Search

Increasing reports on the significance of dietary patterns in reproduction have arisen from both animal and human studies, suggesting an interactive association between nutrition and male fertility. The aim of this study was to investigate the effects of curcumin supplementation on low-carbohydrate-diet-induced metabolic dysfunction, testicular antioxidant capacity, apoptosis, inflammation and spermatogenesis in male mice. Male C57BL/6 mice were fed a normal diet (AIN-93M group, n = 12) and a low-carbohydrate diet for 12 weeks (LC group, fed with low-carbohydrate diet, n = 48), and mice randomly chosen from the LC group were later fed their original diet (LC group, n = 12). This diet was changed to AIN-93M feed (LC/AIN-93M group, n = 12), a ketogenic diet (LC/KD group, n = 12), or a ketogenic diet treated with curcumin supplementation for the final 6 weeks (LC/KDCu group, n = 12). A poor sperm morphology and mean testicular biopsy score (MTBS) were observed in the LC and LC/KD groups, but they were eliminated by the normal diet or ketogenic diet with curcumin. The LC group exhibited a lower testicular testosterone level and a lower 17β-HSD activity and protein expression. This also enhanced apoptosis protein expressions in testis tissue, including Bax/BCl2, cleaved caspase 3, PARP and NF-κB. Meanwhile, we found a statistically significant increase in lipid peroxidation and decreased superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase levels in the LC group. Our study indicated that a replacement of a normal diet or ketogenic diet supplemented with curcumin attenuated poor semen quality and reduced testosterone levels by the LC diet by reducing oxidative stress.

Iron deficiency is the most common micronutrient deficiency in the world. Previous studies have shown that iron deficiency increases oxidative stress and decreases antioxidant enzymes, and studies of male infertility indicated that oxidative stress may affect male reproductive functions. The aim of this study was to investigate the effects of iron supplementation on spermatogenesis and testicular functions in iron-deficient rats. Three-week-old male Sprague Dawley (SD) rats were randomly divided into two groups: an iron-adequate control (AI group, 35 ppm FeSO4) and an iron-deficient group (ID group, 12 ppm FeSO4 exhibited improvements in antioxidant levels. In conclusion, iron supplementation can abrogate testis dysfunction due to iron deficiency through regulation of the testicular antioxidant capacity.

According to the Taiwan Cancer Report, in 2018, prostate cancer was one of the top five cancers reported in men. Each year, many patients with prostate cancer undergo radical prostatectomy (RP) therapy. One of the most common RP complications is erectile dysfunction (ED). Although consensus guidelines for the management of sexual dysfunction after prostate cancer surgery have been developed for many Western and Asian countries, no such clinical practice guidelines have been developed for Taiwan. The consensus opinions expressed in this article were discussed by numerous experienced physicians in Taiwan, based on both existing international guidelines and their individual experiences with clinical trials and providing advice to clinical physicians on how to inform patients of the risk of ED prior to surgery. This review also discusses how recovery and rehabilitation may be affected by socioeconomic status, the existence of an intimate relationship, comorbidities, or the need for cancer adjuvant therapy and how to determine rehabilitation goals and provide appropriate treatments to assist in the recovery of both short- and long-term sexual function.

BACKGROUND This study aimed to investigate the presence of circulating tumor cells (CTCs) in patients with penile squamous cell carcinoma (PSCC). METHODS CTCs were isolated from 14 patients with PSCC, 6 patients with balanoposthitis, and 6 healthy individuals. CTCs were enriched based on cell surface markers and filtered through the IsoFlux device, followed by identification according to cell morphology and immunofluorescence studies. RESULTS CTCs were found in all PSCC blood samples, but not in balanoposthitis samples and samples from healthy individuals. Immunofluorescence studies confirmed the tumor origin. When the patients with PSCC were stratified according to metastatic inguinal lymph node status, a statistically significant difference was observed in the number of detected CTCs. CONCLUSION Our study showed that CTCs in PSCC may represent a valuable marker for differentiating PSCC from other tumors. Based on the correlation with some clinical parameters, CTC analysis is possibly relevant for non-invasive monitoring of disease progression and prognosis. The results also suggested a potential role of CTCs in preventing overtreatment, such as inguinal lymph node dissection.

There is a great interest in determining whether the expression of the programmed cell death ligand 1 is correlated with the efficacy of immune checkpoint inhibitors in patients with clear cell renal cell carcinoma; however, primary tumor biopsies can only provide limited information. Therefore, we explored the expression of programmed cell death ligand 1 on circulating tumor cells, which is a potential predictor of therapeutic response.Circulating tumor cells were isolated from 20 clear cell renal cell carcinoma patients based on cell surface markers targeting clear cell renal cell carcinoma using IsoFlux device, followed by identification according to cell morphology and immunofluorescence studies. Programmed cell death ligand 1 expression status and clinical correlations were also analyzed.Before treatment with programmed cell death protein 1 inhibitors, circulating tumor cells were detected in all patients, ranging from 1 to 22 (median 7), with 75% (15/20) of the patients having programmed cell death ligand 1 + circulating tumor cells. Circulating tumor cell programmed cell death ligand 1 expression did not correlate with the immunohistochemical staining of programmed cell death ligand 1 in primary tumors. During treatment with programmed cell death protein 1 inhibitors, the disease control rate was much higher in the patients harboring programmed cell death ligand 1 + circulating tumor cells (73%, 11/15) than others (20%, 1/5). We also found that changes in total circulating tumor cell numbers and programmed cell death ligand 1 + circulating tumor cell counts correlated well with the disease outcome.We showed that the presence of programmed cell death ligand 1 + circulating tumor cells before programmed cell death protein 1 inhibition treatment could be a prognosis predictive factor and that the dynamic changes in circulating tumor cell numbers may be used to monitor the therapeutic response. Our study confirms the possibility of programmed cell death ligand 1 + circulating tumor cell detection in clear cell renal cell carcinoma patients' blood samples, which can potentially be used as an individualized immunotherapy molecular biomarker for real-time exploration.

Simple Summary Metastasis is critical to the prognosis of patients with bladder cancer, and it is important to understand the mechanism of its occurrence. S1PR1 expression is thought to be associated with poor prognosis, but it is unknown whether it is associated with tumor metastasis. Analysis of clinical gene expression data suggests that endothelial or immune cells in tumor tissue may be the source of S1PR1 expression. Comparative analysis of clinical tumor tissues with bladder cancer cells suggests that S1PR1 expression is associated with cellular adhesion. In vitro experiments demonstrated that S1PR1 expression was negatively correlated with cancer cell motility, and that S1PR1 inhibition by FTY-720 may cause an increase in cancer cell motility, suggesting that the use of S1PR1 inhibition as a synergistic therapy requires additional observations and considerations. Abstract Clinical bladder tumor histological analysis shows that high expression of S1PR1 is associated with poor patient prognosis. However, there are no studies that describe the underlying mechanism. To investigate the relative distribution and actual function of S1PR1 in bladder tumors, we analyzed multiple clinical databases in combination with tumor purity and immune cell infiltration simulations, as well as databases of well-defined histological phenotypes of bladder cancer, and single-cell sequencing of adjacent normal tissues and bladder tumors, and further compared them with bladder cancer cell lines. The results showed that S1PR1 expression was generally higher in normal tissues than in bladder cancer tissues, and its distribution was mainly in endothelial cells or immune cells. The association between high S1PR1 expression and poor prognosis may be due to tumor invasion of adjacent normal tissues, where highly expressed S1PR1 may affect prognostic interpretation. The effect of S1PR1 itself on cancer cells was associated with cell adhesion, and in bladder cancer cells, S1PR1 expression was negatively correlated with cell motility. Moreover, the use of FTY-720 will cause an increased metastatic ability of bladder cancer cells. In conclusion, we suggest that the use of S1PR1-specific inhibition as a synergistic treatment requires more observation and consideration.

Simple Summary Chronic kidney disease (CKD) is found to be linked to elevated apoptosis, oxidative stress and inflammation. Moreover, lower testosterone, poorer sperm quality and lower reproductive function have also been observed. Coenzyme Q10 (CoQ10), a widely used antioxidant involved in mitochondrial energy production, is indispensable for maintaining the efficient energy system of spermatozoa and protecting their membranes from lipid peroxidation, yet there are few studies focusing on the effects of CoQ10 on CKD-induced male infertility. This study suggests that CoQ10 increases testosterone levels and improves spermatogenesis in CKD mice. Abstract The aim of the study was to examine the potential effects of coenzyme Q10 (CoQ10) on reproductive function in a chronic kidney disease (CKD) mouse model. Nine-week-old mice were randomly assigned to two groups: sham surgery (n = 18) and CKD surgery (n = 18). After surgery, the study groups received CoQ10 (10 mg/kg body weight dissolved in corn oil by oral gavage) or corn oil as a vehicle daily for 8 weeks. The groups that underwent 5/6 nephrectomy developed significant elevations of serum BUN and creatinine levels. The CoQ10 treatment significantly increased the serum and testicular CoQ10 levels and alleviated the poor semen quality from incomplete spermatogenesis. The testosterone concentration, in addition to the protein expression of enzymes related to testosterone biosynthesis, was also elevated, and the CKD-induced decrease in antioxidant activity in the testes was significantly ameliorated. The results suggest that CoQ10 could act against CKD-induced testicular dysfunction through improvements in the sperm function, testicular morphology, testosterone levels and related biosynthesis pathways, in addition to antioxidant activity.

To compare perioperative circulating tumor cells (CTC) in primary upper tract urothelial carcinoma (UTUC) patients who underwent hand-assisted retroperitoneoscopic nephroureterectomy (HANU) or robotic-assisted nephroureterectomy (RANU). A total of 29 patients received RANU (n = 10) or HANU (n = 19). Peripheral blood samples were collected before, 24 h after surgery (POh24) and on postoperative day 28 (POD28). The demographic and pathologic data are similar in both groups. RANU had a longer operative time (p = 0.031), less bleeding volume (p = 0.004), and comparable pain sore (p = 0.169). The mean CTC numbers before surgery (2.4 vs. 2.3, p = 0.482), POh24 (2.4 vs. 1.9, p = 0.668) and POD28 (0.5 vs. 0.6, p = 0.280) were not significant different among groups. The amount of CTCs in both groups decreased and reached similar level on POD28. No significant difference of overall and intravesical recurrence rate between the two approaches. In comparison to RANU, more surgical manipulation does not affect tumor cell translocation into the bloodstream in UTUC patients who received HANU. However, a longer follow-up would be needed for the final comparison of tumor recurrence.

This study explored the effects of coenzyme Q(10) (CoQ(10)) on the testicular functions of male mice exposed to cigarette smoke. Eight-week-old BALB/c male mice were divided into the following groups: the AV group (air with a vehicle), the AQ group (air with CoQ(10)), the SV group (smoke with a vehicle), and the SQ group (smoke with CoQ(10)). The results showed that the CoQ(10) concentrations in the sera and testes were decreased in the groups subjected to smoke but they were improved after the administration of CoQ(10). Neither smoke nor CoQ(10) supplementation affected the serum or testis testosterone concentrations. Regarding the antioxidant system in the testis, the exposure to smoke induced malondialdehyde and hydrogen peroxide production and decreased the catalase and glutathione peroxidase activities. Oral CoQ(10) administration reversed the oxidative damage. In apoptosis, the cytochrome c, c-caspase 9, and c-caspase 3 proteins were increased in the groups exposed to smoke but they were decreased after the CoQ(10) administration. In mitochondrial biogenesis, smoke exposure led to decreases in the PGC1-α, NRF1, and NRF2 levels, but CoQ(10) increased the expressions of these proteins. Additionally, oral CoQ(10) administration improved the mitochondrial copy numbers that were reduced following the exposure to smoke. In summary, CoQ(10) administration reduces smoke-induced testicular damage by regulating the antioxidant capacity, the cell apoptosis, the mitochondrial biogenesis, and the copy numbers in the testes.

Background: Wilms' tumor (nephroblastoma) is the most common solid primary renal malignancy in children but extremely rare in adult population. We report the clinical presentation and therapeutic results of our adult Wilms' tumor patients and review the previous literatures about diagnosis and treatments. Methods: A retrospective review was carried out to investigate the patients with adult Wilms' tumor at the Tri-Service General Hospital during a 35-year period (1980–2014). Seven patients ≥16 years old (one female and six males; median age at the time of diagnosis of 24 years; range: 21–48 years) were staged according to the National Wilms' Tumor Study staging system as follows: three patients had Stage II disease, two patients had Stage III disease, and two patients had Stage IV disease. All statistical values were represented as mean ± standard deviation. All tests were two-sided, with P < 0.05 considered statistically significant. All statistical analyses were carried out using SPSS software (IBM, Armonk, NY, USA). Results: The most common clinical presentation is flank pain (57%) followed by palpable mass (43%). Only one patient presented with gross hematuria. Four patients underwent renal arteriography, which all disclosed irregular, tortuous vessel pattern with faint tumor stain. All patients underwent radical nephrectomy (one – hand-assisted laparoscopic nephrectomy and six – open transperitoneal nephrectomy). Two patients developed lung metastases after radical surgery. Six patients received multimodal therapy, including surgery, chemotherapy, and radiation therapy. The mean disease-free survival is 81 months. The 3- and 5-year survival rates are 83% and 71% separately. Conclusions: Selective renal arteriography could provide a valuable diagnostic hint in adult Wilms' tumor. Using multimodality therapy, improved prognosis could be achieved.

Background: Ketamine-associated cystitis (KC) is a new entity of disease. Our aim is to compare the magnetic resonance imaging (MRI) appearances of urinary bladder in recreational ketamine users with lower urinary tract symptoms (LUTS) and healthy subjects. Materials and Methods: MRI of pelvis was performed for 10 consecutive ketamine abusers with KC and 16 healthy young adults at a medical center in the northern Taiwan from January to December, 2011. The thickness of the bladder wall was measured and analyzed. All patients with KC had been diagnosed based on their history, clinical features and urodynamic study. Results: The mean bladder wall thickness of KC patients was significantly thicker than the control group (1.45±0.23 cm vs. 0.62 ± 0.50 cm, p < 0.001). There is significant positive correlation between the duration of ketamine usage and the thickness of bladder wall (r = 0.891, p =0.001); whereas the dosage of ketamine had weak positive correlation with the thickness of bladder wall (r = 0.413, p =0.235). Furthermore, the thickness of bladder wall was also strong correlated with maximum urethral closure pressure (MUCP; r = 0.855, p =0.002). Conclusions: Ketamine-associated cystitis causes increased bladder wall thickness which may be related to the bladder outlet obstruction. MRI is a useful tool to evaluate the bladder wall thickness and contributes to the diagnosis of ketamine associated cystitis.

The aim of this study was to investigate the effects of metformin supplementation on metabolic dysfunction, testicular antioxidant capacity, apoptosis, inflammation and spermatogenesis in male mice with high-fat and high-cholesterol diet-induced obesity. Forty male C57BL/6 mice were fed a normal diet (NC group, n = 10) or a high-fat and high-cholesterol diet (HFC group, n = 30) for 24 weeks, and mice randomly chosen from the HFC group were later treated with metformin for the final 8 weeks of HFC feeding (HFC + Met group, n = 15). Compared with the HFC group, the obese mice supplemented with metformin exhibited improved blood cholesterol, glucose and insulin resistance. The HFC group diminishes in the sperm motility and normal sperm morphology, while the poorer maturity of testicular spermatogenesis was improved by metformin treatment. The HFC group exhibited a higher estradiol level and a lower 17&beta, HSD protein expression. Further analyses showed that metformin treatment increased the activities of superoxide dismutase, catalase and glutathione peroxidase and reduced lipid peroxidation. Nevertheless, both the HFC and HFC + Met groups exhibited increased expressions of apoptosis and inflammation proteins in the testis. Metformin treatment ameliorated obesity-induced poor testicular spermatogenesis and semen quality through increasing the testosterone level and antioxidant capacity.

ZIEL: Diese Studie erfolgte zum Vergleich der Wirksamkeit einer intravesikalen Instillation von Mitomycin C (MMC) zur Prävention eines nicht muskelinvasiven Ta- oder T1-High-Risk-Harnblasenkarzinoms (NMIBC) unter Verwendung verschiedener Schemata. Diese retrospektive Kohortenstudie wurde bei 152 Patienten durchgeführt, die zwischen April 2009 und September 2016 mit einer intravesikalen MMC-Injektion behandelt wurden. Der mittlere Nachbeobachtungszeitraum lag bei 32,67 Monaten. Alle Patienten unterzogen sich einer vollständigen transurethralen Resektion des Blasentumors (TURBT), an die sich innerhalb von 24 Stunden eine postoperative Instillation von MMC anschloss. Die Patienten wurden in 4 Behandlungsgruppen unterteilt: Bei Gruppe 1 erfolgte die Nachbeobachtung ohne MMC-Erhaltungsdosis; Gruppe 2 erhielt in den ersten 8 Wochen einmal pro Woche eine MMC-Instillation; Gruppe 3 erhielt in den ersten 8 Wochen einmal pro Woche und in den darauffolgenden 6 Monaten einmal pro Monat eine MMC-Instillation; Gruppe 4 erhielt in den ersten 8 Wochen einmal pro Woche und in den darauffolgenden 12 Monaten einmal pro Monat eine MMC-Instillation. Die allgemeine Rezidivrate lag bei 27,6 %. Gruppe 1 zeigte eine signifikant hohe (p 0,05) Rezidivrate von 50 %, während sich bei den Rezidivraten der übrigen 3 Schemata kein Unterschied fand (Gruppe 2: 15 %; Gruppe 3: 24,1 %; Gruppe 4: 27,2 %). Darüber hinaus zeigte sich zwischen diesen Patientengruppen kein statistischer Unterschied bei den Rezidivraten von Ta- oder T1-Tumoren sowie niedrig- oder hochgradigen Tumoren. Unser Vergleich der verschiedenen Schemata einer intravesikalen MMC-Instillation ergab bei einer einzigen MMC-Instillation nach TURBT eine signifikant höhere Rezidivrate als bei Patienten, die nach 8 Wochen, 6 Monaten und 12 Monaten eine Erhaltungsdosis erhielten. Zeitlich fanden sich beim MMC-Erhaltungsschema keine signifikanten Unterschiede zwischen der 8. Woche und dem 12. Monat. Daraus folgern wir, dass bei T1- oder Ta-High-Risk-NMIBC nach TURBT einmalig eine MMC-Instillation mit anschließender Erhaltungstherapie mit einmal wöchentlicher Verabreichung über 8 Wochen durchgeführt werden kann. This study was performed to compare the efficacy of intravesical mitomycin C (MMC) instillation for the prophylaxis of Ta or T1 high-risk nonmuscle invasive bladder cancer (NMIBC) using different schedules. This retrospective cohort study was conducted on 152 patients treated with intravesical MMC from April 2009 to September 2016. The mean follow-up time was 32.67 months. All patients underwent a complete transurethral resection of bladder tumor (TURBT) and postoperative instillation of MMC within 24 h. The patients were divided into 4 treatment groups: Group 1 was followed-up without any maintenance MMC dose treatment; Group 2 received an MMC instillation once per week for the first 8 weeks; Group 3 received an MMC instillation once per week for the first 8 weeks, and once per month for the following 6 months; and Group 4 received an MMC instillation once per week for the first 8 weeks, and once per month for the following 12 months. The overall recurrence rate was 27.6 %. Group 1 had a significantly high (p 0.05) recurrence rate of 50 %, while there was no difference in the recurrence rate between the last 3 schedules (Group 2:15 %; Group 3: 24.1 %; group 4: 27.2 %). Moreover, the recurrence rates of Ta or T1 tumors, and low-grade or high-grade tumors were not statistically different among these patient groups. Our comparison of the different schedules of intravesical MMC instillation revealed a significantly higher recurrence rate with one MMC instillation post-TURBT than in patients with a maintenance dose of 8 weeks, 6 months, and 12 months. The time of the MMC maintenance schedule exhibited no significant differences between 8 weeks and 12 months. Thus, we conclude that for T1 or Ta high-risk NMIBC, MMC instillation can be performed once after TURBT, followed by a maintenance treatment once per week for 8 weeks.

Background: In this study, we aimed to identify the association between chronic periodontal disease (CPD) and erectile dysfunction (ED) in a large young population. Patients and Methods: Totally 2191 male participants aged 18–28 years attended the Army Training Center in Taiwan between August 2012 and May 2013. All 1932 included participants filled in the International Index of Erectile Function-5 (IIEF-5) questionnaire and received a comprehensive dental examination to classify whether CPD. Results: There was a statistically significant correlation between the presence of ED and CPD (P < 0.001). Multivariate logistic regression analysis indicated that men with CPD were 1.6 (95% confidence interval = 1.280–2.009, P < 0.001) times more likely to have ED than men without CPD after adjusting confounders. Conclusion: This study demonstrates a link between ED and CPD, and it may be attributed to a combination of psychogenic and organic etiologies, such as systemic inflammation, oxidative stress, and endothelial dysfunction. This study highlights the significance of oral health, which may take a role in sexual function, even in young males. In clinical practice, more comprehensive management strategies to address participants with ED and CPD need to be investigated.

Simple Summary Programmed cell death ligand 1 (PD-L1) inhibitors are commonly used in treating advanced-stage urothelial carcinoma. Contrary to evaluating PD-L1 expression in tumor biopsy samples, this study assessed whether PD-L1 expression in circulating tumor cells (CTCs) can be a predictor of treatment response to PD-L1 inhibitors. The current study proved that there was no statistically significant correlation between the presence of PD-L1-positive CTCs and PD-L1 expression in tumor tissues. Moreover, PD-L1-positive CTCs at baseline could be used as a biomarker to identify patients suitable for PD-L1 blockade therapy. Dynamic changes in PD-L1-positive CTCs during the course of treatment are predictive factors of immunotherapy response and prognostic factors of disease control. Abstract Programmed cell death ligand 1 (PD-L1) inhibitors are commonly used in treating advanced-stage urothelial carcinoma (UC). Therefore, this study evaluated the relationship between PD-L1 expression in circulating tumor cells (CTCs) and treatment response to PD-L1 inhibitors using blood samples collected from patients with UC (n = 23). Subsequently, PD-L1 expression and its clinical correlation were analyzed. All patients had CTCs before PD-L1 inhibitory treatment, of which 15 had PD-L1-positive CTCs. However, PD-L1-positive expression in CTCs was not correlated with PD-L1 expression in tumor biopsy samples. Patients with PD-L1-positive CTCs had better disease control (DC) rates than those without PD-L1-positive CTCs. Moreover, changes in the proportion of PD-L1-positive CTCs were associated with disease outcomes. Furthermore, the PD-L1-positive CTC count in 9 of 11 patients who achieved DC had significantly decreased (p = 0.01). In four patients with progressive disease, this was higher or did not change. PD-L1-positive CTCs at baseline could be used as a biomarker to identify patients suitable for PD-L1 blockade therapy. Dynamic changes in PD-L1-positive CTCs during the course of treatment are predictive factors of immunotherapy response and prognostic factors of disease control. Hence, PD-L1-positive CTCs could be employed as a real-time molecular biomarker for individualized immunotherapy.

Background: To compare the results of endoureterotomy for benign ureteral strictures by using holmium: yttrium-aluminum-garnet (Ho:YAG) and thulium lasers. Methods: A total of 25 patients (15 men and 10 women, mean age: 49.16 years) underwent endoureterotomy with either Ho:YAG or thulium lasers for benign ureteral strictures (13 proximal, 3 middle, and 9 distal), using semirigid ureteroscopy and a 365-μm fiber (Ho-YAG laser) at 1.2 J/pulse and 10 Hz, or a 300-μm fiber (thulium laser) at 8W to 15W. Following incision, a 7-Fr double-J ureteral stent was left for 4 to 6 weeks. Thereafter, patients were followed-up using ultrasonography and/or intravenous urography at 3- to 6-month intervals. Results: Success was defined as the absence of symptoms, plus radiographic resolution of obstructions, as assessed by diuretic renography and/or intravenous urography. With a mean follow-up of 43 months, success was achieved in 10 (52.6%) of 19 patients treated with Ho:YAG laser and in 5 (83.3%) of 6 patients treated with thulium laser. A total of 10 patients developed recurrent strictures and were considered to have treatment failures. Stricture length and the severity of hydronephrosis were correlated with successful outcome. Sex, etiology, side, and stricture location did not predict outcome. Conclusions: Although endoureterotomies using Ho:YAG and thulium lasers had equal efficacy, our analysis revealed that a patient with longer stricture length or severe hydronephrosis is more suitable to receive thulium laser. This general laser procedure is recommended as a safe therapeutic option for the initial management of patients presenting with benign ureteral strictures because it is less invasive.

We aimed to explore the associations between different lipid profiles and semen quality in a large-scale general male population. Sperm concentration, total sperm motility, progressive motility, and normal sperm morphology of total 7601 participants were recorded. The association of these semen parameters with the triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein, and very low-density lipoprotein of serum lipid profiles was analyzed. Sperm concentration was statistically positively correlated with triglyceride and very low-density lipoprotein (adjusted P = 0.001 and P = 0.005, respectively). Total sperm motility and progressive motility were statistically increased with increasing low-density lipoprotein and cholesterol levels (both adjusted P = 0.008 and P < 0.001, respectively). The similar J-shaped associations (high-low-low-high) were noted between individual lipid profile and normal sperm morphology, especially low-density lipoprotein and cholesterol with statistical significance (adjusted P = 0.017 and P = 0.021, respectively). The prevalence of abnormal total sperm motility and progressive motility was decreased in participants with high levels of cholesterol (P = 0.008 and P = 0.019, respectively), and the reverse J-shaped associations (low-high-high-low) were noted between high-density lipoprotein, triglyceride, very low-density lipoprotein, and the prevalence of abnormal normal sperm morphology (P = 0.010, P = 0.037, and P = 0.025, respectively). A high cholesterol level was associated with better sperm motility. Similar J-shaped associations were noted between all lipid profiles and normal sperm morphology; meanwhile, the reverse J-shaped trends were identified between them and abnormal normal sperm morphology prevalence.

The secreted frizzled-related protein 5 gene (SFRP5) that antagonize the Wnt/β-catenin signaling is frequently inactivated by promoter methylation and oncogenic activation of the Wnt signaling pathway is common in many cancers. The curcumin-rich Curcuma longa has been reported to potent anti-cancer property involved in epigenetic regulation to inhibit tumor suppressor gene methylation and re-expression. In a compounds screening, we found that curcumin can inhibit Wnt/β-catenin signaling. Therefore, the aim of this study was to investigate the effects of curcumin on SFRP5 DNA methylation modification in an ovarian cancer cell line (SKOV3). SKOV3 cells were treated with DMSO, 10 μM 5-aza-2′-deoxycytidine (DAC), 5 μM DAC, 20 μM curcumin, and 20 μM curcumin combined with 5 μM DAC for 96 hours, following which RNA and proteins were extracted for further analysis. The results showed that curcumin combined with 5 μM DAC may inhibit cancer cell colony formation, migration through EMT (epithelial–mesenchymal transition) process regulation, total DNMT activity, especially in DNMT3a protein expression, and may also regulate tumor suppressor gene SFRP5 expression involved in the Wnt/β-catenin signaling pathway. The combined treatment attenuated ovarian cancer development.