌 (Zn)和镉 (Cd)的含量。结果表明 :精索静脉曲张不育患者精静脉血和精浆中Cd含量较对照组明显增高 (P <0 .0 1)、而精浆中的Zn含量较对照组明显减低 (P <0 .0 1)。此外 ,其精索静脉血和精浆中Cd/Zn比值与对照组也有显著性差异 (P <0 .0 1)。提示Cd的增高可能是导致精索静脉曲张不育的原因之一     

睾酮在精子生成过程中分泌动力学的实验研究

目的　研究睾酮在精子生成过程中的作用浓度。　方法　对ＳＤ 大鼠的精索静脉分别作双、单侧高位结扎后３、２１ 天睾丸间液及不同部位血清的睾酮浓度进行测定,并观察睾丸显微结构的变化。　结果　大鼠体内睾丸间液睾酮浓度最高;血清睾酮浓度依次为睾丸静脉［（４２－５０３ ±１２－７４９） ｍｇ／Ｌ］ 、近端精索静脉［（４２－５０３±１２ ．７４９） ｍｇ／Ｌ］ 、睾丸动脉［（５－５９８ ±３－６４９）ｍｇ／Ｌ］ 、尾静脉［（２．５３３±１－７１９） ｍｇ／Ｌ］和下腔静脉血［（２－４１８ ±１－４９５） ｍｇ／Ｌ］ 。双侧精索内静脉结扎后３ 天,双侧睾丸重量、血清和睾丸间液睾酮浓度均显著下降。左侧精索内静脉结扎后３ 天,左侧睾丸重量、睾丸动脉和睾丸间液睾酮浓度均显著下降;其余在正常水平。所有结扎侧睾丸精曲小管上皮轻度变性,并伴有部分结构不清。２１ 天后均恢复正常。　结论睾酮在体内除了正常循环外,还可能存在１ 个从睾丸睾丸静脉精索静脉精索动脉睾丸动脉睾丸的“小循环”。近端精索静脉的结扎对睾丸内的睾酮浓度和睾丸结构的影响是暂时性的,能自行恢复和修复     

Can LDH activity in spermatic vein indicate testicular damage? A preliminary report

We aimed to investigate the relationship between varicocele and lactic dehydrogenase (LDH), an intracellular enzyme that indicates cellular damage. LDH levels were measured in the blood samples of 17 oligoasthenospermic infertile patients with varicocele which were obtained synchronously from spermatic and peripheral veins during operation. Sperm counts ranged from 1 to 74 million/ml, while motility ranged from 10% to 60%. LDH level in spermatic vein was found statistically higher than the level in peripheral vein (p=0.042). There was no correlation between sperm counts and LDH level in spermatic vein. We found a significant increase in spermatic vein LDH level in varicocele. We think that further studies are needed to reveal the relationship between spermatic vein LDH level and varicocele.     

Nitric oxide production is increased in the spermatic veins of adolescents with left idiophatic varicocele

BACKGROUND/PURPOSE: The existence of an excessive release of nitric oxide (NO) within dilated spermatic veins has been recorded in adults with varicocele suggesting a high oxidative stress. The authors investigated whether NO overproduction is already present in the dilated veins of adolescent varicocele and which enzymatic isoforms in the spermatic vein could be expressed. METHODS: The study group consisted of 10 adolescent patients affected by left idiophatic varicocele of grade II and III. The increase in NO production was established by determination of serum concentration of L-hydroxyarginine (L-NHA) and Nitrite/nitrate (NOx). Both endothelial and inducible NOsynthase (NOS) were investigated by Western blot analysis and by immunohistochemical localization using specific monoclonal fluorescein conjugated antibodies. RESULTS: Serum L-NHA levels were significantly greater in the spermatic veins when compared with the peripheral veins 176.8 +/- 32.3 micromol/L versus 3.38 +/- 0.64 micromol/L (P =.0004 Similarly, NOx levels were increased, respectively, 68.2 +/- 16.7 nmol/mL versus 12.9 +/- 2.65 nmol/mL (P =.029). Endothelial NOS was localized in the spermatic vein of varicocele patients, but not overexpressed; the inducible isoform was not detected. CONCLUSIONS: Adolescents with varicocele already present an increase in NO within dilated veins. The dilated spermatic vein is not the major source for the increase in NO level. These results could have an implication in the natural history of adolescent varicocele and in programming the ideal time for surgical treatment.     

男性不育患者精索静脉曲张的超声诊断研究

目的:探讨高频超声诊断男性不育患者精索静脉曲张(varicocele,VC)的检测指标及其VC导致睾丸体积改变情况。方法:采用高频超声方法对46例正常对照者的精索静脉及178例男性不育患者左侧曲张的精索静脉进行了检测。根据临床及超声检查结果将178例VC患者分为4组,其中亚临床型VC(SVC)组45例,临床型VCⅠ级(VCⅠ)组44例,Ⅱ级(VCⅡ)组48例,Ⅲ级(VCⅢ)组41例。结果:①对照组双侧平静呼吸时精索静脉最大内径(DR)、Valsalva试验时精索静脉最大内径(DV)、最大返流速度(Vmax)、返流持续时间(TR)及睾丸体积差别均无显著性(P>0.05);②VC组与对照组及各级VC组DR、DV、Vmax、TR比较的差别具有显著性(P<0.001);③各VC组左侧睾丸体积小于右侧(P<0.01),VCⅡ、VCⅢ组右侧睾丸体积小于对照组(P<0.05),VCⅢ组左侧睾丸体积小于SVC组(P<0.05)。结论:①高频超声可为男性不育VC患者提供精确的精索静脉内径、血流动力学及睾丸大小等客观指标,有助于男性不育病因的筛选;②单侧VC可引起双侧睾丸体积变小,尤以左侧为甚,亚临床型及临床型VC均可导致患侧睾丸体积缩小,且VC愈严重,睾丸体积愈小。     

Intraoperative varicocele anatomy: a macroscopic and microscopic study.

Varicoceles are found in approximately 15% of all men in the general population and up to 41% of all infertile men. However, the exact location and relationship of internal and external spermatic arteries, veins and lymphatics within the inguinal portion of the spermatic cord have not been previously well described in infertile men. The results of detailed intraoperative macroscopic and microscopic surgical dissections of the spermatic cord and gubernaculum of 83 infertile men with 115 palpable varicoceles are described. Enlarged veins exiting the testis and traversing the gubernaculum were present in 48% of the dissections. Enlarged external spermatic veins were detected in 74% of all spermatic cords. Typically, small internal spermatic veins drained into a large vein more proximally in the spermatic cord. An average of 3.6 lymphatics per spermatic cord was identified and preserved during the dissections. A solitary testicular artery was observed in 69% of the dissections. The testicular artery was adherent to the posterior surface of a large internal spermatic vein in 50% of the dissections and was surrounded by a dense complex of closely adherent veins in 30%. To decrease the incidence of postoperative varicocele recurrences we suggest a surgical approach that addresses all identifiable dilated and connecting veins. These findings suggest that surgical approaches that include intraoperative access to and ligation of low inguinal (external spermatic) and gubernacular veins may cause fewer recurrences, unligated small internal spermatic veins may be a cause of varicocele recurrence, and large internal spermatic veins should be individually identified, dissected and ligated since the testicular artery and lymphatics are often adherent to these veins. Optical magnification is important to facilitate identification of lymphatics, testicular arteries and small internal spermatic veins.     

镇痛灵对雄性1型糖尿病大鼠性功能的影响

目的 :本实验以成年雄性大鼠为研究对象 ,观察和探讨中药镇痛灵对糖尿病大鼠性功能的影响。　方法 :3～ 5月龄雄性Wistar大鼠 32只 ,随机分为糖尿病组 2 2只 ,正常对照组 10只。 72h后 ,将造模成功的糖尿病大鼠随机分为 2组 :未治疗组 ;镇痛灵治疗组。第 5周测血糖 ,阿朴吗啡勃起实验后 ,乙醚麻醉下断头取血 ,分离血清 ,取一侧睾丸组织制成匀浆液 ,测定血清及组织匀浆中NO及NOS水平。　结果 :糖尿病大鼠与正常对照组比较 ,血清NO、NOS明显降低 ,差异有高度显著性 (P <0 .0 0 1) ;镇痛灵治疗组血清NO、NOS值与未治疗组比较明显升高 ,差异有显著性 (P <0 .0 1) ;阿朴吗啡勃起实验证实 ,镇痛灵治疗组大鼠阴茎勃起次数明显多于未治疗组 ,差异有显著性(P <0 .0 1) ,而与正常对照组比较 ,差异无显著性 (P >0 .0 5 )。　结论 :复方中药合剂镇痛灵有降血糖作用 ,对糖尿病并发的性功能障碍有一定治疗作用。     

Pre-ischemic administration of nitric oxide synthase inhibitors reduced germ cell apoptosis after spermatic vessel ligation in the rat testis

INTRODUCTION: The Fowler-Stephens maneuver, a mode of spermatic vessel ligation, is a method of choice in the management of high testes. The aim of the present study is to investigate the effects of pre-ischemic administration of N(G)-nitro-L-arginine methyl ester (L-NAME), a nitric oxide (NO) synthase (NOS) inhibitor, in preventing testicular ischemic damage and germ cell-specific apoptosis in rats. MATERIALS AND METHODS: 30 min before ligation of the spermatic vessels, L-NAME was administered intraperitoneally to a group of rats and saline was given to another group of rats (controls). Biochemical assessments of NO and germ cell-specific apoptosis were performed. RESULTS: Testicular NO levels in the L-NAME group showed significant decreases in the ipsilateral (p = 0.004) and contralateral (p = 0.015) testes in relation to those of the control group. The apoptotic indices were found in 2.3% of the L-NAME group and 3.1% of the control group. CONCLUSION: Pre-ischemic administrations of the NOS inhibitor, L-NAME, effectively decreased NO production and to some degree caused a reduction in germ cell apoptosis in the rat testes after spermatic vessel ligation. Further studies are mandatory to confirm our preliminary results and to address the potential introduction of NOS inhibitors into clinical practice.     

转流术与断流术治疗精索静脉曲张症的疗效评价

目的　为评价精索静脉转流术与结扎术二种手术方法对治疗精索静脉曲张引起男性不育的疗效。方法　于术后一年中分别随访 82例病人 ,接受转流者 47例 ,结扎者 35例。结果　 (1)术后病人症状、精子质量均得到显著改善 ,但是 ,两组间无明显差异 (P >0 .0 5 )。 (2 ) 15例有症状者术后缓解 ,47例转流受术者无一复发 ,35例结扎受术者 2例复发 ,占 5 .7%。两者精子质量改善者共 47例 ,占 5 8.5 3% ,妊娠及分娩 2 5例 ,占 30 .5 %。 (3)术后 3月 ,精子活力提高明显好于精子质量的其它参数 ,而在术后半月中 ,精子活力的提高转流者 2 7例 ,结扎者仅 7例。结论　精索内静脉转流术仍是部分精索静脉曲张不育症者治疗的较好手段