Seminal plasma anti-Müllerian hormone level correlates with semen parameters but does not predict success of testicular sperm extraction （TESE）

Aim： To assess seminal plasma anti-Müllerian hormone （AMH） level relationships in fertile and infertile males. Methods： Eighty-four male cases were studied and divided into four groups： fertile normozoospermia （n = 16）, oligoastheno- teratozoospermia （n = 15）, obstructive azoospermia （OA） （n = 13） and non-obstructive azoospermia （NOA） （n = 40）. Conventional semen analysis was done for all cases. Testicular biopsy was done with histopathology and fresh tissue examination for testicular sperm extraction （TESE） in NOA cases. NOA group was subdivided according to TESE results into unsuccessful TESE （n = 19） and successful TESE （n = 21）. Seminal plasma AMH was estimated by enzyme linked immunosorbent assay （ELISA） and serum follicular stimulating hormone （FSH） was estimated in NOA cases only by radioimmunoassay （RIA）. Results： Mean seminal AMH was significantly higher in fertile group than in oligoasthenoteratozoospermia with significance （41.5±10.9 pmol/L vs. 30.5±10.3 pmol/L, P 〈 0.05）. Seminal AMH was not detected in any OA patients. Seminal AMH wascorrelated positively with testicular volume （r = 0.329, P = 0.005）, sperm count （r = 0.483, P = 0.007）, sperm motility percent （r = 0.419, P = 0.021） and negatively with sperm abnormal forms percent （r = -0.413, p = 0.023）. Nonsignificant correlation was evident with age （r = -0.155, P = 0.414） and plasma FSH （ r = -0.014, P = 0.943）. In NOA cases, seminal AMH was detectable in 23/40 cases, 14 of them were successful TESE （57.5%） and was undetectable in 17/40 cases, 10 of them were unsuccessful TESE （58.2%）. Conclusion： Seminal plasma AMH is an absolute testicular marker being absent in all OA cases. However, seminal AMH has a poor predictability for successful testicular sperm retrieval in NOA cases.

Evaluations of cytotoxicity of Smilax myosotiflora and its effects on sexual hormone levels and testicular histology in male rats

Objective: To investigate the cytotoxicity of Smilax myosotiflora(S. myosotiflora)methanolic extract and its effects on sexual hormone levels and testicular histology in male rats.Methods: The cytotoxicity of S. myosotiflora methanolic extract was investigated by employing brine shrimp lethality assay. Forty eight male rats were randomly divided into four groups(Groups I–IV) of 12 each. Rats in Group I were administered with 0.5 m L of distilled water(vehicle), whilst Groups II, III and IV received 200, 400 and 800 mg/kg of the methanolic extract of S. myosotiflora in 0.5 m L of the vehicle, respectively. Male rats treated with continuous daily dosing were killed and necropsied after a total dose period of 60 days. Sexual hormones were assayed and histological examination of testes was performed according to standard methods.Results: S. myosotiflora extracts did not produce any cytotoxicity to brine shrimp in all concentrations tested. Serum testosterone level was significantly higher in rats treated with high dose of S. myosotiflora. Testicular histology showed normal architecture with all stages of spermatogenesis in all experimental groups.Conclusions: The present work confirmed that S. myosotiflora extract improves reproductive functions, without any cytotoxic activity and produces no histological changes to the testes.

Immunohistochemical observation on luteinizing hormone in rat testes before and after testicular capsulotomy

Aim: In the testicular capsulotomized rats, although there was a significant increase in the luteinizing hormone (LH)levels, the secretion of testosterone remained low. In order to clarify the mechanisms of this phenomenon, the bindingof endogenous LH to the testes were observed before and after testicular capsulotomy. Methods; Peroxidase-anti-peroxidase (PAP) method was used to detect the binding of LH to the testes in rats. Results; An intense positivestaining of LH was found in the Leydig cells of both the normal and sham-operated control testes. However, at 40 d af-ter operation, the LH immunoreactivity was decreased in the Leydig cells of the capsulotomized testis. By d 60, onlyvery weak positive staining could be observed in these cells. Conclusion; A progressive reduction of endogenousLH binding to the testis occurred in the capsulotomized rat. (Asian J Androl 2001 Sep; 3 : 227 - 230)

Exogenous gonadotropin releasing hormone (GnRH) modulates scrotal and testicular biometrics, libido, endocrinological and heamatological profiles in Ganjam goat under humid tropical coastal ecosystem of Odisha

Objective:To assess the effect of exogenous gonadotropin releasing hormone(GnRH)in libido,scrotal and testicular biometrics,endocrinological and heamatological profiles of Ganjam goat buck during winter and pre-monsoon seasons.Methods:Forty eight healty Ganjam goat bucks of 3-4 years old were equally divided into the control and treatment groups.The control group received distilled water as placebo,while the treatment group received GnRH injection(4μg Buserelin acetate/mL)once a week for four months.Body weight,scrotal circumference and testicular parameters(testicular volume,testicular weight and testis index),endocrinological profiles[follicle stimulating hormone(FSH),luteinizing hormone(LH),and testosterone],sex behavioural profiles(libido score,mating ability score,and sex behavioural score)and heamatological profiles(red blood cells,white blood cells,haemoglobin,and packed cell volume)were estimated.Results:The libido,scrotal and testicular biometrics,and endocrinological profiles significantly differed between the control and GnRH-treated bucks within and between the seasons within the two groups(P<0.05).Body weight,scrotal circumference,testicular volume,testicular weight,testis index,FSH,LH,testosterone,libido score,mating ability score,sex behavioural score,red blood cells,haemoglobin and packed cell volume were significantly higher in the GnRH-treated bucks compared to the control bucks in pre-monsoon and winter seasons(P<0.05).Body weight,scrotal circumference,testicular volume,testicular weight,testis index,FSH,LH,testosterone,libido score,mating ability score,sex behavioural score,red blood cell counts(in treatment),and haemoglobin were significantly higher in pre-monsoon compared to winter season in the experimental groups(P<0.05).The white blood cell counts neither differed between seasons nor between the two groups.Conclusions:Exogenous GnRH supplementation and pre-monsoon season have higher beneficial effects in improvement of endocrinological profiles with cascading beneficial effects on scrotal circumference,testicular volume,testicular weight,and sex behavioural profiles,which in turn will improve the sperm production and its cryo-survivability and fertility rate in Ganjam goat.

Probability to retrieve testicular spermatozoa in azoospermic patients

Aim: The degree of probability to retrieve spermatozoa from testicular tissue for intracytoplasmic sperm injection intooocytes is of interest for counselling of infertility patients. We investigated the relation of sperm retrieval to clinical dataand histological pattern in testicular biopsies from azoospermic patients. Methods: In 264 testicular biopsies from142 azoospermic patients, the testicular tissue was shredded to separate the spermatozoa, histological semi-thin sec-tions of which were then evaluated using Johnsen score. Results: The retrieval of spermatozoa correlated signifi-cantly (P < 0.001) with the testicular volume (r = 0.49), the FSH concentration ( r = -0.66), the maximum score(r = 0.85) and the mean Johnsen score (r = 0.81). In the multivariate regression analysis the successful testicularsperm extraction showed the closest relationship to the maximum score. The testicular volume correlated significantlywith the mean Johnsen score ( r = 0.64, P < 0. 001), and the basal serum FSH concentration mainly with the maxi-mum score ( r = -0.77; P < 0. 001 ). Patients with a history cryptorchidism showed a significantly lower Johnsenscore compared to the patients who did not have any testicular disease in the past (3.7 ± 2.4 vs. 5.9 ± 2. 5; P < O.01). Conclusion: In a limited range, the testicular volume and the FSH concentration in serum were related to theJohnsen score which correlated significantly with the sperm retrieval. The successful sperm retrieval can be expected inall azoospermic patients irrespective of the results of clinical examination. However, the probability of retrieval of sper-matozoa decreased significantly in patients with a FSH level > 18 U/L, tesficular volume < 5mL, mean Johnsen score< 5, and maximum Johnsen score < 7.

Heshouwu decoction, a Chinese herb for tonifying kidney, ameliorates hypothalamic-pituitary-testicular axis secretion in aging rats

An increasing amount of evidence demonstrates the anti-aging effect of Heshouwu in pill form. In this study, a subacute aging rat model was established by continuous intraperitoneal injection of D-galactose and treated with Heshouwu decoction （a Chinese herb for tonifying the kidney, comprising Heshouwu pill, Herba Epimedii, Radix Salviae Miltiorrhiae, and Poria）. Heshouwu pill treated rats were the positive control group. Radioimmunoassay, immunohistochemical staining, and western blot assay showed hypothalamic gonadotropin-releasing hormone, hypothalamic substance P, and serum gonadotropin levels to be significantly increased in the model rats; the concentrations of hypothalamic ~3-endorphin, and serum levels of insulin-like growth factor I and testosterone were significantly decreased. 1713- and 3[3-hydroxysteroid dehydrogenase expression in testicular tissue was also decreased. Intragastric administration of Heshouwu decoction at high （9.6 g/mL/100 g）, medium （4.8 g/mL/100 g）, and low （2.4 g/mlJ100 g） doses, Heshouwu decoction pretreatment at a medium dose （4.8 g/mL/100 g）, and Heshouwu pill （2.06 g/mL/100 g） significantly reversed these changes. Heshouwu decoction pretreatment and high-dose Heshouwu decoction had the greatest anti-aging effects. These experimental findings indicate that Heshouwu decoction can improve hypothalamic-pituitary-testicular axis secretion in a subacute aging rat model, and prevent and delay gonadal axis aging, with an effect superior to that of Heshouwu pill.

Expression of anti-Mullerian hormone receptor on the appendix testis in connection with urological disorders

The female internal sex organs develop from the paramesonephric （Mullerian） duct. In male embryos, the regression of the Mullerian duct is caused by the anti-Mullerian hormone （AMH）, which plays an important role in the process of testicular descent. The physiological remnant of the Mullerian duct in males is the appendix testis （AT）. In our previous study, we presented evidence for the decreased incidence of AT in cryptorchidism with intraoperative surgery. In this report, the expression of the anti-Mullerian hormone receptor type 2 （AMHR2）, the specific receptor of AMH, on the AT was investigated in connection with different urological disorders, such as hernia inguinalis, torsion of AT, cysta epididymis, varicocele, hydrocele testis and various forms of undescended testis. The correlation between the age of the patients and the expression of the AMHR2 was also examined. Reverse transcriptase-polymerase chain reaction （RT-PCR） and immunohistochemistry were used to detect the receptor＇s mRNA and protein levels, respectively. We demonstrate that AMHR2 is expressed in the ATs. Additionally, the presence of this receptor was proven at the mRNA and protein levels. The expression pattern of the receptor correlated with neither the examined urological disorders nor the age of the patients; therefore, the function of the AT remains obscure.

大豆异黄酮对坝上长尾鸡生长性能、免疫功能、睾丸发育及血浆生殖激素的影响

试验旨在研究大豆异黄酮对坝上长尾鸡生长性能、免疫功能、睾丸发育及生殖激素的影响。选取750只40周龄坝上长尾鸡,随机分为5组,每组3个重复,每个重复50只鸡。Ⅰ组、Ⅱ组、Ⅲ组、Ⅳ组和Ⅴ组饲粮中分别添加5、10、15、20、25 mg/kg大豆异黄酮。预试期7 d,正式试验期63 d。结果显示,Ⅱ组、Ⅲ组、Ⅳ组和Ⅴ组坝上长尾鸡增重显著高于Ⅰ组(P<0.05)。Ⅲ组坝上长尾鸡的胸腺指数显著高于其他组(P<0.05);Ⅲ组坝上长尾鸡的法氏囊指数分别比Ⅰ组、Ⅱ组和Ⅴ组显著提高16.09%、14.70%和22.67%(P<0.05);Ⅲ组坝上长尾鸡的脾脏指数比Ⅰ组显著提高17.98%(P<0.05)。Ⅲ组坝上长尾鸡的睾丸指数最高,显著高于Ⅰ组(P<0.05),提高了11.74%。Ⅲ组坝上长尾鸡的采精量、精子密度和有效精子数显著高于Ⅰ组(P<0.05),分别提高了9.52%、4.79%和8.97%。Ⅲ组坝上长尾鸡的睾酮(TESTO)含量分别比Ⅰ组、Ⅱ组和Ⅴ组显著提高10.42%、4.72%和6.42%(P<0.05);Ⅲ组坝上长尾鸡的黄体生成素(LH)含量分别比Ⅰ组、Ⅱ组和Ⅴ组显著提高7.63%、5.83%和10.12%(P<0.05)。研究表明,大豆异黄酮能够改善坝上长尾鸡的生长性能、免疫功能、睾丸发育、精液品质及血浆生殖激素的分泌水平,且最适添加量为15 mg/kg。

异亮氨酸对断奶仔猪睾丸生长发育、抗氧化能力和生殖激素水平的作用研究

试验旨在研究不同水平异亮氨酸对断奶仔猪睾丸生长发育、抗氧化功能及生殖激素的影响。选取28日龄断奶仔猪18头,随机分成3组,每组6个重复,每个重复1头仔猪。各组饲粮异亮氨酸水平分别为0.8%、1.0%、1.2%。试验期21 d。结果显示:与0.8%异亮氨酸组(对照组)相比,1.0%异亮氨酸组睾丸尺寸和重量均显著升高(P<0.05);1.0%和1.2%异亮氨酸组睾丸组织曲细精管横截面积及曲细精管周长均显著升高(P<0.05);1.0%异亮氨酸组睾丸组织谷胱甘肽过氧化物酶(GSH-Px)活性显著增高(P<0.05),丙二醛(MDA)含量显著降低(P<0.05),1.0%异亮氨酸对下丘脑-垂体-睾丸性腺轴生殖相关指标具有明显的调控作用。研究表明,1.0%异亮氨酸可以缓解仔猪断奶导致的氧化应激,通过改变下丘脑-垂体-睾丸组织性腺轴生殖相关激素分泌水平,影响仔猪睾丸形态及生殖相关指标。

人类示指与环指指长比与男性生殖系统癌症相关性的研究进展

人类示指与环指指长比(2D∶4D)是产前性激素(雌激素/雄激素)暴露水平及敏感性的宏观标记物之一,在性别间差异明显。产前性激素暴露对出生后个体的心理特征、运动能力及多种性激素相关疾病均有影响。本研究综述了2D∶4D与男性生殖系统癌症(前列腺癌和睾丸癌)相关性的研究进展,以期为此类疾病的早期筛查提供参考信息。

复方中药提取物对公兔生殖生理的影响

【目的】讨论不同剂量复方中药提取物对公兔精液品质、生殖激素、睾丸形态及精子顶体完整性的影响,为提高公兔的繁殖性能及研制此类功能的中药饲料添加剂提供理论依据。【方法】选取24只新西兰公兔,随机分为4组,每组6只,空白对照组公兔不添加复方中药提取物,试验Ⅰ、Ⅱ和Ⅲ组公兔分别添加150、300、600 mg/kg复方中药提取物。试验周期为12周,饲喂周期为8周。分别于试验第4、8、12周采集血液样本,于试验第8、10、12周采集精液样本,进行血清中性激素的测定与精液品质鉴定。【结果】与对照组相比,8~12周试验组兔精子密度、精子活率、A级精子数量均显著升高(P<0.05),试验Ⅲ组兔精子顶体完整率显著升高(P<0.05);10~12周试验Ⅲ组兔精子畸形率显著降低(P<0.05)。试验组兔睾丸组织表面被膜由较厚的不规则致密结缔组织构成,睾丸内大量曲精小管基底膜清晰可见,曲精小管上皮是由生精细胞与支持细胞构成的复层上皮,曲精小管上皮分布大量精原细胞和分化的精母细胞,管腔内可见数量丰富的精子,间质无明显异常。4~12周试验Ⅱ、Ⅲ组兔血清中促卵泡素(FSH)、黄体生成素(LH)、睾酮(T)含量均显著高于对照组(P<0.05)。【结论】复方中药提取物可明显改善公兔精液品质,提高精子顶体完整率,降低精子畸形率;有效改善睾丸形态,促进生殖器官发育;提高血清中FSH、LH、T生殖激素含量。其中600 mg/kg复方中药提取物对于公兔的生殖生理具有显著影响,在实际生产中具有良好的应用前景。

特发性高钙尿症患儿血清PTH、25(OH)D水平与尿红细胞、尿钙的相关性分析

【目的】探讨特发性高钙尿症患儿血清甲状旁腺激素(PTH)、25-羟维生素D[25(OH)D]、钙、磷水平与尿红细胞、24 h尿钙的相关性。【方法】选取2019年1月至2023年12月本院收治的26例特发性高钙尿症患儿(观察组),另外选取在本院进行体检的33例健康志愿者作为对照组。比较两组血清PTH、25(OH)D、磷、钙水平,分析观察组患儿尿红细胞、24 h尿钙水平与血清PTH、25(OH)D、磷、钙水平的相关性。【结果】观察组血清PTH、25(OH)D水平高于对照组,差异有统计学意义(P<0.05);两组血清磷、钙水平比较,差异无统计学意义(P>0.05)。Pearson相关性分析显示:观察组PTH水平与尿红细胞、24 h尿钙呈正相关(r=0.877、0.717,均P<0.01);血清25(OH)D水平与尿红细胞、24 h尿钙呈正相关(r=0.837、0.746,均P<0.01);血清磷与尿红细胞、24 h尿钙无相关性(P>0.05);血清钙与尿红细胞、24 h尿钙无相关性(P>0.05)。【结论】特发性高钙尿症患儿血清PTH、25(OH)D水平明显升高,其与尿钙及血尿程度呈正相关。

丹参酮ⅡA对成年大鼠睾丸扭转复位后细胞凋亡及性激素水平的影响

目的观察丹参酮ⅡA对成年大鼠睾丸扭转复位后细胞凋亡及性激素水平的影响,探讨其保护作用及机制。方法将64只雄性SD大鼠随机分为4组,假手术组、模型组、丹参酮ⅡA单次和连续治疗组,每组16只。单次治疗组在睾丸扭转复位后经腹腔注射丹参酮ⅡA(25 mg/kg),而连续治疗组除上述操作外,还在术后1周内1次/d继续注射同等剂量丹参酮ⅡA维持。各组大鼠在再灌注第4天、第29天被处死,采用HE染色和TUNEL荧光染色观察睾丸组织病理学改变,采用Western Blot方法进行检测Bcl-2和Bax蛋白,采用ELISA法检测性激素FSH、LH和T水平。结果与模型组比较,经过丹参酮ⅡA治疗的大鼠其睾丸组织损伤减轻,生殖细胞凋亡减少,且连续治疗组比单次治疗组改善更明显(P<0.01)。丹参酮ⅡA连续治疗组与单次治疗组比较,其Bcl-2蛋白表达水平更高,Bax蛋白表达水平更低(均P<0.01)。与假手术组比较,丹参酮ⅡA连续治疗组的3种性激素水平无明显改变(均P>0.05),而模型组和单次治疗组的FSH、LH水平均明显升高,T水平均明显降低(均P<0.01)。结论丹参酮ⅡA可通过增强Bcl-2基因、抑制Bax基因的表达,从而减轻大鼠睾丸缺血再灌注损伤,并同时参与维持T、FSH和LH三者血清浓度之间的动态平衡。

经阴囊及直肠超声联合血清AMH检测对梗阻性与非梗阻性无精子症的鉴别诊断价值

目的:探讨经阴囊及直肠超声联合血清抗米勒管激素(AMH)检测对无精子症的鉴别诊断价值。方法:选取2017年3月—2021年3月咸宁市第一人民医院收治的无精子症患者90例,均行阴囊及直肠超声检查、血清AMH检测,并根据睾丸活检结果将患者分为梗阻性无精子症(OA)组(n=38)和非梗阻性无精子症(NOA)组(n=52)。比较两组睾丸体积及超声征象、血清AMH水平,通过绘制受试者操作特征(ROC)曲线,分析经阴囊及直肠超声、血清AMH及联合诊断OA的效能。结果:超声结果显示,OA组睾丸体积≥12 mL、附睾及远端精道异常超声征象比例均显著高于NOA组,差异均有统计学意义(P<0.05)。OA组血清AMH水平为(8.43±2.57)ng/mL,明显高于NOA组的(5.58±1.72)ng/mL,差异有统计学意义(P<0.05)。ROC曲线显示,睾丸体积≥12 mL、附睾及远端精道异常超声征象(梗阻征象)、血清AMH、超声联合血清AMH诊断OA的曲线下面积(AUC)分别为0.788、0.793、0.881、0.964。结论:经阴囊及直肠超声联合血清AMH检测鉴别OA与NOA有较高的价值。

西沙必利联合血液灌流对CRF维持性血液透析患者胃肠道症状及胃肠激素水平的影响

【目的】探讨西沙必利辅助血液灌流对慢性肾衰竭(CRF)维持性血液透析患者胃肠道症状及胃肠激素水平的影响。【方法】回顾性分析2021年2月至2023年1月本院收治的72例CRF患者的临床资料,根据治疗方法不同将其分为观察组和对照组,每组36例。两组均行维持性血液透析治疗,对照组予以血液灌流治疗,观察组在对照组的基础上予以西沙必利治疗。治疗2周后,比较两组肾功能[血肌酐(Scr)、尿素氮(BUN)、肾小球滤过率(GFR)]、胃肠道症状、胃肠激素[生长抑素(SS)、胃动素(MOT)、血管活性肠肽(VIP)]及血清成纤维细胞生长因子23(FGF-23)、降钙素基因相关肽(CGRP)、肿瘤坏死因子-α(TNF-α)水平及不良反应发生情况。【结果】治疗后,两组Scr、BUN均较治疗前降低,eGER均较治疗前升高(P<0.05);两组Scr、BUN、eGER比较,差异无统计学意义(P>0.05)。治疗后,两组反酸、恶心及呕吐、腹胀、嗳气、便秘评分均低于治疗前,且观察组低于对照组(P<0.05)。治疗后,观察组血清MOT、SS水平低于治疗前及对照组,VIP高于治疗前及对照组(P<0.05)。治疗后,两组血清FGF-23、CGRP、TNF-α水平低于治疗前,且观察组低于对照组(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。【结论】西沙必利辅助血液灌流治疗CRF维持性血液透析患者,可调节胃肠激素水平,改善胃肠道症状,减轻炎症损伤,安全性较高。

非梗阻性无精子症患者睾丸体积、生殖激素水平与睾丸穿刺取精结果的相关性研究

目的:探讨非梗阻性无精子症患者睾丸体积、生殖激素水平与睾丸穿刺取精术(TESA)结果的相关性,以及可用于预测TESA结果的睾丸体积、生殖激素水平的切点值,从而为非梗阻性无精子症患者进一步诊疗提供重要资料。方法:121例研究对象均为非梗阻性无精子症患者(NOA),测定其睾丸体积和生殖激素水平,并根据TESA结果分为无精子组和有精子组。结果:无精子组和有精子组的左侧睾丸体积(ml)、右侧睾丸体积(ml)、泌乳素(PRL,ng/ml)、卵泡刺激素(FSH,mIU/ml)、黄体生成素(LH,mIU/ml)、雌二醇(E2,pmol/L)、血清总睾酮(TT,nmol/L)水平分别为7.07±1.06和11.75±1.38、7.37±1.37和11.70±1.98、12.43±11.69和9.60±4.55、15.77±10.84和8.01±7.43、6.12±2.92和8.11±20.11、119.36±43.52和141.12±48.33、11.43±4.05和12.46±4.60。无精子组血清FSH和PRL水平平均值高于有精子组,并且有显著的统计学差异。虽然无精子组的睾丸体积平均数小于有精子组,但两组之间没有统计学差异。对于年龄、血清E2和TT水平,两组之间也没有统计学差异。利用ROC曲线优选的睾丸体积切点值为9 ml,此点其敏感性为93.8%/89.6%(左/右),特异性为100%/94.3%(左/右),睾丸体积ROC曲线的AUC为0.984/0.961(左/右),表明其诊断准确性较高;优选的血清FSH水平切点值为8.18 mIU/ml,此点其敏感性为71.2%,特异性为75.0%,FSH水平ROC曲线的AUC为0.743,表明其诊断准确性中等。结论:睾丸体积和FSH水平对于预测NOA患者TESA结果具有重要意义,并且睾丸体积诊断准确性明显优于FSH。

生殖激素水平和睾丸体积对非梗阻性无精症患者精子存在的预测价值

目的探讨非梗阻性无精症(non-obstructive azoospermia,NOA)患者生殖激素水平、睾丸体积等参数对睾丸内是否存在精子的预测价值,以及可用于预测经皮睾丸精子抽吸术(testicular sperm aspiration,TESA)结果的切点值。方法将我中心男科门诊就诊的133例NOA患者按TESA的结果分为有精子组(n=33)和无精子组(n=100),测定生殖激素水平、睾丸体积、精浆果糖、中性-ɑ糖苷酶、染色体、AZF等。结果有精子组和无精子组左侧睾丸体积分别为(9.12±2.25)、(6.25±2.63)m L,右侧睾丸体积分别为(9.23±2.02)、(6.47±2.48)m L,促卵泡生成素(follicle-stimulating hormone,FSH)分别为(9.82±2.09)、(22.62±15.00)m IU/m L,总睾酮(total testosterone,TT)分别为(5.19±0.68)、(4.15±1.82)ng/m L,总睾酮/黄体生成素(T/LH)分别为:0.61±0.19、0.57±0.35,总睾酮/雌激素(T/E2)分别为:162.40±16.66和141.40±93.40。无精子组血清FSH显著高于有精子组,优选的FSH水平切点值为13.31 m IU/m L时,其敏感度为74.1%,特异性为96.2%。FSH水平ROC曲线的AUC为0.850,表明其诊断准确性中等。结论就单一因素而言,FSH水平对于NOA患者预测睾丸内是否有精子发生具有相当重要的价值,并且明显优于睾丸体积;两者的联合应用对非梗阻性无精子症患者预测其睾丸内精子存在更有意义。

非梗阻性无精子症患者睾丸体积、生殖激素水平对睾丸细针穿刺取精结果的预测

目的探讨非梗阻性无精子症(NOA)患者睾丸体积、生殖激素水平对睾丸细针穿刺取精(TFNA)结果的预测价值。方法 219例NOA患者在局麻下接受较好一侧睾丸的TFNA手术,按TFNA结果分为有精子组(n=85)和无精子组(n=134),比较两组患者的年龄、睾丸体积、雌二醇(E_2)、睾酮(T)、黄体生成素(LH)及卵泡刺激素(FSH)等生殖激素水平,并用ROC曲线优选有明显差异的指标。结果有精子组患者的穿刺侧睾丸体积明显大于无精子组患者;有精子组患者LH及FSH水平明显低于无精子组患者,两组比较,差异均有统计学意义(P<0.05);两组患者的年龄、E_2及T水平比较,差异无统计学意义(P>0.05)。穿刺侧睾丸体积、FSH及LH水平的ROC曲线的AUC值分别为0.728、0.803及0.631,穿刺侧睾丸体积与FSH的诊断准确性较好,优选切点值分别为9mL及8.20IU/L。结论结合穿刺侧睾丸体积和FSH水平对预测NOA患者的TFNA结果具有重要价值。

LHRH-A缓释剂促进雄性赤点石斑鱼性类固醇激素分泌和精巢发育与排精的研究

研究了促黄体生成素释放激素类似物(LHRHA)不同处理方式对雄性赤点石斑鱼性类固醇激素分泌和精子生成及精子排放的影响。对照组在0、7d二次注射生理盐水(50μg·kg-1BW),注射组在0、7d二次注射LHRHA(50μg·kg-1BW),埋植组在0d埋植LHRHA缓释剂(100μg·kg-1BW)。结果表明,通过埋植LHRHA缓释剂,血清睾酮(T)和11-酮基睾酮(11-KT)水平快速增加,显示血清睾酮和11-酮基睾酮水平与赤点石斑鱼精子生成和精子排放有密切关系。组织学观察表明,在21d,对照组和注射组鱼精巢充满了精子细胞、精母细胞和精原细胞,而在同一时间,LHRHA埋植组鱼精巢含有大量精子,表明精子排放仍在进行。在40d期间采集精液总量为对照组<注射组<埋植组,差异显著。当注射组在处理14d后精液量逐渐回落到对照组水平时,埋植组仍然维持较高精液量水平。各组采集的精子的活力与采集的精液量呈正相关,而精子密度没有显著差异。数据显示,LHRHA缓释剂能显著增加赤点石斑鱼的精液量及延长精子排放时间而不改变精子的质量。

无精症患者睾丸病理、性激素水平及睾丸容积检测

目的:观察无精症患者睾丸病理、血清性激素水平及睾丸容积变化。方法:对97例无精症患者[A组32例(唯支持细胞综合征),B组28例(精子发育停滞于精母细胞)、C组37例(生精功能低下)]与正常对照40例(D组)进行睾丸活检病理、性激素和睾丸容积检测。结果:A、B、C组FSH和Johnsen评分均有差异(P<0.05)。A、B组睾丸容积低于C、D组,而LH水平高于C、D组(P<0.05),B组E2水平低于其他各组(P<0.05)。结论:FSH结合睾丸活检病理与睾丸容积可作为判断睾丸生精功能的重要指标。