棉酚的男性避孕作用机理研究现状

棉酚是人棉籽中提炼出来的一种多酚类化合物，具有男性避孕作用。它主要通过破坏精子能量产生和精子的动力装置，使精子安全失去活力，达到抗受精作用。棉酚还可以影响精子细胞，精母细胞的细胞核调控，减少核基础蛋白的含量，尤其影响组蛋白的含量及其修饰，抑制信使核糖核酸（ｍＲＮＡ）的合成，甚至引起精母细胞的凋亡。棉酚对支持细胞，睾丸间质细胞也产生抑制作用，对下丘脑－垂体轴系也有影响，但是，棉酚与低血钾，不可逆性无     

外源性睾酮抑制精子发生机制的研究

目的研究外源性睾酮对健康成年男性精子数量和功能的影响，评价外源性雄激素对精子的抑制作用。方法40名有生育能力的健康成年男性志愿者随机分为2组，每组20人，治疗处理如下。十一酸睾酮（TU）组：TU1000mg IM（首剂剂量），然后每6个星期500mg IM共2次，是分别在治疗期第6周和第12周，之后无继续治疗措施；对照组：同期注射等体积生理盐水。结果首次TU注射后精子计数逐渐减少，但相对较慢，在第6周时平均精子计数降低到62．4（平均仅减少了14．9％，19．3％）×10^6／ml；在第18周时才达到最大的抑制，平均精子计数降低到3.8（平均减少了63．5％，95．1％）×10^6／ml。在恢复期结束，所有各组的平均精子计数均恢复到〉20×10^6／ml的水平。TU注射之后，血总T和游离T水平均升高，然后恢复正常。结论外源性雄激素能够抑制精子发生，结果具有可逆性，对部分蛋白质功能的进一步研究，将为男性激素避孕机制的研究提供更多信息。     

棉酚的男性避孕作用机理研究现状

棉酚是从棉籽中提炼出来的一种多酚类化合物,具有男性避孕作用。它主要通过破坏精子能量产生和精子的动力装置,使精子完全失去活力,达到抗受精作用。棉酚还可以影响精子细胞、精母细胞的细胞核调控,减少核基础蛋白的含量,尤其影响组蛋白的含量及其修饰,抑制信使核糖核酸(mRNA)的合成,甚至引起精母细胞的凋亡。棉酚对支持细胞、睾丸间质细胞也产生抑制作用,对下丘脑-垂体轴系也有影响。但是,棉酚与低血钾、不可逆性无精子症的相关性尚需进一步探讨。     

这些因素影响男性生育功能

精子的“武侠世界”里有许多“恶人”,整日与它们为敌,杀伤极多。1.吸烟研究发现,吸烟是造成男性不育症的重要原因之一。烟叶中的尼古丁会降低性激素分泌、杀伤精子。2.酗酒酗酒可损害男性生殖器官,引起血清睾酮水平降低,从而引起性欲减退、精子畸形。过度饮酒还易诱发前列腺炎,甚至影响性功能,造成不育。     

“热激”组合长效睾酮发展男性避孕的研究前景

环境恶化、人口增长和资源耗竭是困扰新世纪人类生存和经济发展的严峻问题。人口多、底子薄和人均资源相对不足是制约中国社会和经济发展的关键问题。有专家估计，中国资源环境能支撑的最大人口容量为15～16亿。发展新的避孕方法，合理调控中国人口的增长速度是面临的一项艰巨任务。     

吸烟对男性睾酮、雌二醇分泌的影响

目的探讨吸烟与男性睾酮、雌二醇分泌水平的关系。方法收集来萧山中医院门诊进行体检结果健康、无生殖系相关疾病史的男性血清样本148份（吸烟者81人，不吸烟对照67人），应用Beckman Coulter Access全自动微粒子化学发光免疫分析仪检测性激素睾酮、雌二醇水平。数据应用SPSS 10．0软件进行统计分析。结果不吸烟组不同年龄段的雌二醇水平差异无统计学意义（F=1．979，P=0．10），与年龄之间无相关；吸烟组不同年龄段的雌二醇水平差异有统计学意义（F=7．252，P=0．00），与年龄之间呈显著正相关（F=0．291，P=0．009）。不吸烟者睾酮水平差异有统计学意义（F=8．173，P=0．00），年龄之间具有显著性负相关（r=-0．534，P=0．00），吸烟者睾酮水：平差异无统计学意义（F=0．085，P=0．987），与年龄之间无相关。结论吸烟可能使男性睾酮、雌二醇分泌紊乱。     

RISUG男性避孕针研究进展

自1984年印度医学家报道“在指导下对精子的可逆性抑制”（reversible inhibition of sperm under guidance,RISUG）在男性避孕节育中有良好效果,并被宣布作为可以解放女性避孕痛苦的男性避孕药以来,国际上对RISUG的研究也有近40年时间。然而不同学者报道其研究结果差异甚大,部...     

11酸睾酮男性激素类避孕针可接受性研究

1997年～1999年期间开展了一项由六个研究中心参加的十一酸睾酮男性激素类避孕针的临床多中心避孕效果评价的研究。同期也开展了该方法的可接受性研究。对参加临床效果研究的308名男性志愿者分别于注射避孕针前、注射避孕针后的4个月、8个月、停止注射避孕针后和研究期间退出时进行随访调查,并对受试者的妻子进行的调查。同时,还组织受试者及其妻子、使用其它男性避孕方法的男性以及妻子使用女性避孕方法的男性进行了24组小组专题讨论会。对服务提供者、政策制定者、男性学专家等进行了54次个人深入访谈。定性资料和定量资料综合显示,受试者参与临床试验研究的动机不尽相同,多半参加者是因为女方使用避孕方法有严重副反应,半数因不愿意绝育。大多数受试者觉得该方法可以减轻妻子因避孕而导致的负担。认为打针的方法比绝育术好是由于它有可恢复性。部分受试对象觉得打针后体力增强。有的性功能增强。大多数访谈对象反映近期副反应不大。部分出现痤疮。个别受试对象反映睾丸“变小变软”,身体乏力。注射部位疼痛和使用不方便(每月打针一次大频繁,需查精液,注射药物起效前仍要使用避孕方法,要到门诊注射等)影响其可接受性。农民在农忙时也会很容易忘记去注射。他们希望半年或一年打一针更好。部分人,特别是     

中药治疗男性无精子症1例报告

患者，男，28岁，婚后4年未避孕，同居不育，性生活3—40：／周，能正常射精，精液量约2～3ml／次，连续两次精液检查，离心沉淀后镜下未见精子，外周血染色体检查无异常，采用李顺强方法行精道造影，结果无异常，睾丸容积分别为10m1、12ml。2008年10月在笔者所在计划生育服务站诊断为男性不育，经克罗米芬治疗，于2009年1月复查精液无精子。     

长效醋酸甲孕酮用于男性避孕的药代动力学及抑制精子发生的剂量研究

比较两种剂量长效醋酸甲孕酮(DMPA)用于男性避孕的药代动力学特性以及抑制精子发生的效果,推荐进一步临床试验配伍剂量和注射间隔。方法:将筛选合格的正常志愿者30名随机分成3组(每组10名),A组150mgDMPA+1000mg十一酸睾酮酯(TU);B组300mgDMPA+1000mgTU;C组单独注射1000mgTU(为对照组)。A和B组受试者按要求接受指定的配伍剂量注射。注射前后每周静脉取血,直至8周,进行血MPA测定。然后,受试者继续每8周接受指定的配伍剂量或TU单独注射,直至完成24周的治疗期,并按要求定期随访进行精液分析及其它安全性指标监测,最后完成24周的恢复期随访。结果:受试者的各项参数在各组内均匀分布。尽管B组较A组有相对较高的血药浓度,但药代动力学的各项参数在两组之间无显著性差异。A、B和C组抑制精子发生起效时间分别为80±5d、83±8d和92±6d,各组间没有统计学差异。尽管合用组比单用组有更持久地抑制精子发生的趋势,但各组之间没有统计学差异。合用组能更加有效地抑制促性腺激素的分泌,与单用组之间有显著性差异;促性腺激素的抑制程度与配伍中DMPA的剂量无关。结论:A与B组在药代动力学的各项参数与抑制精子发生的疗效上无显著性差异。150mgDMPA与1000mgTU或更长效的雄激素联合应用可能成为2～3个月肌肉注射一针的男性避孕药的最佳剂量组合。推荐使用低剂量DMPA配伍TU进行临床避孕有效性的研究。     

Low Testosterone Levels,Depressive Symptoms,and Falls in Older Men: A Cross-Sectional Study

ObjectivesWhile several studies have cited a potential association between testosterone deficiency and risk of falls among community-dwelling older men, evidence for such an association is conflicting. Depressive symptoms, which occasionally accompany testosterone deficiency but which are often neglected as associated symptoms, may actually provoke falls independent of or jointly with testosterone deficiency. We examined the association between testosterone levels, depressive symptoms, and falls, and assessed the joint effect of testosterone levels and depressive symptoms on falls among older men.Design, Setting, and ParticipantsData for this cross-sectional study were obtained from 869 men aged over 60 years who participated in health check-ups conducted in 2010 from 2 Japanese municipalities. Salivary testosterone (sT) levels were measured using an enzyme-linked immunosorbent assay, and depressive symptoms were assessed via the short form of the Center for Epidemiologic Studies Depression Scale.Main outcome measuresSelf-reported “any fall” over the 1-month period.ResultsAmong the total of 482 participants analyzed (median age, 70 years), 10.8% reported any fall. On comparison between 90th percentile sT levels and lower levels, our logistic regression model with restricted cubic splines showed that lower sT levels were associated with an increased likelihood of suffering any fall after adjustment for sociodemographic characteristics, comorbidities, and mobility function. For example, 5th percentile sT was associated with any fall [adjusted odds ratio (OR), 4.23; 95% confidence interval (CI), 1.66–10.8]. Depressive symptoms were also strongly associated with any fall [adjusted OR, 3.49 (95% CI, 1.52–8.04)]. We noted no apparent interaction of sT and depressive symptoms with falls (P = .079), suggesting that the joint effect of testosterone deficiency and depressive symptoms on falls was multiplicative. Indeed, compared with a combination of 90th percentile sT values and no depressive symptoms, adjusted OR for any fall in a combination involving 5th percentile sT and depressive symptoms was 14.8-fold (95% CI, 3.76–58.0).ConclusionsOur findings indicated that both relatively low testosterone levels and presence of depressive symptoms were independently associated with falls among older men. Causality of these associations should be confirmed in future prospective studies.     

正常人240个人精子染色体核型分析

应用人精子与去透明带金黄地鼠卵受精技术制备人精子染色体标本,对正常男性240个精子核型进行了分析。结果显示,数目畸变精子率为3.34％,结构畸变精子率为6.67％。所观察到的结构畸变类型为无着丝粒断片、染色体断裂、双着丝粒体、易位、和染色单体断裂。在正常男性精子染色体组中,X-精子与Y-精子的比例为49.17％:50.83％;近端着丝粒染色体随体联合呈随机分布,随体联合频率为0.096。     

Assessment of Stigma Towards Homosexuality in China: A Study of Men Who Have Sex with Men

Previous research has documented the deleterious impact of homosexuality stigma on HIV sexual risk behavior among men who have sex with men (MSM) and the vulnerability of this group in China for HIV acquisition. Factor analysis of 10 survey items from 477 MSM from Shanghai yielded two factors: Perceived stigma assessed participants' impressions of the degree of societal stigmatization of homosexuals whereas enacted stigma measured direct personal experiences of stigmatizing behaviors. Enacted stigma exhibited satisfactory internal reliability and was associated with HIV sexual risk behavior. Further research is needed to refine perceived and other stigma constructs for Chinese MSM.     

嘉定区男男性接触者抑郁状况及相关因素研究

目的 了解上海市嘉定区男男性接触者（MSM）抑郁状况并分析其相关因素.方法 采用流调用抑郁自评量表（CES-D）调查嘉定区MSM抑郁状况,并采用Logistic回归分析相关因素.结果 共调查153名MSM,抑郁平均得分（16.41±10.83）分.不同年龄、教育程度、婚姻状况、月均收入和自认性取向等组之间的检出率差异均无统计学意义（P＞0.05）.经多因素Logistic回归分析,近半年固定同性性伴数多者和担心感染艾滋病者抑郁症状检出率高,而初次同性性行为年龄大者和艾滋病传播知识知晓者则相反.结论 抑郁是MSM人群中较为普遍存在的心理健康问题,应加强艾滋病传播相关知识的宣传,采取心理卫生方面干预措施,以提高艾滋病综合防治效果.     

Evaluation of Respondent-Driven Sampling in a Study of Urban Young Men Who Have Sex with Men

Evidence suggests that respondent-driven sampling (RDS) is an efficient approach to sampling among varied populations of adult men who have sex with men (MSM) both in the USA and abroad, although no studies have yet evaluated its performance among younger MSM, a population with a steep rise in HIV infection in recent years. Young MSM (YMSM) may differ in terms of their connectedness to other YMSM (e.g., due to evolving sexual identity, internalization of sexual minority stigma, and lack of disclosure to others) and mobility (e.g., due to parental monitoring) which may inhibit the sampling process. The aims of this study were to evaluate the efficiency and effectiveness of RDS-based sampling among young urban MSM and to identify factors associated with recruitment success. We hypothesized that demographic, social, behavioral, and network factors, including racial/ethnic minority status, homelessness (i.e., as an indicator of socioeconomic marginalization), HIV-positive status, substance use problems, gay community connectedness, and network size would be positively related to recruitment productivity, while sexual minority stigmatization, environmental barriers (e.g., parental monitoring), and meeting sex partners on the internet (i.e., virtual venue) would be negatively related to recruitment productivity. Between December 2009 and February 2013, we used RDS to recruit a sample of 450 YMSM, ages 16–20. Findings suggest that the use of RDS for sampling among YMSM is challenging and may not be feasible based on the slow pace of recruitment and low recruitment productivity. A large number of seeds (38 % of the sample, n = 172) had to be added to the sample to maintain a reasonable pace of recruitment, which makes use of the sample for RDS-based population estimates questionable. In addition, the prevalence of short recruitment chains and segmentation in patterns of recruitment by race/ethnicity further hamper the network recruitment process. Thus, RDS was not particularly efficient in terms of the rate of recruitment or effective in generating a representative sample. Hypotheses regarding factors associated with recruitment success were supported for network size and internalized stigma (but not other factors), suggesting that participants with larger network sizes or high levels of internalized stigma may have more and less success recruiting others, respectively.     

输精管结扎对血清睾酮的长期影响

目的观察输精管结扎对血清睾酮水平的长期影响。方法对539例行输精管结扎18年以上和341例同龄的非结扎男性的血清睾酮水平进行对比研究。结果各结扎组与相应年龄段对照组的血清睾酮水平无显著性差异(P均>0.05)。结论输精管结扎对血清睾酮无显著影响,是一种安全的节育方法。     

上海市青少年男男性接触者性行为安全认知和社会状况调查

[目的]了解青少年男男性接触者（ young men who have sex with men, YMSM ）性行为安全认知和社会状况,为进一步在YMSM中开展艾滋病（ acquired immunodeficiency syndrome, AIDS ） 相关高危行为干预提供科学依据。[方法]采用无记名方式,运用自编的调查问卷、抑郁自填问卷（self-rating depression scale,SDS）、焦虑自填问卷（self-rating anxiety scale,SAS）和半结构式访谈提纲,对28名YMSM进行问卷调查和个人深入访谈。[结果]研究对象年龄16～19岁,平均（18．11±0．83）岁;22人近半年有肛交性行为,其中仅10人每次肛交均使用安全套;15人有过一夜情。研究对象对安全性行为认知较差,19人与性伴讨论过此问题;多数人认为安全套相对安全且购买方便,但主动购买者较少（11人）,不喜欢使用安全套者占多数;对一夜情态度较开放。多数人认为自己行为是后天形成的,主要受性别认同环境、不愉快经历、同性恋信息和家庭教育方式4方面的影响。多数能感受到来自家人等方面的压力,抑郁和焦虑症状检出率分别为32．14％和25．00％。[结论]YMSM中同性性行为安全认知较差且心理压力较大,应加强AIDS健康教育,提倡单一固定性伴侣和安全性行为,推广使用安全套,提供有利于青少年健康成长的支持性环境,为YMSM健康营造和谐氛围。     

L-精氨酸与N-硝基L-精氨酸甲基酯对雄性大鼠睾酮分泌的影响

目的:阐明一氧化氮(NO)对男性生殖轴中睾丸内分泌功能的调节作用。材料与方法:于雄性SD大鼠腹腔内注射不同剂量(0～210mg/kg)的L-ARG(L-arginine,L-ARG,NO前体)与L-NAME(Nw-nitrio-L-arginine-mythel-ester,L-NAME,NO合酶的竞争性抑制剂,0～70mg/kg),每天一次,共8天,最后一次注射后1小时采血 然后将SD大鼠分成4组,分别注射同一剂量的L-ARG(160mg/k8)、L-NAME(50mg/kg)、L-ARG+L-NAME和生理盐水,每天一次,注射13天,每隔3～4天采血一次。用放射免疫同步测定法测定血清中睾酮含量,对所得数据进行统计学处理。结果:L-ARG对睾酮分泌具有抑制作用(P<0.01),而L-NAME则促进睾酮的分泌(P<0.01),两者都具有时间依赖性,并与剂量高度相关。L-ARG和L-NAME混合注射时,睾酮的含量与生理盐水注射组无明显区别(P>0.05)。结论:NO对雄性大鼠的睾酮分泌具有抑制作用。