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Objective: To investigate the clinical efficacy of dapoxetine combined with transcutaneous neuromuscular electrical stimulation (TNES) in the treatment of primary premature ejaculation., Methods: A total of 60 patients who met the diagnostic criteria for primary premature ejaculation were selected as study subjects and randomly divided into a dapoxetine group (control group) and a dapoxetine combined with percutaneous neuromuscular electrical stimulation group (observation group).30 patients in each group were treated for 4 weeks. Intravaginal ejaculatory latency time (IELT), the score of Premature Ejaculation Diagnostic Tool (PEDT), sympathetic skin response located in the penis (PSSR), Patient Health Questionnaire (PHQ-9), and Generalized Anxiety Disorder Questionnaire (GAD-7) before and after treatment were recorded in the two groups. Before and after treatment, the difference in observed indexes in the two groups and the comparison of effective rates between the two groups were analyzed., Results: The latency of IELT and PSSR was prolonged and the PEDT score was decreased in both the observation group and the control group, the difference was statistically significant (P<0.01). Compared with the control group, the observation group had statistically significant differences in extending IELT and PSSR latency and reducing PEDT score (P<0.05). The effective rates of the observation group and control group were 90% and 63.33%, respectively, and the difference was statistically significant (P<0.05). There was no significant difference in the improvement of depression and anxiety levels between the two groups (P> 0.05)., Conclusion: Dapoxetine combined with TNES has a better clinical effect than dapoxetine alone in the treatment of primary premature ejaculation, and can be used as an effective option for clinical treatment of primary premature ejaculation.

Objective: To observe the clinical efficacy of transcutaneous neuromuscular electrical stimulation (TNES) in the treatment of ED., Methods: According to the inclusion and exclusion criteria, we included and studied 25 cases of ED treated by TNES in Northern Jiangsu People's Hospital from June 2021 to February 2022 using the self-matched pre- and post-control method. Before and after treatment, we conducted RigiScan penile hardness test under audiovisual sexual stimulation (AVSS) for all the patients and obtained their scores on the Erectile Hardness Scale (EHS), IIEF-5, Premature Ejaculation Diagnostic Tool (PEDT), Patient Health Questionnaire 9 (PHQ-9) and Generalized Anxiety Disorder Questionnaire 7 (GAD-7)., Results: No adverse reactions such as pain, allergy, skin burn, and subcutaneous congestion were observed in any of the patients. There were statistically significant differences after treatment in erection time, average and maximum hardness of the penile tip, mean hardness of the penile root, and circumference of the penile tip (P < 0.05), but not in the circumference and maximum hardness of the penile root during erection compared with the baseline (P > 0.05). Significant improvement was observed after treatment in the IIEF-5 score (P < 0.05), with a total effectiveness rate of 68%, as well as in the PEDT score (P < 0.05) GAD-7 anxiety score (P < 0.05), but not in the PHQ-9 depression score (P > 0.05)., Conclusion: TNES, as a safe and non-invasive therapy, can improve penile hardness under AVSS and the erectile function and anxiety symptoms of ED patients, and can be used as a new option for the treatment of ED.

Objective: To establish an animal model of acute blunt scrotal trauma (BST) and evaluate the types of lesion by conventional ultrasonography (CUS) and contrast-enhanced ultrasonography (CEUS)., Methods: We made acute BST models in 21 healthy male New Zealand rabbits by striking 3 - 12 times the unilateral testes randomly selected with a 0. 5 kg iron ball falling freely from a 30 cm height. Then we evaluated the lesion types in the models by CUS and CEUS and verified our evaluation against pathological results., Results: Acute BST models were successfully established in all the 21 animals, including contusion in 10, hematoma in 6, and rupture in 5, all confirmed by pathology. CUS clearly manifested the morphology, internal echoes, and blood flow of the testes, but had a low rate of accurate diagnosis in testicular contusion for over 6 hours as well as in complex lesions. CEUS revealed an earlier perfusion of the contrast agent and shorter arriving time (AT) and time to peak intensity ( TP) in testicular contusion than in the control testes (P <0.05) , but showed no statistically significant difference between the two groups in the half time of descending peak intensity (P>0.05). For testicular hematoma, contrast agent clearly presented its outline and a delayed low enhancement in the surrounding tissue, with significant differences from the control in AT and TTP. In severe testis rupture, occasional outflow but no perfusion of contrast agent was observed., Conclusion: BST models can be established in rabbits by repeated strikes of the unilateral testes lesion of contrast agent was observed. with a freely falling iron ball. Simple contusion injury can be induced by less than 6 strikes, while complex injuries can be inflicted by more than 10. Combined application of CUS and CEUS can improve the accuracy of diagnosis of different types of lesion.

Objective: To evaluate contrast-enhanced ultrasonography (CEUS) in detecting testicular perfusion in acute testis contusion., Methods: We established the model of testis contusion in 11 healthy male New Zealand rabbits by randomly hitting one side of the scrotum under general anesthesia. We examined the bilateral scrotums of all the animals before, immediately after and at 2, 4 and 6 hours after modeling by color Doppler flow imaging (CDFI) and CEUS, and analyzed the time-intensity curve (TIC), arriving time (AT), time to peak intensity (TTP), peak intensity (PI), half time of descending peak intensity (HT) and area under the curve (AUC) in the healthy and injured testis, respectively., Results: CEUS exhibited a higher sensitivity in detecting tissue perfusion than CDFI. The mode of contrast agent perfusion in testicular contusion was fast in and slow out. There were no evident differences between the contused and the healthy testis in AT, TTP and PI before modeling. The contused testis showed significantly earlier AT and TTP, higher PI and larger AUC (P < 0.05) than the healthy one at different time points after modeling, but no statistically significant difference was found in HT (P > 0.05)., Conclusion: Accurate parameters of testicular perfusion in acute testis contusion can be quantitatively obtained by CEUS, which are of important value for the diagnosis of testis contusion.

Objective: To determine the expressions of HO-2 and eNOS in the corpus cavernosum of castrated rats and investigate the correlation of HO-2 and eNOS with erectile dysfunction., Methods: Forty SD rats of 10 weeks were equally divided into 3 castrated groups (4, 8 and 12 weeks respectively after removal of bilateral testes) and a sham operation control group. All the rats were detected for serum testosterone (T), intracavernosal pressure (ICP) and mean arterial blood pressure (MAP) 2, 8 and 12 weeks after the surgery, the content of HO-2 analyzed by Western blot and the expressions of eNOS and HO-2 determined by immunohistochemistry., Results: Testosterone level and ICP/MAP ratio were markedly decreased after the castration (P < 0.05). The HO-2 expression was detected in the corpus cavernosum of all but the 12-week castrated rats, and the area under the curve was (341.50 +/- 99.70) in the 4-week castrated group, significantly less than in the 8-week (705.00 +/- 152. 74) and the control group (876 +/- 443. 36) (P < 0. 05), with no obvious difference between the latter two. eNOS was found mainly in the vascular endothelial cells of the corpus cavernosum, significantly less in the castrated (123.94 +/- 30. 23) than in the control group (421.21 +/- 125. 12)., Conclusion: Androgens might mediate the penile erectile function through HO-2 and eNOS in the corpus cavernosum of rats.

Objective: To investigate the expression of Rho-kinase and heme oxygenase and the interaction among NOS/NO, HO/CO and RhoA/Rho-kinase in the corpus cavernosum of spontaneous hypertensive rats (SHRs)., Methods: A series of electric stimuli were applied to the corpus cavernosum nerves of 7 SHRs, the changes of ICP/MAP observed continuously and the expressions of ROCK2, HO-2 and eNOS analyzed by Western blot and immunohistochemistry. Another 7 WKY rats were taken as controls., Results: Compared with the controls, ICP/MAP did not rise obviously (P < 0.05), HO-2 dropped sharply (P = 0.006) and the expression of the ROCK2 protein was elevated markedly (P = 0.017) in the SHRs. Immunohistochemistry showed HO-2 to be distributed in the smooth muscle cells and nervous cells of the corpus cavernosum, and eNOS mainly in the vascular endothelial cells. The expressions of HO-2 and eNOS were obviously reduced in the SHRs., Conclusion: NOS/NO, HO/CO and RhoA/Rho-kinase are related with erectile dysfunction in SHRs and may interact on one another.

Erectile dysfunction (ED) has been plaguing men for a long time and the incidence of this disease is as high as 52% among males aged between 40 and 70. Recent discovery has shown a connection between the RhoA/Rho-kinase signaling system and ED. This paper reviews the progress in the study of RhoA/Rho-kinase signaling pathway, expounds its mechanism in penile erection and provides a base for further research on the role of RhoA/Rho-kinase signaling pathway in penile erection.

Objective: To develop a nested polymerase chain reaction (PCR) technique for fetal SRY gene identification using cell-free fetal DNA in maternal plasma., Methods: Peripheral blood samples were obtained from 30 pregnant women and cell-free DNA was extracted by the phenol/chloroform method from plasma. The nested PCR was carried out to amplify the fragment of SRY gene by two sets of PCR primer pairs. Direct sequencing analysis was then performed on the PCR product., Results: Among the 17 women bearing male fetuses, SRY sequences were detected in 15 plasma samples after nested PCR amplification, while none of the 13 women bearing female fetuses had the positive results. The accuracy and sensitivity were 93.3% (28/30) and 88.2% (15/17), respectively., Conclusion: The phenol/chloroform extraction for fetal DNA in maternal plasma was effective and simple. And the nested PCR amplification of SRY sequence is a convenient and low-cost approach for the non-invasive early prenatal diagnosis of sex-linked inheritant diseases.

The improvement of diagnosis and treatment of andrological disease depends on scientific advances in the corresponding domain of andrology. In this article, the author thought topic selection was of great significance for the improvement of diagnosis and treatment based on his clinical and scientific experience for years in the field of andrology. Topic selection should be closely combined with clinical practice and follow the principles of importance, innovation, feasibility and reality, which meets the demands of basic, therapeutic and epidemiologic aspects in andrology research. Several common approaches to topic selection were discussed as well in the article.

The precursor of prostate specific antigen (proPSA) are distinct molecular forms of free PSA in serum. proPSA is comprised of native proPSA as well as several truncated forms, in which [-2] proPSA and [-4] proPSA are more prostate cancer (PCa)-associated than [-7] proPSA and [-5] proPSA. Clinical studies have recently provided evidence that [-2] proPSA can significantly improve the detection of PCa, particularly in patients with total serum PSA values less than 4 microg/L. In this paper, the mechanism and characteristics of proPSA formation and impact of proPSA on the early detection of PCa are reviewed.

Objective: To evaluate total antioxidant capacity (TAC) of seminal plasma in fertile and infertile men and understand the relation between seminal plasma TAC and male fertility., Methods: Two hundred and twenty-five infertile men were divided into 10 cases of obstructive azoospermic men, 42 cases of non-obstructive azoospermic men,20 cases of oligozoospermic men, 78 cases of asthenozoospermic men, 57 cases of oligoasthenozoospermic men, and 18 cases of normozoospermic men, then 28 fertile men were taken as the control. The seminal parameter analysis was performed by computer-assisted semen analysis (CASA) system. Seminal plasma TAC was measured using spectroscopic analysis., Results: Seminal plasma TAC were (1.71 +/- 1.33) U in obstructive azoospermic men, (12.73 +/- 9.44) U in non-obstructive azoospermic men, (10.85 +/- 6.64) U in oligozoospermic men, (13.88 +/- 8.24) U in asthenozoospermic men, (11.20 +/- 7.02) U in oligoasthenozoospermic men, (18.07 +/- 8.73) U in normozoospermic men, and (19.82 +/- 6.33) U in fertile men. There was no significant difference in TAC between normozoospermic men and fertile men (P > 0.05). Compared with fertile men, seminal plasma TAC in other infertile groups was significantly lower (P < 0.01). There were significantly made positive correlation between seminal plasma TAC and sperm density (r = 0.182, P < 0.05), as well as sperm with grade a (r = 0.150, P < 0.05)., Conclusion: Seminal plasma TAC is closely related to male fertility, and the decreased level of TAC in seminal plasma may be one of the causes of male infertility.

Objective: To investigate the significance of prostate specific antigen (PSA) examination in seminal plasma of infertile patients., Methods: Eighty-five infertile patients were collected randomly. The level of PSA in seminal plasma was detected by ELISA method. The correlations between PSA and several seminal parameters including sperm density, motility and acid phosphatase (ACP) were analyzed., Results: The PSA, ACP concentrations and sperm motility in 65 cases of abnormal liquefaction patients were obviously lower than those in normal liquefaction patients(P < 0.01). But there were no significant differences in sperm density among the three groups(P > 0.05). PSA levels were significantly correlated with ACP and sperm motility(P < 0.01)., Conclusions: The seminal PSA in infertile patients is markedly correlated with semen liquefaction. The abnormal quality and quantity of PSA can result in a depression of sperm motility and subinfertility.

Men with non-obstructive azoospermia(NOA) can now be treated by using intra-oocyte round spermatid injection(ROSI) or elongated spermatid injection(ELSI). Spermatids can be retrieved from semen or from testis biopsy specimens. But the rates of fertilization and pregnancy with spermatids have been disappointing. Many problems limiting success rate and hindering a wide application of this technique still remain unresolved, including the incomplete maturation of spermatid nuclear, oocyte activation and identification of a live spermatid.

Objectives: To investigate the possible differences in the inhibin B levels of seminal plasma and serum between fertile and infertile males and to obtain information on the relation between serum inhibin B or seminal plasma inhibin B and spermatogenesis., Methods: Semen and blood samples were collected from fertile(n = 20), oligospermia(n = 20), asthenospermia(n = 22) and non-obstructive azoospermia(NOA) (n = 20) males at 8:00 am = 10:00 am. Semen parameters were analyzed. Levels of inhibin B in seminal plasma and serum, ACP, Fru, alpha-Glu in seminal plasma, serum levels of FSH, T, LH were determined., Results: Both levels of serum inhibin B and levels of seminal plasma inhibin B correlated significantly negatively with serum FSH(r = -0.536, P < 0.001 vs r = -0.288, P = 0.01), and statistically positively with sperm concentration(r = 0.49, P < 0.001 vs r = 0.48, P < 0.001). There was positive correlation between levels of seminal plasma inhibin B and activity of alpha-Glu in seminal plasma (r = 0.377, P = 0.001). The difference in levels of seminal plasma inhibin B was found only between fertile males or asthenospermia and NOA (P < 0.01 and P < 0.05, respectively). However, significant differences in levels of serum inhibin B were found not only between males with normal sperm concentration (including fertile males and asthenospermia) and NOA (P < 0.01), fertile males and oligospermia (P < 0.05), but also between oligospermia and NOA (P < 0.05). There was no correlation between serum inhibin B and seminal plasma inhibin B., Conclusions: Both levels of serum inhibin B and seminal plasma inhibin B could reflect testis spermatogenesis status. Levels of seminal plasma inhibin B could also reflect the function of seminiferous duct, but the wide range of values limited its applicability.

Objectives: To detect the cholesterol ester transfer protein (CETP) levels in semen of infertile patients and evaluate the correlation between CETP in semial plasma and infertility., Methods: One hundred and sixty-three infertile patients and fifteen fertile males were selected randomly. The routine examination of ejaculates was fulfilled by computer aided semen analysis (CASA). The CETP levels in all seminal plasma samples and fifty-five serum samples were detected by ELISA method., Results: The CETP levels in infertile patients and fertile males were (2.21 +/- 1.23) microgram/L and (1.40 +/- 0.45) microgram/L, respectively. There were no significant differences between the two groups(P > 0.05). And there were no significant differences of CETP levels in seminal plasma among groups of azoospermia(n = 29), oligoasthenozoospermia (n = 58), oligospermia(n = 15), asthenozoospermia(n = 44) and normozoospermia(n = 17) in the infertile patients(P > 0.05). The CETP in seminal plasma and serum were detected in 55 infertile patients, and there was no correlation between CETP levels in seminal plasma and serum using Spearman analysis(r = 0.009, P > 0.05). The mean CETP level in seminal plasma was almost 1/1,000 of that in serum., Conclusions: The CETP level in seminal plasma is extremely low and has no relation with the changes of sperm density or motility. It may ensure the integrity of sperm membrane before the sperm enters into female genital tract.

Objectives: To evaluate the clinical significance of the detection of IgG and IgM antibodies against Chlamydia trachomatis (CT) in semen of asymptomatic infertile patients., Methods: One hundred and sixteen asymptomatic infertile patients and eighteen fertile males were selected randomly. The routine parameter analysis of semen was fulfilled by computer aided semen analysis(CASA). Then the seminal plasma was separated and the IgG, IgM antibodies against CT in seminal plasma were determined with ELISA method., Results: IgG and IgM antibodies against CT were present in 13.8% (16/116) and 3.4% (4/116) of the semen of infertile patients, while for the fertile males the percentages were 11.1% (2/18) and 0, respectively. There were no differences between the two groups(P > 0.05). In the infertile patients, 22 patients were azoospermia. And in the rest 94 infertile patients, the percentages of IgG and IgM antibodies in abnormal sperm density group were 21.4% (6/28) and 7.1% (2/28), which were higher than those in normal group, but there were no statistical differences(P > 0.05). Similarly, the IgG, IgM antibodies were not correlated with the sperm motility(P > 0.05). The positive percentage of CT in 116 patients was 25.9% (30/116)., Conclusions: The percentages of IgG and IgM antibodies against CT in semen of asymptomatic infertile patients are similar to that in fertile males, which do not correlate with the changes of semen parameters, and may not be used for indication of CT infection.

Objectives: To develop a method by which large and purified populations of spermatids can be isolated in semen of male infertile patients., Methods: A total of fifteen ejaculates containing cellular elements from infertile patients with various andrological pathologies were obtained after a 24-hour abstinence. A modified discontinuous Percoll gradient (15%, 22%, 30%, 40%, 50%, 60%) centrifugation method was used to isolate the spermatids. After centrifugation at 2,000 r/min for 30 min at 18 degrees C, the single Percoll fractions were separated and analyzed in order to select the one with the greatest purity of spermatid. The germinal cells in each isolated fraction were counted using a Macro sperm counting chamber, then the contents of spermatids were determined by morphology (Wright-Giemsa staining method) and flow cytometry (FCM) analysis, while the contaminated leukocytes were assessed by anti-CD45 immunocytochemistry., Results: After Percoll centrifuged, six single fractions were obtained. Morphology and FCM analysis showed that the 22% fraction contained mostly spermatids [(91.85 +/- 5.18)%, P < 0.005] and the mean density in this fraction was (1.010 +/- 0.786) x 10(5)/ml. While in the 30% fraction, various immature spermatogenic cells including spermatids were present and leukocytes mostly presented in the 60% fraction., Conclusions: A large population of relatively purified spermatids can be isolated from the ejaculates of infertile patients by using this modified discontinuous Percoll gradient centrifugation method.

Objectives: To develop a simple and effective method by which spermatids can be isolated from mouse testis., Methods: Combination of enzymatic digestion was used to prepare suspension of spermatogenic cells from adult mouse testis, and then a modified discontinuous Percoll gradient (15%, 22%, 30%, 40%, 50%, 60%) centrifugation method was introduced to isolate spermatids from the cellular suspension. The content of spermatids in each isolated fraction by Percoll method was determined by morphology (Wright-Giemsa staining) and flow cytometry analysis, and the viability of spermatogenic cells was assessed using Eosin Y exclusion test., Results: More than 97% of the testicular cells remained their viability after enzymatic digestion. After Percoll centrifuged, six fractions were formed. In each isolated fraction, the 22% fraction contained mostly spermatids(mean 86.7%) and cell viability was more than 85.5%. While in the 30% fraction, immature spermatogenic cells were present, and more than 92% of the cells remained their viability., Conclusions: A large of relatively purified spermatids can be isolated from mouse testis by enzymatic digestion combined discontinuous Percoll gradient centrifugation method.