TNF and otitis media with effusion: Our findings in the OME group were similar to the results described in a study by Zhao et al. [45], which demonstrated that early-life or lifelong appropriate exercise effectively alleviated age-induced oxidative damage in the testes and downregulated the expression of the proinflammatory cytokines IL-1β and TNF-α and the inflammatory signaling pathway component NF-κB but increased the levels of the anti-inflammatory cytokine IL-10, enhancing testosterone biosynthesis, serum testosterone levels, and sperm quality parameters.