Objective:To investigate the relationship among seminal oxidation-reduction potential(nORP),sperm DNA frag-mentation(DFI)and semen parameters in patients with varicocele.Methods:Clinical data of 522 patients treated in the reproduc-tive andrology clinic of the Northern Theater General Hospital from November 2023 to December 2023 were retrospectively analyzed,in-cluding 435 men of childbearing age and 87 men of infertile age.The patients were divided into the varicocele group(n=116)and non-varicocele group(n=406)according to clinical diagnosis.The differences of seminal plasma nORP,DFI,sperm high DNA stain ability(HDS)and semen parameters were analyzed between the two groups.The relationship among general clinical data,seminal plasma nORP,semen parameters,DFI and HDS in patients with varicocele were further analyzed.According to the severity of varico-cele,the patients were divided into three groups,including mild,moderate and severe.And the differences of seminal plasma nORP and semen parameters,DFI and HDS among all groups were analyzed.The differences of seminal plasma nORP,semen parameters,DFI and HDS were compared between the varicocele and non-varicocele groups.Results:The total sperm count,sperm concentra-tion,progressive motility sperm percentage(PR％)and normal sperm morphology rate(NSMR)in patients with varicocele were sig-nificantly lower than those in control group(P＜0.05).And seminal plasma nORP,DFI and HDS in patients with varicocele were sig-nificantly higher than those in control group(P＜0.05).Seminal plasma nORP in patients with varicocele was significantly negatively correlated with total sperm,sperm concentration and NSMR(P＜0.05),and significantly positively correlated with DFI and HDS(P＜0.05).There were significant differences in nORP,total sperm count,sperm concentration,PR％,DFI and HDS among mild,moderate and severe varicocele groups(P＜0.05).Seminal plasma nORP,sperm concentration,PR％and DFI in severe group were significantly lower than those in mild and moderate groups(P＜0.05).Sperm count and HDS in severe group were significantly lower than those in mild group(P＜0.05).In infertile patients,seminal plasma nORP,DFI and HDS in varicocele group were significantly higher than those in control group(P＜0.05).And PR％in varicocele group was significantly lower than that in control group(P＜0.05).Conclusions:Seminal plasma nORP in patients with varicocele may be an important marker of oxidative stress affecting DFI and semen parameters.

Objective:To evaluate the clinical efficacy of"Shibao Decoction"in the management of late-onset hypogonadism(LOH)caused by deficiency of kidney essence.Methods:Sixty male patients with late-onset hypogonadism of kidney essence defi-ciency type were randomly assigned to the treatment group and the control group,each with 30 cases.The patients in treatment group were treated with oral Shibao Decoction,while the control group was treated with oral Testosterone Undecanoate Capsules.The patients in both groups were treated for 12 weeks.The PADAM symptom score,TCM syndrome score,serum total testosterone(TT),serum free testosterone(FT),sex hormone binding globulin(SHBG),body mass index(BMI),total skeletal muscle mass index(SMI),appendicular skeletal muscle mass index(ASMI),FBG,FINS,and insulin resistance index(HOMA-IR)levels were compared be-tween the two groups.Results:After treatment,PADAM scores for each item and TCM symptoms score decreased,TT and FT in-creased in both groups,all with statistically significant differences from those of pre-treatment(P＜0.05).The level of SHBG in the control group decreased(P＜0.05),which had not changed significantly in the treatment group(P＞0.05).After treatment,SMI and ASMI increased in both groups significantly(P＜0.05).BMI decreased in the control group(P＜0.05),which had not changed significantly in the treatment group(P＞0.05).The level of FINS decreased in the control group(P＜0.05),which had not changed significantly in the treatment group(P＞0.05).FPG had not changed significantly in both groups(P＞0.05),and the insulin resist-ance index(HOMA-IR)had significantly improved in both groups,all with statistically significant differences from those of pre-treat-ment(P＜0.05).After treatment,the total effective rates of PADAM score and TCM syndrome score in the treatment group were 73.3％and 86.6％respectively,and the total effective rates in the control group were 66.7％and 76.6％respectively.The total ef-fective rates of the two scores in the treatment group were slightly higher than those in the control group(P＞0.05).There was no sig-nificant difference in the indicators between the two groups after treatment,and the treatment group is generally comparable with the control group in the therapeutic effects(P＞0.05).And no adverse reactions occurred during treatment in both groups.Conclu-sion:The"Shibao Decoction"has a remarkable therapeutic effect on late-onset hypogonadism caused by deficiency of kidney essence and has good safety.It can be used as an alternative to testosterone undecanoate and is worthy of clinical promotion and application.

Objective:To explore the role of prostate health index(PHI)and its derivatives for early screening in patients with PI-RADS score 3 and prostate-specific antigen(PSA)levels of 4-20 μg/L.Methods:Clinical data of 203 patients with a score of 3 on the PI-RADS v2.1 scoring system who underwent ultrasound-guided transperineal prostate aspiration biopsy from April 2021 to April 2024 from Provincial Hospital of Shandong First Medical University,Qilu Hospital of Shandong University and Weifang People's Hospital were collected.Patients who met the inclusion criteria were divided into prostate cancer(PCa)group(62 cases)and benign prostatic hyperplasia(BPH)group(141 cases).Serum total prostate-specific antigen(tPSA),serum free prostate-specific an-tigen(fPSA),and PSA isoform 2(p2PSA)were routinely detected after admission.And prostate-specific antigen density(PSAD),prostate health index(PHI)and prostate health index density(PHID)were calculated with the basic personal information being col-lected.The efficacy of each parameter in early screening of patients with PI-RADS score of 3 and PSA level of 4-20 μg/L was as-sessed using ROC curve approach.Results:There was no statistical difference in tPSA,fPSA and fPSA/tPSA between the two groups(P＞0.05).There was a statistical difference in p2PSA,PSAD,PHI,PHID and age between the two groups(P＜0.05).PHI(AUC=0.783 7,95％CI:0.711 3-0.856 1)and PHID(AUC=0.782 3,95％CI:0.708 3-0.856 4)showed a good pre-dictive ability in the early screening of prostate cancer.In the clinically significant prostate cancer(csPCa)group,the ROC curve are-as of PHI and PHID were 0.823 0 and 0.788 5,respectively,which showed better predictive efficacy of prediction of csPCa.The ROC curves of the combined diagnostic indexes were plotted on the basis of the independent ROC curves,and the area under the curve of PHI combined with age,p2PSA and PHID(AUC=0.843 6)was the largest and had the best predictive ability among all the com-bined diagnostic indexes.Conclusion:In patients with PI-RADS score 3 and PSA level between 4 and 20 μg/L,PHI and its deriva-tives(PHI and PHID)provide a new way for early screening of prostate cancer compared with the traditional index tPSA,which has a high value of application in reducing the over-penetration.

Objective:To explore the effect of evidence-based standardized procedures(SOP)on urinary incontinence manage-ment in patients with radical prostatectomy.Methods:Sixty-three patients who underwent radical prostatectomy from October 2022 to September 2023 were included in the control group.And 63 patients who underwent radical prostatectomy from October 2023 to Sep-tember 2024 were included in the observation group.The patients in the control group received routine perioperative care.As an addi-tion,the SOP on urinary incontinence management was performed in the patients of observation group.The incidence of urinary inconti-nence,severity of urinary incontinence(1 h urine pad test),quality of life(Incontinence Quality of Life Questionnaire)and comfort level(General Comfort Question)of the two groups were compared after 3 and 6 months of surgery.Results:The incidence of urina-ry incontinence at 3 and 6 months after operation in the observation group was 36.51％and 19.05％,respectively,which were lower than those(53.97％and 38.10％)of the control group,respectively.And the incidence rates of the two groups decreased significant-ly(P＜0.05).The score of life quality after 3 months of operation was(56.17±12.75)in the control group,which was lower than that(70.41±14.50)of the observation group.The 3-month postoperative comfort score was(52.73±11.26)in the control group and(63.49±13.52)in the observation group.The 6-month postoperative incontinence quality of life score was(64.70±11.38)in the control group and(85.41±12.04)in the observation group.And the 6-month postoperative comfort score was(60.96±8.04)in the control group and(83.49±12.04)in the observation group.The quality of life and comfort scores of the two groups 6 months after operation were significantly improved than those 3 months after operation,and the improvement of the observation group was more obvi-ous than that of the control group(P＜0.05).There were significant differences in the degree of urinary incontinence between the two groups at 3 months and 6 months after operation(P＜0.05).Conclusion:SOP management for the patients underwent radical pros-tatectomy can be an effective method for reducing the incidence of postoperative urinary incontinence,which promotes the recovery of postoperative urinary control.

Prostate cancer is a common tumor of the male genitourinary system,with its incidence continuously increasing.Early accurate diagnosis is crucial for treatment and prognosis.PSA and MRI are important methods for screening and diagnosis of prostate cancer.However,there is still controversy over whether patients with PSA levels between 4-10 μg/L and PI-RADS score of 3 need to undergo prostate biopsy.Radiomics technology provides a new approach for the early and accurate diagnosis of prostate cancer by min-ing and analyzing medical image information in a high throughput,which helps to reduce unnecessary biopsies.This article reviews the research progress of MRI radiomics in the screening of prostate cancer in the"gray zone"of PSA and PI-RADS score of 3,aiming to improve diagnostic accuracy and provide references for future research in the field of radiomics.

Objective:Varicocele(VC)induces male infertility by mediating changes in the testicular microenvironment,in which testicular hypoxia and high-pressure are important pathological conditions.This study aims to compare the mouse spermatogenesis(GC-2spd)cells and Sertoli(TM4)cells of mouse testis after hypoxic modeling and hypoxic and high-pressure combined modeling,and to explore the feasibility of establishing a hypoxic and high-pressure combined cell model.Methods:On the basis of cell hypoxia induced by CoCl2,the complex model of testicular cell hypoxia and high pressure was constructed by changing the osmotic pressure of GC-2 and TM4 cell medium with a high concentration of NaCl solution.After selecting the intervention concentration of CoCl2 by MTT test and detecting the expression level of HIF-1α for the determination of the optimal osmotic pressure conditions of the cell model,the cells were divided into normal group,hypoxia model group and composite model group.And the levels of OS,programmed cell death,inflammatory factors,and the expression levels of pyroptosis-related proteins were compared between the normal group and the groups with different modeling methods.Results:The optimal intervention concentration of CoCl2 in GC-2 and TM4 cells was 150 and 250μmol/L,respectively,and the expression of HIF-1α was the highest in both cells under osmotic pressure of 500 mOsmol/kg(P＜0.05).Compared with the normal group,the SOD levels of GC-2 and TM4 cells decreased(all P＜0.05),CAT level decreased(all P＜0.05),and MDA level increased(all P＜0.01),and the OS level of GC-2 and TM4 cells was more obvious than that of the hy-poxia model group(all P＜0.05).Compared with the normal group,apoptosis occurred in GC-2 and TM4 cells after composite model-ing(all P＜0.05).Compared with the normal group,the mRNA expressions of IL-1β,IL-18,TNF-α and COX-2 in GC-2 and TM4 cells significantly increased(P＜0.01)and higher than those in hypoxia model group(P＜0.05)and induced pyroptosis(P＜0.01).The expression level of GSDMD increased(P＜0.05).Conclusion:The cell model with hypoxia and high pressure com-bined modeling can not only induce oxidative stress and apoptosis of cells better than that with hypoxia alone,but also further cause in-flammatory response damage and pyroptosis,which simulates the changes of testis microenvironment mediated by hypoxia and high pressure combined conditions in VC.This cell model can be used for studying the pathogenesis of VC-associated male infertility,evalu-ating drug efficacy,and exploring pharmacological mechanisms.

Objective:To explore the expression regulation of lipid metabolism gene ABHD5 in testes.Methods:Differential gene analysis was performed by integrating databases of TCGA and GTEx to identify the target gene ABHD5.The expression trends of ABHD5 gene in testicular carcinoma tissue were analyzed.Human testis single-cell atlases were obtained from the Human Protein Atlas and Male Health Atlas databases to determine the expression distribution of ABHD5 across different testicular cell types.Additionally,the GTEx database was utilized to visualize the expression pattern of ABHD5 in the testis,thereby enhancing the understanding of its transcriptional profile.The relationship between ABHD5 expression and age was assessed through integrated database analysis.Western blotting and immunofluorescence were performed to detect differential expressions of ABHD5 in testicular tissues of young and aged mice respectively.Results:The TCGA database indicated that the expression of ABHD5 in human testicular carcinoma tissue was significantly lower than that in normal testicular tissue which showed a negative correlation with patient survival.ABHD5 was highly ex-pressed in germ cells of the testis reveaked from Human Protein Atlas and Male Health Atlas databases.The stability of ABHD5 protein was crucial for testicular tissue,and its expression decreased with age.Furthermore,Western blot and immunofluorescence staining demonstrated that ABHD5 expression in the testicular tissue of aged mice was significantly lower than that in young mice.Conclu-sion:ABHD5 plays an important role in testicular tissue,and may be inseparable from testicular tumors and reproductive aging.How-ever,its mechanism of action remains to be further studied.

Objective:To analyze the effect of Y chromosome AZFc microdeletion on pregnancy outcome of intracytoplasmic sperm injection(ICSI).Methods:From 2016 to 2023,6 765 cases of oligozoospermia in our hospital were selected as the research objects.The results of Y chromosome microdeletion test were retrospectively analyzed.According to the inclusion exclusion criteria and the principle of propensity distribution 1∶2,180 patients were included in the study.Sixty patients with Y chromosome AZFc microde-letion and ICSI assisted pregnancy were enrolled into the experimental group.The other 120 patients without Y chromosome microde-letion and ICSI assisted pregnancy were included in the control group.Baseline characteristics,five male sex hormones,laboratory em-bryo culture and pregnancy outcomes were compared between the two groups.Results:There was no significant difference in male age,female age,infertility years,gravidity and parity between the two groups(P＞0.05).There was no significant difference in the five sex hormones of men(P＞0.05).Except for transplantable embryos(P＜0.05),there was no significant difference in other indi-cators in the process of embryo culture.There was no difference in pregnancy outcome indicators between the two groups except for the preterm birth rate(P＜0.05).Conclusion:ICSI assisted pregnancy with Y chromosome AZFc microdeletion has no significant effect on pregnancy outcome.And close follow-up of offspring is required.

Objective:To explore the diagnostic value of shear wave elastography(SWE)for clinically significant prostate cancer(csPCa).Methods:We retrospectively analyzed the clinical data of 359 cases with suspected prostate cancer(PCa)in Baoji Central Hospital from June 2017 to July 2023.All the patients underwent the following examinations in the order of serum prostate-spe-cific antigen(PSA)testing,transrectal ultrasonography(TRUS),measurement of the stiffness of the entire prostate gland by SWE,and TRUS-guided prostate puncture biopsy.The stiffness of the entire prostate gland was defined as the average of Young's modulus at both sides of the base,middle,and apex of the prostate,including the maximum Young's modulus(Emax),mean Young's modulus(Emean),and minimum Young's modulus(Emin).We analyzed the correlation of the parameters of the stiffness of the entire prostate gland with the pathological results,focusing on their diagnostic performance for csPCa.Results:Of the 359 cases,189 were diag-nosed by pathological puncture biopsy as BPH,26 as non-csPCa,and 144 as csPCa.The PSA level,Emax,Emean and Emin were significantly higher in the csPCa than those in the BPH and non-csPCa groups(all P＜0.01),but showed no statistically significant difference between the BPH and non-csPCa groups(all P＞0.05).The area under the receiver operating characteristic curve(AUC),optimal cut-off value,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and accura-cy of Emax in the diagnosis of csPCa were 0.852,143.92 kPa,72.22％,84.65％,75.91％,81.98％and 79.67％;those of Emean were 0.868,82.42 kPa,67.36％,91.16％,83.62％,80.66％and 81.62％;and those of Emin were 0.682,32.73 kPa,47.22％,89.30％,73.91％,71.54％and 72.14％,respectively.In the non-csPCa group,Emax,Emean and Emin were found be-low the optimal cut-off value in 73.08％(19/26),92.31％(24/26)and 88.46％(23/26),respectively.Conclusion:The stiff-ness of the entire prostate gland measured by SWE contributes to the diagnosis of csPCa,reduces unnecessary detection of non-csPCa,and provides some reference for its active surveillance.

Objective:To explore the clinical efficacy of Wenshen Chushi Decoction combined with low intensity pulsed ultra-sound(LIPUS)on erectile dysfunction(ED)caused by renal deficiency and phlegm-dampness syndrome.Methods:One hundred and twenty ED patients were included from the Department of Andrology in the First Hospital of Hunan University of Traditional Chinese Medicine.The patients in control group were treated with Wenshen Chushi Decoction.While the patients in observation group were trea-ted with Wenshen Chushi Decoction combined with LIPUS for 8 consecutive weeks.After the treatment,the efficacy was evaluated using the International Index of Erectile Function-5(IIEF-5)score,Penile Flow Index(PFI),Traditional Chinese Medicine Syndrome Score,Self-Rating Depression Scale(SDS)score,and Self-Rating Anxiety Scale(SAS)score.Safety was also observed.And the ef-ficacy was followed up 4 weeks after the end of treatment.Results:Fifty-seven cases were enrolled into control group finally with 55 cases in the treatment group.After the treatment,all the patients in both of groups showed an improvement in IIEF-5 scores(P＜0.01).Compared with the control group(19.09±2.22),the IIEF-5 score in observation group(20.42±2.39)increased signifi-cantly(P＜0.01).After the treatment,the scores of PFI,TCM syndrome and SDS in both groups decreased(P＜0.01,P＜0.05,P＜0.01).Compared with the control group([3.77±1.21],[9.91±1.71]and[39.88±2.63]points),the observation group([2.92±1.08],[4.78±1.45],and[34.51±2.09]points)showed a more significant decrease(P＜0.01).There was no significant difference in total effective rate between the two groups(P＞0.05).During follow-up,the IIEF-5 scores of both groups of patients were higher than those before(P＜0.05,P＜0.01),and the observation group score was higher than that in the control group([17.15±3.37]vs[13.63±1.96],P＜0.01).No adverse reaction and abnormality of indicators occurred in both of two groups.Conclusion:Wenshen Chushi Decoction has a significant therapeutic effect on ED caused by renal deficiency and phlegm-dampness syndrome.It can not only improve the quality of erection,but also improve the physical and mental symptoms associated with ED,which makes therapeutic effect lasting longer.