Association Between Sleep Quality and Semen Parameters and Reproductive Hormones: A Cross-Sectional Study in Zhejiang, China.

BACKGROUND: The effects of sleep duration on semen quality have been documented in many epidemiological studies. However, the association between sleep quality and semen parameters and reproductive hormones is still unclear. PATIENTS ENROLLMENT AND METHODS: We conducted a cross-sectional study among 970 outpatients from the Reproductive Medicine Center in Zhejiang, China between October 2017 and July 2019. All participants delivered a semen sample, underwent a physical examination, and answered a questionnaire to provide the following information: demographics, life habits, and sleep habits. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). We first divided the patients into two groups according to sleep quality (good sleep: PQSI < 5 and poor sleep: PSQI ≥ 5). Then, we analyzed routine sperm parameters (semen volume, sperm total motility, progressive motility, sperm concentration, total sperm number, and normal sperm morphology) and reproductive hormones (follicle-stimulating hormone, luteinizing hormone, estrogen, testosterone, and prolactin) of each group. Finally, we used multivariate linear regression analysis and Spearman correlation coefficients to examine the relationship between sleep quality (discrete variable or dichotomous variable) and sperm parameters, reproductive hormones. RESULTS: A negative correlation was found between the general PSQI scores and several semen parameters: total motility (r= -0.187979, p< 0.001), progressive motility (r= -0.192902, p< 0.001), concentration (r= -0.167063, p< 0.001), total sperm number (r= -0.160008, p< 0.001), and normal sperm morphology (r= -0.124511, p< 0.001). However, there was no significant correlation between the semen volume, all reproductive hormones and the general PSQI scores. After adjusting for confounders, men with poor sleep had lower total motility (ß= -9.287; 95% CI, -12.050, -6.523), progressive motility (ß= -8.853; 95% CI, -11.526, -6.180), concentration (log scale, ß= -0.131; 95% CI, -0.181, -0.082), total sperm number (log scale, ß= -0.137; 95% CI, -0.189, -0.084), and normal sperm morphology (ß= -1.195; 95% CI, -1.844, -0.547), but semen volume and all reproductive hormones were not markedly altered. CONCLUSION: Poor sleep quality might be related to impaired semen quality, but we found no evidence that poor sleep quality affects reproductive hormones.

[Microsurgical subinguinal varicocelectomy with delivery of the testis and ligation of gubernacular veins: Evaluation of clinical effects].

OBJECTIVE: To compare the clinical effects and postoperative complications of microsurgical subinguinal varicocelectomy (MSV) with or without delivery of the testis and ligation of gubernacular veins in the treatment of varicocele. METHODS: We retrospectively analyzed the clinical data about 163 varicocele patients treated by MSV, 40 with (group A) and the other 123 without delivery of the testis and ligation of gubernacular veins (group B). We compared the operation time, postoperative complications, rate of recurrence, and semen parameters before and at 3 months after surgery between the two groups of patients. RESULTS: The operation time was significantly longer in group A than in B (ï¼»81.1 ± 20.0ï¼½ vs ï¼»62.3 ± 9.6ï¼½ min, P = 0.041). Sperm concentration, total sperm count per ejaculate, sperm viability, and the percentage of progressively motile sperm were significantly improved in both groups at 3 months after MSV as compared with the baseline (P < 0.05). There were no statistically significant differences in the above semen parameters between the two groups of patients with grade Ⅲ varicocele before and after surgery (P < 0.05). Scrotal edema developed in 5 cases in group A and wound infection in 2 cases in group B after MSV, but no postoperative testicular atrophy or recurrence was observed in either of the two groups. CONCLUSIONS: MSV with delivery of the testis and ligation of gubernacular veins showed no advantages over that without in reducing varicocele recurrence and improving semen parameters, but rather involved longer operation time and a higher incidence rate of postoperative complications.

Risk factors for bladder calculi in patients with benign prostatic hyperplasia.

We aim to find the risk factors that influence the formation of bladder calculi in patients with benign prostate hyperplasia (BPH) and to reduce the surgical intervention related to bladder calculi.Between January 2015 and October 2016, 332 patients with BPH underwent surgical therapy were retrospectively evaluated. Patients with BPH were categorized into 2 groups: 94 patients with bladder calculi in group 1 and 238 patients without bladder calculi in group 2. Medical history, age, body mass index (BMI), total prostate specific antigen, total prostate volume (TPV), International Prostate Symptom Score (IPSS), intravesical prostatic protrusion (IPP), urodynamic parameters, and urine culture were compared between groups.There was no significant difference in the age, BMI, peak flow rate, and total IPSS between groups. TPV, total prostate specific antigen, and duration of BPH were significantly lower in group 1 than those in group 2. In addition, IPP was significantly higher in group 1 than group 2 (P < .001). Besides, after exclusion of patients with urinary retention and indwelling catheter, group 1 associated with a significantly higher preoperative positive rate of urine culture than that of group 2 (P = .046). Multivariate analysis indicated that IPP was a significant independent risk factor for the presence of bladder calculi.The incidence of bladder calculi in patients with BPH was proved to be closely associated with preoperative positive urine culture and longer IPP in our study. Furthermore, the IPP was presented to be an independent risk factor for the formation of bladder calculi. And early antibacterial therapy of urinary tract infection (UTI) may help to prevent the presence of bladder calculi in patients with BPH.

Chronic Kidney Disease and Carotid Atherosclerosis in Patients With Acute Stroke.

BACKGROUND AND PURPOSE: Chronic kidney disease (CKD) is increasingly recognized as an independent risk factor for cardiovascular disease and stroke. Our aim was to examine the association between estimated glomerular filtration rate (eGFR) and carotid plaques, stenosis and occlusions, and to assess whether CKD and its severity affect carotid atherosclerosis in a cohort of unselected patients with acute stroke. METHODS: A total of 249 consecutive patients with acute stroke (ischemic or hemorrhagic) were included in this study and baseline eGFR, carotid intima-media thickness (cIMT), and carotid stenosis were evaluated. The eGFR was calculated using the modified Modification of Diet in Renal Disease equation, which was adjusted for data from Chinese CKD patients. An eGFR rate of <60 mL/min/1.73 m was defined as CKD. The cIMT and carotid plaques were detected by carotid ultrasound. RESULTS: CKD, defined as eGFR<60 mL/min/1.73 m, was found in 66 individuals (26.50%). Among the 5 subtypes, the level of low-density lipoprotein cholesterol was significantly higher in the moderate and severe stenosis groups compared with the normal, elevated cIMT and mild stenosis groups (P<0.01). The value of eGFR gradually decreased with increasing degree of carotid stenosis, and the differences between the groups were statistically significant (P<0.01). On linear regression analysis, eGFR was negatively correlated with the degree of carotid stenosis (r=0.03; P<0.05). On ordinal logistic regression analysis, eGFR was an independent risk factor associated with carotid atherosclerosis (1.05; 95% confidence interval, 0.47-1.63). CONCLUSIONS: There was a significant burden of atherosclerosis among individuals with CKD. CKD is an independent predictor of carotid plaques, stenoses, and occlusions in patients with acute stroke.

Creation of Bt rice expressing a fusion protein of Cry1Ac and Cry1I-like using a green tissue-specific promoter.

The insecticidal genes from Bacillus thuringiensis Berliner (Bt) have long been successfully used for development of insect-resistant rice. However, commercial planting of Bt rice has been delayed by the concern over food safety, although no scientific evidence is ever found to justify the concern. To address this safety concern, we developed a transgenic insect-resistant rice line using a green tissue promoter to minimize the Bt protein expression in the rice seeds. The Bt protein expressed in the rice was a fusion protein of two different Bt toxins, Cry1Ac and Cry1I-like protein. The fusion of the two toxins may be helpful to delay the development of insect resistance to Bt rice. Laboratory and field bioassays demonstrated that the transgenic rice plants created by this study were highly active against the rice leaf folder Cnaphalocrocis medinalis (Guenée) and the striped stem borer Chilo suppressalis (Walker). Western analysis indicated that the fusion protein was specifically expressed in green tissues but not in seeds. Therefore, the transgenic rice created in this study should be useful to mitigate the food safety concern and to delay the development of insect resistance.

Attentional blink in adolescents with varying levels of impulsivity.

We explore the temporal attention function in a non-clinical sample of adolescents varying in impulsivity, as assessed with the Barratt Impulsiveness Scale. In a Rapid Serial Visual Presentation task, in which two targets (T(1) and T(2)) were presented in close temporal proximity among distractors, participants tried to identify T(1) and detect T(2) in one (dual-task) experiment and only to detect T(2) in a second, control (single-task) experiment. The sensitivity of T(2) detection was analyzed using signal detection theory. The attentional blink -- the impairment in T(2) detection following the identification of T(1) -- was increased in magnitude and protracted in adolescents with high impulsivity, compared with those with low impulsivity. Moreover, a few more participants with high impulsivity appeared to have a blink temporally weighing toward a later time, an observation also made in children with attention deficit hyperactivity disorder (ADHD) in an earlier study. Taken together, these findings suggest impairment in temporal attention in adolescents with high impulsivity. As in ADHD children, a gating deficit may play a central role in this attention impairment.

Auditory discrimination in female adolescents varying in schizotypal features: preliminary findings.

Earlier experiments have suggested impaired auditory perception in patients with schizophrenia. The purpose of the present study was to investigate auditory discrimination in young adults varying in schizotypal features. Three hundred and forty-nine female adolescent subjects were rated with the Schizotypal Personality Questionnaire (SPQ) and the Perceptual Aberration Scale (PAS) and with questions from the Chinese Health Questionnaire (CHQ) that address non-psychotic, psychological status of the subjects. Sixty-one subjects were selected to participate in an auditory detection and discrimination task, with 20 subjects each with low and high, and 21 subjects with intermediate, SPQ scores. The sensitivity in auditory discrimination and the response bias were computed, using signal detection theory. The results show that the ratings of the subjects in the three questionnaires correlate with one another and that subjects with higher SPQ scores appear to perform worse in auditory discrimination. The impaired performance occurs for most of the signal-to-noise ratios. Taken together, these preliminary findings are consistent with earlier studies demonstrating impaired auditory processing in schizophrenia patients. In contrast, the significant correlation between both the SPQ and PAS scores and the CHQ score suggests that further studies are required to rule out the effect of non-psychotic factors such as anxiety on the current results. Second, the three groups of subjects did not differ in the response bias. This latter finding provides evidence at odds with the 'self-monitoring' model of auditory hallucination.

Impairment of temporal attention in patients with schizophrenia.

Evidence is accumulating that attention impairment is a core cognitive deficit in patients with schizophrenia. Here we investigate whether they are impaired in the temporal deployment of attention. Specifically, we explore how allocation of processing resources at one time point might affect the processing of a subsequent event differently in normal and schizophrenia subjects. Thirty patients and 31 age- and education-matched control subjects participated in a rapid serial visual presentation task, in which two targets (T1 and T2) were presented in rapid succession among a number of distractors. Subjects were required to identify T1 and detect T2. The sensitivity of T2 detection was analyzed with signal detection theory. The results showed that the attentional blink (the impairment in T2 detection following the identification of T1) is increased in magnitude and protracted in the patients. This observation suggests a less efficient mechanism in temporal gating of attention and in processing rapidly changing visual stimuli in schizophrenia patients.

Altered performance of schizophrenia patients in an auditory detection and discrimination task: exploring the 'self-monitoring' model of hallucination.

It has been suggested that perceptual hallucination results from a bias in attributing a self-generated event to an external source. The 'self-monitoring' model proposes that the impairment arises from a defective corollary discharge in perceptual decisions. However, psychophysical studies in schizophrenia patients have not found consistent support for the model. We re-explored this issue by including subjects with mood disorders as patient controls and employed signals of variable intensities in an auditory detection and discrimination task. Using signal detection theory, we found decreased sensitivity in auditory detection and discrimination in schizophrenia patients, as compared to control subjects. Moreover, the psychometric functions of schizophrenics had a shallower slope than those of the controls. According to the uncertainty theory of signal detection, this suggested that schizophrenia patients monitored a smaller number of perceptual channels. On the other hand, hallucinating and non-hallucinating schizophrenia patients did not differ from each other, nor did they as a group differ from control subjects in terms of response bias. Overall, our results do not support the idea that hallucination results from an altered bias in the online processing of perceptual signals.