[Alterations of regional homogeneity in patients with psychogenic erectile dysfunction: A study by resting-state functional MRI].

OBJECTIVE: To study the correlation between the brain regional homogeneity (ReHo) features and the clinical characteristics of the patients with psychogenic erectile dysfunction (pED). METHODS: Using IIEF-5 and the Self-Esteem and Relationship (SEAR) questionnaire, we evaluated the erectile function and psychosocial status of 32 pED patients and 28 healthy male subjects. Then, we compared the regional brain activity between the patients and healthy controls by resting-state functional magnetic resonance imaging (RS-fMRI) and the ReHo method, analyzed the correlation of the ReHo value of the altered brain regions with the results of IIEF-5 and SEAR questionnaire investigation, and explored the relationship between the ReHo features and the symptoms of the pED patients. RESULTS: Compared with the healthy male subjects, the pED patients obtained significantly lower IIEF-5 scores (22.21 ± 0.98 vs 13.97 ± 3.60, P < 0.01) and SEAR scores (61.92 ± 3.73 vs 37.58 ± 7.96, P < 0.01), a higher ReHo value of the left lateral cerebellum, and a lower ReHo value of the right precentral gyrus. The ReHo value of the left lateral cerebellum was correlated negatively with the IIEF-5 scores (r= －0.51, P < 0.01) and SEAR scores (r = －0.54, P < 0.01), while that of the right precentral gyrus positively with the IIEF-5 scores (r = 0.57, P < 0.01) and SEAR scores (r = 0.66, P < 0.01). CONCLUSIONS: Patients with pED had lateral cerebellum-mediated abnormal sensory integration and precentral gyrus-related dysfunction of motor imagery and motor execution.

[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%.

[Distribution of traditional Chinese medicine syndrome types of male infertility in Chengdu area].

OBJECTIVE: To explore the distribution characteristics of the traditional Chinese medicine (TCM) syndrome types of male infertility in Chengdu area, China, in order to provide some objective evidence for the clinical treatment and studies of male infertility. METHODS: We collected the clinical data on 500 cases of male infertility treated in the outpatient and inpatient departments of the Affiliated Hospital of Chengdu University of Chinese Medicine and Chengdu Hospital for Reproduction, Women and Children from January to December 2017. Based on the results of examinations using the four diagnostic methods of TCM, namely, observation, auscultation and olfaction, interrogation, and palpation, we differentiated the TCM syndromes of the patients and analyzed the distribution characteristics of the syndrome types. RESULTS: Analysis of the baseline characteristics and the results of Chi-square test showed statistically significant differences in the distribution of the frequency of sexual intercourse, body mass index, history of urinary tract infection, testis volume, testicular texture, vas deferens and varicocele among the 500 patients (P < 0.05). As for the distribution of the TCM syndrome types, 115 cases (23.0%) were diagnosed with the unlicensed discernible type of syndrome, 109 (21.8%) with kidney-yang deficiency, 36 (7.2%) with kidney-essence deficiency, 30 (6.0%) with both kidney-yang deficiency and liver-qi stagnation, 30 (6.0%) with both kidney-yang deficiency and spleen-asthenia with excessive dampness, 28 (5.6%) with kidney-yin deficiency, 20 (4.0%) with spleen-asthenia and excessive dampness, 19 (3.8%) with liver-qi stagnation, 19 (3.8%) with phlegm dampness obstruction, 19 (3.8%) with kidney-yang and kidney-essence deficiency, 16 (3.2%) with downward damp-heat, 11 (2.2%) with both kidney-yin and kidney-yang deficiency, 10 (2.0%) with qi-stagnation and blood stasis, and 38 (7.6%) with other types of syndromes. CONCLUSIONS: The main TCM syndrome types of male infertility in Chengdu area include kidney-yang deficiency, kidney-yang deficiency with liver-qi stagnation, and kidney-yang deficiency with spleen-asthenia and excessive dampness. The distribution and influencing factors of the syndrome types need to be further explored and clarified by more large-sample and high-quality studies.

[Inhibitory effect of Qilan Capsules on the expressions of vasculogenic mimicry-related proteins in prostate cancer].

Objective: To investigate the effect of Qilan Capsules (QLC) on the expressions of the related proteins HIF-1α, VEGF-α, EphA2 and MMP-1 in the formation of vasculogenic mimicry (VM) in prostate cancer. METHODS: Prostate cancer PC-3 cells were cultured, transfected with siRNA, and divided into eight groups, blank control, HIF-1α siRNA, VEGF-α siRNA, EphA2 siRNA, QLC intervention, QLC + HIF-1α siRNA, QLC + VEGF-α siRNA, and QLC + EphA2 siRNA. The expressions of the HIF-1α, VEGF-α and EphA2 proteins in the pathway of VEGF were determined by Western blot. RESULTS: Compared with the blank control group, the expression of HIF-1α was evidently decreased in the HIF-lα siRNA and QLC + HIF-lα siRNA groups (0.624 7 ± 0.042 8 vs 0.032 8 ± 0.002 5 and 0.036 8 ± 0.018 1, P < 0.05), so were that of VEGF-α in the VEGF-α siRNA and QLC + VEGF-α siRNA groups (0.068 9 ± 0.005 1 vs 0.016 9 ± 0.000 7 and 0.010 9 ± 0.000 8, P < 0.05), that of EphA2 in the EphA2 siRNA and QLC + EphA2 siRNA groups though with no statistically significant difference (0.1684 ± 0.0126 vs 0.134 5 ± 0.028 6 and 0.165 4 ± 0.039 8, P > 0.05), and that of MMP-1 in the HIF-lα siRNA, VEGF-α siRNA and EphA2 siRNA groups (1.696 1 ± 0.152 7 vs 0.435 9 ± 0.036 9, 0.198 7 ± 0.009 0 and 0.0218 ± 0.000 7, P < 0.05). CONCLUSIONS: Qilan Capsules can suppress VM formation in prostate cancer by inhibiting the expressions of HIF-1α, VEGF-α and MMP-1, which plays a role in the clinical treatment of prostate cancer by checking the growth and development of the blood supply system in the tumor tissue.

[Effect of Qiangjing Tablets on the MAPK signaling pathway in SD rats with asthenospermia].

OBJECTIVE: To investigate the effects of Qiangjing Tablets (QJT) on sperm quality and the MAPK signaling pathway in the SD rat model of asthenospermia (AS). METHODS: A total of 100 male SD rats were randomly divided into five groups of equal number, blank control, AS model control, high-dose QJT, medium-dose QJT, and low-dose QJT. All the rats were intragastrically administered ORN at 200 mg/kg/d for establishment of the AS model except those in the blank control group, which were given 1% CMC sodium solution at 1 ml/100 g by gavage. Meanwhile the animals of the high-, medium-, and low-dose QJT groups were gavaged with QJT at 6700, 3300 and 1700 mg/kg/d, respectively, qd 6 days a week for 20 days. Then the testis issue and the apoptosis of the testicular cells were observed under the electron microscope, the expression of vimentin in the testis was determined with the immunohistochemical SP method, that of ERK1/2 detected by Western blot, and the concentration of TGF-ß1 in the semen measured by ELISA. RESULTS: The AS model controls showed round nuclei of spermatocytes, homogeneously distributed chromatins, broken or lost mitochondria, and expanded rough endoplasmic reticulum in the testis tissue. In comparison, the rats of the high-, medium-, and low-dose QJT groups exhibited round nuclei of spermatocytes, homogeneously distributed chromatins, and well-structured mitochondria, rough endoplasmic reticulum and ribosome, which were all similar those of the blank controls. Compared with the blank controls, the AS model rats manifested significantly increased expressions of ERK1/2 (1.00 ± 0.00 vs 1.26 ± 0.10, P<0.01) and vimentin (0.16 ± 0.01 vs 0.17 ± 0.01, P<0.01) and apoptosis rate of cells in the testis tissue (ï¼»9.20 ± 3.07ï¼½ vs ï¼»42.20 ± 9.17ï¼½ %, P<0.01), but decreased level of TGF-ß1 in the semen (ï¼»627.67 ± 26.07ï¼½ vs ï¼»566.73 ± 68.44ï¼½ ng/ml, P<0.05). In comparison with the model controls, the rats of the high- and medium- -dose QJT groups presented remarkably down-regulated expressions of ERK1/2 (1.26 ± 0.10 vs 1.14 ± 0.08, P<0.01; 1.26 ± 0.10 vs 1.18 ± 0.05, P<0.05) and vimentin (0.17 ± 0.01 vs 0.16 ± 0.01, P<0.01; 0.17 ± 0.01 vs 0.17 ± 0.09, P<0.05) and decreased rate of cell apoptosis (ï¼»42.20 ± 9.17ï¼½ vs ï¼»21.60 ± 5.94ï¼½ %, P<0.01; ï¼»42.20 ± 9.17ï¼½ vs ï¼»33.95 ± 6.39ï¼½ %, P<0.05). The concentration of TGF-ß1 in the semen was markedly lower in the high-dose QJT than in the AS model control group (ï¼»621.78 ± 30.80ï¼½ vs ï¼»566.73 ± 68.44ï¼½ ng/ml, P < 0.05). CONCLUSIONS: Qiangjing Tablets could improve semen quality in asthenospermia rats by acting against oxidative stress.

[Umbilicus application of Huobi Powder for ED with kidney deficiency dampness: A randomized controlled clinical trial].

OBJECTIVE: To prove the clinical efficacy of umbilicus application of Huobi Powder for the treatment of erectile dysfunction (ED) with the traditional Chinese medicine (TCM) syndrome of kidney deficiency dampness by related clinical indexes. METHODS: This randomized controlled double-blind clinical study included 72 ED patients with the TCM syndrome of kidney deficiency dampness treated by 12-hour application of Huobi Powder (the trial group, n = 36) or placebo (the control group, n = 36) to the umbilicus qd for 28 consecutive days. We recorded the IIEF-5 and Erection Quality Scale (EQS) scores, TCM syndrome indexes, radial rigidity of the erectile penis, and the angle of penile erection before and after treatment. We established a database with the collected data and performed statistical analysis with the SPSS21.0 software. RESULTS: Statistically significant differences were observed after treatment between the trial and control groups in the TCM syndrome-based efficacy (69.44% vs 36.11%, P <0.01) and Western medicine-based clinical effectiveness (77.78% vs 36.11%, P <0.01). The trial group, as compared with the control, showed remarkably decreased TCM syndrome indexes (18.19 ± 9.12 vs 12.97 ± 11.92, P <0.05), increased IIEF-5 score (13.83 ± 4.91 vs 18.67 ± 3.09, P <0.01), radial rigidity of the erectile penis (ï¼»53.43 ± 11.05ï¼½% vs ï¼»71.96 ± 12.92ï¼½%, P <0.01) and the angle of penile erection (ï¼»42.15 ± 11.77ï¼½% vs ï¼»66.96 ± 12.34ï¼½%, P <0.01), but no significant difference in the EQS score (37.11 ± 16.70 vs 35.33 ± 14.11, P >0.05). CONCLUSIONS: Umbilicus application of Huobi Powder has a definite clinical effect on ED with the TCM syndrome of kidney deficiency dampness.

[Traditional Chinese medicine fumigation combined with Levofloxacin for type â ¢A prostatitis with the symptoms of damp heat and blood stasis].

OBJECTIVE: To investigate the clinical effects of traditional Chinese medicine (TCM) fumigation on type ⅢA prostatitis with the symptoms of damp heat and blood stasis. METHODS: We randomly divided 72 cases of type ⅢA prostatitis with the symptoms of damp heat and blood stasis into an experimental and a control group of equal number, the former treated with TCM fumigation plus oral Levofloxacin while the latter with oral Levofloxacin only. After 4 weeks of treatment, we compared the National Institute of Health Chronic Prostatitis Symptom Index (NIHCPSI) score, TCM symptoms score, maxinum flow rate (Qmax), and average urinary flow rate (Qave) between the two groups of patients. RESULTS: The total effectiveness rate was significantly higher in the experimental than in the control group (91.7% vs 61.1%, P< 0.01), while the NIHCPSI score in the experimental group was markedly decreased after treatment as compared with the baseline (14.5 ± 8.2 vs 26.5 ± 9.3, P< 0.05) and significantly lower than that in the control (14.5 ± 8.2 vs 20.6 ± 7.9, P< 0.05). Qmax was remarkably increased in the experimental group after treatment in comparison with the baseline (ï¼»21.2 ± 4.3ï¼½ vs ï¼»15.8 ± 3.6ï¼½ ml/s, P< 0.05) and the control group, and so was Qave as compared with pretreatment (ï¼»16.3 ± 3.5ï¼½ vs ï¼»10.5 ± 2.8ï¼½ ml/s, P< 0.05) and the control. However, the patients of the control group showed no statistically significant differences before and after treatment either in Qmax (ï¼»15.4 ± 3.4ï¼½ vs ï¼»16.1 ± 2.9ï¼½ ml/s, P>0.05) or in Qave (ï¼»10.9 ± 2.4ï¼½ vs ï¼»11.1 ± 2.9ï¼½ ml/s, P>0.05). CONCLUSIONS: TCM fumigation combined with Levofloxacin is an effective therapy for type ⅢA prostatitis with the symptoms of damp heat and blood stasis, which can significantly improve the symptoms, reduce the NIHCPSI score, and increase the Qmax and Qave of the patient.

[Qilan Capsules plus androgen-deprivation therapy for Qi-deficiency blood-stasis type of prostate cancer after castration].

OBJECTIVE: To observe the synergistic effect of Qilan Capsules in the treatment of the patient with Qi-deficiency blood-stasis type of prostate cancer receiving androgen-deprivation therapy after castration. METHODS: This randomized controlled double-blind study included 246 cases of Qi-deficiency blood-stasis type of prostate cancer after castration, which were randomly divided into an experiment and a control group of equal number to be treated with Qilan Capsules + androgen-deprivation and placebo + androgen-deprivation, respectively. After 6 months of treatment, we compared the International Prostate Symptoms Scores (IPSS), TCM Symptoms Scores (TCMSS), maximal urine flow rate (Qmax), and the level of serum prostate-specific antigen (PSA) between the two groups of patients. RESULTS: Statistically significant differences were observed between the experiment and control groups in the syndrome classification-based efficacy (87.7% vs 67.9%, P <0.05) and total effectiveness rate (86.0% vs 71.6%, P <0.05). Compared with the baseline, the experiment group showed remarkable improvement after treatment in TCMSS (17.1±5.1 vs 8.3±4.0, P <0.05), IPSS (17.7±7.5 vs 11.4±4.6, P <0.05), and Qmax (ï¼»10.9±4.3ï¼½ ml/s vs ï¼»14.7±3.7ï¼½ ml/s, P <0.05), and so did the control group (16.8±5.2 vs 11.5±5.2, 17.8±6.7 vs 14.6±5.8, and ï¼»11.0±4.3ï¼½ ml/s vs ï¼»12.0±4.1ï¼½ ml/s, P <0.05). The above three parameters were even more markedly improved in the former than in the latter group (P <0.05). However, there was no statistically significant difference between the two groups in the improvement of the PSA level after treatment (P >0.05). CONCLUSIONS: Qilan Capsules can significantly enhance the effect of androgen-deprivation therapy in the treatment of Qi-deficiency blood-stasis type of prostate cancer after castration though cannot obviously improve the PSA level.

[Efficacy and safety of traditional Chinese medicine combined with sildenafil in the treatment of ED in Chinese men： A real-world study].

OBJECTIVE: To make a real-world study on the efficacy and safety of traditional Chinese medicine (TCM) combined with sildenafil in the treatment of erectile dysfunction (ED) that failed to respond to TCM medication. METHODS: This study included 1 038 ED patients with the International Index of Erectile Function-5 (IIEF-5) scores ≤21 and improvement <30% after 4 weeks of TCM medication, differentially diagnosed with kidney-yang or kidney-yin deficiency syndrome. We administered TCM combined with sildenafil (Viagra, Pfizer Pharmaceutical Co., Ltd) at 100 mg 1 hour before sexual intercourse. After 2 and 4 weeks of medication, we recorded the scores in IIEF-5, erection hardness, Sexual Encounter Profile question 2 (SEP-2: whether vaginal penetration is successful), SEP-3 (whether sexual intercourse is successful), and TCM Syndromes Scale as well as the indexes of routine blood, urine, liver function, and renal function of the patients, and compared them with those obtained before treatment. RESULTS: No serious adverse reactions were observed in any of the patients. Compared with the baseline, the patients achieved significantly increased IIEF-5 scores after 2 and 4 weeks of medication (15.01 ± 2.25 vs 16.96 ± 2.55 and 19.41 ± 2.82, P <0.05), penileelectionhardness remarkably improved at 4 weeks (3.36% vs 44.58%, P<0.05), and the positive answers to SEP-2 and SEP-3 both markedly increased at 2 (38.11% vs 90.49%, P<0.05; 22.01% vs 63.77% , P<0.05) and 4 weeks (38.11% vs 96.95% , P<0.05; 22.01% vs 89.73%, P<0.05). CONCLUSIONS: TCM combined with sildenafil is safe and effective in the treatment of ED in Chinese men, which can significantly improve the IIEF-5 score and erection hardness of the patients.

[Treatment of Benign Prostatic Hyperplasia by Longbishu Capsule Combined Doxazosin Mesylate Tablet].

Objective To observe the efficacy and safety of Longbishu Capsule (LBS) com- bined Doxazosin Mesylate Tablet (DMT) in treating benign prostatic hyperplasia (BPH). Methods Total- ly 360 BPH with Shen deficiency blood stasis syndrome (SDBSS) were randomly assigned to group A, B, and C, 120 cases in each group. Patients in Group A took LBS placebos combined DMT. Those in Group B took LBS combined DMT. Those in Group C took LBS combined DMT placebos. The dose for LBS was 3 pills each time, 0. 3 g/pill, twice per day. The dose of DMT was 1 tablet each time, 2 mg/tablet, once per day. The therapeutic course for all was 12 months. A total of 113 cases in Group A were recruited in FAS analysis, 115 cases in Group B, and 116 cases in Group C. Main efficacy indicators [International Prostate Symptom Score (IPSS) , maximum urinary flow rate (Qmax) , Quality of Life (QOL) ] , and sec- ondary efficacy indicators [postvoid residual urine volume (PVR) and prostate volume (PV) , symptoms scores of Chinese medicine (CM) I were observed in each group. The efficacy was analyzed in the three groups by taking average age of subjects (66 years) as the hierarchy factor (50 ≤age ≤66 and <66 0. 05). There was no statistical difference in clinical efficacy among post-treatment groups (P >0. 05). The efficacy in subjects more than 66 years old of Group B was superior to that of Group A and C with statistical difference (P <0. 05). Conclusions LBS, DMT, or LBS combined DMT was safe and effective for treating BPH. LBS combined DMT was suit- able for patients complicated with abnormal PVR or aged over 66 years.

[Qilin Pills for obstructive azoospermia after ejaculatory duct reconstruction].

OBJECTIVE: To observe the clinical effect of Qilin Pills in the treatment of severe oligozoospermia after microsurgical ejaculatory duct reconstruction for obstructive azoospermia. METHODS: We retrospectively analyzed 75 cases of obstructive azoospermia treated by ejaculatory duct reconstruction followed by administration of Qilin Pills. The patients were divided into a Qilin group (n=42) and a control group (n=33) postoperatively, treated with Qilin Pills and placebo, respectively. After 3 months of medication, we compared the sperm quality between the two groups of patients. RESULTS: After 3 months' treatment, all the patients experienced remarkable improvement in sperm quality (P<0.05). Compared with the controls, the patients in the Qilin group showed dramatic increases in sperm concentration, from (0.57±0.25) and (0.60±0.18) ×106/ml before medication to (2.83±0.59) and (1.72 ±0.52) ×106/ml after medication, significantly higher in the Qilin than in the control group (P<0.05). The percentage of grade a sperm was increased from (5.52±5.97) and (5.30±6.26)% to (11.56±9.96) and (10.27±6.52)%, that of grade a+b sperm from (9.68±8.63) and (8.64±10.10)% to (23.42 ±14.10) and (20.81±14.70)%, and that of morphologically normal sperm from (2.00±1.27) and (2.31±0.94)% to (3.54±2.47) and (3.47±1.33)%, respectively. No statistically significant differences were observed in sperm motility and normal sperm morphology between the two groups after treatment (P>0.05). The total effectiveness rate was higher in the Qilin group than in the controls (88.1% vs 72.7%), but with no significant difference between the two groups (P>0.05). CONCLUSIONS: Qilin Pills are fairly effective in improving the quantity of sperm in obstructive azoospermia patients after ejaculatory duct reconstruction.

[Inhibitory effect of Qiangjing Tablets on the Fas/FasL pathway of cell apoptosis in male SD rats with infertility].

OBJECTIVE: To observe the effects of Qiangjing Tablets (QJT) on the semen quality and Fas/FasL signaling pathway in male SD rats with infertility. METHODS: Models of infertility were made in 50 male SD rats by intragastric administration of Tripterygium (GTW) for 3 weeks, and another 20 rats were taken as blank controls. Then 40 successfully established rat models were randomly divided into four groups, model control, low-dose QJT, medium-dose QJT, and high-dose QJT, the latter three groups treated intragastrically with QJT at 58 mg, 105 mg, and 233 mg per kg of the body weight per day, respectively. After 4 weeks of medication, the rats were killed for examination of semen quality and determination of the expression of the apoptosis factor FasL in the testis tissue. RESULTS: Compared with the blank controls, the model rats showed significant decreases in sperm concentration ([71.99 ± 9.72] vs [10.94 ± 3.58] x 106/ml, P < 0.01), motility ([48.95 ± 4.10] vs [9.31 ± 5.79]%, P < 0.01), and viability ( [82.06 ± 6.16] vs [24.03 ± 6.93]%, P < 0.01). In comparison with the model controls, the rats in the QJT groups exhibited remarkably increased sperm concentration, motility, and viability, more significantly in the high-dose group ([59.66 ± 4.53] x 106/ml, [35.45 ± 5.21] %, and [61.97 ± 9.75]%) and medium-dose group ([40.89 ± 4.90] x 106/ml, [24.41 ± 4.79]%, and [60.06 ± 10.62]%) (P < 0.05 or P < 0.01). The expression of FasL was markedly reduced in the low-, medium-, and high-dose QJT groups (0.5215 ± 0.0189, 0.5371 ± 0.0364, and 0.4556 ± 0.0215) as compared with that of the model controls (0.5989 ± 0.0448 ) (P < 0.05 or P < 0.01). CONCLUSION: By upregulating the Fas/FasL signaling pathway, Tripterygium glycosides may induce the apoptosis of spermatogenic cells and reduce sperm concentration, motility and viability, resulting in infertility. The Chinese medicine Qiangjing Tablets can improve the reproductive function of male rats by decreasing the expression of the apoptosis factor FasL in the testis.

[Longbishu Capsule combined with mesylate doxazosin: an efficacious therapy for benign prostatic hyperplasia].

OBJECTIVE: To assess the clinical effect and safety of the Chinese medicine Longbishu Capsule combined with mesylate doxazosin in the treatment of benign prostatic hyperplasia (BPH) of the kidney deficiency and blood stagnation type. METHODS: This was a randomized, double-blind, double-simulation control study. We equally assigned 60 men diagnosed with BPH of the kidney deficiency and blood stagnation type to an experimental and a control group, the former treated with mesylate doxazosin plus Longbishu Capsule and the latter with mesylate doxazosin plus placebo. We compared the International Prostate Symptom Score (IPSS), quality of life (QOL), Chinese symptom score (CSS), maximal urinary flow rate (Qmax), and prostate volume between the two groups of patients before and after 6 months of medication. RESULTS: After treatment, there were 5 cured cases, 13 markedly effective cases, 9 effective cases, 1 ineffective case, and 2 eliminated cases in the experimental group, as compared with 2 cured cases, 8 markedly effective cases, 10 effective cases, 7 ineffective cases, and 3 eliminated cases in the control group. The total effectiveness rate was obviously higher in the former (96.4%) than in the latter (74.1%). IPSS, Qmax, and CSS were improved in both of the groups after medication, even more significantly in the experimental than in the control group (IPSS: 15.22 ± 2.98 vs 18.15 ± 5.88, P <0.05; Qmax: [13.56 ± 2.26] ml/s vs [11.78 ± 2.97] ml/s, P <0.05; CSS: 6.18 ± 2.13 vs 9.52 ± 3.15, P <0.05). Because of the difference in the QOL score between the two groups at the baseline (P = 0.038 <0.05), no more comparison was made in this aspect after treatment. CONCLUSION: The combination of Longbishu Capsule with mesylate doxazosin is safe and effective for the treatment of BPH.

[Correlation of IPSS with IL-8 and COX-2 levels in patients with benign prostatic hyperplasia and prostatitis].

OBJECTIVE: To investigate the correlation of International Prostate Symptom Score (IPSS) with the levels of interleukin-8 (IL-8) and cyclooxygenase-2 (COX-2) in the prostate tissue and expressed prostatic secretion (EPS) in patients with benign prostatic hyperplasia (BPH) complicated by prostatitis. METHODS: We divided 80 BPH patients to be treated by transurethral resection of the prostate (TURP) into a simple BPH group (n = 30) and a BPH with prostatitis group (n = 50) based on the pathologic features. We statistically analyzed IPSS and the levels of IL-8 and COX-2 in EPS before surgery and the IL-8 and COX-2 levels in the prostate tissue after surgery. RESULTS: IPSS was positively correlated with the IL-8 and COX-2 levels in the prostate tissue and EPS of the BPH patients, moderately in the simple hyperplasia group (r > 0.5) and highly in the other (r > 0.8). The levels of IL-8 and COX-2 in the prostate tissue and EPS were significantly higher in the BPH with prostatitis group than in the simple BPH group (P < 0.05). CONCLUSION: The levels of IL-8 and COX-2 in EPS indirectly reflect those in the prostate tissue. IPSS and the levels of IL-8 and COX-2 in EPS can help determine whether BPH is complicated by histological prostatic inflammation.

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.

[Modified Bazhengsan for urination symptoms of chronic prostatis with damp-heat accumulated in the lower jiao].

OBJECTIVE: To study the clinical effects of the modified formula of Bazhengsan on the urination symptoms of chronic prostatis with damp-heat accumulated in the lower jiao. METHODS: A total of 72 chronic prostatitis patients with damp-heat accumulated in the lower jiao were equally randomized to receive the modified formula of Bazhengsan (the trial group) and the primal Bazhengsan (the control group), both for a course of 28 days. Then we observed the changes in the NIH-CPSI scores, scores on Traditional Chinese Medicine (TCM) syndrome, maximum flow rate of urine (MFR) and results of the expressed prostatic secretion test (EPS). RESULTS: Among the 31 patients of the trial group, 6 were cured, 10 achieved excellent results, 9 got improved, and 6 failed to respond, with a total efficacy rate of 80.6%. While in the control group, 4 were cured, 10 achieved excellent results, 11 got improved, and 7 failed to respond, with a total efficacy rate of 78.1%. Significant improvement was observed in NIH-CPSI scores, TCM syndrome and EPS results in both of the groups (P < 0.05), and the trial group showed significant difference from the control in the improvement of urination symptoms (P < 0.05). CONCLUSION: Modified Bazhengsan is effective in the treatment of chronic prostatis with damp-heat in the lower jiao. It can significantly improve its clinical symptoms, especially urination symptoms.

[Clinical features of benign prostatic hyperplasia complicated by chronic prostatitis].

OBJECTIVE: To explore the clinical characteristics of benign prostatic hyperplasia (BPH) complicated by chronic prostatitis (CP). METHODS: A total of 120 cases of BPH pathologically confirmed after transurethral resection of the prostate (TURP) were assigned to a BPH group (n=75) and a BPH + CP group (n=45) according to whether they were complicated by CP. The total prostatic volume (TPV) and PSA density (PSAD) were calculated and statistically analyzed based on the results of transrectal ultrasonography and f-PSA, t-PSA and f-PSA/t-PSA tests before surgery. RESULTS: The BPH group showed a significantly upward tendency in f-PSA and t-PSA (P < 0.05) with the increase of age or prostate volume, but not significantly in PSAD and f-PSA/t-PSA (P > 0.05). In comparison, the BPH + CP group exhibited remarkable increases in f-PSA, t-PSA and PSAD (P < 0.05) but not in fPSA/t-PSA (P > 0.05). ROC curve analyses of various indexes showed the area under the curve to be 0.644, 0.628 and 0.624 for f-PSA, t-PSA and PSAD, respectively, all between 0.5 and 0.7. CONCLUSION: BPH is frequently associated with CP. Clinically, high f-PSA, t-PSA and PSAD are important but not sure indicators of BPH complicated by CP.

[Effect of zengjing no. 1 capsule on morphology and motility of sperm in patients with oligospermia].

OBJECTIVE: To explore the effect of Zengjing Capsule No. 1 (ZJC1) on morphology and motility of sperm in patients with oligospermia (OSM). METHODS: Seventy-two OSM patients were assigned to 2 groups by a randomizing digital table, the treated group and the control group, they were treated respectively by ZJC1 and Wuzi Yanzong Pill (WYP). The changes of density, motility and morphology of sperm in patients before and after 3-month treatment were examined using computerized WLJY-9000 colour semen analysis system with refined Papanicolaou's stain. RESULTS: The density, motility and morphology of sperm were improved and sperm deformity rate was significantly decreased after treatment in both groups (P < 0.01), but the effects in the treated group were better than those in the control group (P < 0.01). CONCLUSION: ZJC1 can enhance the density and motility of sperm and reduce the sperm deformity rate in patients with OSM.

[The microstructure studies of penile cavernous tissue of erectile dysfunction rat models with chronic renal failure].

OBJECTIVE: To investigate the mechanism of erectile dysfunction (ED) in rat models with chronic renal failure (CRF). METHODS: Chronic renal failure was induced by adult male Sprague-Dawley rats, which were subjected to an excisional 5/6 nephrectomy. The rats in NCRF group and CRF group were divided into three groups randomly. Injected with apomorphine(APO, 80 microg/kg), penile erections of three groups were observed and noted by the 2nd week, 4th week respectively and 6th week from the 14th day of 5/6 nephrectomy and experimental models of ED with CRF were selected; NOS activity was examined and the microstructures of penile were observed under optical microscope with computer configuration image analysis system in selected rat models. RESULTS: Compared with the controls, the areas of smooth muscle and NOS activity in the penile cavernous tissue of ED rats with CRF decreased significantly (P < 0.01 or P < 0.05) , and collagen fibers slightly increased, and these alterations had close correlations with the duration of CRF. The CONCLUSIONS: Penile erection is seriously affected in rats with CRF. The decreases of areas of blood sinus had no obvious changes. the number of smooth muscles and NOS activity might be the most important factors.

[Angiogenesis and regulatory factors in rats with BPH induced by testosterone].

OBJECTIVE: To study angiogenesis and regulatory factors in the proliferated prostatic tissues of Sprague Dawley (SD) rats with BPH induced by testosterone. METHODS: Sixteen castrated SD rats, aged 8 weeks and weighing 200 approximately 250 g, were equally randomized into a model group and a control group, and the BPH model was established by subcutaneous injection of testosterone. Immunohistochemistry and MIAS (micro-image analysis system) were used to test the manifestations of MVD (microvessel density), VEGF (vascular endothelium growth factor), flk-1, endostatin, MMP-2 (matrix metalloproteinase-2) and TIMP-2 (tissue inhibitor of metalloproteinase-2) in the prostatic tissues of both the model and the control groups. Multiple linear regression with the stepwise method was adopted to analyze the data. RESULTS: The manifestations of MVD, VEGF, flk-1, MMP-2, MMP-2/TIMP-2 and VEGF/endostatin in the model group were higher, while that of endostatin was lower than in the control group (P < 0.01), and the manifestation of TIMP-2 showed no statistical difference between the two groups. The regression analysis indicated that MVD was positively correlated to VEGF, VEGF/endostatin and MMP-2/TIMP-2 (r = 0.974, 0.986, 0.982, P < 0.05) and negatively correlated to endostatin (r = - 0.975, P < 0.05) . CONCLUSION: Testosterone could induce BPH in SD rats by increasing MVD and promoting the multiplication of vascular endothelial cells after regradation of basement membrane.