Male infertility (MI) and male sexual dysfunction (MSD) can often coexist together due to various interplay factors such as psychosexual, sociocultural and relationship dynamics. The presence of each form of MSD can adversely impact male reproduction and treatment strategies will need to be individualized based on patients’ factors, local expertise, and geographical socioeconomic status. The Asia Pacific Society of Sexual Medicine (APSSM) and the Asian Society of Men’s Health and Aging (ASMHA) aim to provide a consensus statement and practical set of clinical recommendations based on current evidence to guide clinicians in the management of MI and MSD within the Asia-Pacific (AP) region. A comprehensive, narrative review of the literature was performed to identify the various forms of MSD and their association with MI. MEDLINE and EMBASE databases were searched for the following English language articles under the following terms: “low libido”, “erectile dysfunction”, “ejaculatory dysfunction”, “premature ejaculation”, “retrograde ejaculation”, “delayed ejaculation”, “anejaculation”, and “orgasmic dysfunction” between January 2001 to June 2022 with emphasis on published guidelines endorsed by various organizations. This APSSM consensus committee panel evaluated and provided evidence-based recommendations on MI and clinically relevant MSD areas using a modified Delphi method by the panel and specific emphasis on locoregional socioeconomic-cultural issues relevant to the AP region. While variations exist in treatment strategies for managing MI and MSD due to geographical expertise, locoregional resources, and sociocultural factors, the panel agreed that comprehensive fertility evaluation with a multidisciplinary management approach to each MSD domain is recommended. It is important to address individual MI issues with an emphasis on improving spermatogenesis and facilitating reproductive avenues while at the same time, managing various MSD conditions with evidence-based treatments. All therapeutic options should be discussed and implemented based on the patient’s individual needs, beliefs and preferences while incorporating locoregional expertise and available resources.

This paper reviewed the clinical data of a patient with primary abdominal cocoon syndrome, situs inversus totalis and bilateral cryptorchidism admitted to our hospital in March 2021, and discussed the clinical characteristics of the disease based on the literature. This case is relatively rare, and all three diseases involve congenital abnormalities that may lead to developmental disorders in the embryo. The clinical manifestations of abdominal cocoon syndrome lack of specificity, preoperative diagnosis is difficult, often accompanied by partial dysplasia, so it is necessary to improve the awareness of preoperative differential diagnosis.

【Objective】 To investigate the efficacy of low intensity pulsed ultrasound (LIPUS) in the treatment of erectile dysfunction (ED). 【Methods】 A total of 121 ED patients treated during June 2020 and June 2022 were selected as the research objects. According to the International Erectile Index Score (IIEF-EF), the patients were divided into three subgroups:mild (17-25 points), moderate (11-16 points), and severe (0-10 points). The total effective rate, erectile hardness scale (EHS), sex life log questions (SEP), general assessment questionnaire (GAQ), peak systolic velocity (PSV), end diastolic velocity (EDV), and adverse reactions of the three groups before treatment, 4 weeks and 12 weeks after treatment were analyzed. 【Results】 A total of 119 patients completed the follow-up. There were significant increases in IIEF-EF and EHS at week 4 and 12 (P<0.05), and the total effective rate was 69.75% and 76.47%, respectively. The total effective rate was significantly higher in the mild and moderate groups than in the severe group at week 4 and 12 (P<0.05). The patients who answered "yes" to SEP2 and SEP3 accounted for 91.60% and 71.43%, respectively at week 4, and 92.44% and 78.15% at week 12, both significantly higher than the rates before treatment (52.10% and 27.73%, P<0.05). The proportion of patients who answered "yes" to GAQl and GAQ2 at week 4 were 84.87% and 71.43%, respectively, and were 82.35% and 70.59% respectively at week 12, with no significant difference. The PSV level significantly increased at week 12 compared to that before treatment [(48.85±14.11) cm/s vs. (41.42±14.90) cm/s] (P<0.05), while the EDV level significantly decreased [(-0.57±7.01) cm/s vs. (2.25± 5.68)cm/s] (P<0.05). 【Conclusion】 LIPUS can improve erectile function in ED patients without obvious adverse reactions.

Objective Through analyzing the scientific research performance of recruited doctors in Nanjing Drum Tower hospital,we can understand its current situation and problems,and then provide reasonable suggestions to promote the recruited doctors' scientific research capacity.Methods Descriptive statistics was used to analyze the projects application and outputs in scientific research.Results The proportion of recruited doctors who received National Natural Science Fund Youth Project has been increasing every year (the average growth rate is 16.46 ％).Many recruited doctors gained projects in the first year after admission(25.33％),but still 40.14％ of these doctors did not gained any project.Each recruited doctor published 1.58 SCI papers on average (19.33％).Conclusions We should innovate the training system,optimize the construction of scientific research platform,establish hospital science project,and implement scientific evaluation system to mobilize these youth talents comprehensively.

Objective Through investigating the current situation of scientific research in medicine graduate students, we can provide scientific basis for training postgraduates effectively and reference for graduate education reform. Methods A total of 243 medicine graduate students in Drum Tower Hospital were surveyed and asked to complete the designed questionnaires which included general situation, the objective to study, the situation of participation projects, the management of student, and achievements. Results 33.74％ (82) of students' purpose was confusion, 51.44％ of (125) graduate students engaged in clinical and basic research, the scientific research graduate students and doctoral students participated in the tutor research project more than the professional type graduate students and Postgraduate student (P<0.05). There were significant differences in the number of SCI related papers published by the postgraduates who differ in their ways of training and in different degrees (P<0.05). Conclusion Graduate students are an important part of high-level talents in China. They are the successors of future scientific research. The effectiveness of training postgraduates' scientific research ability will directly affect the future scientific research level of the country. So we should strengthen the cultivation of graduate students' scientific research accomplishment, construct a scientific training model, set up scientific training mode and supervision mech-anism, in order to promote the research level of medical graduate students.

Objective To summarize the experience and the insufficiency of Nanjing Drum Tower Hospital on patent management,and find out the problemsand countermeasures for the management.Methods The authorized patents during 2003-2014 of Nanjing Drum Tower Hospital were analyzed statistically,and the date was overall analyzed combined withthe number,type,content,maintenance and transfer of patent and inventors' educational background,title and subject;and results are further analyzed;Results Patent grant increased significantly more than the invention patent in recent years.In terms of patent types,most patents are utility model patents,and conversion rate of patent outcome is very low.Conclusions Suggestions are proposed to improve hospital patent management:strengthening the guidance of the management of patent policy;promoting patent work;enhancing the professional quality of patent managers;optimizing the patent management processe andstrengthening the patent examination and data analysis;strengthening strategic cooperation among intellectual property management department,patent agency and biological pharmaceutical enterprises.

Objective To observe the expression of Her-2/neu protein and androgen receptor (AR) in human prostate cancer and to evaluate their significances in the progression of prostate cancer. Methods The Her-2/neu protein and AR immunohistochemical stain were carried out in human prostate tissue microarray that consisted of prostate cancer (107 cases) and benign prostate tissue (42 cases). The prostate cancer cases were divided into 4 groups: group one (Gleason score 6),group two (Gleasonscore 7), group three (Gleasonscore 8) and group four (Gleasonscore 9) according to the Gleason score. The immunostains immunohistochemical stain were interpreted in two aspects of the staining intensity and the percentage of positive cells. The significance and relationships between the expression of Her-2/neu protein and AR in prostate cancer and benign prostate tissue (BPT) and the grouping of different Gleason scores of prostate cancer were then evaluated. Results The positive expression rate of Her-2/neu protein was significantly higher in prostate cancer tissue than in BPT [43.9%(47/107) vs. 14.3%(6/42), x2=11.562, P=0.009], and the positive expression intensity of Her-2/neu immunoreactivity was also higher (x2= 11.764, P=0.008). There were significant differences in positive expression intensity of Her-2/neu immunoreactivity among the different Gleason scores groups (x2 = 20. 512, P = 0. 015), and the expression intensity was significantly positively correlated with Gleason scores ( r= 0. 269, P = 0. 005). There was significant difference in AR immunoreactivity between in prostate cancer (67 %, 72/107) and in BPT (50 %, 21/42, x2 =3. 843, P=0. 050). Among prostate cancer cases, the positive expression intensity of AR was not significantly different among groups 1 through 4 (x2 = 4. 318, P = 0. 229), and was not significantly correlated with Gleason scores ( r = - 0. 065, P = 0. 505 ). Moreover, the positive expression intensity of Her-2/neu protein was not significantly correlated with that of AR (r = -0. 115, P=0. 237). Conclusions Overexpression of Her-2/neu protein in human prostate cancer tissue suggests that Her-2/neu may have some role in prostate tumorigenesis. Her-2/neu protein expression is positively correlated with Gleason score in prostate cancer, which suggests that Her-2/neu may be a potential prognostic predictor of prostate cancer.

Objective To evaluate the expression of molecular markers in prostate cancer and to clarify the significance of these markers as prognostic indicators for androgen deprivation therapy. Methods A series of 116 prostate cancer patients under androgen deprivation therapy as a single treatment was reviewed. Expression levels of 7 proteins, including androgen receptor(AR),E-cadherin, Chromogranin A(CgA) , Ki-67, Survivin, EZH2 and hepsin, were measured by immunohistochemical staining. Results Of the 7 molecules. Ki67,EZH2 and Survivin expression were significantly associated with several conventional prognostic factors. Univariate analysis identified clinical stage, Glea-son scores,pretreatment serum PSA level, Ki-67 and Survivin expression as significant predictors for prostate-specific antigen (PSA) progression after endocrine therapy. Of these significant factors, Survivin expression, clinical stage and Gleason scores appeared to be independently related to PSA progression after endocrine therapy by multivariate analysis. Furthermore, there were significant differences in PSA progression-free survival according to positive numbers of these three independent risk factors. Conclusion Survivin could be a useful independent prognostic factor in prostate cancer with endocrine therapy, besides clinical stage and Gleason score.

Trauma and surgery sometimes cause erectile dysfunction because of injury to pelvic nerves and cavernous nerves of the penis. The ideal treatment is to make the injured nerves regenerate themselves and erectile function recover completely. This paper reviews the recent advances in the studies of erigentes regeneration and plerosis following injury in order to find the best method to enhance erigentes regeneration.
Erectile Dysfunction ; therapy ; Humans ; Male ; Penile Erection ; physiology ; Penis ; innervation ; Peripheral Nerve Injuries ; Regeneration ; Transurethral Resection of Prostate ; adverse effects

OBJECTIVETo evaluate percutaneous epididymal sperm aspiration (PESA) and testicular sperm extraction (TESE) in the diagnosis and treatment of azoospermia.

METHODSWe examined 385 azoospermia patients using the techniques of PESA and TESE.

RESULTSOf the total number of the azoospermia patients, 64 (16.62%) had sperm in the epididymis and 45 (11.69%) in the testis. Intracytoplasmic sperm injection (ICSI) was applied to 64 of the patients with sperm in the epididymis or testis. The pregnancy rate after the embryo transfer was 39.07%.

CONCLUSIONPESA and TESE, as an effective therapy for azoospermia, can further the classification of azoospermia and provide chances of procreation to azoospermia patients with partial obstruction.

Adult ; Azoospermia ; diagnosis ; therapy ; Cell Separation ; methods ; Epididymis ; cytology ; Humans ; Male ; Sperm Injections, Intracytoplasmic ; methods ; Testis ; cytology ; Treatment Outcome