[Correlations between resting-state brain functional characteristics and TCM syndrome in premature ejaculation patients with heart-kidney disharmony].

OBJECTIVE: To investigate the correlation between the characteristics of resting-state brain function and the types of traditional Chinese medicine (TCM) syndrome in premature ejaculation (PE) patients with heart-kidney disharmony, and the pathogenesis of abnormal ejaculation of the patients. METHODS: We enrolled 33 PE patients with heart-kidney disharmony and 32 healthy controls matched in general demographic data, evaluated the severity of the main and concurrent symptoms of PE using the PE Diagnostic Tool (PEDT) and TCM Syndrome Scale (TCMSS), and obtained the brain structural and functional MRI data. We processed the collected data and calculated the amplitude of low-frequency fluctuations (ALFF), fractional ALFF (fALFF) and regional homogeneity (Reho) of the brain with the DPABI software. Using the REST software package, we compared the significantly different brain areas between the PE and control groups by two-sample t-test and corrected the results for multiple comparisons by AlphaSim, followed by Pearson correlation analysis of ALFF, fALFF and Reho in abnormal brain areas and the PEDT and CMSS scores of the patients. RESULTS: The PE patients showed decreased ALFF values in the bilateral inferior temporal gyrus, left middle frontal gyrus and left orbital part of the inferior frontal gyrus, and increased ALFF values in the bilateral hippocampus, thalamus and precuneus, right inferior occipital gyrus, right calcarine and left inferior parietal, with positive correlations of the ALFF values of the left thalamus with the scores on PEDT (r = 0.35, P < 0.05) and TCMSS (r = 0.44, P < 0.05). The fALFF values of the patients were also decreased in the left temporal pole of the middle temporal gyrus and left anterior cingulate gyrus, but increased in the left inferior temporal gyrus. The Reho values of the patients were decreased as well in the right inferior temporal gyrus, left middle frontal gyrus, right dorsolateral superior frontal gyrus, right middle occipital gyrus, right middle occipital gyrus and right precuneus, but increased in the left temporal pole of the middle temporal gyrus, left middle frontal gyrus and left superior frontal gyrus, with negative correlations between the Reho value of the right superior parietal gyrus and TCMSS scores (r = －0.35, P < 0.05). CONCLUSION: Abnormal brain regions were found in PE patients with heart-kidney disharmony, with might be the pathologically associated with PE symptoms and heart-kidney disharmony of the patients.

[Cordyceps sinensis combined with Jujing Pills for male infertility].

OBJECTIVE: To observe the clinical effect and safety of Cordyceps sinensis (CS) combined with Jujing Pills (JJP) in the treatment of male infertility. METHODS: We randomly divided 90 male infertility patients into three groups of an equal number and treated them with JJP tid 5g once, CS bid 1g once and CS+JJP, respectively, all for 12 weeks. Before and after 4, 8 and 12 weeks of medication, we obtained the semen volume, sperm concentration, percentages of progressively motile sperm (PMS) and morphologically normal sperm (MNS) and sperm DNA fragmentation index (DFI), and compared them between the two groups of patients. RESULTS: The total therapeutic effectiveness rate was significantly higher in the CS+JJP than in the CS and JJP groups (96.42% vs 78.57% and 63.33%, P < 0.05), and so was PMS (ï¼»30.05 ± 10.24ï¼½% vs ï¼»24.74 ± 11.24ï¼½% and ï¼»22.71 ± 13.60ï¼½%, P < 0.01). The CS+JJP group also showed a higher percentage of MNS than the JJP group (ï¼»4.16 ± 2.86ï¼½% vs ï¼»2.73 ± 1.86ï¼½%, P < 0.01) but lower than the CS group (ï¼»5.03 ± 2.99ï¼½%) (P < 0.05). The sperm DFI was markedly lower in the CS+JJP than in the CS and JJP groups (ï¼»15.26 ± 6.93ï¼½% vs ï¼»15.90 ± 7.39ï¼½% and ï¼»16.85 ± 8.52ï¼½%, P < 0.05). CONCLUSIONS: Cordyceps sinensis combined with Jujing Pills can effectively improve sperm quality and reduce sperm DFI. Based on the TCM theory of "mutual generation between metal and water", Cordyceps sinensis can significantly enhance the effectiveness of the kidney-tonifying therapy.

[Associations between the efficiency of the brain white matter network and clinical symptoms in patients with type â ¢ B prostatitis].

OBJECTIVE: To investigate the changes in the topological properties of the global and local nodal efficiencies of the brain white matter network in patients with type III B prostatitis, and to analyze the correlation between the information transmission efficiency of different brain regions and pelvic pain. METHODS: We enrolled 19 patients with type Ⅲ B prostatitis and 32 normal controls matched in general demographic data for this study. We assessed the pelvic pain of the patients based on the NIH-CPSI, obtained the structural and diffusion-weighted MR images of the brain, preprocessed the MRI data, constructed the brain structural networks and calculated the topological properties of the nodal local and global efficiencies using the FSL software package and brain connection toolbox. Finally, we compared the topological properties between the two groups by t-test with the SPSS 20 software, performed multiple correction of the values using the false discovery rate (FDR) method, and investigated the associations of the altered brain regions with the NIH-CPSI scores by Pearson correlation analysis. RESULTS: The global efficiency of the orbital part of the right median frontal gyrus in the patients with type Ⅲ B prostatitis, compared with that in the normal controls, was dramatically decreased (0.095 ± 0.046 vs 0.13 ± 0.015, P < 0.01) while that of the left median cingulate gyrus markedly increased (0.16 ± 0.027 vs 0.14 ± 0.019, P < 0.01), which were corrected by FDR. The local efficiency of the left median cingulate gyrus was also remarkably decreased in the patients as compared with that in the controls (0.25 ± 0.075 vs 0.19 ± 0.036, P < 0.01), and so was that of the left paracentral lobule (0.25 ± 0.088 vs 0.17 ± 0.065, P < 0.01), which were corrected by FDR. In the patients, the local efficiencies of the left precuneus (r = 0.46, P = 0.045), right supplementary motor area (r = 0.47, P = 0.043) and left median cingulate gyrus (r = 0.60, P = 0.0065) were positively correlated with the total score of NIH-CPSI, the scores of pain and discomfort symptoms, and the scores of the influence of the symptoms on the quality of life. CONCLUSIONS: The changes of the brain regions in the executive control network of the patient with type Ⅲ B prostatitis might be involved in enhancing his sensitivity to pain and discomfort, and consequently lead to pelvic pain and discomfort.

[Acupuncture therapy for chronic prostatitis / chronic pelvic pain syndrome and its central neural mechanisms].

Chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS) is one of the common diseases in andrology, with the main clinical symptoms of long-term and repeated pain or discomfort in the pelvic region. Acupuncture has been widely used in the treatment of CP/CPPS-related pelvic pain and discomfort with rapid and long-lasting effects, and its combination with Western medicine can produce an even better effect than Western medicine alone. At present, various theories have been advanced on the action mechanisms of the acupuncture therapy for CP/CPPS, involving immunoregulation, improvement of inflammatory response, and so on, but all fail to give a full explanation. With the development of neuroimaging technology, CP/CPPS patients are found with changes in the structure and function of the brain, and a large number of studies have confirmed the effect of acupuncture in improving the cerebral function and structure of the patients with chronic pain symptoms. This review outlines the advances in the studies of acupuncture therapy for CP/CPPS and its underlying central neural mechanisms, paving the theoretical ground for a deeper insight into the central neural mechanisms of and an optimized protocol for acupuncture treatment of CP/CPPS-related pain symptoms.

[Psychological factors and penile blood supply in patients with erectile dysfunction].

OBJECTIVE: To explore the psychological factors and blood supply to the penis in ED patients. METHODS: From August to November 2018, we obtained Symptom Checklist 90 (SCL-90) scores and conducted an Eysenck Personality Questionnaire (EPQ) investigation among 106 ED patients in our Department of Andrology, followed by the test of intracavernosal injection of the vasoactive agent (ICI-VAA) and color duplex Doppler ultrasonography (CDDU). According to the results of ICI-VAA and CDDU, we divided the patients into a normal and an abnormal group, compared their item and total scores on SCL-90 with the national norm by t-test and analyzed the distribution of personality types in different groups by Chi-square test. RESULTS: The results of ICI-VAA and CDDU showed 42 cases to be normal and the other 64 abnormal. Compared with the normal group, the abnormal cases exhibited significantly decreased peak systolic velocity (PSV) in the left and right corpus cavernosum (ï¼»30.90 ± 6.83ï¼½ vs ï¼»19.39 ± 5.07ï¼½ cm/s, P < 0.01; ï¼»30.74 ± 7.00ï¼½ vs ï¼»18.98 ± 4.57ï¼½ cm/s, P < 0.01), but increased end-diastolic velocity (EDV) in the left corpus cavernosum (ï¼»1.77 ± 2.38ï¼½ vs ï¼»3.21 ± 2.78ï¼½ cm/s, P < 0.01). The ED patients undergoing ICI-VAA and CDDU obtained remarkably higher SCL-90 scores than the national norm on depression (1.70 ± 0.64 vs 1.50 ± 0.59, P < 0.01), anxiety (1.62 ± 0.56 vs 1.39 ± 0.43, P < 0.01), compulsion (1.86 ± 0.61 vs 1.62 ± 0.58, P < 0.01), hostility (1.65 ± 0.66 vs 1.48 ± 0.56, P < 0.01), phobia (1.33 ± 0.45 vs 1.23 ± 0.41, P = 0.02), and psychoticism (1.61 ± 0.55 vs 1.29 ± 0.41, P < 0.01) as well as a higher total score (1.61 ± 0.48 vs 1.44 ± 0.48, P < 0.01). The patients with normal results of CDDU got markedly increased scores on anxiety (1.60 ± 0.53, P < 0.01), compulsion (1.83 ± 0.63, P = 0.02) and psychoticism (1.61 ± 0.48, P < 0.01), and so did those with abnormal results of CDDU on depression (1.73 ± 0.65, P < 0.01), anxiety (1.64 ± 0.59, P < 0.01), compulsion (1.88 ± 0.60, P < 0.01), hostility (1.68 ± 0.75, P < 0.01), phobia (1.35 ± 0.44, P = 0.02), psychoticism (1.61 ± 0.59, P < 0.01) and an increased total score as well (1.63 ± 0.51, P < 0.01). Statistically significant differences were not found in either the item scores or the total score on SCL-90 (P > 0.05), nor in the distribution of the EPQ personality types between the normal and abnormal cases (χ2 = 1.12, P = 0.77). CONCLUSIONS: The personality types of ED patients are mainly phlegmatic and melancholic, and their psychological problems chiefly include depression and anxiety, which are more serious in those with insufficient penile blood supply.

[Correlation of betweenness centrality of the right hemispheric network with ejaculatory function in premature ejaculation patients].

OBJECTIVE: To explore the topological properties of the betweenness centrality of the nodes and edges in the brain white matter network of premature ejaculation (PE) patients and analyze the correlation of the importance of the key brain regions and interregional white matter structural connectivity with the ejaculatory function of the patients.Method: We collected the demographic and clinical data, along with the T1 and MR diffusion tensor imaging (MR-DTI) data, on 18 PE patients and 22 normal controls matched in age, sex and education. After preprocessing of the data obtained, we divided the whole brain into 90 symmetrical cortical and subcortical regions (defined as nodes of the brain network) by automated anatomical labeling, examined the structural connectivity between different brain regions by probabilistic white matter fiber tracking (defined as edges of the brain network), and calculated the betweenness centrality of the nodes and edges using the brain connection toolbox. Then, we performed the Mann-Whitney U test on the betweenness centrality of the nodes and edges, subjected the results to false discovery rate (FDR) correction, and assessed the correlation of the attribute values of between-group differences with the ejaculatory function of the patients. RESULTS: Compared with the normal controls, the PE patients showed a significantly decreased betweenness centrality of the right superior occipital gyrus (SOG) (281.18 ± 255.26 vs 67.78 ± 58.98, Z = －3.49, FDR-corrected P < 0.05), but increased betweenness centrality of the right superior temporal gyrus (STG) (222.91 ± 155.60 vs 557.00 ± 322.65, Z = 3.55, FDR-corrected P < 0.05) and betweeness centrality of the edge between the right rolandic operculum and right insula (4.23 ± 8.39 vs 23.83 ± 23.91, Z = 3.84, FDR-corrected P < 0.05). The betweenness centrality of the right SOG was correlated negatively with the level of difficulty in delaying ejaculation (r = －0.51, P = 0.03) and the probability of ejaculation before expectation (r= －0.61, P = 0.01), while that of the right STG positively with PE-related frustration (r = 0.54, P = 0.02) and the level of concern about PE-related distress of the partner (r = 0.47, P = 0.04). CONCLUSIONS: Abnormalities of structural connections were found in the visual stimulus- and emotion processing-related regions in the right cerebral hemisphere of PE patients, which might be associated with rapid ejaculation or decreased ejaculation control and lead to a series of psychological problems.

[Correlation between TCM syndrome types and clinical symptoms of benign prostatic hyperplasia with chronic prostatitis].

OBJECTIVE: To investigate the correlation between the syndrome types of traditional Chinese medicine (TCM) and clinical symptoms of benign prostatic hyperplasia (BPH) with chronic prostatitis (BPH-CP). METHODS: We selected 150 cases of BPH-CP in this study and divided them into 7 TCM syndrome types. Using univariate and multivariate logistic regression analyses, we studied the correlation of each TCM syndrome type with the age, disease course, prostate volume, postvoid residual urine volume (PVR), prostate-specific antigen (PSA) level, maximum urinary flow rate (Qmax), and International Prostate Symptoms Score (IPSS). RESULTS: Kidney-yin deficiency was correlated positively with the prostate volume but negatively with Qmax and IPSS; kidney-yang deficiency positively with the age and prostate volume but negatively with IPSS; the damp heat syndrome positively with the PSA level but negatively with the disease course, prostate volume and Qmax; the spleen-qi deficiency syndrome positively with the prostate volume but negatively with the disease course; liver-qi stagnation positively with the disease course but negatively with the age, prostate volume and PVR; the syndrome of qi stagnation and blood stasis positively with the disease course and IPSS but negatively with PVR; the syndrome of lung-heat and qi blockage positively with the age, Qmax and IPSS but negatively with the disease course. CONCLUSIONS: The TCM syndrome types of BPH-CP are closely correlated to their clinical symptoms. The analysis of the clinical objective indexes of BPH-CP can provide some reliable evidence for accurate identification of the TCM syndrome type of the disease.

[Modified Jujing No.2 Decoction for varicocele-induced male infertility].

Objective: To investigate the clinical effect of Jujing No.2 Decoction on male infertility induced by varicocele. METHODS: We equally randomized 70 male patients with varicocele-induced infertility into a treatment group and a control group, the former treated with modified Jujing No.2 Decoction (1 dose a day, bid) and the latter given Danshen Tablets (4 tablets once, tid) plus Liu Wei Di Huang Wan (8 pills once, tid), both for 3 months. We examined the spermatic veins of the patients by ultrasonography and performed seminal analysis before and after medication. RESULTS: Compared with the controls, the patients in the treatment group showed significant improvement after medication in sperm concentration (ï¼»12.35±2.12ï¼½ vs ï¼»18.56±4.16ï¼½ ×106/ml, P<0.05), progressively motile sperm (ï¼»16.18±6.34ï¼½ vs ï¼»24.63±8.51ï¼½ %, P<0.05), and morphologically normal sperm (ï¼»11.59±5.31ï¼½ vs ï¼»14.17±6.02ï¼½ %, P<0.05). In the control group, sperm concentration was increased from (12.29±2.07) ×106/ml at the baseline to (13.13±3.13) ×106/ml after medication, progressively motile sperm from (16.13±6.45) % to (20.55±7.30) % (P<0.05), and morphologically normal sperm from (11.62±5.35) % to (12.69±5.77) %. The total effectiveness rate was significantly higher in the treatment than in the control group (71.88% vs 46.67%, P<0.05). The inner diameter of the left spermatic vein was decreased from (0.32±0.05) mm at the baseline to ï¼»0.26±0.05ï¼½ mm after medication in the treatment group (P<0.05) and from (0.32±0.03) mm to (0.29±0.04) mm in the control (P<0.05), with statistically significant difference between the two groups after medication (P<0.05). CONCLUSIONS: Jujing No.2 Decoction is effective in the treatment of varicocele-induced male infertility.

[Yiqi Zhujing granule for idiopathic oligoasthenozoospermia: a clinical study].

OBJECTIVE: To assess the efficacy of Yiqi Zhujing Particle in the treatment of idiopathic oligoasthenozoospermia. METHODS: We equally randomized 78 patients with idiopathic oligoasthenozoospermia to a control group and a Yiqi Zhujing group, the former treated with oral medication of zinc gluconate liquid (10 ml, bid) and vitamin E (100 mg, bid), and the latter given Yiqi Zhujing Granule (1 packet, bid) in addition, both for 3 months. We compared the semen parameters and biochemical indexes of the seminal plasma obtained before and after medication between the two groups of patients. RESULTS: After 3 months of treatment, remarkable improvement was observed in the percentage of progressively motile sperm and sperm viability in the control group (P < 0.05) as well as in the total sperm count, sperm concentration, percentage of progressively motile sperm, and sperm viability in the Yiqi Zhujing group (P < 0.05). The total sperm count, sperm concentration, percentage of progressively motile sperm, and sperm viability were even more significantly improved in the Yiqi Zhujing than in the control group (P < 0.05). Besides, both groups showed different degrees of improvement in the biochemical indexes of the seminal plasma, and the Yiqi Zhujing group exhibited even more significant improvement in seminal plasma zinc, alpha-glucoside enzyme, seminal plasma fructose, and acid phosphatase than the control (P < 0.05). The improvement of sperm concentration was correlated positively with the change of seminal plasma zinc (r = 0.201, P < 0.05) but negatively with that of seminal plasma fructose after treatment (r = -0.136, P < 0.05). There was a positive correlation between the alpha-glucoside enzyme level and sperm viability (r = 0.314, P < 0.05). CONCLUSION: Yiqi Zhujing Particle is effective for idiopathic oligoasthenozoospermia by significantly improving the total sperm count, sperm concentration, percentage of progressively motile sperm, sperm viability, seminal plasma zinc, seminal plasma fructose, and alpha-glucoside enzyme.

[A preliminary study of serum free testosterone and testosterone secreting index in men with erectile dysfunction].

OBJECTIVE: To observe the changes of serum free testosterone (FT) and testosterone secreting index (TSI) in ED patients, and to assess the contribution of these two indexes to the diagnosis of ED caused by endocrine factors. METHODS: We studied 120 ED patients and 30 healthy men undergoing pre-marital medical check-up in Jiangsu Province Hospital of TCM by analyzing the scores on erectile function and desire domain in IIEF, testing the serum total testosterone, luteinizing hormone by chemiluminescent enzyme immunoassay (CLIA), measuring free testosterone by radioimmunoassay( RIA), and calculating TSI. RESULTS: Of the 120 ED patients, 5% and 1538% were below the reference norm of TT and FT values respectively. TT, FT and TSI decreased with age, with statistical with FT and TSI, but not with TT. FT and TSI statistically declined with lower IIEF score on ED domain, but this was not the case with TT. There were no significant differences in TI, FT and TSI among different sexual desire groups the ED patients. CONCLUSION: FT is much more valuable than TF in the diagnosis of ED with hypogonadism. Both FT and TSI are important parameters in assessing the severity of ED.