[Normative diagnosis and treatment of small penis].

Small penis is a disease of sexual dysplasia, which might be related to chromosome or genetic abnormalities, pubertal dysplasia, endocrine abnormality, and other factors. Hypogonadism is common in small penis. Children with small penis often have small testes, short stature, and male secondary sexual deficiencies, and the incidence of infertility is high in adulthood. Small penis can be early detected by accurately measuring the stretched penile length, screening the pathogenic causes, and differentiating it from buried or concealed penis. Once definite diagnosis is made, positive clinical intervention should be initiated. Early treatment can improve the prognosis of small penis, the patient's quality of life and the rate of natural pregnancy.

[Considerations on priapism].

Priapism is a rare pathological penile erection, and there are some inadequacies in its definition, classification, diagnosis, and therapeutic strategies. In this article, we sum up our years of experience with priapism and put forward some new views and ideas about its definition, classification, pathophysiologic process, pathological change, diagnostic essentials, therapeutic measures, indications of successful treatment, and post-therapeutic rehabilitation of erectile function. We also describe the clinical features, diagnosis and treatment of some special types of priapism, such as intermittent seizure, sleep-related painful erection, and tumor-related priapism, hoping to help urologists and andrologists in the further understanding and management of priapism.

[Micropump infusion of gonadorelin in the treatment of hypogonadotropic hypogonadism in patients with pituitary stalk interruption syndrome: cases analysis and literature review].

Two cases of hypogonadotropic hypogonadism caused by pituitary stalk interruption syndrome treated by pulse infusion of gonadorelin via micropump were reported, and their clinical features and the treatment process of pulse infusion of gonadorelin via micropump summarized. Both of the 2 patients were presented primarily with hypogonadotropic hypogonadism. After the treatment with pulse infusion of gonadorelin via micropump, their syndrome of androgen deficiency improved and the gonadotropin levels promoted at the end of 12 weeks' follow-up. Pulse infusion of gonadorelin via micropump is an alternative to treat hypogonadotropic hypogonadism caused by pituitary stalk interruption syndrome.

[Changes in the ultrastructure of sperm flagella in severe idiopathic asthenospermia patients: observation of 22 cases].

OBJECTIVE: To observe the ultrastructural changes of sperm flagella in patients with severe idiopathic asthenospermia. METHODS: Using the transmission electron microscope, we examined the ultrastructure of sperm flagella from 22 patients with severe idiopathic asthenospermia. RESULTS: Ultrastructural anomalies were found in all the 22 patients, 6 with partial or complete absence of internal and external dynamic arms in dedicative of primary ciliary dyskinesia, 1 with hyperplasia, hypertrophy and disordered organization of the fibrous sheath usually referred to as dysplasia of the fibrous sheath, and the other 15 with non-specific flagellar anomalies. CONCLUSION: Examination of the ultrastructure of sperm flagella in severe idiopathic asthenospermia patients can help to distinguish congenital from acquired flagellar structural anomalies and give valuable guidance in the treatment.

[Spermatic vein and artery ligation for varicocele].

OBJECTIVE: To assess the influence of spermatic vein and artery ligation on testicular hemodynamics, spermatogenesis and testis volume in varicocele patients. METHODS: Eighty-eight varicocele patients were randomly divided into a spermatic vein and artery ligation (n = 46) and a spermatic vein and artery preservation group (n = 42). The testicular hemodynamic parameters, testis volume and results of semen analyses were obtained before and 6 months after the surgery and compared between the two groups. RESULTS: There were no significant differences in peak systolic velocity (V(max)), end diastolic velocity (V(min)), mean enveloped velocity (V(mean)) and V(min) of the capsular artery (CA) either between the ligation and preservation groups (P > 0.05) or between pre- and post-operation (P > 0.05). Sperm density, vitality and motility were significantly improved after surgery (P < 0.01), with no significant differences between the two groups (P > 0.05). No significant difference was found in the testis volume between the two groups before and after the operation (P > 0.05). CONCLUSION: Spermatic vein and artery ligation in varicocelectomy does not affect the testicular hemodynamics, spermatogenesis and testis volume of varicocele patients. Both the spermatic vein and artery should be ligated when necessary.

[Diagnosis and treatment of bilateral testicular intratubular seminoma: a case report and review of literature].

OBJECTIVE: To explore the diagnosis and treatment of testicular intratubular seminoma. METHODS: One case of testicular intratubular seminoma was diagnosed with testicular biopsy. Epididymal sperm was aspirated and intracytoplasmic sperm injection ( ICSI) was performed. And local radiotherapy was conducted on the bilateral testes after fertilization. RESULTS: The result of testicular biopsy revealed bilateral testicular intratubular seminoma. Large numbers of sperms were found in the epididymal aspirate. ICSI did not succeed for the first time. The second ICSI succeeded. The local radiotherapy by 60Co had been conducted on the bilateral testes, and testicular tumor didn't develop further. CONCLUSION: Testicular intratubular seminoma is a type of intratubular germ cell neoplasia, with no clinical manifestations, and usually found in testicular biopsy. Earlier management promises better prognosis.

[Construction of an antisense RNA recombinant adenovirus vector of the human PDE5A1 gene promoter].

OBJECTIVE: To construct an antisense RNA recombinant adenovirus vector of the human PDE5A1 promoter gene. METHODS: A cDNA fragment containing the human PDE5A1 promoter and the human PDE5A1-specific exon was determined according to the gene bank. The antisense RNA fragment was synthesized artificially and subcloned into the pENTR. Then, the sequence of pENTR fragment was detected, and the recombinant adenovirus vector pAd/CMV/V5/antisense-PDE5A1 was constructed by LR reaction with the Gateway expression system. The identified recombinant adenovirus plasmid was digested with Pac I and transformed into 293A cells to package recombinant adenovirus particles. The recombinant adenovirus particles were tested with PCR technique and purified after acquisition by CsCl density gradient ultracentrifugation. RESULTS: The sequencing result showed a 145 bp fragment in pENTR, which was proved to be the domain of the antisense RNA fragment. PCR confirmed that the antisense RNA fragment was cloned into the recombinant adenovirus vector pAd/CMV/V5/antisense-PDE5A1 successfully and could infect 293A cells. The titer of virus stocks was up to 10(8) - 10(10)/microl after purification. CONCLUSION: With the Gateway expression system, the culturing and reproduction of 293A cells can reproduce recombinant adenovirus pAd/CMV/V5-DEST successfully, and the recombinant adenovirus vector can meet the need of in vivo gene transfection in laboratory studies.

[The effects of antisenes oligodeoxynucleotide on the cyclic nucleotide monophosphates in smooth muscle cells of human corpus cavernosum].

OBJECTIVES: To investigate the effects of antisense oligodeoxynucleotide(ASON) on the cyclic nucleotide monophosphates (cNMP) in smooth muscle cells of human corpus cavernosum, and provide experimental groundwork for the gene therapy of erectile dysfunction. METHODS: PDE5 gene ASON(containing exon 1) was transfected into the corpus cavernosum smooth muscle cells with the presence of liposome DOTAP. Another sense oligodeoxynucleotide(SON) and 1% of bovine serum were also transducted into the cells as controls. Two of cNMP, cAMP and cGMP, were probed and measured by ELISA at 1, 2, 4, 6, 10, 24 and 48 h after transfection. RESULTS: After transfection, the level of cGMP(1-6 h) in human corpus cavernosum smooth muscle cells was significantly higher than that in controls(P < 0.01). CONCLUSIONS: The PDE5 gene ASON had been showed to manifest stimulative effect on the cGMP in smooth muscle cells of human corpus cavernosum in vitro, and it provides experimental groundwork for the gene therapy of erectile dysfunction.