The Impact of Body Mass on Male Fertility in a Cohort of 127 Patients

Background: Aromatase and leptin are two adipose tissue cytokines. The former converts androgens into estrogens and stimulates adipogenesis. The latter cannot fully stimulate GnRH release as its hypothalamic receptors are reduced in obese men. Thus, obesity which is associated with an adipose tissue increment can interfere with male fertility. Objective: We aim to study the correlation between the body mass index (BMI) of an individual and the quality of semen he produces. Patients and Method: By means of the software R 4.2.1 we performed a retrospective analysis of the relationship between the BMI and the semen alterations in the patients managed at the former Military Teaching Hospital of Cotonou from October 1, 2017, to September 30, 2022: a bi-varied analysis and Fischer’s exact test (significance threshold 5%, confidence interval 95%) followed by a logistic regression when a non-significant p-value is below 0.20. Results: 127 males managed for infertility (mean age = 36.2 years) were recorded, including 11.1% obese (BMI > 30 kg/m2) and 36.5% overweighted (25 kg/m2 < BMI ≤ 30 kg/m2). The most frequent semen alterations were: oligoasthenospermia (27.8%), asthenospermia (22.2%), oligoasthenoteratospermia (14.3%), azoospermia (13.5%) and asthenoteratospermia (9.5%). Bi-varied analysis showed no correlation between the BMI and the semen alterations (p-value ranged from 0.086 to 0.9) and no difference in semen alterations between patients with BMI below and above 25 kg/m2 (p-value ranged from 0.12 to 0.9). Logistic regression demonstrated that asthenoteratospermia were correlated with BMI ≥ 25 kg/m2 [OR = 2.1, 95% CI (1.50 - 2.70), p = 0.021]. Conclusion: Male obesity and overweight can trigger asthenoteratospermia.

Cigarette smoking,body mass index associated with the risks of age-related cataract in male patients in northeast China

AIM: To determine the association between cigarettes smoking, body mass index (BMI) and the risk of age-related cataract (ARC) in middle-aged and elderly men in Northeast China. METHODS: A hospital-based case control study was conducted. Cases (n =362) were men who had surgically treated ARC, 45-85 years old; controls frequency-matched (n=362) were men who had been admitted to the same hospital as cases for other diseases not related with eye diseases. Cases and controls were matched with 1:1. The cases and controls were interviewed during their hospital stay, using a structured interviewer-administrated questionnaire that included information on sociodemographic characteristics, socioeconomic, lifestyle habits (tobacco smoking and alcohol consumption, etc.), anthropometric measures, personal medical history, and family history of ARC in first-degree relatives, and simultaneously BMI was calculated. The odds ratios (OR) and 95% confidence intervals (CI) of ARC were estimated using multiple logistic regression models. RESULTS: After adjusting for age and multiple potential confounders, higher BMI was associated with an increased risk of ARC. Cigarette smoking, years smoking or moderate cigarette smoking (1-29 cigarettes per day) had no relation with the risk of ARC (P>0.05), although patients smoking >= 30 cigarettes per day had an elevated risk of ARC as compared with the non-smokers (OR=1.55, 95% CI; 1.16-2.85, P=0.026). Higher BMI was associated with an increased risk of ARC. Both overweight and obesity was associated with an obviously increased risk for surgically ARC (OR=1.55, 95% CI:1.02-1.98, P=0.015 and OR=1.71, 95% CI:1.32-2.39, P=0.013 respectively) compared to normal BMI. Then participants were grouped into quartiles of BMI (Q1 to Q4), compared to controls in the lowest quartile, the ORfor cases in the highest quartile of BMI was 1.54 (OR=1.54, 95% CI: 1.08-2.46, P=0.022). The results of univariate analysis showed cigarette smoking was not associated with ARC formation for men with lower or normal BMI (P >0.05). Compared to the non-smokers, for men of overweight or obesity, cigarette smoking was associated with a significantly increased risk for surgically ARC (OR=2.00, 95% CI: 1.49-6.65, P=0.003 and OR=1.66, 95% CI: 1.63-13.21, P=0.002 respectively). Similarly, smokers in the highest quartile of BMI had approximately 1.5 times the risk of ARC as non-smokers in the lowest quartile (OR =1.46, 95% CI: 1.06-5.29, P<0.001). Followed multivariate models revealed that the association had never changed. CONCLUSION: Current cigarette smoking is positively related to ARC only among those who smoking 30 or more cigarettes per day. For men who are both overweight and obesity, cigarette smoking is associated with a significantly increased risk for ARC.

Male gender and increased body mass index independently predicts clinically relevant morbidity after spleen-preserving distal pancreatectomy

AIM To identify risk factors for clinically relevant complications after spleen-preserving distal pancreatectomy(SPDP). No previous studies explored potential predictors of morbidity after SPDP.METHODS The data of 41 patients who underwent a SPDP in a single surgical center between 2000 and 2015 were retrospectively reviewed from a prospectively maintained electronic database established in our Department of Surgery. The database included demographic, clinical, bioumoral, pathological, intraoperative and postoperative parameters. Uni-and multivariate ana-lyses were performed to assess potential predictors of clinically relevant morbidity. Postoperative morbidity was defined as in-hospital complications and mortality was assessed at 90 d. Clinically relevant morbidity was defined as complication ≥ grade 2 Dindo.RESULTS Overall morbidity rate was 34.1%(14 patients): grade Ⅰ(6 patients, 14.6%), grade Ⅱ(2 patients, 4.8%), grade Ⅲa(1 patient, 2.4%), and grade Ⅲb(5 patients, 12.2%). A number of 5 patients(12.2%) required re-laparotomy for postoperative complications. There was no postoperative mortality. Thus, at least one clinically relevant complication occurred in 8 patients(19.5%). Univariate analysis identified male gender(P = 0.034), increased body mass index(P = 0.002) and neuroendocrine pathology(P = 0.013) as statistically significant risk factors. Multivariate analysis identified male gender [odds ratio(OR): 1.29, 95%CI: 1.07-1.55, P = 0.005] and increased body mass index(OR: 23.18, 95%CI: 1.72-310.96, P = 0.018) as the only independent risk factors of clinically relevant morbidity after SPDP.CONCLUSION Male gender and increased body mass index are independently associated with increased risk of clinically relevant morbidity after SPDP. These findings may assist a surgeon in clinical decision-making to better select patients suitable for SPDP.

两样本孟德尔随机化研究肥胖与男性不育症的因果关系

目的:通过孟德尔随机化(MR)研究阐明肥胖与男性不育症(MI)之间的因果关系。方法:进行双样本MR分析,以评估遗传预测的体质量指数(BMI)与MI风险的因果关联。暴露因子为BMI(n;病例组;=99998,n;对照组;=12746)。MI的遗传信息来自一项全基因组关联研究(GWAS),该研究包含73479例欧洲人。在单变量孟德尔随机化研究(UVMR)分析中,将逆方差加权法(IVW)作为主要方法,MR-Egger回归模型和加权中值估计模型作为因果推断的补充方法。其次,运用多种敏感性分析方法来验证MR结果的稳健性,包括Cochran's Q检验、MR-Egger截距检验、MR-PRESSO、留一法检验和漏斗图。为了评估BMI对MI风险的直接因果效应,进行多变量孟德尔随机化研究(MVMR)。结果:UVMR发现遗传预测BMI与MI风险增加之间存在因果关系(OR:1.237,95%CI:1.090~1.404,P=0.001)。敏感性分析发现,目前的研究几乎不存在偏倚(P>0.05)。在调整2型糖尿病、饮酒和吸烟等危险因素后,MVMR进一步证实遗传预测的BMI对MI风险增加有直接影响(P均<0.05)。结论:两样本MR研究表明,遗传预测的BMI可能与MI风险增加之间存在因果关系。未来的研究可基于这一发现,进一步探讨肥胖与MI两者之间因果关系的具体机制,为预防和治疗提供新途径。

不同体重指数青年男性的静息能量消耗特点及预测方程评价

目的:探讨不同体重指数(body mass index,BMI)青年男性静息能量消耗(resting energy expenditure,REE)的特点,比较常见静息代谢率(resting metabolic rate,RMR)预测方程与间接测热法的差异。方法:以2017年12月至2021年6月于北京大学第三医院运动医学科进行静息代谢测试的30名青年男性为研究对象,采用间接测热法测定RMR,采用生物电阻抗法测定体成分。分析研究对象REE的特点,并与11个常见预测方程的推算值进行比较,通过配对t检验和组内相关系数(intra-class correlation coefficient,ICC)评估两者差异。结果:30名青年男性的平均年龄为(26.93±4.16)岁,整体RMR为(1960.17±463.11)kcal/d(1 kcal=4.1868 kJ),其中BMI正常者的RMR为(1744.33±249.62)kcal/d,显著低于超重或肥胖者[(2104.06±520.32)kcal/d](P<0.01),但体质量校正后,BMI正常者的RMR显著高于超重或肥胖者[(24.02±2.61)kcal/(kg·d)vs.(19.98±4.38)kcal/(kg·d),P<0.01];不同BMI受试者的RMR与体质量、脂肪量、去脂体重、体表面积、细胞外液呈显著正相关(P均<0.05)。11个预测方程的预测值与实测值的一致性均不佳(ICC均<0.75),其中,超重或肥胖青年男性采用世界卫生组织(World Health Organization,WHO)推荐使用的RMR预测方程的预测值与实测值的一致性相对较高(ICC=0.547,P<0.01)。结论:不同BMI青年男性的RMR存在显著差异,超重或肥胖者要考虑体质量矫正后的RMR情况。不同预测方程的预测值与RMR的实测值一致性较差,建议通过间接测热法准确测定RMR。对于超重和肥胖的青年男性可以考虑采用WHO推荐使用的预测方程计算RMR,但有必要建立适用于不同BMI人群的RMR预测方程。

中老年男性体检人群良性前列腺增生关联因素研究

背景寻找良性前列腺增生(benign prostatic hyperplasia,BPH)发生的影响因素有助于对BPH进行早期预防。目的探讨中老年男性体检人群临床指标与前列腺体积的相关性,寻找BPH的关联因素。方法回顾性分析2021年6月—2023年6月某三甲医院体检中心行健康检查的中老年男性的资料,以前列腺总体积(total prostate volume,TPV)为分组标准,TPV>25 cm3为BPH组,TPV≤25 cm3为健康对照组,采用Spearman相关性分析和多因素Logistic回归分析与TPV相关的因素。结果共纳入6732例45~89岁中老年男性,其中BPH组3972例,健康对照组2760例。与健康对照组相比,BPH组年龄[M(IQR):56(51~60)岁vs 53(49~58)岁,P<0.001]、体质量指数(body mass index,BMI)[M(IQR):26.41(24.64~28.36)kg/m^(2) vs 25.76(24.06~27.80)kg/m^(2),P<0.001]、空腹胰岛素(insulin,INS)[M(IQR):10.67(7.27~15.53)mmol/L vs 10.25(6.90~14.93)mmol/L,P=0.005]、总前列腺特异性抗原(total prostate specific antigen,tPSA)[M(IQR):1.01(0.66~1.63)ng/L vs 0.75(0.51~1.10)ng/L,P<0.001]较高,高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)[M(IQR):1.18(1.00~1.37)mmol/L vs 1.19(1.01~1.40)mmol/L,P=0.004]、游离前列腺特异性抗原(free prostate specific antigen,fPSA)/tPSA[M(IQR):0.31(0.23~0.41)vs 0.32(0.24~0.42),P=0.016]较低。相关性分析显示,TPV与年龄(r=0.24,P<0.001)、tPSA(r=0.33,P<0.001)、fPSA(r=0.36,P<0.001)均呈显著正相关。多因素Logistic回归分析结果显示,随着年龄(OR=1.051,95%CI:1.042~1.060,P<0.001)、BMI(OR=1.095,95%CI:1.076~1.116,P<0.001)和tPSA(OR=1.775,95%CI:1.647~1.913,P<0.001)的增长或升高,BPH的发病风险升高,但高HDL-C男性发生BPH的概率较低(OR=0.790,95%CI:0.665~0.945,P=0.009)。结论tPSA、年龄、BMI、HDL-C与前列腺增生发生有关。

酚类化合物混合暴露与男性精液质量的关联分析

酚类化合物是一类常见的环境内分泌干扰物,流行病学研究表明酚类化合物可能影响男性精液质量,但结果迥异。此外,现有的研究大多局限于单一酚类化合物的影响,忽视了现实情况中多种酚类物质混合暴露的健康影响,酚类化合物混合暴露与男性精液质量的关联仍需进一步探讨。本研究将所建立的高效液相色谱-串联质谱(HPLC-MS/MS)方法应用于大样本人群(799名向上海人类精子库捐赠精子样本的志愿者)尿样中18种酚类化合物的浓度测定,并探索了酚类暴露与精液质量之间的关联。通过测量精液指标(包含精子浓度、精子总数、精液体积和精子前向运动百分比),采用多元线性回归和加权分位数之和模型(WQS)分别探索单一酚类化合物暴露和多污染物混合暴露与精液质量参数间的关联。调整潜在的协变量后,多元线性回归模型发现尿液中对羟基苯甲酸乙酯(EtP)暴露与男性精子浓度和精子总数呈显著负相关(P<0.05);WQS混合暴露模型发现,酚类化合物混合暴露与精子浓度下降相关,其中对羟基苯甲酸甲酯与EtP是起主要影响作用的化合物。综上,酚类暴露可能与男性精液质量下降相关,主要表现在降低精子浓度和精子总数。

超重老年男性骨钙素与肌量的相关性研究

目的观察超重老年男性病人中,骨钙素与骨骼肌质量的相关性。方法收集2020—2022年南京鼓楼医院老年科收治的167例超重老年男性病人为研究对象,根据骨钙素水平分为低骨钙素组和正常骨钙素组,分析骨钙素与超重老年男性腰部肌量的相关性,并采用线性回归分析肌量的影响因素。结果2组间年龄、HbA1c、Ⅰ型胶原交联C末端肽(CTX)、Ⅰ型前胶原氨基端前肽(P1NP)、25-羟基维生素D、腰部肌量、髋部肌量差异均有统计学意义(P均<0.05)。骨钙素、CTX、P1NP均与髋部肌量及腰部肌量呈正相关(r=0.204~0.322,P均<0.05),年龄、BMI、腹围均与髋部肌量及腰部肌量呈负相关(r=-0.282~-0.187,P均<0.05)。多元线性回归分析显示,髋部肌量的独立影响因素为年龄、腹围(β=-0.081、-0.127,P均<0.05),腰部肌量的独立影响因素为年龄、腹围、骨钙素(β=-0.201、-0.136、0.187,P均<0.05)。结论超重老年男性病人腰部、髋部肌量与骨钙素呈正相关。骨钙素是腰部肌量的独立相关因素。

2型糖尿病男性患者血脂、体重指数与性功能障碍的关系

目的探究男性2型糖尿病患者血脂、体重指数(BMI)与性功能障碍的关系。方法选取南阳市中心医院2020年6月至2023年6月接诊的男性2型糖尿病患者252例,收集患者的临床资料,检测患者入院时的血脂相关指标水平及BMI,根据病历复查结果随访,记录患者性功能障碍的发生率,分为性功能障碍组和正常组,筛查男性2型糖尿病患者发生性功能障碍的影响因素,评估血脂相关指标及BMI对男性2型糖尿病患者发生性功能障碍的预测价值。结果截至随访结束,252例患者中失访11例,有效随访率为95.63%。剩余241例患者中确诊性功能障碍163例,发生率为67.63%。性功能障碍组合并高血压占比及抑郁程度评分、BMI、总胆固醇(TC)、甘油三酯(TG)及低密度脂蛋白胆固醇(LDL-C)均高于性功能正常组(P<0.05),睾酮低于性功能正常组(P<0.05)。logistic分析结果显示,合并高血压、抑郁程度评分、BMI、TC、TG、LDL-C是男性2型糖尿病患者发生性功能障碍的危险因素(P<0.05),睾酮是男性2型糖尿病患者发生性功能障碍的保护因素(P<0.05)。受试者工作特征曲线分析显示,BMI、TC、TG、LDL-C单一及联合预测男性2型糖尿病患者发生性功能障碍的曲线下面积分别为0.764(95%CI:0.705~0.853)、0.810(95%CI:0.745~0.876)、0.735(95%CI:0.657~0.812)、0.759(95%CI:0.693~0.836)、0.872(95%CI:0.817~0.927)。结论BMI、TC、TG、LDL-C与男性2型糖尿病患者发生性功能障碍有关,且可用于男性2型糖尿病患者并发性功能障碍的预测。

The impact of male overweight on semen quality and outcome of assisted reproduction

It is well-documented that male overweight and obesity causes endocrine disorders that might diminish the male reproductive capacity; however, reports have been conflicting regarding the influence of male body mass index （BMI） on semen quality and the outcome of assisted reproductive technology （ART）. The aim of this study was to investigate whether increased male BMI affects sperm quality and the outcome of assisted reproduction in couples with an overweight or obese man and a non-obese partner. Data was prospectively collected from 612 infertile couples undergoing ART at a Danish fertility center. Self-reported information on paternal height and weight were recorded and BMI was calculated. The men were divided into four BMI categories： underweight BMI 〈 20 kgm^-2, normal BMI 20-24.9 kg m^-2, overweight BMI 25-29.9 kgm^-2 and obese BMI 〉 30 kgm^-2. Conventional semen analysis was performed according to the World Health Organization guideline and sperm DNA integrity was analyzed by the Sperm Chromatin Structure Assay （SCSA）. No statistically significant effect of male BMI was seen on conventional semen parameters （sperm concentration, total sperm count, seminal volume and motility） or on SCSA-results. Furthermore, the outcome of ART regarding fertilization rate, number of good quality embryos （GQE）, implantation and pregnancy outcome was not influenced by the increasing male BMIo

Low Sperm Counts: Biophysical Profiles of Oligospermic Males in Sub-Saharan Africa

Introduction: Male infertility is a public health burden and a psychological dilemma in the life of the affected man. Subjects and Methods: A total of 911 men were studied retrospectively, from 2010 to 2015. Among these, 49.7% had normal sperm count, 39.3% were oligospermic and 12.0% were azoosper-mic. Azoospermic men were withdrawn from this study solely to investigate the seminal fluid parameters and the biophysical characteristics of oligospermic men in contrast to those with normal sperm count. Age was stratified into <30, 30 - 39.9, 40 - 49.9, 50 - 59.9 and ≥60 years;body mass index was categorized into underweight (<18.5), normal (18.5 - 24.9), overweight (25.0 - 29.9) and obese (≥30) and standard semen analysis was performed. Results: The means (±sd) of age and of BMI of the 802 subjects of the study were 42.7 (±7.0) years and 26.9 (3.9) kg/m2 respectively. There was no significant difference in the age or BMI of normal and oligospermic men. A total of 453 (56.5%) had normal sperm count while 349 (43.5%) were oligospermic. Compared to normal weight men, those overweight and those obese were, respectively, 1.11 (χ2 = 0.44, P-value = 0.51, OR = 1.11, 95% CI = 0.81, 1.54) and 1.56 times (χ2 = 4.50, P-value = 0.03, OR = 1.56, 95% CI = 1.03, 2.36) more likely to be oligo-spermic. The mean of normal oval head sperms was significantly higher (t = -7.31, P-value = 0.00001) in normal men (47.8 ± 8.9) than in oligospermic men (43.0 ± 10.7). Oligospermic men were over 4 times as likely to produce progressive sperm motility of <32% (χ2 = 70.90, P-value = 0.000001, OR = 4.24, 95% CI = 2.99, 6.02) than men with normal sperm count. Multivariate regression analysis shows negative but significant correlations between age and semen volume (coef. = - 0.04, Std Err. = 0.01, t = - 4.01, P-value = 0.0001, 95% CI: - 0.06, - 0.02) and between BMI and sperm count (coef. = - 0.18, Std Err. = 0.06, t = - 3.26, P-value = 0.001, 95% CI: - 0.29, - 0.07). Conclusion: Our findings suggest that overweight and obesity are associated with oligospermia and oligospermia is significantly linked with low progressive motility, and various sperm cell defects.

老年男性血清尿酸水平与局部肌肉含量的相关性

目的探讨老年男性局部肌肉含量与血清尿酸水平之间的相关性,为临床肌少症的预防与治疗提供新的观点和依据。方法选择2019年1月至2021年12月于南京大学医学院附属鼓楼医院老年科治疗的350例60岁及以上男性患者为研究对象,根据尿酸水平将患者分为Q1、Q2、Q3、Q4组,四分位切点分别为0~<320、320~<360、360~<420、≥420μmol/L,对4组间髋部肌肉和脊柱肌肉占比、血脂等进行比较。采用SPSS 20.0统计软件进行数据分析。根据数据类型,采用非参数Kruskal-Wallis H检验进行组间比较。校正年龄、体质量指数、血脂等混杂因素后,用偏相关分析对血清尿酸水平与局部肌肉含量进行相关性分析。结果随着尿酸水平的升高,Q4组胆固醇、甘油三酯、肌酐水平均明显升高,差异有统计学意义(P<0.05)。4组患者髋部肌肉含量比较,差异无统计学意义(P=0.641),尿酸水平与髋部肌肉在总体趋势方面呈现“反J”型。脊柱肌肉含量方面,Q4组明显低于Q1组(P=0.024)。在Q4组,髋部肌肉含量与尿酸水平呈明显负相关(r=-0.239,P=0.006)。脊柱肌肉含量与尿酸水平在4组均未表现有明显的相关性。结论60岁及以上的老年男性,高尿酸血症可导致局部肌肉含量,尤其是髋部肌肉含量的减少。为帮助维持骨骼肌质量及髋部肌肉含量,建议维持理想的尿酸水平,将尿酸水平控制在420μmol/L以下。

青年男性肥胖相关基因单核苷酸多态性与精液质量参数的相关性分析

目的通过对青年男性肥胖相关基因(FTO基因)单核苷酸rs9930609多态性进行检测,探讨其对精液质量的影响,间接判断其是否是影响男性生育力的危险因素。方法选取2021年1月至12月在甘肃省妇幼保健院进行备孕前检查的122例肥胖青年男性与120例非肥胖青年男性作为研究对象。检测其精液质量及外周血FTO基因rs9930609(A/T)多态性,分析FTO基因单核苷酸多态性与精液质量参数变化的关系。结果AA型基因携带者的体重、体重指数(BMI)、精子密度、精子DNA碎片率(DFI)与AT及TT型基因携带者比较,差异具有统计学意义(P<0.05);精子密度<15×10~6/mL人群的AA型基因携带率为22.03%,高于精子密度≥15×10~6/mL人群13.66%的AA型基因携带率(P=0.022);DFI>15%人群的AA型基因携带率为30.28%,显著高于DFI≤15%人群11.94%的AA型基因携带率(P=0.002);AA型基因携带者发生肥胖的风险是TT型基因携带者的5.834倍(P=0.000);A等位基因携带者发生肥胖的风险是T等位基因携带者的3.832倍(P=0.003)。结论FTO基因rs9939609(A/T)多态性改变与精液参数具有相关性,AA型等位基因所介导的肥胖是导致精子密度异常、DFI异常的重要诱因,也是间接影响男性生育力的危险因素。对于存在精液质量异常的肥胖男性,检测其FTO基因rs9939609(A/T)多态性,将有助于制订更为有效的减肥措施,从而改善精子质量。

Aggressive angiomyxoma of the epididymis: A case report

BACKGROUND Aggressive angiomyolipoma is an extremely rare benign mesenchymal tumor that was originally described as a locally recurrent mucinous spindle cell tumour.Agg-ressive angiomyolipoma originates from myofibroblasts,vascular smooth muscle cells,or fibroblasts,and displays various phenotypes of myofibroblasts and abnor-mal muscle arteries.Aggressive angiomyolipoma was first identified in 1983 and fewer than 50 male patients have been reported to date.It is an extremely rare mesenchymal tumour and often confused with other diseases.Patients with epididymal aggressive angiomyolipoma lack typical symptoms,most of which occur incidentally,although some patients may experience mild pain,discomfort,and swelling.Pain may be exacerbated by pressure from the mass.CASE SUMMARY A 66-year-old male was admitted to the hospital on January 14,2022 with chief complaint of swelling in the left scrotum for one year.There was no apparent cause for the swelling.The patient did not consult with any doctor or receive any treatment for the swelling.The enlarged scrotum increased in size gradually until it reached approximately the size of a goose egg,and was accompanied by discom-fort and swelling of the left cavity of the scrotum.The patient had no history of any testicular trauma,infection,or urinary tract infection.The patient urinated freely,1-2 times at night,without urgency,dysuria(painful urination),or haematuria.There was no significant family history of malignancy.The patient underwent excision of the enlarged tumour and the left epididymis under general anaes-thesia on January 18,2022.Twelve months of follow-up revealed no recurrence.The patient was satisfied with the treatment.CONCLUSION Aggressive angiomyolipoma is extremely rare clinically and often confused with other diseases.The pathogenesis of aggressive angiomyolipoma is unclear and the clinical presentation is mostly a painless enlarged mass.The diagnosis of aggressive angiomyolipoma requires a combination of medical history,preoperative imaging such as computed tomography and magnetic resonance imaging,cytological examination and preoperative and postoperative pathological biopsy.The preferred treatment is surgery,with the possibility of a new alternative treatment option after hormonal therapy.Aggressive angiomyolipoma should be considered in the differential diagnosis of parametrial tumors of the male genital area that present as clinically significant masses.The high recurrence rate of aggressive angiomyolipoma may be related to incomplete tumor resection,and patients with aggressive angiomyolipoma are advised to undergo annual postoperative follow-up and imaging for recurrence.

栀子对不同性别大鼠食欲及体质量的影响

目的:研究栀子对不同性别大鼠食欲及体质量的影响,分析栀子发挥减肥作用的有效剂量。方法:将60只SD大鼠(雌雄各半,雌雄分开喂养)随机分为对照组(等体积生理盐水)、栀子低剂量组(0.75 g/kg)、栀子等效剂量组(0.95 g/kg)、栀子中剂量组(1.50 g/kg)和栀子高剂量组(3.00 g/kg),灌胃给药4周。每周测定给药后5 h、10 h内各组大鼠饮食量,计算各组饮食抑制率和体质量增长率。结果:与同组雄性大鼠比较,除栀子高剂量组第2周外,第1周、第3周、第4周灌胃5 h后,各剂量组雌性大鼠的饮食抑制率均升高(P<0.05);除栀子高剂量组第4周外,第1周、第2周、第3周灌胃10 h后,各剂量组雌性大鼠的饮食抑制率均升高(P<0.05),且栀子等效剂量组升高最明显(P<0.01)。与对照组比较,第1至10天栀子中剂量组、栀子高剂量组雌性大鼠体质量增长率显著降低(P<0.01)。总体来看,与对照组比较,栀子等效剂量组雌性大鼠体质量增长率降低(P<0.05),栀子中剂量组、栀子高剂量组体质量增长率显著降低(P<0.01)。与对照组比较,第1至10天、第11至20天、第21至28天栀子高剂量组雄性大鼠体质量增长率均降低(P<0.05或P<0.01)。结论:栀子对雌性大鼠的食欲抑制和减肥作用明显优于雄性大鼠,且栀子等效剂量即可对雌性大鼠发挥减肥作用。

不同BMI的精液常规检查正常人群精子DNA损伤与IVF-ET临床妊娠结局相关性研究

目的:分析不同BMI的精液常规检查正常人群中,精子DFI、HDS与IVF-ET妊娠结局之间的相关性。方法:回顾性分析199个IVF-ET周期的临床资料,用基于流式细胞术的精子染色质结构分析法检测精子DFI、HDS,分析精子DFI、HDS与IVF-ET妊娠结局的相关性。结果:在超重(24.0 kg/m^(2)≤BMI<28.0 kg/m^(2))人群中,精子DFI与IVF-ET临床妊娠呈负相关(OR=0.935,P=0.043);在BMI正常(18.5 kg/m^(2)≤BMI<24.0 kg/m^(2))人群中,IVF-ET临床妊娠结局与精子DFI无显著相关性,与男性年龄呈负相关(OR=0.744,P=0.020);在肥胖(BMI≥28.0 kg/m^(2))人群中,IVF-ET临床妊娠结局与精子DFI无显著相关性,与男性BMI呈负相关(OR=0.779,P=0.043)。结论:男性BMI影响精子DFI与IVF-ET妊娠结局的相关性:①精子DFI仅在超重人群中与IVF-ET临床妊娠结局相关;②在BMI正常和肥胖人群中,男性年龄和男性BMI分别是影响IVF-ET临床妊娠结局的重要因素;③未发现精子HDS与IVF-ET妊娠结局的相关性。

男性更年期综合征与骨骼肌质量相关性探究

男性更年期综合征(MCS)发生于男性的中老年过渡阶段,由于年老导致的身体机能下降使男性在生命中后阶段的生活质量可能产生不同程度的降低,从而影响正常的工作与生活。骨骼肌质量下降与MCS具有一定关联,然而目前对于其相关性的探讨略显不足。对男性更年期综合征与骨骼肌质量的相关性进行探究,将为今后MCS的研究提供一定思路。

中国东北地区男性吸烟和BMI与ARC的危险性研究

目的:探讨中老年男性吸烟、体质指数(BMI)与年龄相关性白内障(ARC)危险性之间的关系。方法:采用以医院为基础的病例对照研究方法。病例由45～85岁的362例ARC男性患者组成,对照为同期入住相同医院,经频数匹配的362例患其它疾病的男性,采取1∶1匹配。采用自行设计的调查表对研究对象进行调查,内容包括人口学特征、社会经济状况、生活方式(吸烟和饮酒等)、身体测量值、个体疾病既往史以及一级亲属白内障家族史等,并计算BMI。采用多因素Logistic回归分析估计各因素与ARC关系的比值比(OR)及其95%可信区间(CI)。结果:调整年龄和多种混杂因素后的分析结果表明,吸烟、吸烟时间及吸烟1～29支/d与发生ARC的危险性无关(P>0.05)。但吸烟≥30支/d与不吸烟者比较,发生ARC的危险性增加(OR=1.55,95%CI:1.16～2.85,P=0.026)。与正常BMI(18.5～)者相比,无论是瘦弱(<18.5),还是超重(24.0～)或肥胖(≥28)者发生ARC的危险性明显升高(分别为OR=1.34,95%CI:1.03～1.64,P=0.019;OR=1.55,95%CI:1.02～1.98,P=0.015;OR=1.71,95%CI:1.32～2.39,P=0.013)。与BMI最低四分位数的对照组相比较,病例组BMI最高四分位数者发生ARC的危险性显著增加(OR=1.54,95%CI:1.08～2.46,P=0.022)。经单因素分析的结果表明,BMI较低和正常者吸烟与ARC无关(P>0.05)。但超重或肥胖者吸烟与发生ARC的危险性显著增加,分别为不吸烟者的2和1.7倍(OR=2.00,95%CI:1.49～6.65,P=0.003和OR=1.66,95%CI:1.63～13.21,P=0.002)。同样,BMI为最高四分位数吸烟者发生ARC危险性约是不吸烟者1.5倍(OR=1.46,95%CI:1.06～5.29,P<0.001)。进一步多因素分析的结果并未发生改变。结论:男性吸烟≥30支/d与ARC呈正相关,超重和肥胖的男性吸烟发生ARC的危险性显著地升高。

男性身体意象失调：大众媒体的影响及作用机制

近年来,男性身体意象失调越来越普遍,大众媒体被认为是一种重要的影响因素。大量研究证实了媒体对男性身体意象的消极影响,主要表现在对身体意象的认知、情绪情感和行为调控等方面。研究者基于社会文化理论提出三重影响模型(Thompson,Heinberg,Altabe,&Tantleff-Dunn,1999),用以解释媒体影响男性身体意象的作用机制。该模型假设社会文化因素,即家庭、同伴、媒体是身体意象失调的三个最初影响源;外貌比较和"瘦理想"或"肌肉理想"内化是社会文化和身体意象失调之间的中介变量。未来研究应关注被试群体的多样化,将实验室研究和纵向研究相结合,并考虑其他变量的影响作用,对三重影响模型进行丰富和拓展,同时运用脑科学技术探究其神经机制。此外,还应从干预的角度展开研究。

苜蓿雄性不育植株与可育植株现蕾初期花蕾蛋白质组比较

采用双向凝胶电泳对现蕾初期苜蓿雄性不育植株（Ms-4）及其可育植株（MF）花蕾蛋白质进行了分离,获得了分辨率和重复性较好的双向电泳图谱。通过ImageMaster 2D软件对Ms-4和MF银染图谱分析发现,两者在等电点5~7、分子量20~60 kD范围内蛋白质斑点分布最多,可识别的总蛋白质点数均在6 000个左右,其中差异表达的蛋白质点数为98个;进一步通过质谱分析成功鉴定了22个差异蛋白点。利用Blast2GO程序对 22个蛋白点进行功能注释和代谢途径分析发现,核酮糖羧化酶小亚基、尿苷三磷酸-葡萄糖-1-磷酸尿苷酰基转移酶等蛋白在光合作用、碳水化合物代谢、多细胞生物有机体的发育等过程中起着重要的作用,同时参与了细胞质、细胞壁等组成,并具有绑定、催化、结合和水解等功能。研究结果初步推断,在苜蓿花药发育过程中,蛋白的缺失及表达量的变化可能会使与花粉发育有关的能量缺失,物质合成发生改变,导致雄性不育。