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.
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
One major challenge in male factor infertility is nonobstructive azoospermia(NOA),which is characterized by spermatozoa-deficient semen without physical duct blockage.This review offers a thorough overview of the hist...One major challenge in male factor infertility is nonobstructive azoospermia(NOA),which is characterized by spermatozoa-deficient semen without physical duct blockage.This review offers a thorough overview of the histopathology of the testes in NOA cases,clarifying its complex etiology and emphasizing the possible value of histopathology inspection for both diagnosis and treatment.Variable histopathological findings have been linked to NOA,such as tubular hyalinization,Sertoli cell-only syndrome,hypospermatogenesis,and germ cell arrest.Understanding the pathophysiology and forecasting the effectiveness of treatment are further enhanced by both morphometric and ultrastructural analyses.The potential significance of testicular biopsy in forecasting reproductive outcomes is assessed,especially concerning assisted reproductive technologies like intracytoplasmic sperm injection(ICSI).Besides,testicular microlithiasis,serum hormone profiles,and testicular size are investigated concerning NOA histopathology.It is concluded that understanding the histopathological patterns in NOA is crucial for its accurate diagnosis and appropriate management.Further research is still warranted to improve understanding of the complex pathophysiology underlying NOA.展开更多
Mutations and rearrangements of mitochondrial genes cause plant cytoplasmic male sterility. It is a significant way to utilize hybrid vigor to enhance crop yield. Ogu cytoplasmic male sterility(CMS) is a natural cytop...Mutations and rearrangements of mitochondrial genes cause plant cytoplasmic male sterility. It is a significant way to utilize hybrid vigor to enhance crop yield. Ogu cytoplasmic male sterility(CMS) is a natural cytoplasmic male sterility type discovered in radishes, being successfully transferred to rapeseed and cruciferous vegetables. However, current studies lack depth in exploring the molecular mechanisms of its male sterility. This study confirmed that orf138 is the causal gene for Ogu CMS through the genetic transformation in Arabidopsis. Transcriptome analysis of aborted anthers in different stages suggested that differentially expressed genes(DEGs) are mainly enriched in pathways such as glycerophospholipid metabolism and arginine and proline metabolism. It reveals that key genes involved in lipid metabolism pathways are significantly down-regulated in the sterile line(OguA), including BnaGPAT1, localized within the tapetum mitochondrial and endoplasmic reticulum. This could lead to changes in the metabolism of substances like acylglycerols within the tapetum, causing disruptions in lipid metabolism. This is consistent with morphological and subcellular structural changes in the tapetum and microspore cells, as observed in the transmission electron microscopy. This abnormal lipid metabolism may trigger specific reactive oxygen species(ROS) accumulation in an oxidative stress response, ultimately leading to an aborted microspore. Our study based on transcriptome has deepened our understanding of the molecular mechanisms in Ogu CMS.展开更多
Primary ciliary dyskinesia(PCD)is a clinically rare,genetically and phenotypically heterogeneous condition characterized by chronic respiratory tract infections,male infertility,tympanitis,and laterality abnormalities...Primary ciliary dyskinesia(PCD)is a clinically rare,genetically and phenotypically heterogeneous condition characterized by chronic respiratory tract infections,male infertility,tympanitis,and laterality abnormalities.PCD is typically resulted from variants in genes encoding assembly or structural proteins that are indispensable for the movement of motile cilia.Here,we identified a novel nonsense mutation,c.466G>T,in cilia-and flagella-associated protein 300(CFAP300)resulting in a stop codon(p.Glu156*)through whole-exome sequencing(WES).The proband had a PCD phenotype with laterality defects and immotile sperm flagella displaying a combined loss of the inner dynein arm(IDA)and outer dynein arm(ODA).Bioinformatic programs predicted that the mutation is deleterious.Successful pregnancy was achieved through intracytoplasmic sperm injection(ICSI).Our results expand the spectrum of CFAP300 variants in PCD and provide reproductive guidance for infertile couples suffering from PCD caused by them.展开更多
Male infertility can result from impaired sperm motility caused by multiple morphological abnormalities of the flagella(MMAF).Distinct projections encircling the central microtubules of the spermatozoal axoneme play p...Male infertility can result from impaired sperm motility caused by multiple morphological abnormalities of the flagella(MMAF).Distinct projections encircling the central microtubules of the spermatozoal axoneme play pivotal roles in flagellar bending and spermatozoal movement.Mammalian sperm-associated antigen 17(SPAG17)encodes a conserved axonemal protein of cilia and flagella,forming part of the C1a projection of the central apparatus,with functions related to ciliary/flagellar motility,skeletal growth,and male fertility.This study investigated two novel homozygous SPAG17 mutations(M1:NM_206996.2,c.829+1G>T,p.Asp212_Glu276del;and M2:c.2120del,p.Leu707*)identified in four infertile patients from two consanguineous Pakistani families.These patients displayed the MMAF phenotype confirmed by Papanicolaou staining and scanning electron microscopy assays of spermatozoa.Quantitative real-time polymerase chain reaction(PCR)of patients’spermatozoa also revealed a significant decrease in SPAG17 mRNA expression,and immunofluorescence staining showed the absence of SPAG17 protein signals along the flagella.However,no apparent ciliary-related symptoms or skeletal malformations were observed in the chest X-rays of any of the patients.Transmission electron microscopy of axoneme cross-sections from the patients showed incomplete C1a projection and a higher frequency of missing microtubule doublets 1 and 9 compared with those from fertile controls.Immunofluorescence staining and Western blot analyses of spermatogenesis-associated protein 17(SPATA17),a component of the C1a projection,and sperm-associated antigen 6(SPAG6),a marker of the spring layer,revealed disrupted expression of both proteins in the patients’spermatozoa.Altogether,these findings demonstrated that SPAG17 maintains the integrity of spermatozoal flagellar axoneme,expanding the phenotypic spectrum of SPAG17 mutations in humans.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
Background:Testicular sperm aspiration(TESA)is a minimally invasive testicular sperm retrieval technique that has been utilized in the treatment of male factor infertility.We sought to evaluate sperm retrieval outcome...Background:Testicular sperm aspiration(TESA)is a minimally invasive testicular sperm retrieval technique that has been utilized in the treatment of male factor infertility.We sought to evaluate sperm retrieval outcomes of primary and redo TESA in men with severe oligoasthenoteratozoospermia(OAT)and obstructive azoospermia(OA).Methods:This is a retrospective analysis of consecutive TESAs(primary and redo)for men with severe OAT and OA performed between January 2011 and August 2022 at a high-volume infertility center.We compared TESA outcomes in men with severe OAT to those with OA and compared outcomes of men who underwent primary and redo TESA on the same testicular unit.Results:439 TESAs(366 primary and 73 redo)in men with severe OAT(n=133)and OA(n=306)were included.Men with OA had significantly higher sperm retrieval rate(SRR)and motile SRR compared to men with severe OAT(99%vs.95%and 98%vs.83%,respectively,p<0.05).The requirement for multiple biopsies and the total number of aspirates were significantly lower in men with OA compared to those with severe OAT(15%vs.32%and 1.2±0.5 vs.1.4±0.7,respectively,p<0.05).In both groups,SRR,motile SRR,the requirement for multiple biopsies,and the total number of aspirates were not significantly different in primary compared to redo cases.Conclusion:Our data demonstrate that TESA retrieval rates are significantly higher in men with OA compared to those with severe OAT.The data also demonstrate that a redo TESA in these men is as effective as a primary TESA,suggesting that areas of active spermatogenesis are preserved 6 months after TESA.展开更多
Varicocele(VC)is a common cause of male infertility,yet there is a lack of molecular information for VC-associated male infertility.This study investigated alterations in the seminal plasma metabolomic and lipidomic p...Varicocele(VC)is a common cause of male infertility,yet there is a lack of molecular information for VC-associated male infertility.This study investigated alterations in the seminal plasma metabolomic and lipidomic profiles of infertile male VC patients.Twenty infertile males with VC and twenty-three age-matched healthy controls(HCs)were recruited from Peking Union Medical College Hospital(Beijing,China)between October 2019 and April 2021.Untargeted metabolite and lipid profiles from seminal plasma were analyzed using mass spectrometry.Four hundred and seventy-six metabolites and seventeen lipids were significantly different in infertile male VC patients compared to HCs.The top enriched pathways among these significantly different metabolites are protein digestion and absorption,aminoacyl-transfer RNA(tRNA)biosynthesis,and biosynthesis of amino acids.Different key lipid species,including triglyceride(TG),diacylglycerol(DG),ceramides(Cer),and phosphatidylserine(PS),varied betweenVC and HC groups.The distinct metabolites and lipids were moderately correlated.DL-3-phenyllactic acid is a potential diagnostic biomarker for VC-related male infertility(area under the curve[AUC]=0.893),positively correlating with sperm count,concentration,and motility.Furthermore,DL-3-phenyllactic acid is the only metabolite shared by all four comparisons(VC vs HC,VC-induced oligoasthenospermia[OAS]vs VC-induced asthenospermia[AS],OAS vs HC,and AS vs HC).DL-3-phenyllactic acid significantly decreased in OAS than AS.Metabolite-targeting gene analysis revealed carbonic anhydrase 9(CA9)might be the strongest candidate associated with the onset and severity of VC.The seminal plasma metabolite and lipid profiles of infertile males with VC differ significantly from those of HCs.DL-3-phenyllactic acid could be a promising biomarker.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
In Burkina Faso, as in other African countries, infertility has become a social burden for the population and a public health problem. Male infertility accounts for 30% to 40% of all infertility cases. The diagnosis o...In Burkina Faso, as in other African countries, infertility has become a social burden for the population and a public health problem. Male infertility accounts for 30% to 40% of all infertility cases. The diagnosis of male infertility or hypofertility is often made by a simple laboratory analysis of sperm to explore sperm parameters. In most African countries, such as Burkina Faso, microbiological analysis in the context of sperm analysis is still not developed, and is carried out solely based on microscopy and traditional culture, which does not allow the growth of fragile and demanding bacteria. Our study investigated the microorganisms of sperm that may be involved in male infertility, using conventional bacteriology techniques and real-time PCR. However, it did not intend to perform a multivariate statistical association analysis to estimate the association of microorganisms with abnormal semen parameters. This prospective cross-sectional pilot study was carried out on patients who visited the bacteriology laboratory of Centre MURAZ, a research Institute in Burkina Faso, for male infertility diagnosis between 2 August and 31 August 2021. Bacteria were isolated and identified using standard bacteriology techniques. In parallel, common pathogenic microorganisms known to be associated with male infertility were targeted and detected in the sperm using a multiplex real-time PCR assay. A total of 38 sperm samples were analyzed by bacteriological culture and bacteria isolated were Staphylococcus aureus (S. aureus) 5.55%, Klebsiella pneumoniae (K. pneumoniae), Enterococcus faecalis (E. faecalis), Streptococcus agalactiae (S. agalactiae) and Staphylococcus hoemalyticus (S. hoemalyticus) respectively 2.70%. Real-time PCR targeted and detected Chlamydia trachomatis (C. trachomatis) at 7.89%, Ureaplasma urealyticum (U. urealyticum) at 21.05%, Ureaplasma parvum (U. parvum) at 18.42%, Mycoplasma hominis (M. hominis) at 15.79%, Mycoplasma genitalium (M. genitalium) at 10.53% and Trichomonas vaginalis (T. vaginalis) at 2.63%. Neisseria gonorrhoeae (N. gonorrhoeae) was targeted by the real-time PCR assay and was not detected (0%) in the tested semen samples. Our study highlights critical limitations of culture performance (low sensitivity), particularly in Burkina Faso, which has a total inability to detect microorganisms (fragile and demanding microorganisms) detected by PCR-based assays. There is therefore an urgent need to at least optimize culture, procedures and algorithms for detection of microorganisms associated with male infertility in clinical laboratories of Burkina Faso. The most effective solution is the routine implementation of molecular diagnostic methods.展开更多
Depression currently affects about 280 million people worldwide and its prevalence has been increasing dramatically,especially among the young and people of reproductive age,which consequently leads to an increase in ...Depression currently affects about 280 million people worldwide and its prevalence has been increasing dramatically,especially among the young and people of reproductive age,which consequently leads to an increase in antidepressant consumption.Antidepressants are associated with sexual dysfunction in both men and women;however,their role in male fertility has been scarcely studied.Fluoxetine and sertraline,two serotonin reuptake inhibitors(SSRIs),are among the most prescribed antidepressants worldwide.To determine their possible effects,human sperm cells were exposed to either sertraline or fluoxetine at concentrations previously found in blood and seminal fluid of patients undergoing treatment.Spermatozoa were incubated for up to 24 h at 37℃ and 5%CO_(2),and important functional parameters such as sperm motility,viability,mitochondrial membrane potential,cellular reactive oxygen species(ROS)production,chromatin/DNA integrity,acrosome status,and tyrosine phosphorylation were assessed.At low levels,fluoxetine consistently decreased progressive motility throughout time while promoting fluctuations in ROS levels and sperm capacitation.Nevertheless,it did not affect viability,mitochondrial membrane potential,acrosome reaction nor chromatin/DNA integrity.Sertraline,on the other hand,had little to nonsignificant impact at low doses,but affected almost all tested parameters at supratherapeutic concentrations.Altogether,our results suggest that both antidepressants may impair sperm function,possibly through different mechanisms of action,but fluoxetine is the only exhibiting mild negative effects at doses found in vivo.展开更多
Testicular histology based on testicular biopsy is an important factor for determining appropriate testicular sperm extraction surgery and predicting sperm retrieval outcomes in patients with azoospermia.Therefore,we ...Testicular histology based on testicular biopsy is an important factor for determining appropriate testicular sperm extraction surgery and predicting sperm retrieval outcomes in patients with azoospermia.Therefore,we developed a deep learning(DL)model to establish the associations between testicular grayscale ultrasound images and testicular histology.We retrospectively included two-dimensional testicular grayscale ultrasound from patients with azoospermia(353 men with 4357 images between July 2017 and December 2021 in The First Affiliated Hospital of Sun Yat-sen University,Guangzhou,China)to develop a DL model.We obtained testicular histology during conventional testicular sperm extraction.Our DL model was trained based on ultrasound images or fusion data(ultrasound images fused with the corresponding testicular volume)to distinguish spermatozoa presence in pathology(SPP)and spermatozoa absence in pathology(SAP)and to classify maturation arrest(MA)and Sertoli cell-only syndrome(SCOS)in patients with SAP.Areas under the receiver operating characteristic curve(AUCs),accuracy,sensitivity,and specificity were used to analyze model performance.DL based on images achieved an AUC of 0.922(95%confidence interval[CI]:0.908-0.935),a sensitivity of 80.9%,a specificity of 84.6%,and an accuracy of 83.5%in predicting SPP(including normal spermatogenesis and hypospermatogenesis)and SAP(including MA and SCOS).In the identification of SCOS and MA,DL on fusion data yielded better diagnostic performance with an AUC of 0.979(95%CI:0.969-0.989),a sensitivity of 89.7%,a specificity of 97.1%,and an accuracy of 92.1%.Our study provides a noninvasive method to predict testicular histology for patients with azoospermia,which would avoid unnecessary testicular biopsy.展开更多
Background: According to the World Health Organization, the worldwide prevalence of infertility is 17.5%. The male share of responsibility is undeniable. Several factors, such as smoking, alcoholism, obesity and envir...Background: According to the World Health Organization, the worldwide prevalence of infertility is 17.5%. The male share of responsibility is undeniable. Several factors, such as smoking, alcoholism, obesity and environmental pollution are sources of infertility in men. The aim of this study was to determine the spermological profile of infertile men and the factors associated with sperm parameter abnormalities. Methods: This retrospective study analysed 1000 sperm samples over an 11-year period, from January 2010 to December 2021. Results: The average age was 37.52 ± 8.66 years. Surgical history of varicocele and teratozoospermia were associated (p-value = 0.0001). Candida albicans was associated with a 2.27-fold risk of necrozoospermia and a 3.14-fold risk of oligozoospermia. The link between the reason for requesting a spermogram and the age range between 38 and 47 was significant (p-value Conclusion: Today, lifestyle and environmental pollution play a major role in sperm parameter abnormalities.展开更多
As a prerequisite for sexual reproduction,gametophyte development is an interesting process involving cell proliferation,differentiation and specialization.Gametogenesis has been extensively explored in model plants,b...As a prerequisite for sexual reproduction,gametophyte development is an interesting process involving cell proliferation,differentiation and specialization.Gametogenesis has been extensively explored in model plants,but the regulatory mechanism of gametophyte development largely remains unknown in Cucurbitaceae species.In present study,we have shown that watermelon ClBBM and ClPLT2,two AP2/ERF transcription factors,participated in both male and female gametophyte development.Clbbm and Clplt2 single mutants resembled wild-type phenotypes in both vegetative and reproductive development.But Clbbm/Clplt2 double mutant showed partial pollen abortion and bore less seeds comparing to WT.Our results indicated that the abnormal pollen grains were caused by premature tapetum degeneration,and reduced seed-set was due to faulty embryo sac development.ClBBM and ClPLT2 were expressed in FG4 embryo sacs,and their transcripts were also detectable in the tapetum and microspore of stage 9 anthers,which was consistent with developmental stages of defective phenotypes observed in double mutant.The expression of genes essential for tapetum development,ClATM1,ClAMS,ClMS1 and ClMS188,was decreased in Clbbm/Clplt2 double mutants.Moreover,the transcriptome analysis indicated that ClBBM and ClPLT2 participated in tapetum and pollen wall development by regulate cell cycle,transmembrane transport,glucan and cellulose metabolic process.Collectively,ClBBM and ClPLT2 were functionally redundant in regulating gametophyte development in watermelon,and their functions differ from their homologous genes in model plant Arabidopsis.展开更多
Varicocele is a prevalent condition in the infertile male population.However,to date,which patients may benefit most from varicocele repair is still a matter of debate.The purpose of this study was to evaluate whether...Varicocele is a prevalent condition in the infertile male population.However,to date,which patients may benefit most from varicocele repair is still a matter of debate.The purpose of this study was to evaluate whether certain preintervention sperm parameters are predictive of successful varicocele repair,defined as an improvement in total motile sperm count(TMSC).We performed a retrospective study on 111 patients with varicocele who had undergone varicocele repair,collected from the Department of Endocrinology,Metabolic Diseases and Nutrition,University of Catania(Catania,Italy),and the Unit of Urology at the Selcuk University School of Medicine(Konya,Türkiye).The predictive analysis was conducted through the use of the Brain Project,an innovative tool that allows a complete and totally unbiased search of mathematical expressions that relate the object of study to the various parameters available.Varicocele repair was considered successful when TMSC increased by at least 50% of the preintervention value.For patients with preintervention TMSC below 5×10^(6),improvement was considered clinically relevant when the increase exceeded 50% and the absolute TMSC value was>5×10^(6).From the preintervention TMSC alone,we found a model that predicts patients who appear to benefit little from varicocele repair with a sensitivity of 50.0% and a specificity of 81.8%.Varicocele grade and serum follicle-stimulating hormone(FSH)levels did not play a predictive role,but it should be noted that all patients enrolled in this study were selected with intermediate-or high-grade varicocele and normal FSH levels.In conclusion,preintervention TMSC is predictive of the success of varicocele repair in terms of TMSC improvement in patients with intermediate-or high-grade varicoceles and normal FSH levels.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
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 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One major challenge in male factor infertility is nonobstructive azoospermia(NOA),which is characterized by spermatozoa-deficient semen without physical duct blockage.This review offers a thorough overview of the histopathology of the testes in NOA cases,clarifying its complex etiology and emphasizing the possible value of histopathology inspection for both diagnosis and treatment.Variable histopathological findings have been linked to NOA,such as tubular hyalinization,Sertoli cell-only syndrome,hypospermatogenesis,and germ cell arrest.Understanding the pathophysiology and forecasting the effectiveness of treatment are further enhanced by both morphometric and ultrastructural analyses.The potential significance of testicular biopsy in forecasting reproductive outcomes is assessed,especially concerning assisted reproductive technologies like intracytoplasmic sperm injection(ICSI).Besides,testicular microlithiasis,serum hormone profiles,and testicular size are investigated concerning NOA histopathology.It is concluded that understanding the histopathological patterns in NOA is crucial for its accurate diagnosis and appropriate management.Further research is still warranted to improve understanding of the complex pathophysiology underlying NOA.
基金supported by the National Natural Science Foundation of China (31930032)。
文摘Mutations and rearrangements of mitochondrial genes cause plant cytoplasmic male sterility. It is a significant way to utilize hybrid vigor to enhance crop yield. Ogu cytoplasmic male sterility(CMS) is a natural cytoplasmic male sterility type discovered in radishes, being successfully transferred to rapeseed and cruciferous vegetables. However, current studies lack depth in exploring the molecular mechanisms of its male sterility. This study confirmed that orf138 is the causal gene for Ogu CMS through the genetic transformation in Arabidopsis. Transcriptome analysis of aborted anthers in different stages suggested that differentially expressed genes(DEGs) are mainly enriched in pathways such as glycerophospholipid metabolism and arginine and proline metabolism. It reveals that key genes involved in lipid metabolism pathways are significantly down-regulated in the sterile line(OguA), including BnaGPAT1, localized within the tapetum mitochondrial and endoplasmic reticulum. This could lead to changes in the metabolism of substances like acylglycerols within the tapetum, causing disruptions in lipid metabolism. This is consistent with morphological and subcellular structural changes in the tapetum and microspore cells, as observed in the transmission electron microscopy. This abnormal lipid metabolism may trigger specific reactive oxygen species(ROS) accumulation in an oxidative stress response, ultimately leading to an aborted microspore. Our study based on transcriptome has deepened our understanding of the molecular mechanisms in Ogu CMS.
基金supported by the China Postdoctoral Science Foundation Grant(2023M734294)Jiangsu Provincial Medical Key Discipline Cultivation Unit(JSDW202215)the National Natural Science Foundation of China(No.82001618).
文摘Primary ciliary dyskinesia(PCD)is a clinically rare,genetically and phenotypically heterogeneous condition characterized by chronic respiratory tract infections,male infertility,tympanitis,and laterality abnormalities.PCD is typically resulted from variants in genes encoding assembly or structural proteins that are indispensable for the movement of motile cilia.Here,we identified a novel nonsense mutation,c.466G>T,in cilia-and flagella-associated protein 300(CFAP300)resulting in a stop codon(p.Glu156*)through whole-exome sequencing(WES).The proband had a PCD phenotype with laterality defects and immotile sperm flagella displaying a combined loss of the inner dynein arm(IDA)and outer dynein arm(ODA).Bioinformatic programs predicted that the mutation is deleterious.Successful pregnancy was achieved through intracytoplasmic sperm injection(ICSI).Our results expand the spectrum of CFAP300 variants in PCD and provide reproductive guidance for infertile couples suffering from PCD caused by them.
基金supported by the National Natural Science Foundation of China(No.82171599 and No.32270901)the National Key Research and Developmental Program of China(2022YFC2702601 and 2022YFA0806303)the Global Select Project(DJKLX-2022010)of the Institute of Health and Medicine,Hefei Comprehensive National Science Center.
文摘Male infertility can result from impaired sperm motility caused by multiple morphological abnormalities of the flagella(MMAF).Distinct projections encircling the central microtubules of the spermatozoal axoneme play pivotal roles in flagellar bending and spermatozoal movement.Mammalian sperm-associated antigen 17(SPAG17)encodes a conserved axonemal protein of cilia and flagella,forming part of the C1a projection of the central apparatus,with functions related to ciliary/flagellar motility,skeletal growth,and male fertility.This study investigated two novel homozygous SPAG17 mutations(M1:NM_206996.2,c.829+1G>T,p.Asp212_Glu276del;and M2:c.2120del,p.Leu707*)identified in four infertile patients from two consanguineous Pakistani families.These patients displayed the MMAF phenotype confirmed by Papanicolaou staining and scanning electron microscopy assays of spermatozoa.Quantitative real-time polymerase chain reaction(PCR)of patients’spermatozoa also revealed a significant decrease in SPAG17 mRNA expression,and immunofluorescence staining showed the absence of SPAG17 protein signals along the flagella.However,no apparent ciliary-related symptoms or skeletal malformations were observed in the chest X-rays of any of the patients.Transmission electron microscopy of axoneme cross-sections from the patients showed incomplete C1a projection and a higher frequency of missing microtubule doublets 1 and 9 compared with those from fertile controls.Immunofluorescence staining and Western blot analyses of spermatogenesis-associated protein 17(SPATA17),a component of the C1a projection,and sperm-associated antigen 6(SPAG6),a marker of the spring layer,revealed disrupted expression of both proteins in the patients’spermatozoa.Altogether,these findings demonstrated that SPAG17 maintains the integrity of spermatozoal flagellar axoneme,expanding the phenotypic spectrum of SPAG17 mutations in humans.
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Background:Testicular sperm aspiration(TESA)is a minimally invasive testicular sperm retrieval technique that has been utilized in the treatment of male factor infertility.We sought to evaluate sperm retrieval outcomes of primary and redo TESA in men with severe oligoasthenoteratozoospermia(OAT)and obstructive azoospermia(OA).Methods:This is a retrospective analysis of consecutive TESAs(primary and redo)for men with severe OAT and OA performed between January 2011 and August 2022 at a high-volume infertility center.We compared TESA outcomes in men with severe OAT to those with OA and compared outcomes of men who underwent primary and redo TESA on the same testicular unit.Results:439 TESAs(366 primary and 73 redo)in men with severe OAT(n=133)and OA(n=306)were included.Men with OA had significantly higher sperm retrieval rate(SRR)and motile SRR compared to men with severe OAT(99%vs.95%and 98%vs.83%,respectively,p<0.05).The requirement for multiple biopsies and the total number of aspirates were significantly lower in men with OA compared to those with severe OAT(15%vs.32%and 1.2±0.5 vs.1.4±0.7,respectively,p<0.05).In both groups,SRR,motile SRR,the requirement for multiple biopsies,and the total number of aspirates were not significantly different in primary compared to redo cases.Conclusion:Our data demonstrate that TESA retrieval rates are significantly higher in men with OA compared to those with severe OAT.The data also demonstrate that a redo TESA in these men is as effective as a primary TESA,suggesting that areas of active spermatogenesis are preserved 6 months after TESA.
基金supported by the National Key Research and Development Program of China(No.2018YFE0207300)Beijing Natural Science Foundation(No.M23008)+1 种基金the National High Level Hospital Clinical Research Funding(No.2022-PUMCH-B-124)the National High Level Hospital Clinical Research Funding(No.2022-PUMCH-A-057)。
文摘Varicocele(VC)is a common cause of male infertility,yet there is a lack of molecular information for VC-associated male infertility.This study investigated alterations in the seminal plasma metabolomic and lipidomic profiles of infertile male VC patients.Twenty infertile males with VC and twenty-three age-matched healthy controls(HCs)were recruited from Peking Union Medical College Hospital(Beijing,China)between October 2019 and April 2021.Untargeted metabolite and lipid profiles from seminal plasma were analyzed using mass spectrometry.Four hundred and seventy-six metabolites and seventeen lipids were significantly different in infertile male VC patients compared to HCs.The top enriched pathways among these significantly different metabolites are protein digestion and absorption,aminoacyl-transfer RNA(tRNA)biosynthesis,and biosynthesis of amino acids.Different key lipid species,including triglyceride(TG),diacylglycerol(DG),ceramides(Cer),and phosphatidylserine(PS),varied betweenVC and HC groups.The distinct metabolites and lipids were moderately correlated.DL-3-phenyllactic acid is a potential diagnostic biomarker for VC-related male infertility(area under the curve[AUC]=0.893),positively correlating with sperm count,concentration,and motility.Furthermore,DL-3-phenyllactic acid is the only metabolite shared by all four comparisons(VC vs HC,VC-induced oligoasthenospermia[OAS]vs VC-induced asthenospermia[AS],OAS vs HC,and AS vs HC).DL-3-phenyllactic acid significantly decreased in OAS than AS.Metabolite-targeting gene analysis revealed carbonic anhydrase 9(CA9)might be the strongest candidate associated with the onset and severity of VC.The seminal plasma metabolite and lipid profiles of infertile males with VC differ significantly from those of HCs.DL-3-phenyllactic acid could be a promising biomarker.
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.
文摘In Burkina Faso, as in other African countries, infertility has become a social burden for the population and a public health problem. Male infertility accounts for 30% to 40% of all infertility cases. The diagnosis of male infertility or hypofertility is often made by a simple laboratory analysis of sperm to explore sperm parameters. In most African countries, such as Burkina Faso, microbiological analysis in the context of sperm analysis is still not developed, and is carried out solely based on microscopy and traditional culture, which does not allow the growth of fragile and demanding bacteria. Our study investigated the microorganisms of sperm that may be involved in male infertility, using conventional bacteriology techniques and real-time PCR. However, it did not intend to perform a multivariate statistical association analysis to estimate the association of microorganisms with abnormal semen parameters. This prospective cross-sectional pilot study was carried out on patients who visited the bacteriology laboratory of Centre MURAZ, a research Institute in Burkina Faso, for male infertility diagnosis between 2 August and 31 August 2021. Bacteria were isolated and identified using standard bacteriology techniques. In parallel, common pathogenic microorganisms known to be associated with male infertility were targeted and detected in the sperm using a multiplex real-time PCR assay. A total of 38 sperm samples were analyzed by bacteriological culture and bacteria isolated were Staphylococcus aureus (S. aureus) 5.55%, Klebsiella pneumoniae (K. pneumoniae), Enterococcus faecalis (E. faecalis), Streptococcus agalactiae (S. agalactiae) and Staphylococcus hoemalyticus (S. hoemalyticus) respectively 2.70%. Real-time PCR targeted and detected Chlamydia trachomatis (C. trachomatis) at 7.89%, Ureaplasma urealyticum (U. urealyticum) at 21.05%, Ureaplasma parvum (U. parvum) at 18.42%, Mycoplasma hominis (M. hominis) at 15.79%, Mycoplasma genitalium (M. genitalium) at 10.53% and Trichomonas vaginalis (T. vaginalis) at 2.63%. Neisseria gonorrhoeae (N. gonorrhoeae) was targeted by the real-time PCR assay and was not detected (0%) in the tested semen samples. Our study highlights critical limitations of culture performance (low sensitivity), particularly in Burkina Faso, which has a total inability to detect microorganisms (fragile and demanding microorganisms) detected by PCR-based assays. There is therefore an urgent need to at least optimize culture, procedures and algorithms for detection of microorganisms associated with male infertility in clinical laboratories of Burkina Faso. The most effective solution is the routine implementation of molecular diagnostic methods.
文摘Depression currently affects about 280 million people worldwide and its prevalence has been increasing dramatically,especially among the young and people of reproductive age,which consequently leads to an increase in antidepressant consumption.Antidepressants are associated with sexual dysfunction in both men and women;however,their role in male fertility has been scarcely studied.Fluoxetine and sertraline,two serotonin reuptake inhibitors(SSRIs),are among the most prescribed antidepressants worldwide.To determine their possible effects,human sperm cells were exposed to either sertraline or fluoxetine at concentrations previously found in blood and seminal fluid of patients undergoing treatment.Spermatozoa were incubated for up to 24 h at 37℃ and 5%CO_(2),and important functional parameters such as sperm motility,viability,mitochondrial membrane potential,cellular reactive oxygen species(ROS)production,chromatin/DNA integrity,acrosome status,and tyrosine phosphorylation were assessed.At low levels,fluoxetine consistently decreased progressive motility throughout time while promoting fluctuations in ROS levels and sperm capacitation.Nevertheless,it did not affect viability,mitochondrial membrane potential,acrosome reaction nor chromatin/DNA integrity.Sertraline,on the other hand,had little to nonsignificant impact at low doses,but affected almost all tested parameters at supratherapeutic concentrations.Altogether,our results suggest that both antidepressants may impair sperm function,possibly through different mechanisms of action,but fluoxetine is the only exhibiting mild negative effects at doses found in vivo.
基金supported by the Key Research and Development Program of Guangzhou Science and Technology Projects(No.2023B03J1260).
文摘Testicular histology based on testicular biopsy is an important factor for determining appropriate testicular sperm extraction surgery and predicting sperm retrieval outcomes in patients with azoospermia.Therefore,we developed a deep learning(DL)model to establish the associations between testicular grayscale ultrasound images and testicular histology.We retrospectively included two-dimensional testicular grayscale ultrasound from patients with azoospermia(353 men with 4357 images between July 2017 and December 2021 in The First Affiliated Hospital of Sun Yat-sen University,Guangzhou,China)to develop a DL model.We obtained testicular histology during conventional testicular sperm extraction.Our DL model was trained based on ultrasound images or fusion data(ultrasound images fused with the corresponding testicular volume)to distinguish spermatozoa presence in pathology(SPP)and spermatozoa absence in pathology(SAP)and to classify maturation arrest(MA)and Sertoli cell-only syndrome(SCOS)in patients with SAP.Areas under the receiver operating characteristic curve(AUCs),accuracy,sensitivity,and specificity were used to analyze model performance.DL based on images achieved an AUC of 0.922(95%confidence interval[CI]:0.908-0.935),a sensitivity of 80.9%,a specificity of 84.6%,and an accuracy of 83.5%in predicting SPP(including normal spermatogenesis and hypospermatogenesis)and SAP(including MA and SCOS).In the identification of SCOS and MA,DL on fusion data yielded better diagnostic performance with an AUC of 0.979(95%CI:0.969-0.989),a sensitivity of 89.7%,a specificity of 97.1%,and an accuracy of 92.1%.Our study provides a noninvasive method to predict testicular histology for patients with azoospermia,which would avoid unnecessary testicular biopsy.
文摘Background: According to the World Health Organization, the worldwide prevalence of infertility is 17.5%. The male share of responsibility is undeniable. Several factors, such as smoking, alcoholism, obesity and environmental pollution are sources of infertility in men. The aim of this study was to determine the spermological profile of infertile men and the factors associated with sperm parameter abnormalities. Methods: This retrospective study analysed 1000 sperm samples over an 11-year period, from January 2010 to December 2021. Results: The average age was 37.52 ± 8.66 years. Surgical history of varicocele and teratozoospermia were associated (p-value = 0.0001). Candida albicans was associated with a 2.27-fold risk of necrozoospermia and a 3.14-fold risk of oligozoospermia. The link between the reason for requesting a spermogram and the age range between 38 and 47 was significant (p-value Conclusion: Today, lifestyle and environmental pollution play a major role in sperm parameter abnormalities.
基金supported by the National Youth Talent Program(Grant No.A279021801)Key-Area R&D Program of Guangdong Province(Grant No.2022B0202060001)+3 种基金Science and Technology Innovation Team of Shaanxi(Grant No.2021TD-32)the Natural Science Foundation of Shaanxi Province(Grant Nos.2021JM-089,2022JM112 and 2022JQ-162)the Key R&D Project from Yangling Seed Industry Innovation Center(Grant No.K3031322016)Fundamental Research Funds for the Central Universities(Grant No.2452022111)。
文摘As a prerequisite for sexual reproduction,gametophyte development is an interesting process involving cell proliferation,differentiation and specialization.Gametogenesis has been extensively explored in model plants,but the regulatory mechanism of gametophyte development largely remains unknown in Cucurbitaceae species.In present study,we have shown that watermelon ClBBM and ClPLT2,two AP2/ERF transcription factors,participated in both male and female gametophyte development.Clbbm and Clplt2 single mutants resembled wild-type phenotypes in both vegetative and reproductive development.But Clbbm/Clplt2 double mutant showed partial pollen abortion and bore less seeds comparing to WT.Our results indicated that the abnormal pollen grains were caused by premature tapetum degeneration,and reduced seed-set was due to faulty embryo sac development.ClBBM and ClPLT2 were expressed in FG4 embryo sacs,and their transcripts were also detectable in the tapetum and microspore of stage 9 anthers,which was consistent with developmental stages of defective phenotypes observed in double mutant.The expression of genes essential for tapetum development,ClATM1,ClAMS,ClMS1 and ClMS188,was decreased in Clbbm/Clplt2 double mutants.Moreover,the transcriptome analysis indicated that ClBBM and ClPLT2 participated in tapetum and pollen wall development by regulate cell cycle,transmembrane transport,glucan and cellulose metabolic process.Collectively,ClBBM and ClPLT2 were functionally redundant in regulating gametophyte development in watermelon,and their functions differ from their homologous genes in model plant Arabidopsis.
文摘Varicocele is a prevalent condition in the infertile male population.However,to date,which patients may benefit most from varicocele repair is still a matter of debate.The purpose of this study was to evaluate whether certain preintervention sperm parameters are predictive of successful varicocele repair,defined as an improvement in total motile sperm count(TMSC).We performed a retrospective study on 111 patients with varicocele who had undergone varicocele repair,collected from the Department of Endocrinology,Metabolic Diseases and Nutrition,University of Catania(Catania,Italy),and the Unit of Urology at the Selcuk University School of Medicine(Konya,Türkiye).The predictive analysis was conducted through the use of the Brain Project,an innovative tool that allows a complete and totally unbiased search of mathematical expressions that relate the object of study to the various parameters available.Varicocele repair was considered successful when TMSC increased by at least 50% of the preintervention value.For patients with preintervention TMSC below 5×10^(6),improvement was considered clinically relevant when the increase exceeded 50% and the absolute TMSC value was>5×10^(6).From the preintervention TMSC alone,we found a model that predicts patients who appear to benefit little from varicocele repair with a sensitivity of 50.0% and a specificity of 81.8%.Varicocele grade and serum follicle-stimulating hormone(FSH)levels did not play a predictive role,but it should be noted that all patients enrolled in this study were selected with intermediate-or high-grade varicocele and normal FSH levels.In conclusion,preintervention TMSC is predictive of the success of varicocele repair in terms of TMSC improvement in patients with intermediate-or high-grade varicoceles and normal FSH levels.
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.
