The Effect of COVID-19 on Male Sex Hormones: A Meta-Analysis of Prospective Cohort Study.

PURPOSE: To evaluate the possible effects of novel coronavirus disease 2019 (2019-NCOV) on male sex hormones and reproductive ability, and analyze its incidence and risk factors. METHODS: We retrieved from PubMed, Embase, The Cochrane Library, Web of Science, Clinical Trails, CNKI, CBM, Wan Fang Database and VIP to collect research on the effects of COVID-19 on the male sex hormone. Our literature search was conducted until April 2022, and two investigators independently screened articles based on inclusion and exclusion criteria. In strict accordance with the inclusion and exclusion criteria, two researchers independently screened the literature and comprehensively analyzed 8 cohort studies on the impact of COVID-19 on male sex hormone. And We used RevMan5.4.1 and Stata15.0 for statistical analysis. Finally, there were eight cohort studies on the effects of COVID-19 on male sex hormones. RESULTS: T(RR = - 3.94; 95% CI - 6.22, - 1.66; P = 0.0007), testosterone in the COVID-19 group decreased by 3.94 nmol/L compared with the control group, and the difference was statistically significant. LH (RR = 0.85; 95% CI - 0.26, 1.96; P = 0.13), the LH in COVID-19 group was 0.85 mlU/ml higher than that in control group, but the difference was not statistically significant. FSH (RR = 0.25; 95% CI - 0.72, 1.23; P = 0.61), the FSH of COVID-19 group was 0.25 mlU/ml higher than that of the control group, but the difference was not statistically significant. PRL (RR = 2.42; 95% CI 0.52, 4.31; P = 0.01), the PRL in the COVID-19 group was 2.42 ng/ml higher than that in the control group, and the difference was statistically significant. E2(RR = 11.88; 95% CI 9.90, 13.86; P < 0.00001), The level of E2 in the COVID-19 group was 11.88 pg/ml higher than that in the control group, and the difference was statistically significant. T:LH (RR = - 0.39; 95% CI - 076, - 0.02; P = 0.04), the ratio of T:LH in COVID-19 group was lower than that in control group, and the difference was statistically significant. FSH:LH (RR = - 0.38; 95% CI - 0.86, 0.11; P = 0.13), the ratio of FSH:LH decreased in COVID-19 group compared with control group, but the difference was not statistically significant. CONCLUSIONS: COVID-19 can affect the level of sex hormones, especially T, which may further affect male fertility. Due to the limitations of this study, this conclusion needs to be further verified by large-sample, high-quality prospective cohort studies on the long-term effects of COVID-19 on male sex hormones and fertility.

Cuproptosis mediates copper-induced testicular spermatogenic cell death.

Cuproptosis, a novel mechanism of programmed cell death, has not been fully explored in the context of spermatogenic cells. This study investigated the potential involvement of cuproptosis in spermatogenic cell death using a mouse model of copper overload. Sixty male Institute of Cancer Research (ICR) mice were randomly divided into four groups that received daily oral gavage with sodium chloride (control) or copper sulfate (CuSO4) at 50 mg kg-1, 100 mg kg-1, or 200 mg kg-1, for 42 consecutive days. Mice subjected to copper overload exhibited a disruption in copper homeostasis. Additionally, significant upregulated expression of key cuproptosis factors was accompanied by a significant rise in the rates of testicular tissue cell apoptosis. Immunohistochemical analysis revealed the presence of ferredoxin 1 (Fdx1) in Sertoli cells, Leydig cells, and spermatogenic cells at various stages of testicular development, and the Fdx1-positive staining area was significantly increased in copper-overloaded mice. Mitochondrial dysfunction and decreased adenosine triphosphate levels were also observed, further implicating mitochondrial damage under cuproptosis. Further analyses revealed pathological lesions and blood-testis barrier destruction in the testicular tissue, accompanied by decreased sperm concentration and motility, in copper-overloaded mice. In summary, our results indicate that copper-overloaded mice exhibit copper homeostasis disorder in the testicular tissue and that cuproptosis participates in spermatogenic cell death. These findings provide novel insights into the pathogenic mechanisms underlying spermatogenic cell death and provide initial experimental evidence for the occurrence of cuproptosis in the testis.

The 100 most-cited publications on Peyronie's disease: a bibliometric analysis and visualization study.

This study aimed to summarize the characteristics of the top 100 most-cited publications on Peyronie's disease (PD) research and to analyse past and current research hotspots and trends. The SCI-E database of the Web of Science Core Collection (WoSCC) provided us with the top 100 most-cited publications in PD research, from which we took the following information: general trend of publication, year of publication, nation/region, institution, journal, author, and keywords. VOSviewer (version 1.6.18) and Excel (version 2016) were used for information analysis. Through a standardized search, we ultimately found 1019 papers in the field of PD research, from which we extracted the 100 articles that had received the highest citations. The articles were published between 1949 and 2016. The United States is a major contributor to PD research (n = 67). The University of California, Los Angeles, was the institution with the largest number of articles (n = 11). These articles were published in 16 journals, with the largest number appearing in the Journal of Urology (n = 47). The author with the most articles was Levine LA (n = 9). Gelbard MK's articles had the highest citation frequency (n = 1158). Erectile dysfunction (n = 19) was the keyword with the highest frequency, indicating that PD-related erectile dysfunction was the leading focus of research in this field. Most of the keywords that have appeared in the past decade are related to the clinical treatment of PD. Therefore, we believe that improving patients' erectile function to the greatest extent in clinical treatment is the frontier and hot spot of future research.

Bibliometrics and visualization analysis of literature on male hypogonadism from 2000 to 2023: research focus and frontiers.

Male hypogonadism can seriously affect male health and fertility, yet comprehensive bibliometric and visualization analyses of research in this area have been lacking. This study aimed to examine the distribution of literature, identify research hotspots, and discern development trends in male hypogonadism by analyzing 4026 English documents published between 2000 and 2023 using bibliometric and visual analyses. The results indicated a significant increase in publications and citations related to male hypogonadism over the past two decades, with the United States, the University of Florence, Maggi M, and the Journal of Clinical Endocrinology & Metabolism recognized as the most productive and highly cited country, institution, author, and journal, respectively. The article titled "The GPR54 gene as a regulator of puberty" received the highest number of citations. The keywords were categorized into four distinct clusters, including the etiology and pathogenesis of male hypogonadism, symptoms of late-onset hypogonadism, testosterone replacement therapy and its contraindications, the correlation between male hypogonadism and metabolic syndrome (MetS), obesity, and the epidemiology of male hypogonadism. The most frequently co-occurring keywords were "hypogonadism", "testosterone", and "men", while "oxidative stress" was the most prominent burst keyword. The analysis also identified "male infertility" and "oxidative stress" as the primary burst keywords in the last five years, indicating their emerging high-interest topics. Overall, this study provides a comprehensive overview of male hypogonadism research, offering valuable insights for researchers interested in this area, including potential collaborators, current research hotspots, and future research directions.

Fixed drug eruption-induced balanoposthitis: a case report.

Fixed Drug Eruptions (FDE) represent a distinctive type of adverse drug reaction, typically characterized by recurring, sharply demarcated skin lesions occurring at identical sites with each administration of the causative drug. A less frequent, albeit significant manifestation of FDE, is balanoposthitis, an inflammatory condition affecting the glans penis and prepuce. This rare case report explores the clinical presentation, diagnosis, and therapeutic management of FDE-induced balanoposthitis in a 34-year-old male patient who developed this condition following azithromycin administration to treat a pulmonary infection. The patient's distinctive symptoms, coupled with a medical history of similar antibiotic-induced reactions, pointed strongly towards an FDE diagnosis. Management entailed immediate discontinuation of the offending drug and initiation of symptomatic treatment, culminating in a positive therapeutic outcome. This case illuminates the potential of commonly prescribed medications, such as antibiotics, to incite balanoposthitis via FDE. It underscores the critical need for healthcare professionals to include FDE in their differential diagnosis for balanoposthitis, especially when patient exposure to high-risk medications is evident. Furthermore, the report emphasizes the pressing requirement for additional research to elucidate the pathogenesis of FDE-induced balanoposthitis and to devise effective therapeutic and preventive measures.

A systematic review of the effect of COVID-19 on semen parameters.

Background and objectives: Since the outbreak of COVID-19, more and more studies have proved that it has an impact on the male reproductive system. The purpose of this article is to investigate the effects of COVID-19 on male semen parameters, further analyze the incidence and risk factors of diseases related to semen parameters, and put forward to corresponding preventive measures. Methods: Retrieved from PubMed, Embase, The Cochrane Library, Web of Science, Clinicaltrails, CNKI, CBM, Wanfang Database and VIP to collect research on the effects of COVID-19 on the male reproductive system. The literature search was conducted until January 2022. In strict accordance with the inclusion and exclusion criteria, two researchers independently screened the literature and comprehensively analyzed five cohort studies on the impact of COVID-19 on male reproductive system. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included cohort studies, and Revman 5.4.1 was applied for statistical analysis. Results: Semen volume (RR = -0.10; 95% CI: 0.45, 0.26; P = 0.60), there was no significant difference between the test group and the control group; Sperm count (RR = -45.28; 95% CI: 66.38, 24.19; P = 0.0001), the sperm count of the COVID-19 test group was lower than that of the control group, and the difference was statistically significant; Sperm concentration (RR = -15.65 × 106; 95%CI: 31.52 × 106, 0.21 × 106; P = 0.05), there was no significant difference between the test group and the control group; progressive sperm motility (RR = 4.31; 95% CI: 4.62, 13.24; P = 0.34), there was no effect on progressive sperm motility in the COVID-19 test group compared with the control group. Conclusions: COVID-19 can reduce semen quality and affect male fertility. However, due to the limitations of this study, this conclusion needs to be further verified by large-sample, high-quality prospective cohort studies on the long-term effects of COVID-19 on male reproductive function.

Seminal plasma biomarkers for predicting successful sperm retrieval in patients with nonobstructive azoospermia: a narrative review of human studies.

BACKGROUND: Non-obstructive azoospermia (NOA) is considered to be the most severe form of male infertility. Before the emergence of surgical testicular sperm extraction and assisted reproductive technology, NOA patients could hardly become biological fathers of their children. However, failure of the surgery could cause physical and psychological harm to patients such as testicular damage, pain, hopeless of fertility and additional cost. Therefore, predicting the successful sperm retrieval (SSR) is so important for NOA patients to make their choice whether to do the surgery or not. Because seminal plasma is secreted by the testes and accessory gonads, it can reflect the spermatogenic environment, making it a preferential choice for SSR valuation. The purpose of this paper is to summarize the available evidence and provide the reader with a broad overview of biomarkers in seminal plasma for SSR prediction. RESULTS: A total of 15,390 studies were searched from PUBMED, EMBASE, CENTRAL and Web of Science, but only 6615 studies were evaluated after duplications were removed. The abstracts of 6513 articles were excluded because they were irrelevant to the topic. The full texts of 102 articles were obtained, with 21 of them being included in this review. The included studies range in quality from medium to high. In the included articles, surgical sperm extraction methods included conventional testicular sperm extraction (TESE) and microdissection testicular sperm extraction (micro-TESE). Currently, the biomarkers in seminal plasma used to predict SSR are primarily RNAs, metabolites, AMH, inhibin B, leptin, survivin, clusterin, LGALS3BP, ESX1, TEX101, TNP1, DAZ, PRM1 and PRM2. CONCLUSION: The evidence does not conclusively indicate that AMH and INHB in seminal plasma are valuable to predict the SSR. It is worth noting that RNAs, metabolites and other biomarkers in seminal plasma have shown great potential in predicting SSR. However, existing evidence is insufficient to provide clinicians with adequate decision support, and more prospective, large sample size, and multicenter trials are urgently needed.

RéSUMé: CONTEXTE: L'azoospermie non obstructive (ANO) est considérée comme la forme la plus grave d'infertilité masculine. Avant l'émergence de l'extraction chirurgicale de spermatozoïdes testiculaires et de la procréation médicalement assistée, les patients atteints d'ANO pouvaient difficilement devenir les pères biologiques de leurs enfants. Cependant, l'échec de la chirurgie peut causer des dommages physiques et psychologiques aux patients, tels que des lésions testiculaires, des douleurs, une fertilité impossibilité et des coûts financiers supplémentaires. Par conséquent, prédire une récupération réussie de spermatozoïdes (RRS) est très important pour les patients avec ANO, pour faire leur choix de réaliser ou non la chirurgie. Comme le plasma séminal est sécrété par les testicules et les glandes accessoires, il peut être le reflet de l'environnement de la spermatogenèse, ce qui en fait un choix préférentiel pour l'évaluation de la RRS. Le but du présent article est de résumer les preuves disponibles, et de fournir au lecteur un aperçu général des biomarqueurs du plasma séminal susceptibles de prédire la RRS. RéSULTATS: Au total, 15390 études ont été  consultées à partir de PUBMED, EMBASE, CENTRAL et Web of Science, mais seulement 6615 ont été évaluées après suppression des doublons. Les résumés de 6513 articles ont été exclus car non pertinents pour le sujet. Les textes intégraux de 102 articles ont été obtenus, dont 21 ont été inclus dans cette revue. La qualité des études incluses varie de moyenne à élevée. Dans ces articles inclus, la méthode chirurgicale d'extraction de spermatozoïdes était soit l'extraction conventionnelle de spermatozoïdes testiculaires (TESE), soit l'extraction de spermatozoïdes testiculaires par microdissection (micro-TESE). Actuellement, les biomarqueurs du plasma séminal utilisés pour prédire la RRS sont principalement les ARN, les métabolites, l'AMH, l'inhibine B, la leptine, la survivine, la clusterine, LGALS3BP, ESX1, TEX101, TNP1, DAZ, PRM1 et PRM2. CONCLUSIONS: Les preuves n'indiquent pas de façon concluante que l'AMH et l'INHB dans le plasma séminal sont utiles pour prédire la RRS. Il convient de noter que les ARN, métabolites et autres biomarqueurs du plasma séminal ont montré un potentiel élevé de prédiction de la  RRS. Cependant, les preuves existantes sont insuffisantes pour fournir aux cliniciens une aide à la décision adéquate ; des essais plus prospectifs, de grande taille, et multicentriques sont nécessaires de toute urgence.

The traditional Chinese medicine Qiangjing tablet prevents blood-testis barrier injury induced by CdCl2 through the PI3K/Akt/Rictor signaling pathway.

OBJECTIVE: Environmental contaminants such as cadmium (Cd) may have a deleterious impact on sperm and reduce male fertility by compromising the blood-testis barrier (BTB). Hence, the effects of the traditional Chinese medicine Qiangjing tablet (QJP) on sperm quality and BTB alterations induced by Cd in mouse testes were examined. METHODS: Adult KM mice challenged with Cd chloride were examined, QJP was administered to mice as an oral drug by gavage, and the experiments lasted 2 weeks. Testicular and epididymal weights, sperm quality, anti-sperm antibodies (AsAb), hormone levels, and histology were evaluated. Changes in the levels of N-cadherin, occludin, ZO-1, claudin-11, F-actin, and ß-tubulin and their mRNAs were evaluated. The effects of QJP on the PI3K/Akt/Rictor pathway were evaluated. RESULTS: CdCl2 decreased reproductive organ weight, sperm quality, and testosterone (T) levels; increased AsAb, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) levels; induced structural damage in testicles with BTB disruption; increased BTB permeability; and decreased N-cadherin, occludin, ZO-1, claudin-11, F-actin, and ß-tubulin expression. After treatment, QJP blocked the effects of Cd on reproductive organ weight, sperm quality, and T; mitigated germinal epithelium compartment alterations; decreased AsAb, FSH, and LH levels; and preserved BTB ultrastructure and function. In addition, QJP induced increases in N-cadherin, occludin, ZO-1, claudin-11, F-actin, and ß-tubulin levels and the expression of their mRNAs through the PI3K/Akt/Rictor pathway. After the application of JRAB2011, the levels of a specific mTORC2 suppressor, Rictor, and the BTB-protective effect of QJP were greatly reduced. CONCLUSIONS: We demonstrated the effect of QJP against Cd-induced damage to the BTB, and the results indicate that QJP may play a significant role in opposing the effects of Cd through the PI3K/Akt/Rictor pathway.

Effect of oral alpha-lipoic acid (ALA) on sperm parameters: a systematic review and meta-analysis.

BACKGROUND: Male fertility has gradually become a worldwide problem with limitations in the treatment. Alpha-lipoic acid, has been applied to improve the quality of sperm in clinical practice. However, there was currently no high quality of systematic review to evaluate the effects of alpha-lipoic acid on sperm parameters. MATERIAL AND METHODS: The Cochrane Library, MEDLINE, EMBASE, Web of Science, Clinicaltrials.org, China National Knowledge Infrastructure Database, China Biology Medicine Database, etc., were retrieved. Related randomized controlled trials had be collected and selected up to March 10, 2022. English literature and Chinese literature were searched using terms including "male infertility", "semen", "sperm", "alpha-lipoid acid", "α-lipoid acid", "alpha lipoid acid", "thioctic acid". All statistical analyses were conducted by RevMan 5.3. RESULTS: A total of 133 participants in three studies included. Compared with sham therapy, treated with alpha-lipoic acid has significant improvement in the following sperm parameters, including abnormal sperm forms (mean difference[MD] = -1.06, 95% confidence interval [CI] = -1.29-0.84, p < 0.00001), sperm concentration (MD = 3.98, 95%CI = 2.28-5.67, p < 0.00001), sperm total motility (grade a+b+c) (MD = 6.68, 95%CI = 4.88-8.48, p < 0.00001) and progressive motility(grade a+b) (MD = 6.90, 95%CI = 5.62-8.17, p < 0.00001) and semen volume(MD = -0.17, 95%CI = -0.31-0.02, p = 0.03). CONCLUSIONS: In this meta-analysis of three randomized controlled trials, compared with other treatments, alpha-lipoic acid could improve normal sperm forms, sperm concentration, sperm total motility and progressive motility, but more stringent randomized controlled trials must be conducted.

RéSUMé: CONTEXTE: La fertilité masculine est progressivement devenue un problème mondial avec des possibilités de traitement limitées. L'acide alpha-lipoïque a été utilisé dans la pratique clinique pour améliorer la qualité du sperme. Cependant, il n'existe actuellement aucune revue systématique de haute qualité sur l'évaluation des effets de l'acide alpha-lipoïque sur les paramètres du sperme. Les bases de données Cochrane, MEDLINE, EMBASE, Web of Science, Clinicaltrials.org, China National Knowledge Infrastructure Database, China Biology Medicine Database, etc., ont été utilisées. Les essais contrôlés randomisés en relation ont été recueillis et sélectionnés jusqu'au 10 mars 2022.  La littérature anglaise et la littérature chinoise ont été recherchées en utilisant les termes tels que « infertilité masculine ¼, « sperme ¼, « spermatozoïde ¼, « acide alpha-lipoïque ¼, « acide α-lipoïque ¼, « acide alpha lipoïque ¼, « acide  thioctique ¼. Toutes les analyses statistiques ont été effectuées par RevMan 5.3. RéSULTATS: Au total, 133 participants provenant de trois études ont été inclus. Par rapport à la thérapie simulée, le traitement par l'acide alpha-lipoïque présente une amélioration significative des paramètres de sperme qui suivent : formes anormales de spermatozoïdes (différence moyenne [DM] = -1,06 ; intervalle de confiance à 95 % [IC] = -1,29--0,84, p < 0,00001), concentration de spermatozoïdes (DM = 3,98 ; IC à 95 % = 2,28-5,67, p < 0,00001), motilité totale des spermatozoïdes (grade a + b + c) (MD = 6,68 ; IC à 95% = 4,88-8,48, p < 0,00001), motilité progressive (grade a + b) (MD = 6,90 ; IC à 95% = 5,62-8,17, p <0.00001) et volume de sperme (MD =-0,17 ; IC à 95 % = -0,31--0,02, p = 0,03). CONCLUSIONS: Dans cette méta-analyse de trois essais contrôlés randomisés, l'acide alpha-lipoïque, par rapport à d'autres traitements, pourrait améliorer les formes normales de spermatozoïdes, la concentration de spermatozoïdes, la motilité totale des spermatozoïdes et la motilité progressive ;  mais des essais contrôlés randomisés plus rigoureux doivent être menés.

Exosomes in the f ield of reproduction: A scientometric study and visualization analysis.

Background: The diagnostic capabilities of exosomes in the field of reproductive biomedicine have attracted much attention. The aim of this scientometric study was to statistically and qualitatively assess the knowledge structure, hot issues, and research trends of papers about exosomes in the field of reproduction using visualization methods. Methods: The Web of Science Core Collection was searched for studies on exosomes in the field of reproduction. We performed bibliometric and visual analyses using VOSviewer, CiteSpace, and Microsoft Excel. Results: After database search, 1,011 articles were included, with number of studies being published every year continually increasing. These publications came from 61 nations or regions, with the US having the highest number. The University of Queensland was the main institution in which the research was conducted. The journal Placenta contained the highest number studies. There were 5,247 authors in total. Carlos Salomon had the highest number of papers with co-citations. Exosomes, extracellular vesicles, pregnancy, microRNAs, preeclampsia, placenta, microvesicles, gene expression, biomarkers, and first trimester were the most frequently used terms. Conclusion: Exosome research is booming in reproductive biomedicine. Future studies will likely focus on exosomes as biomarkers in gamete formation and fertilization, pregnancy, and cancers associated with reproduction. In addition to focusing on fundamental research, we should concentrate on the application of the results and the investigation of exosomes in infertile patients.

Bibliometric and visual analysis of blood-testis barrier research.

Background: Extensive research on the blood-testis barrier has been undertaken in recent years. However, no systematic bibliometric study has been conducted on this subject. Our research aimed to identify the hotspots and frontiers of blood-testis barrier research and to serve as a guide for future scientific research and decision-making in the field. Methods: Studies on the blood-testis barrier were found in the Web of Science Core Collection. VOSviewer, CiteSpace, and Microsoft Excel were used to conduct the bibliometric and visual analyses. Results: We found 942 blood-testis barrier studies published in English between 1992 and 2022. The number of annual publications and citations increased significantly between 2011 and 2022, notably in the United States. China and the United States, the US Population Council, Endocrinology, and Cheng C. Yan were the most productive countries, institution, journal, and author, respectively. The study keywords indicated that blood-testis barrier research involves a variety of compositional features (tight junctions, cytoskeleton, adherens junctions), cell types (Sertoli cells, germ cells, Leydig cells, stem cells), reproductive toxicity (cadmium, nanoparticles, bisphenol-a), and relevant mechanisms (spermatogenesis, apoptosis, oxidative stress, dynamics, inflammation, immune privilege). Conclusion: The composition and molecular processes of the blood-testis barrier as well as the blood-testis barrier in male infertility patients are the primary research hotspots in this field. In addition, future research will likely focus on treatment and the development of novel medications that target signal pathways in oxidative stress and apoptosis to preserve the blood-testis barrier. Further studies must extend to clinical diagnosis and therapy.

Qiangjing tablets repair of blood-testis barrier dysfunction in rats via regulating oxidative stress and p38 MAPK pathway.

BACKGROUND: The blood-testis barrier (BTB) is a physical barrier of the testis to prevent various exogenous substrates from entering apical compartments and provides immune privilege for spermatogenesis, which is essential for normal spermatogenic function of testis. It has been shown that oxidative stress can damage BTB by activating the p38 MAPK pathway. In Traditional Chinese Medicine, Qiangjing tablets (QJT) improve spermatogenesis and increase pregnancy rates. Previous studies have confirmed that QJT can improve sperm quality and have obvious antioxidant effects. In this study, we explore whether QJT contributes to recovery from BTB dysfunction in rats. METHODS: BTB dysfunction was induced in rats by 1% Cyclophosphamide (CP). The CP-induced rats in the treatment group were given a dose of QJT (0.45 g/kg·d) by gavage. Testis tissues were collected for histopathological and biochemical analysis, and the testis weight was estimated. Levels of BTB-related proteins and antioxidant enzyme were analyzed in the testis tissues. RESULTS: QJT resolved the pathological injury of rats testis induced by CP. Furthermore, MDA levels were significantly reduced, and the levels of SOD markedly increased in the testicular tissue after QJT treatment. In addition, QJT down-regulated the expression of p38 protein in rat testis and up-regulated the expressions of key proteins ZO-1, occludin and F-actin in BTB. CONCLUSION: These results demonstrate that QJT exerts protective effects on CP-induced rats with BTB dysfunction, likely by regulating the oxidative stress-mediated p38 MAPK pathway.

Novel DNAH1 Mutation Loci Lead to Multiple Morphological Abnormalities of the Sperm Flagella and Literature Review.

The protein encoded by dynein axonemal heavy chain 1 (DNAH1) is a part of dynein, which regulates the function of cilia and sperm flagella. The mutant of DNAH1 causes the deletion of inner dynein arm 3 in the flagellum, leading to multiple morphological abnormalities of the sperm flagella (MMAF) and severe asthenozoospermia. However, instead of asthenozoospermia and MMAF, the result caused by the mutation of DNAH1 remains unknown. Here we report a male infertility patient with severe asthenozoospermia and teratozoospermia. We found two heterozygous mutations in DNAH1 (c.6912C>A and c.7076G>T) and which were reported to be associated with MMAF for the first time. We next collected and analyzed 65 cases of DNAH1 mutation and found that the proportion of short flagella is the largest, while the bent flagella account for the smallest, and the incidence of head deformity is not high in the sperm of these patients. Finally, we also analyzed 31 DNAH1 mutation patients who were treated with intracytoplasmic sperm injection (ICSI) and achieved beneficial outcomes. We hope our research will be helpful in the diagnosis and treatment of male infertility caused by DNAH1 mutation.

Low-intensity extracorporeal shockwave therapy for erectile dysfunction: an overview of systematic reviews.

BACKGROUND: Low-intensity extracorporeal shockwave therapy (LI-ESWT) may be a successful complementary treatment approach for erectile dysfunction (ED). In this study, we aimed to review and summarize the research evidence from systematic reviews (SRs)/meta-analyses (MAs) regarding the clinical effectiveness of LI-ESWT for ED. METHODS: Studies on LI-ESWT for ED were searched using eight electronic databases from establishment of each database to 31 June 2021 with the language restrictions of Chinese and English. All articles were screened, and qualifying data were recorded based on the inclusion criteria. Methods including: the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2); the Risk of Bias in Systematic Reviews (ROBIS); the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); and Grading of Recommendations, Assessment Development, and the Evaluation (GRADE) were used by two independent raters to assess methodological quality, risk of bias, reporting quality, and SR evidence of quality, respectively. RESULTS: Eight SRs/MAs met all inclusion criteria. Seven reviews were rated as critically low on overall confidence and one review was low on confidence based on the AMSTAR-2 appraisal tool. While most PRISMA criteria were met, the major reporting flaws were in relation the financial statements not being included, along with no protocol registrations. Three SRs/MAs were classed as low risk regarding bias as measured by the ROBIS tool. Based on the GRADE method, only one SRs/MAs of high-quality evidence and seven SRs/MAs of moderate-quality evidence were found. The present research results supported LI-ESWT as a complementary therapy for ED patients, but the evidence should be considered carefully due to the methodological flaws identified. DISCUSSION: Our results showed that LI-ESWT as an adjunctive therapy has benefits for ED patients. There were no obvious side effects, and the number of shockwave treatments and energy flux density (EFD) would affect the IIEF-EF, EHS and PSV scores. However, due to the limited sample size and the quality of reporting evidence, our conclusions may not be fully representative.

Effect of Phosphodiesterase-5 Inhibitors on the Treatment of Male Infertility: A Systematic Review and Meta-Analysis.

PURPOSE: Male infertility is a worldwide problem with limitations in the treatment. Phosphodiesterase-5 inhibitors (PDE5is) is the first choice for the treatment of erectile dysfunction, more and more studies show that it has a certain effect on male infertility in recent years. But there was currently no high quality of systematic review to evaluate the effects of PDE5is on semen quality. MATERIALS AND METHODS: We retrieved the electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, etc. Related randomized controlled trials (RCTs) were collected and selected up to May 20, 2020. We have searched literature with terms "male infertility", "phosphodiesterase-5 inhibitors", "PDE5i", "Tadalafil", "Sildenafil", "Vardenafil", "Udenafil", "Avanafil", "semen", and "sperm". Mean value and its standard deviation were used to perform quantitative analysis. All statistical analyses were conducted by RevMan 5.3 and Stata software. RESULTS: There were a total of 1,121 participants in the nine included studies. There was a statistically significant improvement treated with PDE5is compared with sham therapy, which including sperm concentration (mean difference [MD]=1.96, 95% confidence interval [CI]=1.70-2.21, p<0.001; MD=3.22, 95% CI=1.96-4.48, p<0.001), straight progressive motility (%) Grade A (MD=3.71, 95% CI=2.21-5.20, p<0.001), sperm motility (MD=8.09, 95% CI=7.83-8.36, p<0.001), morphologically normal spermatozoa (%) (MD=0.67, 95% CI=0.20-1.15, p=0.005; MD=1.27, 95% CI=0.02-2.52, p=0.05), sperm abnormalities (%) (MD=-0.64, 95% CI=-0.81--0.47, p<0.001), and progressive motile sperm (MD=5.34, 95% CI=3.87-6.81, p<0.001). CONCLUSIONS: In this meta-analysis of nine RCTs, treatment with PDE5is could improve some indicators of male sperm.

Review of Vasectomy Complications and Safety Concerns.

Vasectomy is a simple, safe, effective, and economical method used worldwide for long-term male contraception. As a surgical operation, it has short-term and long-term complications such as hematoma formation, infection, sterilization failure, sperm granulomas, short-term postoperative pain (nodal pain, scrotal pain, and ejaculation pain), and chronic pain syndrome. Whether it increases the risk of autoimmune disease, cardiovascular disease, testicular cancer, or prostate cancer is still controversial. Changes in plasma concentrations of luteinizing hormone, follicle-stimulating hormone, and testosterone after vasectomy have also been studied, as well as the relation between vasectomy and sexual function. Sperm quality decreases very slowly after vasectomy, and vasovasostomy and intracytoplasmic sperm injection could help a couple achieve a pregnancy if they change their minds at any point. We include a follow-up strategy and suggestions for follow-up care at the end of this review.

[Inhibitory effect of Qiangjing Tablets on the secretion of IL-1ß and TNF-ɑ from mouse Sertoli cells: A study based on the microenvironment of spermatogenesis].

OBJECTIVE: To study the effect of Qiangjing Tablets (QJT) on the secretion of the inflammatory cytokines IL-1ß and TNF-ɑ from Sertoli cells in infertile mice based on the microenvironment of spermatogenesis. METHODS: We isolated and cultured mouse Sertoli cells, established the model of Ureaplasma urealyticum (UU) infection in the cells, and treated the cells with QJT at the concentrations of 2.5%, 5% and 10% in the serum. After modeling, we determined the contents of IL-1ß and TNF-ɑ in the supernatant of the cells by ELISA and examined the effect of QJT on the secretion of the inflammatory factors from the Sertoli cells by analyzing the dose-effect and time-effect relationships of the drug. RESULTS: In comparison with the blank control, the UU-infected Sertoli cells showed significantly increased secretion of IL-1ß and TNF-ɑ (P < 0.05), the former reaching the peak value in 12 hours and the latter in 24 hours, followed by a downward trend. The secretion of IL-1ß was remarkably inhibited in the 5% and 10% QJT groups (P < 0.05) and that of TNF- ɑ in the 10% QJT group compared with those in the UU infection model group (P < 0.05). CONCLUSIONS: The secretion of IL-1ß and TNF-ɑ is significantly increased in the UU-infected Sertoli cells, and that of IL-1ß negatively correlated with time. QJT-containing serum can inhibit the secretion of IL-1ß and TNF-ɑ from Sertoli cells, and the inhibitory effect of IL-1 ß is most significant at 5% and 10% and that of TNF- ɑ at 10%.

Vasectomy and male sexual dysfunction risk: A systematic review and meta-analysis.

BACKGROUND: Unintended pregnancy is popular all over the world, accounting for 40% to 50% of all pregnancies. The condition not only exerts pressure on the relationship of couples and severely impacts the quality of life, but also imposes a heavy burden on the health of women and child. Recently, more than 220 million couples have chosen to be sterilized to obtain contraception, 47.3% of married couples select sterilization, of which vasectomy accounts for 17.1%. Vasectomy is currently the most convenient and effective method of male contraception. We will perform the systematic review and meta-analysis to assess the correlation between vasectomy and male sex dysfunction and provide evidence-based evidence for the couple METHODS:: The electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, Clinicaltrials.org., China National Knowledge Infrastructure Database (CNKI), Wan fang Database, China Biology Medicine Database (CBM), VIP Science Technology Periodical Database, Chinese Clinical Trial Registry, and Cochrane Library will be retrieved before November 20, 2021. We will search English literature and Chinese literature with proper Medical Subject Heading or text key words. RevMan 5.3 and Stata 14.0 will be used for Systematic review and Meta-analysis. This protocol reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement. CONCLUSION AND DISSEMINATION: The aim of this study was to evaluate the effect of vasectomy on the sexual function of patients after operation. The results will be published in a public issue journal to provide evidence-based medical evidence for urologists and andrologists to make clinical decisions. REGISTRATION INFORMATION: INPLASY202080014.

The effectiveness and safety of traditional Chinese medicine for the treatment of children with COVID-19.

INTRODUCTION: With the widespread spread of novel coronavirus pneumonia, more and more countries have been affected. Some research reports have shown that traditional Chinese medicine has a significant effect on COVID-19 infection, and the treatment of traditional Chinese medicine is used in some special people, such as children. At present, there is a lack of high-quality systematic reviews on the safety and efficacy of using Chinese medicine to treat children with novel coronavirus pneumonia. MATERIALS AND METHODS: We will search Cochran library, MEDLINE, EMBASE, China National Knowledge Infrastructure Database (CNKI), China Biomedical Database (CBM), VIP Database (VIP), and Wanfang database for research. This study includes randomized controlled trials (RCTs) and non-RCTs, and uses the Cochrane systematic review to review the safety and efficacy of traditional Chinese medicine in preventing and treating children with novel coronavirus pneumonia. RCT research tools and quantitative research quality assessment tools for non-randomized studies will be used to assess the risk of bias in studies included in the systematic review. We will use Revman 5.3 software for meta-analysis, the main result is odds ratio, and then a subgroup analysis will be performed based on the age, intervention degree, and disease severity of the patients reviewed. ETHICS AND DISSEMINATION: This systematic review protocol is designed to provide evidence regarding the effectiveness and safety of traditional Chinese medicine for the treatment of children with COVID-19, such evidence may be useful and important for clinical treatment decisions. The results should be disseminated through publication in a peer-reviewed journal. Since the data and results used in the systematic review will be extracted exclusively from published studies, approval from an ethics committee will not be required. REGISTRATION INFORMATION: PROSPERO CRD42020179150.