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Diabetes mellitus (DM), which is closely related to microvascular dysfunction, is a risk factor for erectile dysfunction (ED). Furthermore, the upregulation of inducible nitric oxide synthase (iNOS) is associated with systemic vascular dysfunction in rats with diabetes. The purpose of this study was to investigate the role of iNOS in diabetes mellitus erectile dysfunction (DMED). First, we developed a type 1 DM rat model using streptozotocin and selected those that developed DMED. Then, we injected these rats with the 1400W, an iNOS inhibitor, for 10 weeks and subsequently assessed their ED. Lastly, we performed various molecular studies and histopathological analyses of penile tissues collected from these rats after the experiments. Through the histopathological studies, we also found that the treatment restored the ratios of the smooth muscle to collagen fibres, delayed the development of microvascular injury and alleviated the oxidative stress caused by hyperglycaemia. Based on these results, we confirmed that upregulation of iNOS leads to microvascular dysfunction in patients with ED. Overall, we found that inhibition of iNOS displayed beneficial effects in the treatment of ED, suggesting that its mechanism should be further explored.

The study was designed and conducted to evaluate the plant-based diet status and its association with erectile function (EF) in Chinese young healthy men. From July 2018 to May 2020, 116 objectively proved physically and psychologically healthy men were selected. Clinical questionnaires, detailed physical examinations and blood tests were all assessed. An overall plant-based diet index (PDI) and a healthful plant-based diet index (hPDI) were developed from each participant to measure plant-based diet quantitatively. The EF was measured by both the International Index of Erectile Function-5 (IIEF-5) and the surrogated measures of endothelial function, peripheral levels of nitric oxide (NO) and E-selectin. In subjects, the mean PDI and hPDI were 53.8 ± 8.2 and 54.7 ± 8.9 respectively. Results of multivariate analysis showed that both PDI and hPDI were negatively associated with BMI (all p .05), but had no relationships with NO, E-selectin, TT levels and IIEF-5 scores (all p .05). In a subgroup of male population, Chinese young healthy men, the plant-based diet, measured by PDI and hPDI, was not related to erectile function. The population can adhere to plant-based diet to keep healthy without concerns of negative influence on erectile function.

Human papillomavirus (HPV) has a high incidence rate in both males and females. HPV infection in women has been shown to affect fertility and lead to foetal death and pregnancy loss. However, research on HPV infection in men is limited. The aim of this study was to study the effect of HPV infection in semen on sperm quality and present the findings of previous studies through a meta-analysis. Databases including PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library, WanFang data and China National Knowledge Infrastructure were searched for relevant studies. A systematic review and meta-analysis were performed, and 17 studies were included for analyses based on a set criterion. Meta-analyses indicated that HPV infection in semen significantly reduced sperm concentration (SMD = -0.12, 95% CI: -0.21 to -0.03, p = .009), sperm motility (SMD = -0.55, 95% CI: -0.780 to -0.33, p = .000), sperm viability (SMD = -0.55, 95% CI: -0.780 to -0.33, p = .000) and sperm morphology (SMD = -0.34, 95% CI: -0.61 to -0.07, p = .015). The high-risk HPV (HrHPV) infection could significantly reduce sperm count (SMD = -0.65, 95% CI: -1.11 to -0.18, p = .007) compared with high-risk HPV (LrHPV) infection. In conclusion, HPV infection in semen significantly reduced sperm quality, and the HrHPV infection could significantly reduce sperm count compared with LrHPV.

To seek novel prognostic biomarkers for testicular germ cell tumour (TGCT) and investigate the tumour immune microenvironment, we identified critical differentially expressed genes (DEGs) by overlapping GSE1818 dataset from Gene Expression Omnibus (GEO). Protein-protein interaction (PPI) network was used to investigate key modules and hub genes. Functional enrichment analysis was performed to investigate the underlying molecular functions of the DEGs in TGCT development and progression. The following survival analysis based on The Cancer Genome Atlas (TCGA) TGCT dataset indicated that AKAP4, SPA17 and TNP1 are correlated with TGCT prognosis. Immunohistochemistry and quantitative real-time polymerase chain reaction verified the down-regulation of the 3 hub genes in TGCT. Gene set enrichment analysis was conducted to further explore the role of the 3 hub genes in TGCT respectively. In addition, TGCT samples had high infiltration of CD8+ T cells, M0 and M1 macrophage cells, and resting myeloid dendritic cells in immune microenvironment. We also constructed the microRNA-gene regulatory networks to identify the key upstream microRNAs in TGCT. In conclusion, our findings indicated that AKAP4, SPA17 and TNP1 are promising biomarkers of TGCT. AKAP4 and TNP1 might regulate immune cells infiltration in immune microenvironment.

To assess the value of biparametric magnetic resonance imaging (bpMRI) for detecting and ruling out prostate cancer in patients with elevated prostate-specific antigen (PSA). The basic information and bpMRI images of enrolled patients who took transperineal template saturate biopsy were retrospectively collected for analysis. Based on our results, we found that free/total PSA, and PI-RADS score were independent risk factors of PCa (p < .05), the PSA density, PI-RADS score were the independent risk factors of csPCa (p < .05). PI-RADS score threshold of 3 could achieve the highest Yonder index for predicting PCa, and PI-RADS score threshold of 4 could achieve the highest Yonder index for predicting csPCa. Therefore, we draw a conclusion that PI-RADSv2 score-based bpMRI could diminish the unnecessary prostate biopsies in patients with elevated PSA when combined with other PSA-related indicators.

This study explored the relationships between the decline in sexual function and psychological burdens and life satisfaction in older men with the aim of providing prospective targets for interventions. From January 2016 to January 2019, we selected 1,326 men aged over 50 years old. We adopted the International Index of Erectile Function-5 (IIEF-5), self-estimated intravaginal ejaculatory latency time (IELT), the premature ejaculation diagnostic tool (PEDT), the General Anxiety Disorder-7 (GAD-7), the Patients Health Questionnaire-9 (PHQ-9), the satisfaction with life scale and the control, autonomy, self-realisation and pleasure scale (CASP-19) to measure premature ejaculation, erectile dysfunction and well-being (including, depression, anxiety, and life quality and satisfaction) respectively. The individuals were divided into two main groups: the decline group and the no-decline group. The incidences of erectile dysfunction (ED), premature ejaculation (PE), anxiety and depression in men who reported a decline in sexuality were 73.83% (330/447), 63.98% (286/447), 75.84% (339/447) and 68.46% (306/447) respectively. Men who showed a decline in sexuality had significantly worse psychological and life satisfaction/quality scores than those in the no-decline group (p < .001 for all). When they had PE or ED simultaneously, these differences widened. Significantly worsened psychological status and life quality/satisfaction scores could be observed in patients who had declined sexual desire and declined frequency of sex (p < .001 for both). Under the impact of the decline in sexual function, the younger participants (age < 60) had significantly worsened negative emotions and life quality and satisfaction. Based on the results of the study, we found that the decline in sexuality was associated with depression and anxiety and worse life satisfaction and quality. Clinicians need to pay more attention to psychological status and life satisfaction and quality for those patients affected by a decline in sexuality.

To compare the difference of mean platelet volume (MPV), platelet lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), platelet (PLT) and leucocyte between testicular torsion (TT), epididymo-orchitis and healthy controls and further evaluate predictive values of these haematologic parameters in diagnosis and the differential diagnosis of TT. Databases were systematically retrieved, and reference search was also conducted manually. We applied Stata software 12.0 to perform a systematic review and meta-analysis. Ultimately, five case-control studies with 672 participants were recruited for analyses. Pooled analyses indicated that TT patients had lower NLR (WMD = -1.66, 95% CI = -3.25 to -0.06) and PLT (WMD = -27.39, 95% CI = -48.03 to -6.75) compared to epididymo-orchitis patients. In the meantime, TT patients had higher NLR and leucocyte than healthy controls (p < .05). That is to say, when a man develops TT, his NLR and leucocyte will rise up but his NLR will not reach the level of epididymo-orchitis. To sum up, NLR, PLT and leucocyte were vital factors for TT diagnosis. Leucocyte is an useful parameter for diagnosing both TT and epididymo-orchitis, but it cannot be used in differentiating the two diseases. NLR is beneficial parameter for differential diagnosis between TT and epididymo-orchitis. PLT can also be utilised in differential diagnosis among young patients.

To investigate whether bilateral surgery can bring more benefits to infertile patients with bilateral varicocele than unilateral surgery. A search of PubMed, Web of Science, EMBASE and the Cochrane Library on 13 January 2019 was conducted to identify studies published in English that used varicocelectomy. The protocol of the present meta-analysis was pre-published on PROSPERO (registration number CRD42019093894). Primary outcomes were spontaneous pregnancy rates. A total of eleven articles were finally enrolled in, with a total of 1,743 patients. Spontaneous pregnancy rate was higher in patient with bilateral varicocelectomy than unilateral varicocelectomy with an odds ratio (OR) of 1.89 (95% CI 1.52-2.35; I2 = 0%; p

We studied the associations and correlations between premature ejaculation (PE) and psychological disorders, such as anxiety and depression, in new perspectives with an aim of improving PE patients' treatment outcomes. Between December 2017 and December 2018, we selected 1,010 men aged over 18 years old. Self-estimated IELT, the premature ejaculation diagnostic tool, the International Index of Erectile Function-5, the General Anxiety Disorder-7 and the Patients Health Questionnaire-9 were used to measure latency time, premature ejaculation, erectile dysfunction, anxiety and depression respectively. Premature ejaculation patients were categorised into two types: lifelong PE (LPE) and acquired PE (APE). Among the 958 men evaluated, the prevalence of anxiety and depression in PE group was 82.07% (444/541) and 74.68% (404/541) respectively. Premature ejaculation patients after adjustment for age, negative association of IIEF-5 and positive relation of PEDT score with GAD-7/PHQ-9 were observed (p