Effect of Shanhaidan Granules combined with tadalafil on erectile dysfunction: A multi-center clinical trial / 中华男科学杂志

Objective@#To observe the clinical effect and safety of Shanhaidan Granules (SHDG) combined with tadalafil tablets (TT) in the treatment of ED.@*METHODS@#In this open multi-center case-control clinical trial, we enrolled 247 ED patients according to the designed criteria, and treated them orally with SHDG at 10 g per time tid (n = 74), TT at 5 mg per time bid (n = 52), or SHDG + TT at the above doses (n = 121), all for 8 weeks. Before and after medication, we recorded the IIEF-6, erection hardness scores (EHS), traditional Chinese medicine syndromes (TCMS) scores, penile cavernous blood flow parameters and adverse reactions, and compared them between the 3 groups of patients.@*RESULTS@#After 8 weeks of treatment, all the patients showed significantly increased IIEF-6, EHS and TCMS scores in comparison with the baseline (P < 0.05). The total effectiveness rates in the SHDG, TT and SHDG + TT groups were 60.8%, 67.3% and 69.4% respectively based on the IIEF-6 scores, remarkably higher in the TT and SHDG + TT groups than in the SHDG group (P < 0.05), and 40.5%, 32.7% and 63.6% respectively according to the TCMS scores, markedly higher in the SHDG and SHDG + TT groups than in the TT group (P < 0.05). Single-center data manifested significantly increased peak systolic velocity (PSV) of the penile artery in the SHDG + TT and TT groups (P < 0.05). The improvement values of relevant parameters were remarkably higher in the SHDG + TT group than in the TT and SHDG groups, so were IIEF-6 scores in the TT than in the SHDG group, and TCM syndromes in the SHDG than in the TT group. No medication-related adverse events were found in any of patients after treatment, except for some mild side effects including muscle soreness and gastrointestinal reactions in a few cases, all soon relieved, none with abnormalities in blood and urine routine tests or hepatic and renal function indicators.@*CONCLUSIONS@#Shanhaidan Granules combined with tadalafil can significantly improve the erectile function and reduce TCM syndromes in ED patients, and therefore can be applied effectively and safely in clinical practice./.

Association between folate metabolism in males and outcome of assistant reproductive technology / 上海交通大学学报（医学版）

Objective: To investigate the association between polymorphisms in methylenetetrahydrofolate reductase (MTHFR), serum homocysteine (HCY) concentration and outcome of assistant reproductive technology (ART). Methods: A retrospective study was conducted in 285 infertile couples who underwent ART. Sperm quality, serum HCY concentration and MTHFR genotype of the males in these couples were collected. According to the results of MTHFR C677T and serum HCY of males, they were divided into four groups, i. e, TT+high HCY, TT+normal HCY, NOT TT+high HCY, and NOT TT+normal HCY (as control). Results: There was no significant difference in the frequency distribution of oligoasthenozoospermia of four groups (P>0.05). The fertilization rates were significantly lower in patients with high plasma HCY levels (P0.05). Conclusion: High serum HCY of males may affect outcome of ART. The detection of MTHFR gene polymorphisms helps to remind supplement folic acid in time.

Short-term medication of L-carnitine before intracytoplasmic sperm injection for infertile men with oligoasthenozoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the pregnancy promoting effect of L-carnitine combined with intracytoplasmic sperm injection (ICSI) in treating male infertility with oligoasthenozoospermia.</p><p><b>METHODS</b>We assigned 129 patients with oligoasthenozoospermia to receive 2 weeks of oral L-carnitine followed by ICSI (medication group, n = 42) and ICSI alone (control group, n = 87). We compared the sperm concentration and motility, the percentage of grade a + b sperm, and sperm deformity before and after L-carnitine medication, as well as the rates of fertilization, cleavage, available embryo and clinical pregnancy between the two groups.</p><p><b>RESULTS</b>The percentage of grade a + b sperm was significantly increased after L-carnitine medication as compared with the baseline ([13.5 +/- 10.7] % vs [9.6 +/- 7.2] %, P<0.05), and so was the rate of available embryo in the medication group after ICSI in comparison with that of the control group (77.50% vs 69.04%, P<0.05).</p><p><b>CONCLUSION</b>Short-term medication of L-carnitine can improve sperm quality and raise the success rate of ICSI.</p>

Advances in application of sildenafil to erectile dysfunction / 中华男科学杂志

Since the worldwide introduction of sildenafil in 1998, 23 million patients with ED have been treated with the drug, and the accumulated experiences have proved its safety and efficacy. This article presents a review about the action mechanism and metabolic process of sildenafil, with a particular focus on the application of sildenafil to ED diagnosis, the curative effect of its daily use on ED, the standard treatment, combined therapy and progressive protocol with sildenafil for ED and its complications, along with such safety aspect as its effect on the sight.