Decreased testosterone secretion index and free testosterone level with multiple symptoms for late-onset hypogonadism identification: a nationwide multicenter study with 5980 aging males in China.

Late-onset hypogonadism (LOH) is a syndrome in middle-aged and elderly men caused by age-related testosterone deficiency. Age-related change of total testosterone (TT) of Asian males is different from Caucasian population, suggesting difference for LOH identification in Asians. A nationwide cross-sectional study involving six centers in China was conducted. Totally 6296 men aged 40-79 were recruited. After exclusions 5980 men were left for analyses. The serum TT level, was neither decreased with aging nor correlated with most hypogonadal symptoms. Instead, ten hypogonadal symptoms were found to be significantly correlated with free testosterone and testosterone secretion index, thus were chosen to form a concise scale. Further analysis identified a level of free testosterone <210 pmol/L, testosterone secretion index <1.8, and the concise scale score ≧17 could be diagnosed as having significantly aggravated LOH. This study developed an evidence-based criteria for LOH identification in Chinese population and may be adopted in other Asians. It includes the impaired testosterone secretion ability and deficiency of bioavailable testosterone, which should be the main cause in LOH pathogenesis despite normal TT levels, as well as correlated multiple hypogonadal symptoms. Our results may guide the LOH treatment to increase testicular function of testosterone secretion and bioavailable testosterone.

[Correlation of age, body mass index and obesity-related biochemical indexes with semen quality in males intending for a second child].

OBJECTIVE: To explore the influence of age, body mass index (BMI) and obesity-related biochemical indexes on semen quality in adult males intending to have a second child in Guangzhou. METHODS: We conducted a questionnaire investigation among 632 adult males seeking medical advice on their intention for a second child at Guangzhou Women and Children's Medical Center from August 2017 to July 2018. We obtained their lipid metabolism indicators and semen parameters, and analyzed the correlation of semen quality with age, BMI, obesity-related biochemical indexes, living environment and occupation. RESULTS: Age, BMI, season of sperm extraction, living environment and occupation all influenced the semen quality of the males. Age was correlated negatively with the percentage of progressively motile sperm (PMS) (r = －0.109, P < 0.05), BMI positively with the semen volume (r = 0.103, P < 0.05) but negatively with the percentage of morphologically normal sperm (MNS) (r = －0.138, P < 0.05), high-density lipoprotein (HDL) negatively with PMS (r = －0.168, P < 0.01) and the percentage of immotile sperm (IM) (r = －0.135, P < 0.05), low-density lipoprotein (LDL) negatively with the semen volume (r = －0.124, P < 0.01), PMS (r = －0.127, P < 0.05), sperm concentration (r = －0.121, P < 0.05) and total sperm count (r = －0.210, P < 0.01) but positively with IM (r = 0.140, P < 0.01). Multivariate regression analysis showed BMI and LDL to be independent factors influencing the semen volume, uric acid to be an independent factor influencing semen liquefaction time, age, HDL and LDL to be independent factors influencing PMS, age, and HDL to be independent factors influencing IM, LDL to be independent factors influencing total sperm count, while BMI and TG to be independent factors influencing MNS. CONCLUSIONS: Age, BMI, season of sperm extraction, living environment and occupation may affect the semen quality of the males in Guangzhou.

[Population intervention of thalassemia relying on family planning service system].

OBJECTIVE: To set up thalassemia population intervention model in order to decrease the birth of thalassemia major, relying on population and family planning service system. METHODS: Pregnant women and their husbands were educated about thalassemia, and participated in screening and prenatal diagnosis if the couple were carriers of thalassemia in the areas of Huangpu, Panyu, Zengcheng and Tianhe districts of Guangzhou. RESULTS: The network of thalassemia intervention mainly dependent on family planning service system was set up in these regions. A total of 10 695 families participated in thalassemia screening and 16 thalassemia major fetuses were diagnosed in the last two years. No one was thalassemia major in the 8360 newborn. CONCLUSION: Thalassemia population intervention model was set up relying on family planning service system and it significantly decreased the birth of thalassemia major.

[Evaluation of strand displacement amplification in the diagnosis of tuberculosis].

OBJECTIVE: To study the clinical significance and reliability of strand displacement amplification (SDA) in detecting Mycobacterium tuberculosis complex. METHODS: SDA and fluorescence quantitative polymerase chain reaction (FQ-PCR) were employed to detect samples from 453 cases of tuberculosis, including 332 sputum samples, 78 samples of pleural effusion, and 43 samples of cerebrospinal fluid. RESULTS: In the 332 sputum samples, 131 were culture-positive, of which 110 samples (88 smear-positive) were Mycobacterium tuberculosis complex and 21 samples (20 smear-positive) were nontuberculous Mycobacteria. The sensitivity and specificity of SDA for the 110 samples of Mycobacterium tuberculosis complex and 21 samples of nontuberculous Mycobacteria were 99.1%, 95.2% and 94.6%, 95.2%, respectively. The positive rates in the 311 cases of Mycobacterium tuberculosis complex for SDA and FQ-PCR were 55.3% (172/311) and 47.0% (146/311), respectively. There were 20 smear positive samples in the 121 samples of pleural effusion and cerebrospinal fluid, of which 19 were Mycobacterium tuberculosis, 1 nontuberculous Mycobacterium. The positive rates for SDA and FQ-PCR were 43.4% (52/120) and 33.4% (40/120), respectively. Internal amplification control (IAC) was designed for SDA to achieve accuracy of the results. CONCLUSION: The automatic assay system of SDA is a rapid and specific test for detecting Mycobacterium tuberculosis complex.