[Analysis of traditional Chinese medicine diagnosis and treatment for erectile dysfunction related to COVID-19 infection].

The incidence of erectile dysfunction (ED) has been reported to increase after COVID-19 infection, and it is common in COVID-19 patients during recovery. This paper presents a summary of the latest research progress on COVID-19-induced ED and explores the traditional Chinese medicine (TCM) diagnosis and treatment approach based on TCM theory and clinical experience. COVID-19 infection may lead to ED through endothelial dysfunction, testicular injury, hormonal imbalance, and psychological factors. The pathogenesis of COVID-19-related ED is mainly characterized by deficiency of the body's essence and excess of pathogenic factors. In the early stage, it is dominated by deficiency of qi and yin, while in the middle stage, it is mainly due to deficiency of qi and blood stasis. In the long-term, ED is based on the imbalance of yin and yang, with liver stagnation and qi stagnation often co-existing. Clinical manifestations of ED vary, and treatment should focus on tonifying qi and nourishing yin, promoting blood circulation, regulating yin and yang, and soothing liver depression according to TCM diagnosis and treatment principles.

Effect of Antioxidants on Sperm Quality Parameters in Subfertile Men: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.

Antioxidant supplementation has been identified as an important intervention for subfertile men. However, the effectiveness of different antioxidants in improving sperm quality remains unclear. In this study, a network meta-analysis (NMA) was designed to evaluate the effects of different antioxidants on sperm quality parameters in subfertile men. Published randomized controlled trials (RCTs) of antioxidants in subfertile men were searched in the PubMed, Embase, and Cochrane Library databases from inception to 31 January, 2021. Eight antioxidants (folic acid, zinc, vitamin E, carnitine, selenium, coenzyme q10 [CoQ10], N-acetylcysteine, and vitamin C) and a placebo (control) were included in our study. A Bayesian NMA with random effects was performed for each outcome (sperm concentration, sperm motility, and sperm morphology); the surface under the cumulative ranking curves (SUCRAs) for the effectiveness of each intervention was applied to identify the optimal intervention. Eighteen studies with 1790 subfertile men were included in the study. CoQ10 elicited a significant increase in sperm concentration (mean difference [MD] = 5.95; 95% CI: 0.05, 10.79) compared with the placebo; it achieved the highest rank in efficacy among all the antioxidants (SUCRA: 79.4%). With regard to sperm motility, carnitine (MD = 12.43; 95% CI: 4.07, 20.26) and CoQ10 (MD = 7.33; 95% CI: 0.35, 14.17) showed significant beneficial effects compared with the placebo; the efficacy of carnitine was the highest among all the antioxidants (SUCRA: 88.7%). With regard to sperm morphology, the efficacy of vitamin C tended to be the highest (SUCRA: 93.6%), although it did not show a significant beneficial effect (MD = 7.73; 95% CI: -0.94, 16.33) compared with the placebo. Overall, for subfertile men, CoQ10 and carnitine interventions showed better effectiveness in increasing sperm concentration and sperm motility, respectively.