Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation)...Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today's world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician's responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of OCT (optical coherence tomography), frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology.展开更多
· Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simu...· Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today’s world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician’s responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test (s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of optical coherence tomography, frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up -to -date information on malingering or simulation in ophthalmology. ·展开更多
The P300, an endogenous subcomponent of the event-related potential, is thought to reflect cognitive processes. The event-related potential evoked by the old-new memory recognition task in the oddball paradigm is suit...The P300, an endogenous subcomponent of the event-related potential, is thought to reflect cognitive processes. The event-related potential evoked by the old-new memory recognition task in the oddball paradigm is suitable for examining the neural processes involved in malingered neurocognitive deficits. Forty-four undergraduates were randomly assigned to a simulated malingering group and a truth-telling group, Another 22 patients with head injudes were enrolled as a control group. All participants completed the old-new memory recognition task in the oddball paradigm. The mean P300 amplitude of the simulated malingering group was significantly reduced compared with the truth-telling group （P 〈 0.01）, but was increased compared with the control group （P〈 0.01）. These results revealed that the P300, evoked by the old-new memory recognition task of the oddball paradigm, may be a helpful indicator for determining cognitive malingering.展开更多
The main high points ofthis tour are sightseeing inthe Maling River Valley, riftvalley drifting, a visit to theBouyei village, and theGuizhou Wedding CustomsMuseum.
Recent studies have shown that lipid metabolism is a key factor affecting anther development and male fertility.However,how plants regulating the metabolic balance of multiple lipids to ensure proper anther developmen...Recent studies have shown that lipid metabolism is a key factor affecting anther development and male fertility.However,how plants regulating the metabolic balance of multiple lipids to ensure proper anther development and male fertility remains unclear.Analyzing lipid molecules related to anther fertility and genes responsible for their biosynthesis is crucial for understanding the physiological significance of lipid metabolism in crop fertility.In this study,we compared the transcriptome and the composition and content of lipids in anthers of two upland cotton(Gossypium hirsutum) materials,Shida 98(WT) and its nearly-isogenic male sterile line Shida 98A(MS).Transcriptomics analysis identified many differentially expressed genes(DEGs) between the two materials,with the genes of the alpha-linolenic acid metabolism pathway being the most significantly associated with the male sterility phenotype.Investigations on lipids revealed that the MS anthers over-accumulated free fatty acids(FFAs),phosphatidic acid(PA),mono-and di-galactosyldiacylglycerol(MGDG and DGDG),and had a decreased content of triacylglycerol(TAG),which was closely related to the abnormal metabolism of alpha-linolenic acid(C18:3);therefore,the major lipids containing C18:3-acyl chains,such as PA,MGDG,DGDG,and TAG,are proposed to play a major role in cotton anther development.We also showed that an excessive level of MGDG and DGDG caused jasmonic acid(JA) overaccumulation in MS anthers,which in turn inhibited the expression of GhFAD3 and consequently reduced the C18:3 content,presumably via a feedback regulation mechanism,ultimately affecting plant fertility.Together,our results revealed the importance of a balanced lipid metabolism in regulating the development of cotton anther and pollen and consequently male fertility.展开更多
Background Understanding the genetic basis of male reproduction in mammals remains challenging.Commercial pig populations offer a unique model for studying fertility,as semen traits are routinely recorded using high-t...Background Understanding the genetic basis of male reproduction in mammals remains challenging.Commercial pig populations offer a unique model for studying fertility,as semen traits are routinely recorded using high-throughput systems.Results In a large-scale GWAS of 15 semen traits based on 286,314 ejaculates collected from 2,954 boars of a purebred pig line,we identified 10 QTL,including four loci with recessive deleterious alleles.Several lead SNPs affected multiple semen traits.For example,a SNP on SSC6 was significantly associated with distal cytoplasmic droplets and with effects on tail abnormalities and sperm motility in a follow up analysis.The allele frequencies of some loci were different in older boar's,most likely due to culling based on poor semen quality.Using WGS,we identified six missense variants in high linkage disequilibrium(LD)with lead SNPs in genes related to sperm production(e.g.,MEIOB,CFAP74 and UBE2B).Remarkably,the frequency of some alleles with predicted deleterious effects on semen traits increased between 2013 and 2019.Conclusions Our results highlight loci with major effects on semen quality,some of which are linked to functional variants in key genes involved in spermatogenesis.The information from this study can be used to select against deleterious alleles affecting semen characteristics in pigs and provides valuable insight into the genetics of mammalian male fertility.展开更多
Mammalian fertilization involves the migration of spermatozoa through the female reproductive system.Early embryonic development is a consequence of several steps and signaling pathways being activated,as well as bioc...Mammalian fertilization involves the migration of spermatozoa through the female reproductive system.Early embryonic development is a consequence of several steps and signaling pathways being activated,as well as biochemical and morphological modifications of spermatozoa that enable them to penetrate the membrane of mature oocytes.There are some crucial steps known to clearly explain the process of fertilization,starting with hyperactivation of spermatozoa,mutual recognition,and binding of gametes mediated by receptors located on the surface membranes of both gametes.The final step is followed by oocyte activation,which is primarily triggered via sperm-derived factors,inducing a sharp increase in intracellular calcium levels,eventually leading to polyspermy block.This review integrates current knowledge of the molecular and physiological events governing fertilization,emphasizing how ion regulation and signaling pathways converge to enable sperm function and oocyte activation.Special attention is given to sperm-derived factors such as phospholipase C zeta(PLCζ)and post-acrosomal sheath WW domain-binding protein(PAWP),which play essential roles in triggering calcium release and supporting early embryonic development.展开更多
Male sexual behaviors,including mounting,intromission,and ejaculation,are not only critical for reproduction but also serve as a model for understanding how the brain orchestrates sequential motor and motivational pro...Male sexual behaviors,including mounting,intromission,and ejaculation,are not only critical for reproduction but also serve as a model for understanding how the brain orchestrates sequential motor and motivational processes.While previous studies have identified key brain regions involved in sexual behaviors,such as the medial preoptic area(MPOA)and the nucleus accumbens(NAc)[14],the neural mechanisms governing the transitions between different phases of male sexual behavior remain poorly understood.展开更多
Objective:To investigate the sterilizing potential of zinc gluconate,calcium chloride(CaCl_(2))and cadmium chloride(CdCl_(2))following a single intratesticular administration in adult male rats.Methods:60 adult male W...Objective:To investigate the sterilizing potential of zinc gluconate,calcium chloride(CaCl_(2))and cadmium chloride(CdCl_(2))following a single intratesticular administration in adult male rats.Methods:60 adult male Wistar albino rats(Rattus norvegicus)weighing 160-200 g and aged 5-6 months randomly received a single intratesticular injection of normal saline(Group A),zinc gluconate 13.3 mg/mL plus L-Arginine(Group B),20%CaCl_(2)(Group C),and CdCl_(2)0.5 mg/kg body weight plus ethylenediaminetetraacetic acid(EDTA)(Group D),respectively,along the entire route from the caudoventral aspect of each testis.They were euthanized up to 180 days to evaluate reproductive tract toxicology.Results:The reproductive organ weights were markedly reduced,with testes severely atrophied in group B,pea-sized and stony hard in group C,and moderately reduced in group D.Azoospermia was evident in groups B and C,while sperm concentration was reduced to<1 million/mL with zero sperm motility in group D.Rats of groups B and C failed to show mounting and copulatory behaviour.A completely disorganized mesh of cellular elements was observed in the seminiferous tubules of group B,while pyknotic germ cell and arrest of spermatogenesis,exfoliated germ cells,occasional syncytial bodies and smaller Leydig cells were evident in groups C and D.Significantly reduced testosterone levels,increased luteinizing hormone(LH)and follicle-stimulating hormone(FSH)levels,returned to normal after 90 days in group D.Conclusions:Zinc gluconate and CaCl_(2)injections severely affected the reproductive organs and libido and rats treated with CdCl_(2)exhibited diminished spermatogenesis with normal libido.Thus,the need-based selection of intratesticular agents should consider their distinct effects on spermatogenesis,libido,and hormonal balance for achieving targeted sterilization outcomes.展开更多
Ustiloxins are the primary secondary metabolites of Ustilaginoidea virens(teleomorph:Villosiclava virens).While these toxins are known to exhibit toxicity in certain animals,their potential risks to human health requi...Ustiloxins are the primary secondary metabolites of Ustilaginoidea virens(teleomorph:Villosiclava virens).While these toxins are known to exhibit toxicity in certain animals,their potential risks to human health require further investigation.Therefore,this study was conducted using male mice as experimental animal to explore their potential health risks.We observed morphological changes in cells and structural lesions in mitochondria using electron microscopy,combined with Hematoxylin and Eosin(H&E)staining.We utilized transcriptomics,proteomics,and bioinformatics techniques to analyze the regulatory networks associated with ustiloxins in the context of liver damage and study the mechanism of liver injury caused by ustiloxins in mice.Differentially expressed genes(DEGs)were linked to terms such as‘metabolism of exogenous substances with cytochrome P450’,‘peroxisomes’,and‘negative regulation of the inflammatory response’.Western blotting and quantitative real-time PCR(qRT-PCR)demonstrated that ustiloxins can further activate the inflammatory pathways of Nrf2/HO-1 and NLRP3 by activating cytochrome P450(CYP450),leading to liver damage in mice.展开更多
Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor ...Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor receptor 2(HER2)-negative and estrogen receptor(ER)-positive,and lacks routine screening,leading to delayed diagnosis and advanced disease.Major risk factors include hormonal imbalance,radiation exposure,obesity,alcohol use,and Breast Cancer Gene 1 and 2(BRCA1/2)mutations.Clinically,it may resemble gynecomastia but usually appears as a unilateral,painless mass or nipple discharge.Advances in imaging and liquid biopsy have enhanced early detection.Molecular mechanisms involve hormonal signaling,HER2/epidermal growth factor receptor(EGFR)pathways,tumor suppressor gene alterations,and epigenetic changes.While standard treatments mirror those for female breast cancer,emerging options such as cyclin-dependent kinase 4 and 6(CDK4/6),and poly(ADP-ribose)polymerase(PARP)inhibitors,immunotherapy,and precision medicine are reshaping management.Incorporating artificial intelligence,molecular profiling,and male-specific clinical trials is essential to improve outcomes and bridge current diagnostic and therapeutic gaps.展开更多
Background:Epidemiological studies have confirmed that longer exposure to insecticides like cypermethrin(CYP)significantly increases the risk of male reproductive toxicity.Crocus sativus L.has been recognized due to i...Background:Epidemiological studies have confirmed that longer exposure to insecticides like cypermethrin(CYP)significantly increases the risk of male reproductive toxicity.Crocus sativus L.has been recognized due to its therapeutic properties,but its exact role and molecular mechanisms in treatment of reproductive dysfunction remain unclear.Methods:During this study,36 rats were randomly divided into six groups(n=6):control,CYP-induced(60 mg/kg),standard(leuprolide 3 mg/kg)and three treatment groups receiving aqueous,ethanolic,and oil extracts(50 mg/kg or 20 mL/kg)for post-toxicity induction.Results:The finding represented that exposure of CYP significantly increased oxidative stress,disrupted testicular architecture,and markedly reduced testosterone levels(P<0.05).Importantly,Crocus sativus L.treatment alleviated these changes by increasing the expression of Nrf2(nuclear factor erythroid 2-related factor 2),restoring the activity of antioxidant enzymes,and enhancing testicular histomorphology.Surprisingly,molecular docking established a high binding affinity of Crocus sativus L.phytoconstituents such as gallic acid,cinnamic acid and quercetin to the Nrf2-Keap1 complex.It is worth noting that,Crocus sativus L.exhibited a high level of protection against reproductive toxicity caused by CYP in male rats,which was mediated by the activation of Nrf2 pathway,reduction of oxidative damage,and favorable ADMET characteristics.Conclusion:Notably,this research provides a more valid,safe,and effective method of developing new drugs for reproductive disorders,however,further investigation is needed to support the research findings and implement it in clinical practice.展开更多
Dear Editor,Amplexus,a reproductive behavior in which the male clasps the female dorsally,is a characteristic of amphibians(Wells,2007).Most species exhibit either inguinal or axillary amplexus,although some reproduce...Dear Editor,Amplexus,a reproductive behavior in which the male clasps the female dorsally,is a characteristic of amphibians(Wells,2007).Most species exhibit either inguinal or axillary amplexus,although some reproduce without it(Wells,2007).While male-female amplexus is predominant,other forms such as male-male and multiple-male amplexus have also been documented(Soni et al.,2025).Release calls are typically produced by amplexed males to signal mating mismatches and mitigate the costs of inappropriate clasping(Kelehear and Shine,2019).Female-female amplexus,however,is rare and considered maladaptive,as it does not lead to fertilization(Chuang et al.,2019).展开更多
Background:Hormonal treatment and response as a predictor of sperm retrieval prior to microdissection testicular sperm extraction(micro-TESE)are not well established in the current literature.This study aimed to inves...Background:Hormonal treatment and response as a predictor of sperm retrieval prior to microdissection testicular sperm extraction(micro-TESE)are not well established in the current literature.This study aimed to investigate the hormonal response as a predictor of sperm retrieval among men with nonobstructive azoospermia(NOA).Methods:Seventy-seven consecutive patients who had testosterone levels≤14 nmol/L were treated medically with an aromatase inhibitor or recombinant human chorionic gonadotropin(rec-hCG)prior to micro-TESE and were included.Thirty-four(44.2%)had unexplained NOA(UNEX),25(32.5%)had Klinefelter syndrome(KS),8(10.4%)had a history of cryptorchidism(UDT),4(5.2%)had microdeletion of the Azoospermia factor C(AZFc),and 6(7.8%)were treated previously with chemotherapy.Baseline and post-treatment serum hormonal levels were documented.Pre-op testosterone levels were entered into binary logistic regressions with age,Follicle-stimulating hormone(FSH),and Luteinizing hormone(LH)levels to test for significance with sperm retrieval.We then built logistic regression models to identify predictors of successful surgical sperm retrieval(SSR).Results:Forty-five patients(58%)had successful retrieval.In 32 patients(42%),no sperm was retrieved.Both the mean pre-op testosterone and the mean testosterone change between the two groups were significant(p=0.02 and p=0.011,respectively).Receiver operating characteristic(ROC)analysis demonstrated an area under the curve(AUC)of 0.785(95%CI=0.685-0.886,p<0.001).The Youden index coefficient was calculated for KS and UNEX.The cut-off point for KS was established at 0.764(sensitivity=0.875,false positive rate[FPR]=0.111),and 0.215 for UNEX(sensitivity=0.438,FPR=0.222).We also observed a correlation between age and SSR(p=0.05).In KS patients,SSR was determined by pre-op testosterone levels irrespective of age.Conclusion:Pre-operative hormonal response is a predictor for SSR in NOA patients who were treated medically.This data may help during pre-operative counselling.展开更多
Compounds isolated from Epimedium include the total flavonoids of Epimedium,icariin,and its metabolites(icaritin,icariside Ⅰ,and icariside Ⅱ),which have similar molecular structures.Modern pharmacological research a...Compounds isolated from Epimedium include the total flavonoids of Epimedium,icariin,and its metabolites(icaritin,icariside Ⅰ,and icariside Ⅱ),which have similar molecular structures.Modern pharmacological research and clinical practice have proved that Epimedium and its active components have a wide range of pharmacological effects,especially in improving sexual function,hormone regulation,anti-osteoporosis,immune function regulation,anti-oxidation,and anti-tumor activity.To date,we still need a comprehensive source of knowledge about the pharmacological effects of Epimedium and its bioactive compounds on the male reproductive system.However,their actions in other tissues have been reviewed in recent years.This review critically focuses on the Epimedium,its bioactive compounds,and the biochemical and molecular mechanisms that modulate vital pathways associated with the male reproductive system.Such intrinsic knowledge will significantly further studies on the Epimedium and its bioactive compounds that protect the male reproductive system and provide some guidances for clinical treatment of related male reproductive disorders.展开更多
Varicocele,the most common and treatable cause of male infertility,significantly impacts fertility.The pathophysiological mechanisms of varicocele have not been fully understood yet.Recent studies have focused on the ...Varicocele,the most common and treatable cause of male infertility,significantly impacts fertility.The pathophysiological mechanisms of varicocele have not been fully understood yet.Recent studies have focused on the pathophysiology of varicocele-induced infertility,highlighting inflammation and oxidative stress as key contributing factors.We reviewed recent research on the roles of inflammation and oxidative stress in the pathophysiology of varicocele and found that they negatively impact semen parameters,spermatogenesis,and testicular and epididymal function.In addition,this article summarizes the related factors of inflammation and oxidative stress caused by varicocele.Finally,a brief consideration on the treatments to address inflammation and oxidative stress is proposed.This review may provide treatment options and targets for varicocele-induced infertility.However,the relationship between inflammation and oxidative stress in varicocele still needs further study.展开更多
Testosterone affects several organs in the body and is very important for male well-being.Aging men with late-onset hypogonadism(LOH)experience physiologic,psychiatric,and sexual symptoms related to a decline in the s...Testosterone affects several organs in the body and is very important for male well-being.Aging men with late-onset hypogonadism(LOH)experience physiologic,psychiatric,and sexual symptoms related to a decline in the serum concentration of testosterone with age.However,it is well-known that the extent of the decline in testosterone concentration does not correlate with the severity of LOH-related symptoms.Therefore,it is difficult to diagnose and treat patients with LOH.In addition,the symptoms,response to testosterone replacement therapy(TRT),and medical insurance coverage differ among ethnicities and countries.The evaluation of testosterone is essential for the diagnosis and treatment of LOH.The effects of testosterone are determined not only by the serum testosterone concentration but also by the androgen receptor sensitivity.A low number of glutamine repeats is indicative of high androgenic activity,and the number shows ethnicity-related differences(fewer in African American than in Caucasian people and more in East Asian people).The diagnosis of LOH is typically made using subjective symptoms and the serum testosterone concentration.The Aging Male Symptoms scale is widely used to evaluate the symptoms.The normal range of total testosterone concentration varies around the world;therefore,clinicians should follow the guidelines of their regional academic society.The principal treatment for LOH is TRT.There are many types of TRT and other treatment strategies are also available.Thus,physicians should treat LOH according to each patient’s situation,considering related disorders,such as diabetes,osteoporosis,metabolic syndrome,and depression.展开更多
Objective Selective estrogen receptor modulators(SERMs)have demonstrated efficacy in the treatment of hypogonadism in males and male factor infertility.Two SERMs,clomiphene citrate and tamoxifen,are now prescribed for...Objective Selective estrogen receptor modulators(SERMs)have demonstrated efficacy in the treatment of hypogonadism in males and male factor infertility.Two SERMs,clomiphene citrate and tamoxifen,are now prescribed for off-label use to treat both conditions in males.However,existing literature compares mixed protocols with active management.We aimed to conduct a meta-analysis to evaluate the effect of clomiphene and tamoxifen versus placebo on natural pregnancy rates.Methods We conducted a comprehensive systematic review of electronic databases:MEDLINE,PubMed/PMC,EMBASE,CINAHL,Cochrane Central Register of Controlled Trials(CENTRAL),Scopus,Google Scholar,and Web of Science.Articles satisfying all selection criteria were analyzed.The primary outcome was the incidence of pregnancy after receiving the treatment.Secondary outcomes included serum follicle-stimulating hormone,luteinizing hormone,and testosterone levels,and sperm count and motility.We calculated the pooled odds ratio,risk ratio,and risk difference to ascertain possible alterations in the direction of the pooled effect size.Results Ten randomized controlled trials were ultimately included and underwent data extraction.Clomiphene citrate and placebo groups had similar pregnancy rates(10.4%and 7.1%,respectively;odds ratio 1.30[95%confidence interval 0.27–6.17];p=0.74).No meta-analysis could be calculated for pregnancy rates in tamoxifen versus placebo groups.Heterogeneity among the studies of both SERMs ranged from low to high.Conclusion Although clomiphene citrate and tamoxifen are often used off-label for the treatment of male infertility secondary to hypogonadism,studies of SERMs in the treatment of idiopathic male factor infertility are limited and heterogenous,preventing this meta-analysis from investigating the efficacy of SERMs on male infertility.The effect of clomiphene citrate or tamoxifen on the pregnancy rate remains uncertain.展开更多
Azoospermia,defined as the absence of sperm in the ejaculate,is a well-documented consequence of exogenous testosterone(ET)and anabolic–androgenic steroid(AAS)use.These agents suppress the hypothalamic–pituitary–go...Azoospermia,defined as the absence of sperm in the ejaculate,is a well-documented consequence of exogenous testosterone(ET)and anabolic–androgenic steroid(AAS)use.These agents suppress the hypothalamic–pituitary–gonadal(HPG)axis,leading to reduced intratesticular testosterone levels and impaired spermatogenesis.This review examines the pathophysiological mechanisms underlying azoospermia and outlines therapeutic strategies for recovery.Azoospermia is categorized into pretesticular,testicular,and post-testicular types,with a focus on personalized treatment approaches based on the degree of HPG axis suppression and baseline testicular function.Key strategies include discontinuing ET and monitoring for spontaneous recovery,particularly in patients with shorter durations of ET use.For cases of persistent azoospermia,gonadotropins(human chorionic gonadotropin[hCG]and follicle-stimulating hormone[FSH])and selective estrogen receptor modulators(SERMs),such as clomiphene citrate,are recommended,either alone or in combination.The global increase in exogenous testosterone use,including testosterone replacement therapy and AAS,underscores the need for improved management of associated azoospermia,which can be temporary or permanent depending on individual factors and the type of testosterone used.Additionally,the manuscript discusses preventive strategies,such as transitioning to short-acting testosterone formulations or incorporating low-dose hCG to preserve fertility during ET therapy.While guidelines for managing testosterone-related azoospermia remain limited,emerging research indicates the potential efficacy of hormonal stimulation therapies.However,there is a notable lack of well-structured,controlled,and long-term studies addressing the management of azoospermia related to exogenous testosterone use,highlighting the need for such studies to inform evidence-based recommendations.展开更多
文摘Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today's world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician's responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of OCT (optical coherence tomography), frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology.
文摘· Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today’s world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician’s responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test (s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of optical coherence tomography, frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up -to -date information on malingering or simulation in ophthalmology. ·
文摘The P300, an endogenous subcomponent of the event-related potential, is thought to reflect cognitive processes. The event-related potential evoked by the old-new memory recognition task in the oddball paradigm is suitable for examining the neural processes involved in malingered neurocognitive deficits. Forty-four undergraduates were randomly assigned to a simulated malingering group and a truth-telling group, Another 22 patients with head injudes were enrolled as a control group. All participants completed the old-new memory recognition task in the oddball paradigm. The mean P300 amplitude of the simulated malingering group was significantly reduced compared with the truth-telling group （P 〈 0.01）, but was increased compared with the control group （P〈 0.01）. These results revealed that the P300, evoked by the old-new memory recognition task of the oddball paradigm, may be a helpful indicator for determining cognitive malingering.
文摘The main high points ofthis tour are sightseeing inthe Maling River Valley, riftvalley drifting, a visit to theBouyei village, and theGuizhou Wedding CustomsMuseum.
基金supported by the Science and Technology Major Program of Bingtuan,China (2023AA008)the National Natural Science Foundation of China (31960369)+1 种基金the Bingtuan Science and Technology Program,China (2025DA001)the Henan Provincial Science and Technology Research Project,China (222102110200)。
文摘Recent studies have shown that lipid metabolism is a key factor affecting anther development and male fertility.However,how plants regulating the metabolic balance of multiple lipids to ensure proper anther development and male fertility remains unclear.Analyzing lipid molecules related to anther fertility and genes responsible for their biosynthesis is crucial for understanding the physiological significance of lipid metabolism in crop fertility.In this study,we compared the transcriptome and the composition and content of lipids in anthers of two upland cotton(Gossypium hirsutum) materials,Shida 98(WT) and its nearly-isogenic male sterile line Shida 98A(MS).Transcriptomics analysis identified many differentially expressed genes(DEGs) between the two materials,with the genes of the alpha-linolenic acid metabolism pathway being the most significantly associated with the male sterility phenotype.Investigations on lipids revealed that the MS anthers over-accumulated free fatty acids(FFAs),phosphatidic acid(PA),mono-and di-galactosyldiacylglycerol(MGDG and DGDG),and had a decreased content of triacylglycerol(TAG),which was closely related to the abnormal metabolism of alpha-linolenic acid(C18:3);therefore,the major lipids containing C18:3-acyl chains,such as PA,MGDG,DGDG,and TAG,are proposed to play a major role in cotton anther development.We also showed that an excessive level of MGDG and DGDG caused jasmonic acid(JA) overaccumulation in MS anthers,which in turn inhibited the expression of GhFAD3 and consequently reduced the C18:3 content,presumably via a feedback regulation mechanism,ultimately affecting plant fertility.Together,our results revealed the importance of a balanced lipid metabolism in regulating the development of cotton anther and pollen and consequently male fertility.
基金the GEroNIMO(Genome and Epigenome Enabled Breeding in Monogastics)project.The GEroNIMO project has received funding from the European Union’s Horizon 2020 research and innovation program under Grant Agreement No 101000236。
文摘Background Understanding the genetic basis of male reproduction in mammals remains challenging.Commercial pig populations offer a unique model for studying fertility,as semen traits are routinely recorded using high-throughput systems.Results In a large-scale GWAS of 15 semen traits based on 286,314 ejaculates collected from 2,954 boars of a purebred pig line,we identified 10 QTL,including four loci with recessive deleterious alleles.Several lead SNPs affected multiple semen traits.For example,a SNP on SSC6 was significantly associated with distal cytoplasmic droplets and with effects on tail abnormalities and sperm motility in a follow up analysis.The allele frequencies of some loci were different in older boar's,most likely due to culling based on poor semen quality.Using WGS,we identified six missense variants in high linkage disequilibrium(LD)with lead SNPs in genes related to sperm production(e.g.,MEIOB,CFAP74 and UBE2B).Remarkably,the frequency of some alleles with predicted deleterious effects on semen traits increased between 2013 and 2019.Conclusions Our results highlight loci with major effects on semen quality,some of which are linked to functional variants in key genes involved in spermatogenesis.The information from this study can be used to select against deleterious alleles affecting semen characteristics in pigs and provides valuable insight into the genetics of mammalian male fertility.
文摘Mammalian fertilization involves the migration of spermatozoa through the female reproductive system.Early embryonic development is a consequence of several steps and signaling pathways being activated,as well as biochemical and morphological modifications of spermatozoa that enable them to penetrate the membrane of mature oocytes.There are some crucial steps known to clearly explain the process of fertilization,starting with hyperactivation of spermatozoa,mutual recognition,and binding of gametes mediated by receptors located on the surface membranes of both gametes.The final step is followed by oocyte activation,which is primarily triggered via sperm-derived factors,inducing a sharp increase in intracellular calcium levels,eventually leading to polyspermy block.This review integrates current knowledge of the molecular and physiological events governing fertilization,emphasizing how ion regulation and signaling pathways converge to enable sperm function and oocyte activation.Special attention is given to sperm-derived factors such as phospholipase C zeta(PLCζ)and post-acrosomal sheath WW domain-binding protein(PAWP),which play essential roles in triggering calcium release and supporting early embryonic development.
基金supported by the National Natural Science Foundation of China(32525031,32500896,32571210,and 32171233)the China Postdoctoral Science Foundation(2025M772776 and BX20250148)+2 种基金the Sanqin Talent Special Support Program(2024STD04)the Natural Science Foundation of Shandong Province of China(ZR2025MS1180)the Natural Science Foundation of Shaanxi Province of China(2019JC-07,2021TD-37,2023-ZDLSF-23,and 2024JC-YBMS-146).
文摘Male sexual behaviors,including mounting,intromission,and ejaculation,are not only critical for reproduction but also serve as a model for understanding how the brain orchestrates sequential motor and motivational processes.While previous studies have identified key brain regions involved in sexual behaviors,such as the medial preoptic area(MPOA)and the nucleus accumbens(NAc)[14],the neural mechanisms governing the transitions between different phases of male sexual behavior remain poorly understood.
基金financially assisted to Timanshi Chansoriya of the fellowship grant of UGC-NFPwD,New Delhi sanctioned vide UGC F.No.01-01/2019-Sch dated 06.11.2020(Serial No.352 ID:NFPWD-2018-20-UTP-6522).
文摘Objective:To investigate the sterilizing potential of zinc gluconate,calcium chloride(CaCl_(2))and cadmium chloride(CdCl_(2))following a single intratesticular administration in adult male rats.Methods:60 adult male Wistar albino rats(Rattus norvegicus)weighing 160-200 g and aged 5-6 months randomly received a single intratesticular injection of normal saline(Group A),zinc gluconate 13.3 mg/mL plus L-Arginine(Group B),20%CaCl_(2)(Group C),and CdCl_(2)0.5 mg/kg body weight plus ethylenediaminetetraacetic acid(EDTA)(Group D),respectively,along the entire route from the caudoventral aspect of each testis.They were euthanized up to 180 days to evaluate reproductive tract toxicology.Results:The reproductive organ weights were markedly reduced,with testes severely atrophied in group B,pea-sized and stony hard in group C,and moderately reduced in group D.Azoospermia was evident in groups B and C,while sperm concentration was reduced to<1 million/mL with zero sperm motility in group D.Rats of groups B and C failed to show mounting and copulatory behaviour.A completely disorganized mesh of cellular elements was observed in the seminiferous tubules of group B,while pyknotic germ cell and arrest of spermatogenesis,exfoliated germ cells,occasional syncytial bodies and smaller Leydig cells were evident in groups C and D.Significantly reduced testosterone levels,increased luteinizing hormone(LH)and follicle-stimulating hormone(FSH)levels,returned to normal after 90 days in group D.Conclusions:Zinc gluconate and CaCl_(2)injections severely affected the reproductive organs and libido and rats treated with CdCl_(2)exhibited diminished spermatogenesis with normal libido.Thus,the need-based selection of intratesticular agents should consider their distinct effects on spermatogenesis,libido,and hormonal balance for achieving targeted sterilization outcomes.
基金supported by the General Scientific Research Project of the Zhejiang Education Department,China(Grant No.Y202249221).
文摘Ustiloxins are the primary secondary metabolites of Ustilaginoidea virens(teleomorph:Villosiclava virens).While these toxins are known to exhibit toxicity in certain animals,their potential risks to human health require further investigation.Therefore,this study was conducted using male mice as experimental animal to explore their potential health risks.We observed morphological changes in cells and structural lesions in mitochondria using electron microscopy,combined with Hematoxylin and Eosin(H&E)staining.We utilized transcriptomics,proteomics,and bioinformatics techniques to analyze the regulatory networks associated with ustiloxins in the context of liver damage and study the mechanism of liver injury caused by ustiloxins in mice.Differentially expressed genes(DEGs)were linked to terms such as‘metabolism of exogenous substances with cytochrome P450’,‘peroxisomes’,and‘negative regulation of the inflammatory response’.Western blotting and quantitative real-time PCR(qRT-PCR)demonstrated that ustiloxins can further activate the inflammatory pathways of Nrf2/HO-1 and NLRP3 by activating cytochrome P450(CYP450),leading to liver damage in mice.
文摘Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor receptor 2(HER2)-negative and estrogen receptor(ER)-positive,and lacks routine screening,leading to delayed diagnosis and advanced disease.Major risk factors include hormonal imbalance,radiation exposure,obesity,alcohol use,and Breast Cancer Gene 1 and 2(BRCA1/2)mutations.Clinically,it may resemble gynecomastia but usually appears as a unilateral,painless mass or nipple discharge.Advances in imaging and liquid biopsy have enhanced early detection.Molecular mechanisms involve hormonal signaling,HER2/epidermal growth factor receptor(EGFR)pathways,tumor suppressor gene alterations,and epigenetic changes.While standard treatments mirror those for female breast cancer,emerging options such as cyclin-dependent kinase 4 and 6(CDK4/6),and poly(ADP-ribose)polymerase(PARP)inhibitors,immunotherapy,and precision medicine are reshaping management.Incorporating artificial intelligence,molecular profiling,and male-specific clinical trials is essential to improve outcomes and bridge current diagnostic and therapeutic gaps.
文摘Background:Epidemiological studies have confirmed that longer exposure to insecticides like cypermethrin(CYP)significantly increases the risk of male reproductive toxicity.Crocus sativus L.has been recognized due to its therapeutic properties,but its exact role and molecular mechanisms in treatment of reproductive dysfunction remain unclear.Methods:During this study,36 rats were randomly divided into six groups(n=6):control,CYP-induced(60 mg/kg),standard(leuprolide 3 mg/kg)and three treatment groups receiving aqueous,ethanolic,and oil extracts(50 mg/kg or 20 mL/kg)for post-toxicity induction.Results:The finding represented that exposure of CYP significantly increased oxidative stress,disrupted testicular architecture,and markedly reduced testosterone levels(P<0.05).Importantly,Crocus sativus L.treatment alleviated these changes by increasing the expression of Nrf2(nuclear factor erythroid 2-related factor 2),restoring the activity of antioxidant enzymes,and enhancing testicular histomorphology.Surprisingly,molecular docking established a high binding affinity of Crocus sativus L.phytoconstituents such as gallic acid,cinnamic acid and quercetin to the Nrf2-Keap1 complex.It is worth noting that,Crocus sativus L.exhibited a high level of protection against reproductive toxicity caused by CYP in male rats,which was mediated by the activation of Nrf2 pathway,reduction of oxidative damage,and favorable ADMET characteristics.Conclusion:Notably,this research provides a more valid,safe,and effective method of developing new drugs for reproductive disorders,however,further investigation is needed to support the research findings and implement it in clinical practice.
基金supported by the National Natural Science Foundation of China(Grant Nos.32571739,32270457,31872216,and 31670392)In addition,this study received approval from the Experimental Animal Ethics and Management Committee of Anhui University(IACUC(AHU)-2024-050).
文摘Dear Editor,Amplexus,a reproductive behavior in which the male clasps the female dorsally,is a characteristic of amphibians(Wells,2007).Most species exhibit either inguinal or axillary amplexus,although some reproduce without it(Wells,2007).While male-female amplexus is predominant,other forms such as male-male and multiple-male amplexus have also been documented(Soni et al.,2025).Release calls are typically produced by amplexed males to signal mating mismatches and mitigate the costs of inappropriate clasping(Kelehear and Shine,2019).Female-female amplexus,however,is rare and considered maladaptive,as it does not lead to fertilization(Chuang et al.,2019).
文摘Background:Hormonal treatment and response as a predictor of sperm retrieval prior to microdissection testicular sperm extraction(micro-TESE)are not well established in the current literature.This study aimed to investigate the hormonal response as a predictor of sperm retrieval among men with nonobstructive azoospermia(NOA).Methods:Seventy-seven consecutive patients who had testosterone levels≤14 nmol/L were treated medically with an aromatase inhibitor or recombinant human chorionic gonadotropin(rec-hCG)prior to micro-TESE and were included.Thirty-four(44.2%)had unexplained NOA(UNEX),25(32.5%)had Klinefelter syndrome(KS),8(10.4%)had a history of cryptorchidism(UDT),4(5.2%)had microdeletion of the Azoospermia factor C(AZFc),and 6(7.8%)were treated previously with chemotherapy.Baseline and post-treatment serum hormonal levels were documented.Pre-op testosterone levels were entered into binary logistic regressions with age,Follicle-stimulating hormone(FSH),and Luteinizing hormone(LH)levels to test for significance with sperm retrieval.We then built logistic regression models to identify predictors of successful surgical sperm retrieval(SSR).Results:Forty-five patients(58%)had successful retrieval.In 32 patients(42%),no sperm was retrieved.Both the mean pre-op testosterone and the mean testosterone change between the two groups were significant(p=0.02 and p=0.011,respectively).Receiver operating characteristic(ROC)analysis demonstrated an area under the curve(AUC)of 0.785(95%CI=0.685-0.886,p<0.001).The Youden index coefficient was calculated for KS and UNEX.The cut-off point for KS was established at 0.764(sensitivity=0.875,false positive rate[FPR]=0.111),and 0.215 for UNEX(sensitivity=0.438,FPR=0.222).We also observed a correlation between age and SSR(p=0.05).In KS patients,SSR was determined by pre-op testosterone levels irrespective of age.Conclusion:Pre-operative hormonal response is a predictor for SSR in NOA patients who were treated medically.This data may help during pre-operative counselling.
基金supported by the National Nature Science Foundation of China(NSFC,No.31960156,No.31660338,No.31760627,and No.32270848)Collaborative Innovation Center of Chinese Ministry of Education(2020-39),Science and Technology Support Program of Guizhou Province(QKH[2021]111,QKH[2020]4Y192,QKH[2018]5772-006,and QKH[2019]5406)Science and Technology Fund of Guizhou Provincial Health Commission(gzwkj2022-019).
文摘Compounds isolated from Epimedium include the total flavonoids of Epimedium,icariin,and its metabolites(icaritin,icariside Ⅰ,and icariside Ⅱ),which have similar molecular structures.Modern pharmacological research and clinical practice have proved that Epimedium and its active components have a wide range of pharmacological effects,especially in improving sexual function,hormone regulation,anti-osteoporosis,immune function regulation,anti-oxidation,and anti-tumor activity.To date,we still need a comprehensive source of knowledge about the pharmacological effects of Epimedium and its bioactive compounds on the male reproductive system.However,their actions in other tissues have been reviewed in recent years.This review critically focuses on the Epimedium,its bioactive compounds,and the biochemical and molecular mechanisms that modulate vital pathways associated with the male reproductive system.Such intrinsic knowledge will significantly further studies on the Epimedium and its bioactive compounds that protect the male reproductive system and provide some guidances for clinical treatment of related male reproductive disorders.
文摘Varicocele,the most common and treatable cause of male infertility,significantly impacts fertility.The pathophysiological mechanisms of varicocele have not been fully understood yet.Recent studies have focused on the pathophysiology of varicocele-induced infertility,highlighting inflammation and oxidative stress as key contributing factors.We reviewed recent research on the roles of inflammation and oxidative stress in the pathophysiology of varicocele and found that they negatively impact semen parameters,spermatogenesis,and testicular and epididymal function.In addition,this article summarizes the related factors of inflammation and oxidative stress caused by varicocele.Finally,a brief consideration on the treatments to address inflammation and oxidative stress is proposed.This review may provide treatment options and targets for varicocele-induced infertility.However,the relationship between inflammation and oxidative stress in varicocele still needs further study.
文摘Testosterone affects several organs in the body and is very important for male well-being.Aging men with late-onset hypogonadism(LOH)experience physiologic,psychiatric,and sexual symptoms related to a decline in the serum concentration of testosterone with age.However,it is well-known that the extent of the decline in testosterone concentration does not correlate with the severity of LOH-related symptoms.Therefore,it is difficult to diagnose and treat patients with LOH.In addition,the symptoms,response to testosterone replacement therapy(TRT),and medical insurance coverage differ among ethnicities and countries.The evaluation of testosterone is essential for the diagnosis and treatment of LOH.The effects of testosterone are determined not only by the serum testosterone concentration but also by the androgen receptor sensitivity.A low number of glutamine repeats is indicative of high androgenic activity,and the number shows ethnicity-related differences(fewer in African American than in Caucasian people and more in East Asian people).The diagnosis of LOH is typically made using subjective symptoms and the serum testosterone concentration.The Aging Male Symptoms scale is widely used to evaluate the symptoms.The normal range of total testosterone concentration varies around the world;therefore,clinicians should follow the guidelines of their regional academic society.The principal treatment for LOH is TRT.There are many types of TRT and other treatment strategies are also available.Thus,physicians should treat LOH according to each patient’s situation,considering related disorders,such as diabetes,osteoporosis,metabolic syndrome,and depression.
文摘Objective Selective estrogen receptor modulators(SERMs)have demonstrated efficacy in the treatment of hypogonadism in males and male factor infertility.Two SERMs,clomiphene citrate and tamoxifen,are now prescribed for off-label use to treat both conditions in males.However,existing literature compares mixed protocols with active management.We aimed to conduct a meta-analysis to evaluate the effect of clomiphene and tamoxifen versus placebo on natural pregnancy rates.Methods We conducted a comprehensive systematic review of electronic databases:MEDLINE,PubMed/PMC,EMBASE,CINAHL,Cochrane Central Register of Controlled Trials(CENTRAL),Scopus,Google Scholar,and Web of Science.Articles satisfying all selection criteria were analyzed.The primary outcome was the incidence of pregnancy after receiving the treatment.Secondary outcomes included serum follicle-stimulating hormone,luteinizing hormone,and testosterone levels,and sperm count and motility.We calculated the pooled odds ratio,risk ratio,and risk difference to ascertain possible alterations in the direction of the pooled effect size.Results Ten randomized controlled trials were ultimately included and underwent data extraction.Clomiphene citrate and placebo groups had similar pregnancy rates(10.4%and 7.1%,respectively;odds ratio 1.30[95%confidence interval 0.27–6.17];p=0.74).No meta-analysis could be calculated for pregnancy rates in tamoxifen versus placebo groups.Heterogeneity among the studies of both SERMs ranged from low to high.Conclusion Although clomiphene citrate and tamoxifen are often used off-label for the treatment of male infertility secondary to hypogonadism,studies of SERMs in the treatment of idiopathic male factor infertility are limited and heterogenous,preventing this meta-analysis from investigating the efficacy of SERMs on male infertility.The effect of clomiphene citrate or tamoxifen on the pregnancy rate remains uncertain.
文摘Azoospermia,defined as the absence of sperm in the ejaculate,is a well-documented consequence of exogenous testosterone(ET)and anabolic–androgenic steroid(AAS)use.These agents suppress the hypothalamic–pituitary–gonadal(HPG)axis,leading to reduced intratesticular testosterone levels and impaired spermatogenesis.This review examines the pathophysiological mechanisms underlying azoospermia and outlines therapeutic strategies for recovery.Azoospermia is categorized into pretesticular,testicular,and post-testicular types,with a focus on personalized treatment approaches based on the degree of HPG axis suppression and baseline testicular function.Key strategies include discontinuing ET and monitoring for spontaneous recovery,particularly in patients with shorter durations of ET use.For cases of persistent azoospermia,gonadotropins(human chorionic gonadotropin[hCG]and follicle-stimulating hormone[FSH])and selective estrogen receptor modulators(SERMs),such as clomiphene citrate,are recommended,either alone or in combination.The global increase in exogenous testosterone use,including testosterone replacement therapy and AAS,underscores the need for improved management of associated azoospermia,which can be temporary or permanent depending on individual factors and the type of testosterone used.Additionally,the manuscript discusses preventive strategies,such as transitioning to short-acting testosterone formulations or incorporating low-dose hCG to preserve fertility during ET therapy.While guidelines for managing testosterone-related azoospermia remain limited,emerging research indicates the potential efficacy of hormonal stimulation therapies.However,there is a notable lack of well-structured,controlled,and long-term studies addressing the management of azoospermia related to exogenous testosterone use,highlighting the need for such studies to inform evidence-based recommendations.
