生精冲剂对精索静脉曲张大鼠睾丸生精功能的作用

目的:探讨生精冲剂对精索静脉曲张睾丸损伤的作用.方法:观察生精冲剂对实验性精索静脉曲张大鼠睾丸组织结构、超微结构的影响.测定各组实验大鼠睾丸SOD、CAT、ACE活性和LPO、NO含量.结果:治疗组鼠睾丸组织结构与超微结构的损害程度明显低于模型组;SOD、CAT、ACE活性测定值明显高于模型组,LPO、NO含量明显低于模型组(P<0.05).结论:生精冲剂对精索静脉曲张造成的睾丸损害有保护作用,其提高精液质量和生育率的机制可能与抗脂质过氧化和增强抗氧化酶活性有关.     

生精冲剂对实验性精索静脉曲张大鼠生精细胞凋亡状况的影响

目的:探讨实验性精索静脉曲张大鼠睾丸生精细胞凋亡状况以及生精冲剂对其凋亡的影响。方法:将60只成年雄性W istar大鼠随机抽出20只为对照组,其余按石津和彦改良法制成左精索静脉曲张大鼠模型,再随机分为模型组20只,治疗组20只。用末端脱氧核苷酸转移酶介导的原位缺口末端标记法(TUNEL)检测睾丸生精细胞凋亡。结果:模型组大鼠睾丸生精细胞凋亡指数明显高于对照组(P<0.01)和治疗组(P<0.01),治疗组与对照组比较有明显差异(P<0.01)。结论:实验性精索静脉曲张大鼠睾丸生精细胞凋亡增加,这可能是影响生育力的机制之一;生精冲剂能够减少精索静脉曲张大鼠睾丸生精细胞凋亡,对睾丸生精功能具有保护作用,进而可提高睾丸的生殖能力。     

生精冲剂对精索静脉曲张大鼠睾丸生精功能保护作用的研究

目的探讨生精冲剂对精索静脉曲张睾丸损伤的保护作用。方法观察生精冲剂对实验性精索静脉曲张大鼠睾丸组织结构、超微结构的影响。测定各组实验大鼠睾丸超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、乙酰胆碱脂酶(ACE)活性和脂质过氧化物(LPO)、一氧化氮(NO)含量。结果治疗组鼠睾丸组织结构与超微结构的损害程度明显低于模型组,SOD、CAT、ACE活性测定值明显高于模型组,LPO、NO含量明显低于模型组(P<0.01)。结论生精冲剂对精索静脉曲张造成的睾丸损害有保护作用,其提高精子质量和生育率的机制可能与抗脂质过氧化和增强抗氧化酶活性有关。     

精索静脉曲张大鼠生精小管生精上皮的超微结构研究

目的 通过精索静脉曲张大鼠睾丸的透射电镜观察,了解生精上皮更多的细胞病理现象.方法 雄性Sprayue-Dawley大鼠30只,随机分为(1)精索静脉曲张组(VG)20只,(2)假手术对照组(SOG)10只,按Saypol方法建立左精索静脉曲张模型,处死观察大鼠,取其左、右侧睾丸组织,作透射电镜观察.结果 VG组双侧睾丸均出现生精小管生精上皮的结构损害,左侧相对较重.与SoG组比较,VG的生精上皮变化表现为:支持细胞胞质内出现大量空泡,大量溶酶体出现(72%vs 28%);紧密连接破坏(69%vs31%),线粒体数量减少(160 vs 362), 两者均有显著性差异(P＜0.01);精子顶体形成异常(62%vs38%),尾部线粒体鞘部分缺失,嵴肿胀(71%vs 29%),尾部横切面线粒体数目减少(186 vs 401), 两者均有显著性差异(P＜0.01).结论 生精小管生精上皮的结构损害是由精索静脉曲张导致男性不育的重要原因.     

茶多酚对精索静脉曲张大鼠睾丸生精细胞凋亡的影响

目的:研究茶多酚对精索静脉曲张大鼠睾丸生精细胞凋亡的影响,分析茶多酚对精索静脉曲张大鼠生精功能是否具有保护作用。方法:清洁级青春期Wistar大鼠32只随机分为4组,每组8只:假手术组(仅模拟手术过程,不结扎血管)、模型组(建立左精索静脉曲张模型)、茶多酚低剂量组[建立精索静脉曲张模型并给予10 mg/(kg·d)茶多酚干预]、茶多酚高剂量组[建立精索静脉曲张模型并给予40 mg/(kg·d)茶多酚干预]。建立左侧精索静脉曲张模型4周后,假手术组及模型组均给予生理盐水1 ml/100 g,茶多酚低剂量组及茶多酚高剂量组分别给予茶多酚10 mg/kg(用生理盐水配置成浓度为1 mg/ml)和40 mg/kg(用生理盐水配置成浓度为4 mg/ml),灌胃,1次/日,持续4周。4周后4组大鼠均处死并分别取左侧睾丸组织,检测低氧诱导因子-1(HIF-1)、Bcl-2、Bax、细胞色素C(Cyt C)和caspase-3在睾丸组织中的表达及生精细胞的凋亡并计算凋亡指数(AI)。结果:茶多酚干预组大鼠Bcl-2表达高于模型组(110.03±3.07),低于假手术组(154.18±2.96);茶多酚低剂量组大鼠Bcl-2(127.67±1.28)表达低于茶多酚高剂量组(136.41±1.95),差异有统计学意义(P0.05)。茶多酚干预组大鼠HIF-1、Bax、Cyt C和caspase-3的表达低于模型组,高于假手术组;茶多酚低剂量组大鼠HIF-1、Bax、Cyt C和caspase-3的表达高于茶多酚高剂量组,差异有统计学意义(P0.05)。假手术组AI最低,茶多酚干预组AI低于模型组,茶多酚高剂量组AI低于茶多酚低剂量组,差异有统计学意义(P0.05)。结论:茶多酚能显著降低精索静脉曲张大鼠睾丸生精细胞的凋亡。     

实验性精索静脉曲张大鼠生精状态评价

目的 通过对大鼠实验性精索静脉曲张(varicocele,VC)模型睾丸生精小管生精上皮结构、性激素水平的分析,探讨精索静脉曲张致不育的机制.方法 40只雄性青春期Wistar大鼠随机分为VC8周组(n=12)、VC12周组(13=12)和相应对照组(分别n=8);左肾静脉部分结扎建立实验性大鼠VC模型.术后8周或12周,分别测量各组大鼠:(1)左侧精索静脉直径、睾丸温度及体质量、睾丸生精小管生精上皮;(2)外周血中促卵泡刺激素(FSH)、黄体生成素(LH)和睾酮(T)的水平.结果 VC8周和VC12周组大鼠左侧精索静脉明显扩张,与对照相比血管直径差异有统计学意义(P<0.01);VC8和VC12周组大鼠左侧睾丸体质量均低于自体右侧睾丸和对照组睾丸,差异有统计学意义(P<0.05);光镜下,VC组大鼠双侧睾丸生精小管生精上皮精子发生阻滞、细胞脱落和细胞层数减少等,VC12周组损伤程度较VC8周组明显加重,左侧较右侧显著;与对照组相比,VC组大鼠外周血FSH、LH升高,T降低,差异均有统计学意义(P<0.01).结论 本研究提示:VC对大鼠双侧睾丸生精小管生精上皮产生明显的损害作用,并导致大鼠血中T水平降低和FSH、LH水平升高.     

精索静脉曲张导致睾丸生精细胞增殖与凋亡的变化

精索静脉曲张（VC）是男性不育的原因之一，在正常人群中VC的发生率为15％～17％，而不育者中VC的发生率占30％～40％。本研究旨在通过观察左侧VC患者双侧睾丸生殖细胞的增殖、凋亡的变化，探讨该病的病理生理机制。     

中药生精冲剂对生精障碍小鼠治疗作用的实验研究

目的:研究生精冲剂对环磷酰胺所致生精障碍小鼠的治疗作用。方法:46只雄性昆明小鼠随机分为正常组(n=10)、模型组(n=12)、对照组(n=12)和中药组(n=12),后3组腹腔注射环磷酰胺,建立生精障碍模型。造模完成后,中药组和对照组分别灌胃中药生精冲剂[16 g/(kg.d)]和克罗米芬[21.6 mg/(kg.d)],正常组与模型组每天灌胃等量生理盐水,连续15 d。次日,测量睾丸重量,并计算睾丸指数;放射免疫法测定血清FSH、LH、T水平;对睾丸组织进行组织学观察。结果:中药组小鼠血清T[(7.046±0.291)nmol/L]、FSH[(2.947±0.587)mIU/ml]、LH[(3.254±0.492)mIU/ml]、睾丸指数[(3.958±0.342)g/kg]与模型组各检测值相比[(6.231±0.317)nmol/L、(5.428±0.719)mIU/ml、(5.155±0.460)mIU/ml、(3.525±0.462)g/kg]差异有显著性(P<0.05)。组织学观察中药组睾丸生精小管生精细胞层数及管腔内精子数明显高于模型组。结论:生精冲剂治疗小鼠生精障碍有效。     

精索静脉曲张大鼠睾丸自噬对生精细胞的影响

目的:研究精索静脉曲张(VC)大鼠模型中睾丸不同水平自噬对生精细胞凋亡的影响。方法:雄性SD大鼠54只随机分为6组:空白对照组、雷帕霉素对照组、氯喹对照组各6只,VC组、VC+雷帕霉素组、VC+氯喹组各12只。采用HE染色观察睾丸、附睾组织形态学变化,并对睾丸及附睾中精子形成情况进行评分,TUNEL染色检测生精细胞凋亡指数(AI),Western印迹检测LC3、p62、Bax、Bcl-2的表达。结果:空白对照组、雷帕霉素对照组、氯喹对照组大鼠睾丸及附睾组织均未发生明显形态学变化,精子形成情况评分及AI亦无显著差异(P>0.05);VC组大鼠睾丸及附睾组织发生明显病理损伤,精子形成情况评分显著降低(P<0.01),AI显著升高(P<0.01),但VC+雷帕霉素组较VC组明显改善,而VC+氯喹组较VC组轻度加重。此外,与空白对照组比较,VC组自噬相关蛋白LC3(包括LC3-Ⅱ/LC3-Ⅰ的比值)和促凋亡蛋白Bax表达显著增加(P<0.01),抑凋亡蛋白Bcl-2表达则显著降低(P<0.01);且VC+雷帕霉素组LC3与Bcl-2表达显著高于VC组(P<0.01),p62和Bax表达则显著低于VC组(P<0.01);而VC+氯喹组LC3与Bcl-2表达显著低于VC组(P<0.01),p62和Bax的表达则显著高于VC组(P<0.01)。结论:VC可诱导大鼠睾丸自噬和生精细胞凋亡,上调自噬可抑制生精细胞凋亡,阻滞自噬则可促进生精细胞凋亡。     

The effect of varicocele repair on testicular volume in children and adolescents with varicocele

PURPOSE: We investigated the effect of varicocele repair on testicular volume according to age in children and adolescents and review the long-term results of varicocele surgery. MATERIALS AND METHODS: The study included 39 boys 11 to 19 years old with clinical palpable varicocele who underwent varicocele surgery with at least 1 year of postoperative followup. Preoperative and postoperative testicular volumes were monitored and measured with an ellipsoid Prader orchidometer. Physical examination findings (testicular volumes and testicular consistency) in all boys, and serum hormone values and semen parameters in 16 adolescents were recorded and compared before and after surgery. RESULTS: Left unilateral varicocelectomy was done in 29 boys (74%) and bilateral varicocelectomy in 10 (26%). While no postoperative hematoma, infection or testicular atrophy was observed, 1 boy (2.5%) had varicocele recurrence and 2 boys (5.1%) had minimal hydroceles that required no intervention. Significant increases were observed in postoperative sperm concentration (p = 0.01), total motile sperm count (p = 0.009), testis volume (p = 0.000) and serum testosterone level (p = 0.014). All 15 boys with preoperative soft testis had normal testicular consistency postoperatively. Of the 19 boys with preoperative testicular atrophy 10 (53%) did regain normal testicular growth, while 9 (47%) retained testicular volume loss after surgery. When comparing preoperative to postoperative increase in testicular volume according to age in all boys, the mean was statistically significantly higher in boys younger than 14 years (left testis p = 0.037, right testis p = 0.000). CONCLUSIONS: Testicular consistency achieved normal firmness after varicocelectomy in all boys with preoperative soft testis. While there was catch-up growth in comparison to the contralateral testis, testicular consistency improved but testicular volumes may not increase significantly after varicocele repair at ages older than 14 years. However, in these adolescents postoperative semen parameters and serum hormone values may significantly improve regardless of testicular volume. Therefore, boys with varicocele and their families should be fully informed in light of these findings.     

Intratesticular varicocele: Report of two cases

Intratesticular varicocele is a rare entity and describes dilated intratesticular veins radiating from the mediastinum testis into the testicular parenchyma. Scrotal ultrasonography of two patients who presented to our urology clinic due to left scrotal pain revealed multiple tubular structures in the testes with diameters of more than 2 mm. Duplex spectral analysis showed a reversed flow response to Valsalva's maneuver. Apropos of two cases, intratesticular varicocele is reviewed.     

Normal and varicocele testis in adolescents

The authors reviewed the results of their research on the structure and composition of normal and varicocele seminiferous tubules in adolescents. They give new evidences of normal structure of adolescent testis and demonstrate, for the first time, the ultrastructural and immunohistochemical modifications of the lamina propria and basal lamina in the adolescent varicocele patients, which are similar to those observed in adults, but less severe, and of the adherence junctions in seminiferous tubules. They also report the presence of oxidative stress in adolescents limited to testis and not generalised as in the adults. These data are well correlated to different clinical studies that support the hypothesis of a progressive course of varicocele and the need for surgical treatment in adolescent varicocele patients.     

Impact of varicocelectomy on the proteome profile of testicular tissues of rats with varicocele

Varicocele (VC) is a common cause of male infertility, but the molecular mechanisms involved in its pathogenesis are unknown. We investigated the impact of varicocelectomy (VCT) on proteome profiles in testicular tissues of rats with VC, and analysed associated target genes and signalling pathways. Sixty male rats with VC were divided into two groups: control (n = 30), and VCT (n = 30). Tissues were collected 4 weeks after sham or VCT surgery. Matrix‐assisted laser desorption/ionisation time‐of‐flight/time‐of‐flight mass spectrometry (MALDI‐TOF/TOF MS) was used to analyse the comparative proteome profiles. Kyoto Encyclopaedia of Genes and Genomes (KEGG) Orthology‐Based Annotation System was used for bioinformatic analysis. Fifteen proteins were differentially expressed between control and VCT groups. These differentially expressed proteins are associated with several specific cellular processes associated with the pathogenesis of testicular growth arrest associated with VC. Furthermore, the evaluation by transmission electron micrograph showed that VCT could decrease apoptosis of spermatogenic cells in rats. Understanding such molecular pathways might provide physicians with a better insight into VC and with potential targets for treatment.     

Incidence and management of hydrocele following varicocele surgery in children

PURPOSE: Hydrocele seems to be the most frequent complication in children who undergo surgery for varicocele and the issue of the optimal management of hydrocele remains controversial. In this retrospective study we evaluated the incidence and management of hydrocele following surgical treatment of varicocele in children treated at 8 European centers of pediatric surgery. MATERIALS AND METHODS: In a 5-year period 278 children between 7 and 17 years old underwent surgical treatment for unilateral left varicocele, including 187 using video surgery and 91 via an open inguinal approach. RESULTS: At an average followup of 24 months (range 12 to 60) 34 children (12.2%) had a left hydrocele. Of the 278 children 14 (5%) were lost to followup. The hydrocele appeared between 1 week and 44 months (median 2 months) after surgery. Concerning hydrocele management 16 of 34 children (47%) were treated with scrotal puncture while under local anesthesia, which led to hydrocele regression after a median of 3 punctures (range 1 to 5), 12 (35.3%) underwent clinical observation since the hydrocele reduced spontaneously within a median of 12 months after its appearance and 6 (17.7%) were treated with open surgery. In 4 cases the hydrocele disappeared and in 2 it recurred after surgery and was successfully treated with punctures. CONCLUSIONS: This study shows that the median incidence of hydrocele after varicocele surgery is about 12% but it seems higher after artery nonsparing vs sparing procedures (17.6% vs 4.3%). On the contrary, no difference was found when the procedure was performed using video surgery or with the open approach. Hydroceles generally develop a few months later but may also appear several years after the surgical repair of varicocele. Noninvasive procedures (scrotal punctures or clinical observation) seem to induce total hydrocele regression in more than 82% of cases. Children who undergo surgery for varicocele should undergo long-term followup to detect a possible hydrocele. In fact, the 5.4% of children lost to followup in our study may potentially have had a hydrocele. Surgery is not always successful for this condition, as shown in the 2 cases of recurrent hydrocele after surgical repair.     

改进型实验性左侧精索静脉曲张的建立及其对大鼠卵泡刺激素及抑制素B的影响

目的:探讨改进型实验性左侧精索静脉曲张(ELV)对大鼠血清卵泡刺激素(FSH)及抑制素B(InhB)的影响。方法:利用改进的方法建立青春期SD大鼠左精索静脉曲张的模型30只;假手术组SD大鼠30只作对照组。术后3个月,取大鼠血清,ELISA法分别检测FSH、InhB的浓度。结果:实验组大鼠血清中FSH浓度[(37.56±9.72)ng/ml]与对照组[(26.69±5.33)ng/ml]相比升高,具有统计学意义(P<0.05);而实验组大鼠血清中InhB的浓度[(349.93±99.48)pg/ml]与对照组[(768.83±146.96)pg/ml]相比下降,具有统计学意义(P<0.05)。结论:改进型ELV致FSH升高及InhB下降,这些变化可能是影响生育能力的机制之一。     

Morphological findings in varicocele An ultrastructural study of 30 bilateral testicular biopsies

A systematic study of a series of thirty bilateral biopsies of testes was performed using electron microscopy. Observations showed how frequently there were bilateral changes within the Sertoli cells. These included a sometimes extensive vacuolization of the endoplasmic reticulum which may cause germ cells to exfoliate. Bilateral vascular lesions including modifications of the capillary endothelium which becomes thick and rich in pinocytotic vesicles and arteriolar spasms with an increase in number of microfilaments in the endothelial cells were constantly observed.