Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 11 de 11
Filtrar
1.
Pharm Biol ; 61(1): 488-498, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36895195

RESUMEN

CONTEXT: Plastics can break down into millions of microplastic (MPs, < 5 mm) particles in the soil and ocean. These MPs can then affect the function of the reproductive system. There is currently no effective solution to this problem aside from traditional Chinese medicine. We have previously used Yishen Tongluo formula (YSTL) to treat sperm DNA damage caused by some toxic substances. OBJECTIVE: To investigate the mechanism underlying the repair of mouse sperm DNA fragmentation caused by polystyrene microplastics by YSTL. MATERIALS AND METHODS: An animal model of polystyrene microplastic (PS-MP)-induced sperm DNA damage was replicated by gavage of SPF ICR (CD1) mice PS-MPs at 1 mg/d and treated with YSTL at 11.89, 23.78 and 47.56 g/kg, respectively, for 60 days. The Sperm DNA fragmentation index (DFI) of each group was detected and compared. The target genes of YSTL identified by transcriptomic and proteomic analyses were validated by qRT-PCR and western blotting. RESULTS: The DFI of the PS group (20.66%) was significantly higher than that of the control group (4.23%). The medium and high doses of the YSTL group (12.8% and 11.31%) exhibited a significant repairing effect. The most enriched pathway was PI3K/Akt. TBL1X, SPARC, hnRNP0, Map7D1, Eps8 and Mrpl27 were screened and SPARC was validated. DISCUSSION AND CONCLUSIONS: The precise mechanism by which YSTL inhibits PD-MPs DNA damage may be associated with the PI3K/Akt pathway and SPARC. It provides a new direction for using traditional Chinese medicine to prevent and repair reproductive system injury caused by MPs.


Asunto(s)
Microplásticos , Plásticos , Masculino , Ratones , Animales , Microplásticos/metabolismo , Microplásticos/farmacología , Plásticos/metabolismo , Plásticos/farmacología , Poliestirenos/toxicidad , Poliestirenos/metabolismo , Semen , Fragmentación del ADN , Fosfatidilinositol 3-Quinasas/metabolismo , Proteómica , Proteínas Proto-Oncogénicas c-akt/metabolismo , Ratones Endogámicos ICR , Espermatozoides
2.
Zhonghua Nan Ke Xue ; 29(12): 1010-1017, 2023 Dec.
Artículo en Chino | MEDLINE | ID: mdl-38639954

RESUMEN

OBJECTIVE: In order to exploring Erectile Dysfunction(ED) syndrome and syndrome differentiation based on latent structure to provide objective evidence to support Traditional Chinese Medicine(TCM) dialectic. METHODS: Cases and clinical experience in the treatment of erectile dysfunction in Chinese medicine in CNKI, Wanfang Database, cqVIP Database, were searched. Time from the database construction to January, 2023. Extraction and specification of symptom data with reference to national standards. Lantern 5.0 software was used to make the latent structure of the data based on LTM-EAST method. Latent probability, conditional probability, information coverage, mutual information and other data were combined to manually interpret the model and perform clustering analysis on the latent classes to analyze the symptomatic features and clinical evidence of erectile dysfunction and establish the rules of identification. RESULT: A total of 361 cases of erectile dysfunction were included, 21 latent variables were constructed, 9 comprehensive clustering models and 13 discriminative rules were established. The pathological factors of the obtained erectile dysfunction are dampness, heat, yin deficiency, blood stasis, spleen deficiency, kidney deficiency, liver depression, and qi stagnation. The certificate types are stasis of blood, liver qi stagnation, damp-heat entrapment (dampness is heavy, heat is heavy, damp-heat is heavy), yin deficiency (yin deficiency with heat, kidney yin deficiency), vital fire failure, qi deficiency (qi deficiency with heat, kidney qi deficiency), heart and spleen deficiency, panic injury to kidney, spleen and kidney deficiency. CONCLUSION: The common types of erectile dysfunction obtained are generally consistent with existing guidelines, but more subcategories exist in the certificate type. The presence of symptoms that cannot be well matched in some of the certificate types is presumed to be due to the complex pathogenesis of erectile dysfunction common compound evidence, many evidence models are seen in the main symptoms of liver qi stagnation evidence pulse strings, suggesting that clinical treatment should pay attention to the regulation of emotional and moral, to ease the patient's emotions. The corresponding dialectical rules can quantify the dialectical criteria and provide an objective basis for non-TCM professionals to clinically determine the TCM evidence type of patients.


Asunto(s)
Disfunción Eréctil , Deficiencia Yin , Masculino , Humanos , Deficiencia Yin/diagnóstico , Disfunción Eréctil/diagnóstico , Medicina Tradicional China/métodos , Síndrome
3.
Medicine (Baltimore) ; 101(43): e31226, 2022 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-36316921

RESUMEN

BACKGROUND: The incidence of male infertility is increasing in recent years, and the semen routine examination of some patients is normal, but the semen pathological examination shows that the sperm DNA fragmentation index (DFI) is high, and the patients' clinical manifestations are infertility or recurrent abortion of their spouses. At present, there is no special treatment for male infertility caused by high DFI, and traditional Chinese medicine compound prescription shows potential value in the treatment of male infertility. Wuwei Fuzheng Yijing formula (WFY) is an effective prescription for the treatment of sperm DNA damage in male infertility, but there is no strict clinical trial to support its application. Therefore, we designed a randomized controlled trial to evaluate the efficacy and safety of WFY in patients with sperm DNA damage in male infertility. METHODS: In this randomized controlled study, 100 patients who met the inclusion criteria were randomly divided into WFY group and levocarnitine oral solution group. The treatment period was 12 weeks. The main observation index was sperm DFI, and the secondary observation index was sperm concentration, motility, survival rate, and TCM syndrome score. Safety observation indicators will include electrocardiogram, blood tests (including blood routine tests, liver and renal function), routine urine tests, and routine stool tests. All results were evaluated at the 4th and 8th week of the baseline, and the end of treatment. DISCUSSION: This study will provide a basis for the efficacy and safety of WFY in the treatment of sperm DNA damage in male infertility with spleen and kidney qi deficiency and blood stasis.


Asunto(s)
Infertilidad Masculina , Semen , Embarazo , Femenino , Masculino , Humanos , Fragmentación del ADN , Infertilidad Masculina/genética , Espermatozoides/patología , Daño del ADN , Ensayos Clínicos Controlados Aleatorios como Asunto
4.
Andrologia ; 54(11): e14582, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36068021

RESUMEN

The sperm DNA fragmentation index (DFI) is an objective indicator of male fertility. Currently, effective treatments for high sperm DFI are limited and traditional Chinese medicine (TCM) has certain advantages in this aspect. Yishen Tongluo formula (YSTL), a TCM formula, has been found to reduce DFI in patients. To better understand the mechanisms underlying its activity, we used transcriptomics and proteomics to analyse the potential target gene YSTL repairing tripterygium glycosides (TGs)-mediated sperm DNA damage in rats, followed by validation analyses using RT-qPCR and western blotting, which showed that relative to the control group, DFI was markedly elevated in the TGs group, but markedly lower in the YSTL group relative to the TGs group. KEGG pathway analysis of 119 differentially expressed genes and 158 DEPs identified using trend analysis revealed that they were enriched for apoptosis and base excision repair at the transcriptomic level and for microRNAs in cancer and complement and coagulation cascades at the proteomic level. Ttr and Pnpla2 were identified as potential target genes for YSTL. Our data show that YSTL can protect rat sperm DNA from TGs-induced damage, which may be related to apoptosis, DNA repair and other pathways, and the possible target genes are Ttr and Pnpla2.


Asunto(s)
Proteómica , Transcriptoma , Masculino , Ratas , Animales , Semen , Espermatozoides , Fragmentación del ADN , Daño del ADN
5.
Pharm Biol ; 60(1): 1286-1302, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35797467

RESUMEN

CONTEXT: Di-2-ethylhexyl phthalate (DEHP), a known persistent organic pollutant, can increase the sperm DNA fragmentation index (DFI). OBJECTIVE: To investigate the mechanism underlying the repair of DEHP-induced sperm DNA damage in mice by Wuwei Fuzheng Yijing (WFY) formula. MATERIALS AND METHODS: The potential targets of WFY and sperm DNA fragment (SDF) were obtained from the TCMSP, BATMAN-TCM, OMIM and GeneCards. The protein-protein interaction (PPI) network, GO and KEGG pathway analyses of WFY-SDF were constructed. An animal model of DEHP-induced sperm DNA damage was replicated by gavage of SPF ICR (CD1) mice DEHP at 1 g/kg/d and treated with WFY at 8.92, 17.84 and 35.67 g/kg, respectively, for 60 d. Sperm DFI of each group was detected and compared. The target genes of WFY identified by transcriptomic and proteomic analyses were validated by qRT-PCR and Western blotting. RESULTS: Network pharmacology pathway analysis indicated that PI3K/Akt was the potential target of WFY on SDF. The DFI of the DEHP group (25.48%) was significantly higher than that of the control group (4.02%). The high-dose WFY group (19.05%) exhibited the most significant repairing effect. The related pathways were PI3K/Akt and metabolic. Aass, Aldh1a7, GSTA3, betaine homocysteine S-methyltransferase (Bhmt), Mug2 and Svs1 were screened and Bhmt was validated. DISCUSSION AND CONCLUSIONS: WFY can repair sperm DNA damage caused by DEHP, and the mechanism may be related to PI3K/Akt and metabolic pathways, and Bhmt. This provides a new direction for using traditional Chinese medicine to prevent and repair reproductive system injury caused by pollutants.


Asunto(s)
Fragmentación del ADN , Dietilhexil Ftalato , Medicamentos Herbarios Chinos , Espermatozoides , Animales , Dietilhexil Ftalato/toxicidad , Medicamentos Herbarios Chinos/farmacología , Masculino , Ratones , Ratones Endogámicos ICR , Fosfatidilinositol 3-Quinasas , Proteómica , Proteínas Proto-Oncogénicas c-akt , Semen , Espermatozoides/efectos de los fármacos , Espermatozoides/patología
6.
Zhonghua Nan Ke Xue ; 26(11): 1020-1024, 2020 Nov.
Artículo en Chino | MEDLINE | ID: mdl-34898074

RESUMEN

OBJECTIVE: To investigate the clinical effect of Luobufukebiri Pills (LP) on asthenospermia and its action mechanism. METHODS: A total of 206 patients with asthenospermia in Henan Provincial Hospital of Traditional Chinese Medicine from March 2018 to December 2018 were randomly assigned to receive oral LP (the experimental group, n = 103) bid 10 pills each time or vitamin E soft capsules (the control group, n = 103) bid 100 mg each time for a course of 12 weeks. We compared the semen volume, sperm concentration, sperm motility, levels of α-glucosidase (α-Glu), fructose (Fru), malondialdehyde (MDA) and superoxide dismutase (SOD) in the seminal plasma, and the number of pregnancies between the two groups of patients before and after treatment. RESULTS: All the patients finished the experiment except 1 in the control group due to personal reasons. After 12 weeks of medication, the patients in the experimental group showed significant increases over the baseline in sperm concentration (ï¼»36.27 ± 11.05ï¼½ vs ï¼»25.96 ± 8.63ï¼½ ×106/ml, P < 0.05), grade a sperm (ï¼»16.92 ± 5.72ï¼½% vs ï¼»9.34 ± 3.18ï¼½%, P < 0.05), grade a+b sperm (ï¼»36.08 ± 6.84ï¼½% vs ï¼»19.88 ± 4.65ï¼½%, P < 0.05), total sperm motility (ï¼»50.37 ± 10.38ï¼½% vs ï¼»24.62 ± 6.12ï¼½%, P < 0.05), and the levels of α-Glu (ï¼»46.94 ± 9.16ï¼½ vs ï¼»32.25 ± 8.30ï¼½ U/ml, P < 0.05), Fru (ï¼»28.08 ± 5.72ï¼½ vs ï¼»16.38 ± 4.62ï¼½ µmol/ml, P < 0.05) and SOD (ï¼»182.28 ± 18.44ï¼½ vs ï¼»100.37 ± 10.22ï¼½ U/ml, P < 0.05), but a decrease in the content of seminal plasma MDA (ï¼»10.37 ± 2.93ï¼½ vs ï¼»15.62 ± 4.68ï¼½ nmol/ml, P < 0.05). Increases were also observed in the control group over the baseline in grade a sperm (ï¼»12.40 ± 6.33ï¼½% vs ï¼»9.26 ± 2.94ï¼½%, P < 0.05), grade a+b sperm (ï¼»25.42 ± 5.24ï¼½% vs ï¼»19.43 ± 4.17ï¼½%, P < 0.05), total sperm motility (ï¼»40.22 ± 9.72ï¼½% vs ï¼»23.99 ± 5.77ï¼½%, P < 0.05), and levels of α-Glu (ï¼»40.31 ± 8.22ï¼½ vs ï¼»31.06 ± 7.51ï¼½ U/ml, P < 0.05) and SOD (ï¼»139.71 ± 14.08ï¼½ vs ï¼»102.11 ± 9.24ï¼½ U/ml, P < 0.05), but a decrease in the content of seminal plasma MDA (ï¼»12.72 ± 3.11ï¼½ vs ï¼»15.62 ± 4.68ï¼½ nmol/ml, P < 0.05). The total clinical effectiveness rate was remarkably higher in the experimental than in the control group (87.38% vs 58.82%, P < 0.05). CONCLUSIONS: Luobufukebiri Pills are safe and effective for the treatment of asthenospermia, which may be attributed to their ability of improving oxidative stress damage.


Asunto(s)
Astenozoospermia , Semen , Astenozoospermia/tratamiento farmacológico , Femenino , Humanos , Masculino , Embarazo , Análisis de Semen , Recuento de Espermatozoides , Motilidad Espermática
7.
Chin J Integr Med ; 25(12): 936-938, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31630363

RESUMEN

With the globalisation of Chinese medicine (CM), the local CM education institutions were established in many other countries outside of China. These CM education institutions have formed a new mode in CM education after integrating with local culture, law and national conditions. This article takes New Zealand CM education institutions as an example to discuss the characteristics of CM education under the British education system, aiming to provide ideas on CM education in China and other countries.


Asunto(s)
Terapias Complementarias/educación , Curriculum/normas , Educación Médica/normas , Internado y Residencia/normas , Medicina Tradicional China/normas , Humanos , Nueva Zelanda
8.
Zhonghua Nan Ke Xue ; 25(2): 154-159, 2019 Feb.
Artículo en Chino | MEDLINE | ID: mdl-32216203

RESUMEN

OBJECTIVE: To explore the protective effect of Yishen Tongluo Recipe (YTR) against aberrant sperm DNA methylation in male rats exposed to benzo(a)pyrene (BaP). METHODS: Thirty male SD rats of the SPF grade were randomly divided into three groups of equal number: solvent control, BaP exposure and YTR intervention. The animals of the solvent control group were injected intraperitoneally with 0.5% DMSO while those of the other two groups with BaP at 0.1 mg/kg/d, all for 60 days, and at 31 days of BaP exposure, those of the YTR group were treated intragastrically with YTR for 30 days. Then, the left epididymides were harvested from all the rats and sperm suspensions collected and centrifuged for extraction of sperm DNA. The methylated DNA immunoprecipitation sequencing (MeDIP-seq) technique was used to detect the whole-genome DNA methylation in different groups. RESULTS: Exposure to BaP induced the up-regulation of 828 genes encoding mRNA in the sperm DNA, while YTR intervention produced a significant protective effect on the transforming growth factor ß3 (TGF-ß3), cystic fibrosis transmembrane conductance regulator (CFTR) and recombination activating gene 1 (RAG1), and down-regulated the expressions of 3 227 genes. BaP exposure also caused the up-regulation of 783 genes encoding lncRNA in the sperm DNA, and YTR treatment exhibited an evident protective effect on 62 of the up-regulated genes, induced the down-regulation of 3 378 genes, and showed a protective effect on 56 of the down-regulated genes. CONCLUSIONS: YTR has a protective effect against aberrant sperm DNA methylation in male rats exposed to BaP, which may be associated with lncRNA.


Asunto(s)
Benzo(a)pireno/toxicidad , Metilación de ADN , Medicamentos Herbarios Chinos/farmacología , Espermatozoides/efectos de los fármacos , Animales , Masculino , ARN Largo no Codificante/genética , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley
9.
Zhongguo Zhen Jiu ; 35(6): 561-6, 2015 Jun.
Artículo en Chino | MEDLINE | ID: mdl-26480553

RESUMEN

OBJECTIVE: To explore the clinical efficacy of acupoint catgut embedding therapy on chronic pelvic cavity pain syndrome differentiated as kidney deficiency and stagnation of damp heat, and explore the impacts on plasma P substance (SP), plasma beta-endorphin (ß-EP). METHODS: One hundred and eighty cases were randomly divided into a catgut embedding group (90 cases) and a western medication group (90 cases). In the western medication group, tamsulosin capsules 0. 2 mg were prescribed for oral administration, once a day; indometacin sustained release tablets, 25 mg, three times a day. Totally, the oral administration for 8 weeks was required. In the catgut embedding group, the acupoint catgut embedding therapy was applied to Qugu (CV 2), Shenshu (BL 23), Zhibian (BL 54), Huiyin (CV 1) and Sanyinjiao (SP 6), once every two weeks; the treatment of 4 weeks made one session, and two sessions were required. Before and after treatment, TCM symptom score, NIH-CPSI (the National Institute of Health Chronic Prostatitis Symptom Index) score, lecithin body numbers in prostatic fluid, score in SAS (self-rating anxiety scale), score in SDS (self-rating depression scale), the levels of SP and ß-EP, etc. were observed in the two groups, and the clinical efficacy was assessed in the two groups. RESULTS: (1) Ten cases were dropped in either group. The total effective rate was 91. 25% (73/80) in the catgut embedding group, higher than 78. 75% (63/80) in the western medication group (P<0. 05). (2) After treatment, TCM symptom score, total score in NIH-CPSI, pain score and the scores in SAS and SDS were all reduced as compared with those before treatment in the two groups (all P<0. 05). After treatment, TCM symptom score, total score and pain score in NIH-CPSI, and the scores in SAS and SDS in the catgut embedding group were both lower than those in the western medication group (all P<0. 05). (3) After treatment, the lecithin body numbers were both increased as compared with those before treatment in the two groups (both P<0. 05), and the result in the catgut embedding group was higher than that in the western medication group (P<0. 05). (4)After treatment, the SP level was lower than that before treatment in the two groups (both P<0. 05); the level of p-EP was increased as compared with that before treatment (both P<0. 05). The SP level in the catgut embedding group was lower than that in the western medication group (P<0. 05); the level of ß-EP was higher than that in the western medication group (P<0. 05). CONCLUSION: The acupoint catgut embedding therapy apparently relieves the clinical symptoms of chronic pelvic cavity pain syndrome differentiated as kidney deficiency and stagnation of damp heat as well as the condition of anxiety and depression, increases lecithin body numbers in prostatic fluid and ß-EP level and reduces SP level.


Asunto(s)
Puntos de Acupuntura , Terapia por Acupuntura , Dolor Pélvico/terapia , Enfermedades de la Próstata/complicaciones , Adolescente , Adulto , Catgut/estadística & datos numéricos , Enfermedad Crónica/terapia , Humanos , Masculino , Dolor Pélvico/etiología , Dolor Pélvico/metabolismo , Enfermedades de la Próstata/metabolismo , Adulto Joven , betaendorfina/metabolismo
10.
Zhongguo Zhen Jiu ; 34(4): 351-4, 2014 Apr.
Artículo en Chino | MEDLINE | ID: mdl-24946635

RESUMEN

OBJECTIVE: To compare the efficacy difference in the treatment of chronic pelvic pain syndrome of Sev-damp-heat stagnation pattern between acupoint catgut embedding therapy and western medication. METHODS: enty cases were randomized into a catgut embedding group (40 cases) and a western medication group (30 cases) at the ratio of 4 : 3. In the catgut embedding group, the catgut embedding therapy was applied to Sanyinjiao (SP 6), Quchi (LI 11), Huiyin (CV 1), Zusanli (ST 36), Zhongji (CV 3), Shenshu (BL 23), etc. The treatment was given once every two weeks, the treatment for 4 weeks was as one session and totally 2 sessions were required. In the western medication group, tamsulosin hydrochloride capsules 0. 2 mg, oral administration, once a day, and Indometacin sustained release tablets, 75 mg, once a day, 3 tablets each time were prescribed. The symptom score of TCM, score of NIH Chronic Prostatitis Symptom Index (NIH-CPSI), lecithin body number in prostatic fluid, (SAS) score of Self-Rating Anxiety Scale and score of Self-Rating Depression Scale (SDS) were compared before and after treatment in the patients of the two groups. The efficacy was evaluated in the two groups. RESULTS: (1)The total effective rate was 91. 9% (34/37) in the catgutembedding group and was 86. 2% (25/29) in the western medication group. The efficacy in the catgutembedding group was better than that in the western medication group (P<0. 05). (2) The symptom score of TCM was all reduced significantly after treatment in the two groups (both P<0.01), and the result in the catgut embedding group was superior to the western medication group (6.42 +/-2. 81 vs 10. 99+/-3. 11 ,P<0. 01). (3) Lecithin body number was increased apparently in the two groups after treatment (both P<0.01), and the result in the catgut-embedding group was superior to the western medicine group (33.56+/-5.88 vs 29. 78+/-7. 06,P<0. 05). (4) Total score of NIH-CPSI, score of pain, score of SAS and score of SDS were all improved apparently after treatment in the two groups (all P<0. 01), and the results in the catgut embedding group were superior to the western medication group (P<0. 01, P<0. 05). CONCLUSION: The acupoint catgut embedding therapy achieves the superior efficacy on chronic pelvic pain syndrome of damp-heat stagnation pattern as compared with conventional western medicine. This therapy relieves clinical symptoms, improves the states of anxiety and depression and increases lecithin body number obviously.


Asunto(s)
Puntos de Acupuntura , Terapia por Acupuntura , Dolor Pélvico/terapia , Prostatitis/terapia , Adolescente , Adulto , Catgut/estadística & datos numéricos , Enfermedad Crónica/terapia , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto Joven
11.
Zhonghua Nan Ke Xue ; 20(4): 363-6, 2014 Apr.
Artículo en Chino | MEDLINE | ID: mdl-24873166

RESUMEN

OBJECTIVE: To investigate the relationship of the common Traditional Chinese Medicine (TCM) syndrome pattern of chronic pelvic pain syndrome (CPPS) with the contents of substance p and beta endorphin in the plasma, and provide reference data for the clinical diagnosis, differentiation and treatment of CPPS by TCM. METHODS: We observed 98 cases of CPPS, which were classified into a lower-part damp-heat invasion group (group A, n = 32), a blood stasis-induced collateral obstruction group (group B, n = 34), and a damp-heat stagnation group (group C, n = 32) according to the TCM syndrome differentiation. Another 35 normal healthy young men were enrolled as controls. We measured the contents of substance p and beta endorphin in the plasma by immunoradiometry and ELISA, and analyzed their relationship with the TCM syndrome pattern. RESULTS: The contents of plasma substance p were significantly higher in groups A ([1135.76 +/- 166.45] pg/ml), B ([1 337.84 +/- 170.81] pg/ml), and C ([1 210.01 +/- 162.27] pg/ml) than in the control ([574.99 +/- 113.09] pg/ml) (all P < 0.01), while the contents of plasma beta endorphin in groups A ([212.70 +/- 29.49] pg/ml), B ([157.99 +/- 24.01] pg/ml), and C ([180.81 +/- 20.20] pg/ml) were remarkably lower than that in the control ([274.73 +/- 27.64] pg/ml) (all P < 0.01). CONCLUSION: In the plasma of CPPS patients, the content of substance p is significantly elevated and that of beta endorphin markedly reduced, which suggests that they may be involved in the inflammatory reaction of CPPS. The levels of plasma substance p and beta endorphin can be used as valuable reference for the TCM classification of chronic prostatitis.


Asunto(s)
Medicina Tradicional China/efectos adversos , Dolor Pélvico/sangre , Prostatitis/sangre , Sustancia P/sangre , betaendorfina/sangre , Estudios de Casos y Controles , Enfermedad Crónica , Humanos , Masculino , Dolor Pélvico/clasificación , Prostatitis/clasificación , Síndrome
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA