ETHNOPHARMACOLOGICAL RELEVANCE:Polygonum capitatum Buch.-Ham. ex D. Don (Pc, DB52/YC141-2003), a traditional herbal medicine utilized by the Miao nationality, is acknowledged for its therapeutic potential and efficacy in treating various urologic disorders, notably chronic bacterial prostatitis (CBP). Experimental and clinical studies have demonstrated that the combination of Pc with Ciprofloxacin (CIP) effectively alleviates the urinary symptoms in CBP patients, offering superior outcomes compared to monotherapy. However, the underlying mechanisms and specific constituents responsible for this synergistic effect remain poorly understood, which hinders its broader clinical application. AIM OF THE STUDY:This study aims to elucidate the potential synergistic mechanism of Pc and CIP in ameliorating CBP and to identify the major active ingredient of Pc that contributed most significantly to the therapeutic efficacy when combined with CIP. MATERIALS AND METHODS:A rat model of CBP was induced in rats by prostate bilateral injections of Escherichia coli (E. coli.), followed by therapeutic intervention with a combination of Pc and CIP. The therapeutic effect of this combination was assessed by quantifying the Prostate viscera coefficient (PVC) and bacterial colonization. Histopathological changes in the prostate were observed using HE staining. The expressions of inflammatory mediators was quantified using Western blotting (WB), qRT-PCR, and immunohistochemical staining (IHC). To elucidate the molecular mechanisms underlying the synergism of the combination therapy, transcriptomic profiling was performed using RNA sequencing (RNA-seq). Differentially expressed genes were analyzed via Ingenuity Pathway Analysis (IPA) to identify regulated pathways, with critical targets further validated by qRT-PCR and WB. For direct drug target identification, Tissue-thermal proteome profiling (Tissue-TPP) was implemented, incorporating differential temperature heat treatment, data-independent acquisition (DIA) quantitative proteomics, and thermal shift curve analysis to characterize interaction targets of the Pc-CIP combination in prostate tissue. Binding affinity between the drug combination and identified targets was further confirmed through thermal shift assays. Finally, molecular docking simulations were conducted to characterize the predominant bioactive constituents of Pc that contributed synergistically to therapeutic outcomes when co-administered with CIP. RESULTS:The results indicated that the combination of Pc and CIP significantly reduced the PVC and bacterial concentration, restored the prostate gland structure, and inhibited the mRNA and protein expression of pro-inflammatory factors (TNF-α and IL-1β) in CBP rats. RNA-Seq combined with IPA analysis showed that Pc combined with CIP significantly inhibited inflammatory signaling pathway in CBP rats, especially the NF-κB/IL-6/JAK2/STAT3 pathway. Moreover, Tissue-TPP revealed that Pik3cb is a direct target of Pc combined with CIP. Molecular docking studies showed that GA, a predominant component of Pc, can directly bind to Pik3cb. Finally, it was also found that the combination of GA and CIP significantly improved CBP. CONCLUSION:The results suggest that Pc combined with CIP can mitigate CBP by targeting Pik3cb to inhibit the NF-κB/IL-6/JAK2/STAT3 signaling pathway, and GA may be a potential pharmacodynamic substance of Pc.

Cinnamon and motherwort are traditional Chinese medicines and are often combined to treat benign prostatic hyperplasia; however, the specific therapeutic mechanisms involved remain unclear. Therefore, in this study, we applied a network pharmacology approach to investigate the potential mechanisms of action of the drug pair cinnamon and motherwort (PCM) for the treatment of benign prostatic hyperplasia. Relevant targets for the use of PCM to treat benign prostatic hyperplasia were obtained through databases. Protein-protein interactions were then identified by the STRING database and core targets were screened. Enrichment analysis was conducted through the Metascape platform. Finally, molecular docking experiments were carried out to evaluate the affinity between the target proteins and ligands of PCM. We identified 22 active ingredients in PCM, 315 corresponding targets and 130 effective targets of PCM for the treatment of benign prostatic hyperplasia. These targets were related to the PI3K-Akt, MAPK, FoxO, TNF, and IL-17 signaling pathways. Network pharmacology was used to identify the effective components and action targets of PCM. We also identified potential mechanisms of action for PCM in the treatment of benign prostatic hyperplasia. Our results provide a foundation for expanding the clinical application of PCM and provide new ideas and directions for further research on the mechanisms of action of PCM and its components for the treatment of benign prostatic hyperplasia.

OBJECTIVE:To evaluate the potential causal relationship between inflammatory factors and PCa using the two-sample Mendelian randomization (MR) method. METHODS:We selected summary statistics of genome-wide association studies (GWAS) (n = 14 824) on 91 inflammatory factors, with PCa as the outcome in the latest 9th edition of FinnGen database for MR analysis. We evaluated the causal relationship between inflammatory factors and PCa using the odds ratio (OR) and 95% confidence interval (CI) of such regression models as inverse variance weighting (IVW), MR-Egger regression, simple mode (SM), weighted mode (WM) and weighted median estimator (WME), with IVW as the main statistical method for this study. We further verified the results of MR by Bayesian analysis, and evaluated the heterogeneity of genetic instrumental variables, pleiotropic effects and sensitivity of single nucleotide polymorphisms (SNP) as instrumental variables to the exposure-outcome relationship by Cochran's Q test, MR-Egger intercept test and leave-one-out cross validation. RESULTS:IVW showed that among the 91 inflammatory factors, interleukin-22 receptor A1 (IL-22RA1) and sulfotransferase 1A1 (ST1A1) were correlated positively with the risk of PCa； IL-22RA1：IVW（OR ［95% CI］: 1.12 ［1.00－1.25］, P = 0.04）；ST1A1：IVW（OR ［95% CI］: 1.08 (1.00－1.16), P = 0. 03）, while Chemokine ligand 11 (CXCL11) and interleukin 17 A (IL-17 A) negatively with the risk of PCa； CXCL11：IVW（OR ［95% CI］: 0.88 ［0.81－0.95］, P = 0.00）；IL-17A：IVW（OR ［95% CI］: 0.91 ［0.84－0.98］, P = 0.02）. No potential horizontal pleiotropy was detected by MR-Egger intercept analysis (P > 0.05, IL-22RA1 = 0.885, ST1A1 = 0.949, CXCL11 = 0.391, IL-17A = 0.884), nor biased SNPs in the MR pleiotropy residual sum and outlier (MR-PRESSO) test (P > 0.05, IL-22RA1 = 0.479, ST1A1 = 0.629, CXCL11 = 0.326, IL-17A = 0.444), or heterogeneity P > 0.05, IL-22RA1 = 0.543, ST1A1 = 0.677, CXCL11 = 0.336, IL-17A = 0.494). Leave-one-out sensitivity analysis indicated no significant impact of individual SNP sites on the overall causal relationship prediction, suggesting the reliable results of analysis. CONCLUSION:Among the 91 inflammatory factors, IL-22RA1 and ST1A1 have a positive causal relationship, while CXCL11 and IL-17A have a negative causal relationship with PCa.

OBJECTIVE:To observe the effect and safety of the traditional Chinese medicine (TCM) Linggui Formula (LGF) in the treatment of asthenospermia with kidney deficiency and blood stasis. METHODS:This randomized controlled trial included 90 cases of asthenospermia with kidney deficiency and blood stasis treated in our hospital from September 2022 to September 2023, 45 by oral medication with LGF (the trial group) and the other 45 with oral levocarnitine solution (the control group), all for 12 weeks. We followed up the patients for 12 weeks, recorded the semen parameters, TCM syndrome scores, sexual hormone levels, pregnancy rates, and DNA fragmentation index (DFI) of the patients, and compared them between the two groups before and after treatment. RESULTS:Totally, 82 of the patients completed the study, 42 in the trial and 40 in the control group. After treatment, the patients in the trial group showed significant increases in the percentage of progressively motile sperm (PMS) (from ［19.25±3.08］% to ［38.57±4.99］%, P< 0.05), total sperm motility (from ［32.29±3.64］% to ［46.50±4.77］%, P< 0.05) and sperm concentration (from ［83.9±37.2］ to ［95.1±34.9］× 10⁶/ml ］, P< 0.05), and so did the controls in PMS (from ［19.75±4.28］% to ［34.46±5.07］%, P< 0.05), total sperm motility (from ［33.02±4.93］% to ［43.11±4.72］%, P< 0.05) and sperm concentration (from ［85.2±39.7］ to ［88.1±35.2］ × 10⁶/ml , P< 0.05), all even more significant in the trial than in the control group (P< 0.05). No statistically significant difference was observed in the semen volume either in the trial (from ［3.38±0.38］ to ［3.24±0.45］ ml, P> 0.05) or in the control group (from ［3.46±0.52］ to ［3.30±0.37］ ml, P> 0.05), or between the trial and control groups (P> 0.05), or in the sexual hormone levels, pregnancy rates, and sperm DFI between the two groups before and after treatment (P> 0.05). Both groups of patients had good safety profiles without serious adverse reactions. CONCLUSION:Linggui Formula can improve the percentage of PMS in asthenospermia patients with kidney deficiency and blood stasis, potentially enhancing pregnancy rates and with a good safety.

ABSTRACT Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common male urological disease, and its clinical manifestations are closely related to the dysregulation of inflammatory factors. Nonsteroidal anti-inflammatory drugs have been shown to be effective in managing inflammation and providing pain relief, but their clinical application remains controversial. Traditional Chinese medicine (TCM) is widely used to regulate inflammatory factors in CP/CPPS, and treatment with TCM has gained some advantages based on an “individualized” or “personalized” medical approach. In addition, TCM extracts and acupuncture therapy have also been proven to be effective for CP/CPPS, as they regulate related inflammatory factors. However, current systematic reviews tend to verify the efficacy and safety of TCM therapies in CP/CPPS, and there is still a deficiency in sorting out their mechanisms of modulating inflammatory factors. Based on the current evidence, our review summarizes the application of TCM in regulating inflammatory factors in CP/CPPS to provide a reference for the treatment of CP/CPPS with TCM therapy and a potential direction with future studies in this field.

Background: In China, acupuncture has been widely used in treating cerebrovascular diseases since time immemorial. Scalp acupuncture using the long-stay method is a traditional acupuncture treatment. However, previous studies have concluded that the clinical efficacy of scalp acupuncture for the treatment of stroke remains uncertain. In addition, no randomized controlled trials have been conducted on scalp acupuncture using the long-stay method. This study aimed to evaluate the efficacy and safety of the long-stay method of scalp acupuncture for limb movement dysfunction in patients after acute ischemic stroke (AIS). Methods: Seventy-two patients with acute strokes were randomly divided into treatment and control groups. The control group received conventional acupuncture with a half-hour needle stay each time, whereas the treatment group underwent scalp needling using a long retention method, with each retention of needles lasting 24 hours. Both groups received acupuncture treatment for 2 weeks and were followed up for 6 months. Cerebrovascular reserve (CVR), breath-holding index (BHI), pulsatility index (PI), Fugl- Meyer, and Barthel index (BI) were assessed at baseline, week 1, week 2, and during follow-up. Results: Compared with the baseline, both groups showed a significant improvement in CVR, Fugl-Meyer, BI, PI, and BHI (P < 0.05). Compared with the control group, the treatment group showed more significant improvements in Fugl-Meyer scores, BI, CVR, PI, and BHI (P < 0.05). Correlation analysis showed that Fugl-Meyer and BI scores increased significantly with CVR recovery over the course of treatment. Conclusion: Scalp acupuncture with the long-stay method can improve neurological deficits and the ability to perform daily activities among AIS patients, which may be related to the improvement of CVR function in patients.

Acupuncture is widely used in China for various conditions. Recently, due to the limitations of conventional treatment, many patients with psychogenic erectile dysfunction (ED) tend to choose acupuncture therapy, which is more commonly applied in countries such as China. The present clinical trial protocol aimed to initially verify the efficacy and safety of acupuncture in the treatment of psychogenic ED. Our study is a prospective, randomized control trial (RCT). The protocol for this RCT is based on the standard protocol items: recommendations for interventional trials (SPIRIT) 2013 statement. After the participants who met the inclusion and exclusion criteria sign an informed consent form, the investigator will schedule them for the trial. Patients will be randomly divided into two groups (acupuncture and sham acupuncture). Both groups will receive 18 sessions of interventions for 6 continuous weeks and will be followed up for 10 weeks. At five time points (0, 2, 4, 6 and 10 weeks), We will measure the primary and secondary outcomes. Emerging evidence support acupuncture therapy for improving male sexual function and its application in andrology. However, its efficacy on patients diagnosed with psychogenic ED has not been extensively studied. With our study, we anticipate to fill the knowledge gap in acupuncture as treatment for psychogenic ED.

良性前列腺增生(BPH)是一种慢性进展性疾病,现代医学对其病因和发病机制的认识尚未完全清晰.中医认为,BPH是精室失用的表现,精室属男子奇恒之腑,司溺窍开阖,其依赖肾精的充实及血络的通利发挥生理功能,肾精不足、血液瘀滞使精室功能紊乱,可致小便排泄障碍,且虚瘀互结,缠绵难愈,因此应用补肾活血法是治疗本病的关键,精室功能恢复正常,患者排尿失常的症状方可得以改善.此外,应灵活辩证,看邪之可解之处,缓缓图之,还可联合中医外治法共同治疗,疗效更加显著.

目的 梳理中成药治疗男性不育症随机对照试验(RCT)的临床特征并评价其报告质量,讨论研究现状及存在问题.方法 检索中国知网、万方数据知识服务平台、维普等数据库建库至2021年12月31日发表的关于单纯使用中成药治疗男性不育症的RCT研究,以临床试验报告统一标准(CONSORT)-中药复方和改良Jadad量表为依据,对纳入的RCT报告质量进行评价.结果 共纳入54篇RCT,涉及23种中成药,出现最多的是复方玄驹胶囊;26篇研究样本量大于101例,最大样本量为405例;对照组药物共使用11种,频率最高的是五子衍宗丸;结局评价指标除精液分析外,包括妊娠率、性激素等;涉及5种中医证型,其中最多的是肾精不足.以CONSORT-中药复方评价:32篇提供诊断标准以及纳排标准,但中医诊断标准出处不统一;13篇报告中成药具体的厂家、批号等信息;22篇阐述了具体随机方法;2篇提及"盲法";18篇记录了研究过程中的不良事件;所有研究均无适当的关键词、无完整的干预措施、无合理的分配隐藏实施方式、无受试者流程图、无临床试验注册、无研究方案和资助说明.以改良Jadad量表评价:0～3分的低质量文献53篇,4分1篇,无5分以上文献.结论 目前国内有关单独使用中成药治疗男性不育症的RCT报告质量普遍偏低,结论可信度存疑,在采纳和运用其结果时应谨慎;研究者应遵循CONSORT-中药复方、改良Jadad量表进行方案设计、注册、实施及报告,充分考虑中成药治疗男性不育症的临床特点,合理设计和报告结局评价指标和结果.

目的 利用网络药理学来探究夏荔芪胶囊治疗慢性前列腺炎(CP)的主要作用机制.方法 使用在线数据库收集夏荔芪胶囊的活性成分和慢性前列腺炎对应的作用靶点.使用Cytoscape构建了有效组分-目标靶点网络,使用String构建了夏荔芪胶囊和慢性前列腺炎交集遗传基因的蛋白-蛋白互相作用(PPI)网络.使用R语言和Clus-terProfiler应用工具,针对夏荔芪胶囊和慢性前列腺炎的交集遗传基因,展开了遗传基因本体论和京都遗传基因和遗传基因组百科全书的富集研究分析.结果 从夏荔芪胶囊中共获得196 个有效成分、1281 个目标靶点和2278 个慢性前列腺炎的目标靶点.映射后获取494 个夏荔芪胶囊治疗慢性前列腺炎的潜在目标靶点.夏荔芪胶囊治疗慢性前列腺炎的分子作用机制涉及AGE-RAGE、脂质和动脉粥样硬化作用监控综合管理、前列腺癌等信号通路,相关通路涉及遏制炎症反应、遏制氧化应激反应、推动前列腺生物细胞凋亡等生物过程.结论 本研究证实了夏荔芪胶囊治疗慢性前列腺炎的作用机制具有多靶点、多通路的特点,为后期药理机制研究提供了理论依据.

Objective To compare 18 F-PSMA-1007 PET/CT, 18 F-FDG PET/CT and 68 Ga-PSMA PET/CT in the diagnostic value of prostate cancer. Method The Chinese and foreign databases, such as Pubmed, Cochrane Library, Embase, CNKI, VIP, Wanfang, etc., were systematically searched within the period from the establishment of the database to June 1, 2022. Clinical studies related to the diagnosis of prostate cancer by methods such as 18 F-PSMA-1007 PET/CT, 18 F-FDG PET/CTCT, 68 Ga-PSMA PET/CT, were researched. Two (2) investigators independently screened literatures, extracted data, and assessed the risk of bias when these data were included in the studies with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Review Manager5.4, Stata 14.0, and Meta-disc 1.4 software were used for meta-analysis to compare the efficacy of different methods in the diagnose of prostate cancer. Results Twenty-seven (27) studies, including 2891 subjects were included in our study. Meta-analysis results showed that the pooled sensitivities of 18 F-PSMA-1007 PET/CT, 18 F-FDG PET/CT, and 68 Ga-PSMA PET/CT were 0.912 (95%CI: 0.883–0.936), 0.748 (95%CI: 0.698–0.795), and 0.916 (95%CI: 0.896–0.934), respectively; the pooled specification were 0.878 (0.844–0.907), 0.639 (95%CI: 0.589–0.687), and 0.734 (95%CI: 0.685–0.779), respectively; the positive likelihood ratios were 6.335 (95%CI: 4.288–9.357), 2.282 (95%CI: 1.497–3.477), and 3.593 (95%CI: 2.986–4.323), respectively; the negative likelihood ratios were 0.878 (95%CI: 0.844–0.907), 0.374 (95%CI: 0.280–0.499), and 0.110 (95%CI: 0.083–0.144), respectively; the diagnostic odds ratios were 65.125 (95%CI: 34.059–124.53), 7.094 (95%CI: 4.091–12.301), and 29.722 (95%CI: 20.141–43.863), respectively; the positive posterior probability was 64%, 38%, and 62%, respectively; the area under the SPOC curve was 0.95 (95%CI: 0.93–0.97), 0.81 (95%CI: 0.78–0.84), and 0.96 (95%CI: 0.92–0.98), respectively. The funnel plots indicated that there was no significant publication bias in the included literatures. Conclusion The current evidences showed that 18 F-PSMA-1007 PET/CT and 68 Ga-PSMA PET/CT had higher diagnostic efficacy of prostate cancer compared with 18 F-FDG PET/CT, among which 68 Ga-PSMA PET/CT was slightly higher in the sensitivity of the diagnosis of prostate cancer, while 18 F-PSMA-1007 PET/CT may have higher efficacy in specificity and confirmed positive rate. Due to the limitations of the quality of the included samples and literatures, the above conclusions should be further validated by expanding the sample size and improving the quality.

Erectile dysfunction (ED) is one of the most common sexual dysfunctions in men. The prevalence of ED has been increasing in recent years, which has critically affected male reproductive health and quality of life. According to various guidelines, phosphodiesterase-5 inhibitors are the most commonly recommended drugs for treating ED. However, many patients turn to alternative therapies because of adverse reactions, such as headache, and the poor efficacy of these drugs. Acupuncture is a long-established treatment in traditional Chinese medicine (TCM) and has been approved by the World Health Organization for improving penile erection as well as other discomforts in patients. However, previous systematic reviews have not discussed the characteristics and the related mechanisms of acupuncture treatment. Therefore, this study focuses on summarizing the characteristics and advantages of TCM in acupuncture treatment for ED based on relevant literature and on predicting and analyzing the related mechanisms.

Review question / Objective: In order to compare the different high energy diet such as high-fat diet and high sugar diet how to damage the male mice model in metabolize and fertility,and explore a reliable mice model method in the study of obesity with male infertility. P：obesity mice model with male infertility. I: High energy diet such as High-fat or High-sugar diet. C:High-fat diet,High-sugar diet, compared with normal diet in mice model. O:High energy diet induce male mice obesity model and damage their fertility. S: Use network meta-analysis. Condition being studied: The relationship between obesity and male infertility attacth more and more attention at present.So many animal expriments are carried out on this problem,there are enough exprimental article to support this meta analysis.

中医认为肝郁、血瘀、肾虚是阳痿发病的三大主要病机,多从肝、肾方面论治阳痿.又以肝阴虚、肝血虚为多,而易于忽略肝阳虚之证候.本文基于肝之生理病理特性,提出肝阳乃维系男子性功能的重要生理基础,肝阳虚是导致阳痿的重要病机之一.肝阳虚所致阳痿的治疗要以温补肝阳为主,注重平调寒热、权衡阴阳,以恢复肝阳之舒达、敷和之性,打破了以"补肾疏肝"为主治疗阳痿的传统方法.乌梅丸酸苦辛并进,为肝阳虚之主方,也是治疗肝阳虚型阳痿的重要方剂.乌梅丸治疗阳痿患者多有寒热错杂、脉弦按之减、易成瘀血等临床表现,临证根据阴阳虚实及寒热轻重,调整酸苦辛甘四味比重,配合临床症状加减用药,使肝阳得以升发舒启,兼清相火虚热,为临床肝阳虚所致阳痿的辨证施治提供新思路.

Background The traditional Chinese medicines Astragalus and Angelica are often combined to treat male infertility, but the specific therapeutic mechanism is not clear. Therefore, this study applies a network pharmacology approach to investigate the possible mechanism of action of the drug pair Astragalus-Angelica (PAA) in the treatment of male infertility. Methods Relevant targets for PAA treatment of male infertility are obtained through databases. Protein-protein interactions (PPIs) are constructed through STRING database and screen core targets, and an enrichment analysis is conducted through the Metascape platform. Finally, molecular docking experiments were carried out to evaluate the affinity between the target protein and the ligand of PAA. Results The active ingredients of 112 PAA, 980 corresponding targets, and 374 effective targets of PAA for the treatment of male infertility were obtained, which are related to PI3K-Akt signaling pathway, HIF-1 signaling pathway, AGE-RAGE signaling pathway, IL-17 signaling pathway, and thyroid hormone signaling pathway. Conclusion In this study, using a network pharmacology method, we preliminarily analyzed the effective components and action targets of the PAA. We also explored the possible mechanism of action of PAA in treating male infertility. They also lay a foundation for expanding the clinical application of PAA and provide new ideas and directions for further research on the mechanisms of action of the PAA and its components for male infertility treatment.

Lifelong premature ejaculation (PE) is one of the most prevalent male sexual dysfunctions. It is still not well known about the possible neural mechanisms of lifelong PE. This study tried to investigate the abnormal characteristics of brain functional networks of lifelong PE and to assess relationships of PE-related functional abnormalities with clinical symptoms. Functional magnetic resonance imaging (fMRI) data and clinical symptoms were collected from 45 lifelong PE patients and 37 healthy controls (HCs) since 2016, including disease and sexual life history, intravaginal ejaculatory latency time measured by stopwatch and other scales. The degree centrality (DC) approach were applied to distinguish altered brain functions between the two groups (p < 0.05, false discovery rate corrected). Correlation analysis was then performed to examine relationships between the imaging findings and clinical symptoms (p < 0.05, Bonferroni corrected). Results showed that compared with HCs, lifelong PE patients had increased DC value in the medial prefrontal cortex (mPFC), precuneus and primary somatosensory cortex (SI) as well as decreased DC value in the insula and orbitofrontal cortex. After controlling for anxiety and depression levels, the significant difference in the mPFC was not found. The DC value in the SI positively correlated with premature ejaculation diagnostic tool (PEDT) score in the patients. The present findings indicate that lifelong PE patients have altered DC in brain regions involved in sensation, motivation and inhibitory control processing. Our study may improve our understanding and provide a new sight into the further research of lifelong PE.

Oligo-astheno-teratozoospermia (OAT) which perplexes doctors and patients due to its complicated etiology, atypical symptoms and poor clinical efficacy, is a general term for the three pathological states of abnormal semen. OAT is the main factor of male infertility. It is also a hot and difficult point in present studies. Empiric drug is the most popular treatment of this disease in the modern medicine. Chinese medicine (CM) is one of the main methods for the treatment of this disease, and it has certain clinical effect. The author believes that the use of modern medical technology to make the diagnosis as clear as possible is the key to treat OAT. The combination of syndrome and disease differentiation is the main mode in the treatment of OAT. Microscopic syndrome differentiation and macroscopic evidence embodies the basic principle of “Si Wai Chuai Nei” and broadens the perspective of CM syndrome differentiation. Classification and treatment are basic methods for the treatment of OAT. The treatment should not be limited to the Shen (Kidney), instead it should focus on the whole body condition. At different stages, the treatment should also pay attention to strengthening the Pi (Spleen), nourishing the Gan (Liver) and promoting blood circulation. Complementing Chinese and Western medicine, and highlighting the characteristics and advantages of CM treatment, have a great guiding value for the treatment of OAT.

OBJECTIVE:To observe the effificacy and safety of Qiaoshao Formula (, QSF) on patients with lifelong premature ejaculation (LPE) of Gan (Liver) depression and Shen (Kidney) defificiency syndrome.METHODS:A total of 60 LPE patients were randomly divided into treatment (QSF) and control (dapoxetine) groups. The treatment group received QSF twice a day and the control group received dapoxetine 1 to 2 h prior to planned sexual intercourse for 4 weeks. The outcomes included intra-vaginal ejaculation latency time (IELT), premature ejaculation diagnostic tool (PEDT), clinical global impression of change (CGIC), scores of Chinese medicine symptoms (CMSS), sex life satisfaction (SLS) and adverse events (AEs).RESULTS:In the treated group, the median IELT was 3 min vs. 1.5 min before and after treatment (P<0.05). PEDT in the treated group was reduced to 11.76±1.68 from 15.83±2.30 after treatment (P<0.05). Besides, patient's SLS was improved from 1.30±0.05 to 6.30±0.04 (P<0.05), and spouse's SLS was increased from 1.30±0.to 6.10±0.06 (P<0.05); CMSS was decrease from 14.86±3.02 to 9.62±2.87 (P<0.05). In addition, no significant AE was observed in both groups.CONCLUSION:QSF may be effective and safe on LPE patients with Gan depression and Shen defificiency syndrome.

OBJECT:Oxidative stress involved in the regulation of arterial erectile dysfunction (A-ED). Previously report have indicated that quercetin have an antioxidant effect. In the current study, we have established the rats' model for study the therapeutic effect of quercetin on A-ED and further investigated the molecular mechanism of action.METHODS:Wistar rats were divided into sham group, A-ED group, A-ED group with low dose of quercetin, and A-ED group with high dose of quercetin. Intracavernous pressure (ICP) and mean arterial pressure (MBp) are two important indicators used for evaluation the A-ED. The changes of ICP and MBp were determined by cavernous nerve electrostimulation after treatment of quercetin at indicated doses. The expression of nitric oxide synthase (NOS) subtypes was detected by RT-PCR and Western blotting.RESULTS:Our results indicated that ICP was significantly reduced in A-ED rats model compared with sham group, and was significantly increased after quercetin treatment (P < 0.01), while no significant effect on the MBp. The data also showed that sGC inhibitor ODQ and NOS inhibitor LNNA can significantly inhibited the ICP which induced by quercetin. These results suggest that NO-cGMP signaling pathway plays a crucial role in A-ED. Then, we found that the mRNA and protein levels of eNOS were significantly reduced in A-ED group compared with sham group. After treated with quercetin may cause the eNOS RNA and protein were significantly up-regulated (P < 0.01), showing a dose-dependent effect. iNOS expression have a certain degree of increased after quercetin treatment. nNOS expression was not significantly increased before and after treated with quercetin. In a word, quercetin can improved the A-ED by up-regulated ICP, which related to up-regulation of NO-cGMP signaling pathway.CONCLUSION:Preliminary results of this study suggested that quercetin protected expression and function of eNOS in cavernous endothelial cells, and restored part of normal function of NO-cGMP pathway in the process of penis erection.