Men’s health: time for a new approach

Background: Many men’s health outcomes are poor at the global level. Men have lower life and healthy life expectancies than women. They are more likely to die from cancer, cardiovascular disease, suicide, road traffic accidents and other major causes of death. They are more likely to smoke, drink alcohol excessively and eat a poor diet. In many countries and for many diseases, men use primary care services less effectively than women.

Objectives: The purpose of this article was to review the key data on men's health at the global level and explore explanations for men's outcomes, including health practices, use of services and health literacy and masculinities. The response of health organisations, the evidence of the impact of gender-sensitive interventions and the case for action on men's health were also considered.

Major findings: Despite the problems with men’s health, it has been largely overlooked by national and global health organisations. When organisations do focus on gender, action is usually targeted at women and girls rather than both sexes. There is an increasing body of evidence that sex-specific initiatives can also be effective.

Conclusions: If population health is to be improved, and if good health is a universal right, steps must be taken to improve men’s health as well as women’s. There is a role for male-targeted health policies (building on the lessons of national men’s health policies in Ireland, Brazil and Australia) as well as changes to service delivery. There is not a choice to be made between men’s health and women’s health: this need not be a zero sum game. Action is needed for both sexes and improving the health of men will also improve the health of women.     

不同体重指数男性不育患者促性腺激素及性激素水平研究

目的:探讨体重指数(BMI)对于男性精液、促性腺激素、性激素的影响.方法:随机抽取男性不育患者524例,根据BMI分成三组.即正常体重组179例,超重组219例,肥胖组126例.对不育患者进行精液常规分析,采用化学发光法测定促卵泡激素、促黄体生成素、睾酮、雌二醇水平.结果:肥胖组精液量(2.30±1.05) ml与正常体重组精液量(2.73±1.02)ml相比较,低于后者,差异有统计学意义(P＜0.05).超重组精子活动率(55.10±20.53)％与正常体重组(49.80±24.47)％相比较,高于后者,差异有统计学意义(P＜0.05),但在前向运动精子率中超重组与正常体重组相比差异无统计学意义(P＞0.05).正常体重组睾酮水平(449.70±120.07) ng/dl,超重组(394.47±178.28) ng/dl,肥胖组(323.37±137.34) ng/dl,三组相比较,差异有统计学意义(P＜0.05).随着BMI增加,各组睾酮逐渐下降.雌二醇虽有增加,但各组间差异无统计学意义.BMI与促黄体生成素水平呈负相关性(r=-0.17,P＜0.05).BMI与总睾酮水平呈明显负相关性(r=-0.31,P＜0.01),BMI与促卵泡生成素和雌激素水平无相关性.结论:肥胖男性不育患者在治疗中应补充雄激素,同时加强锻炼,健康饮食,减轻体重是治疗的重要部分.     

A model of health care provider decision making about HPV vaccination in adolescent males

IntroductionIn the U.S., HPV vaccination of adolescent males remains low, despite the recommendation for routine vaccination. Although research has highlighted that health care provider (HCP) recommendation is very influential in HPV vaccine uptake, research on this topic in the male population is lacking. Accordingly, we used a qualitative approach to identify HCP knowledge, attitudes, and behaviors regarding adolescent male HPV vaccination, one year, after routine vaccination of adolescent males was recommended.MethodA total of 20 U.S. pediatric HCPs participated in 20–30 min interviews about knowledge, attitudes, and practices regarding male HPV vaccination. Interviews were audio-recorded, transcribed and, analyzed using inductive content analysis.ResultsThe providers had been in practice for 1–35 years, 75% were female, and 75% were White. Opinions on HPV vaccination were shaped by knowledge/perception of the risks and benefits of vaccination. Although all providers frequently offered HPV vaccine to male patients, the strength and content of the offer varied greatly. Vaccination opinions determined what issues were emphasized in the vaccine offer (e.g., stressing herd immunity, discussing prevention of genital warts), while adolescent age influenced if and how they pitched their vaccine offer (e.g., HPV as a STI). Most providers agreed with the ACIP recommendations, however, several expressed that providers’ preexisting opinions might remain unchanged despite the recommendations. Consistent with the literature on determinants of HPV vaccination, providers believed that their own recommendation was a major factor in a family's decision to vaccinate. Barriers to vaccination included the “newness” and sexual nature of the vaccine, lack of insurance coverage, and the vaccine not being mandated.ConclusionsProviders’ opinions about, and approaches to offering, HPV vaccination to males were highly variable. Interventions designed to improve male HPV vaccination should focus on helping providers to routinely recommend the vaccine to all of their eligible patients, both males and females.     

卵母细胞发育和受精中的重编程及对雄原核重编程的影响

哺乳动物发育过程中细胞的重编程是当前细胞生物学、转化医学等领域研究的热点之一,因其在体细胞核移植、诱导多能干细胞及再生医学中的应用前景引起了广泛关注。表观遗传学修饰是重编程的主要内容,包括DNA甲基化、组蛋白翻译后修饰、基因组印迹、非编码RNA调控等,这些均可通过不同的机制调控基因组的表达。如卵母细胞发育与成熟过程伴随着基因组的从头甲基化、减数分裂相关基因的去甲基化和组蛋白翻译后的修饰等。此外,受精中,卵母细胞又与进入其中的雄原核发生相互作用,为雄原核基因组的去甲基化等过程提供重编程的环境。总结近年来关于卵母细胞发育和受精过程中重编程机制的研究进展及在胚胎发育中的意义,并探讨自然生殖状况下卵母细胞环境对外源性雄原核重编程的影响。     

Paternal genetic structure of the Qiang ethnic group in China revealed by high-resolution Y-chromosome STRs and SNPs

The Qiang population mainly lived in Beichuan Qiang Autonomous County of Sichuan Province. It is one of the nomads in China, distributed along the Minjiang River. The Qiang population was assumed to have great affinity with the Han, the largest ethnic group in China, when it refers to the genetic origin. Whereas, it is deeply understudied, especially from the Y chromosome. Here in this study, we used validated high-resolution Y-chromosome single nucleotide polymorphisms (Y-SNPs) and short tandem repeats (Y-STRs) panels to study the Qiang ethnic group to unravel their paternal genetic, forensic and phylogenetic characteristics. A total of 422 male samples of the Qiang ethnic group were genotyped by 233 Y-SNPs and 29 Y-STRs. Haplogroup O-M175 (N = 312) was the most predominant haplogroup in the Qiang ethnic group, followed by D-M174 (N = 32) and C-M130 (N = 32), N-M231 (N = 27), and Q-M242 (N = 15). After further subdivision, O2a-M324 (N = 213) accounted for the majority of haplogroup O. Haplogroup C2b-Z1338 (N = 29), D1a-CTS11577 (N = 30). O2a2b1a1a1-F42 (N = 48), O2a1b1a1a1a-F11 (N = 35), and O2a2b1a1-M117 (N = 21) represented other large terminal haplogroups. The results unveiled that Qiang ethnic group was a population with a high percentage of haplogroup O2a2b1a1a1-F42 (48/422) and O2a1b1a1a1a-F11 (35/422), and O2a2b1a1-M117 (21/422), which has never been reported. Its haplogroup distribution pattern was different from any of the Han populations, implying that the Qiang ethnic group had its unique genetic pattern. Mismatch analysis indicated that the biggest mismatch number in haplogroup O2a2b1a1a1-F42 was 21, while that of haplogroup O2a1b1a1a1a-F11 was 20. The haplotype diversity of the Qiang ethnic group equaled 0.999788, with 392 haplotypes observed, of which 367 haplotypes were unique. The haplogroup diversity of the Qiang ethnic group reached 0.9767, and 53 terminal haplogroups were observed (The haplogroup diversity of the Qiang ethnic group was the highest among Qiang and all Han subgroups, indicating the larger genetic diversity of the Qiang ethnic group.). Haplogroup O2a2b1a1a1-F42 was the most predominant haplogroup, including 11.37 % of the Qiang individuals. Median-joining trees showed gene flow between the Qiang and Han individuals. Our results indicated that 1) the highest genetic diversity was observed in the Qiang ethnic group compared to any of the former studied Chinese population, suggesting that the Qiang might be an older paternal branch; 2) the haplogroup D-M174 individuals of Qiang, Tibetans and Japanese distributed in three different subclades, which was unable to identify through low-resolution Y-SNP panel; and 3) the Qiang had lower proportion of haplogroup D compared to Yi and Tibetan ethnic groups, showing that the Qiang had less genetic communication with them than with Han Chinese.