Treatment of varicocele infertility men patients of different Chinese medical syndrome types by integrative medicine treatment selection: a primary research / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the optimal treatment selection for treating varicocele (VC) male infertility patients accompanied with oligozoospermia or azoospermia of different Chinese medical syndrome types by comparing the efficacies of integrative medicine.</p><p><b>METHODS</b>One hundred and twenty male infertility patients with VC accompanied with oligozoospermia or azoospermia were assigned to Chinese medical treatment group (A) and the surgical group (B), each consisting of three Chinese medical syndrome types, i.e., damp-heat stagnation syndrome (DHSS), Shen-deficiency blood stasis syndrome (SDBSS), and blood stasis stagnation syndrome (BSSS), 20 in each group. Corresponding Chinese medical treatment was administered to those in Group A, C, and E, while microscopic ligation of internal vena spermatic was administered to those in Group B, D, and F. The routine analysis of semen, biochemical analysis of seminal plasma, and serum sex hormones (prolactin, testosterone, follicle stimulating hormone, luteinizing hormone, and estradiol) were performed before treatment and by the end of the 24th week after treatment.</p><p><b>RESULTS</b>Totally 18 patients' spouses were pregnant. Of them, 1 in Group A of DHSS (abbreviated as Group A), 3 in Group B of DHSS (abbreviated as Group B), 4 in Group A of SDB-SS (abbreviated as Group C), 5 in Group A of SDBSS (abbreviated as Group D), 1 in Group A of BSSS (abbreviated as Group E), and 4 in Group B of BSSS (abbreviated as Group F). After 24-week treatment, the sperm concentration, class a sperm percentage, class a + b sperm percentage, the motility rate, the seminal plasma of fructose density, and the seminal plasma neutral alpha-glucosidase were more significantly improved in Group B, C, D and F, when compared with the same group before treatment (P <0. 01, P <0. 05). There was no statistical difference in the aforesaid indices between before and after treatment in Group A and Group E (P >0.05). As for the improvement percentage of seminal routine indices, the difference of the seminal plasma of fructose density, and the difference of seminal plasma neutral alpha-glucosidase between before and after treatment in the same Chinese medical syndrome types, better effects were obtained in Group B than in Group A (P <0.01), and better effects were obtained in Group F than in Group E (P <0.01). There was no statistical difference between Group C and D (P >0.05). There was no statistical difference in the 5 items of sex hormones in each group between before and after treatment (P >0.05).</p><p><b>CONCLUSIONS</b>Surgical treatment could effectively improve the semen quality for male infertility VC patients accompanied with oligozoospermia or azoospermia. Of them, Chinese medical treatment could be recommended to those of SDBSS who would not receive surgical treatment.</p>

Sexual function inspection room for special penile insertion disorder / 中华男科学杂志

<p><b>OBJECTIVE</b>To determine the role of the sexual function inspection room in the treatment of patients with special penile insertion disorder.</p><p><b>METHODS</b>This study included 6 couples received at the Andrology Clinic of Shanghai Renji Hospital from September, 2010 to February, 2011, who complained of being unable to accomplish sexual intercourse, all due to the husbands' abnormal penile erection. The couples had tried to make love 3 to 6 times after getting married, but never succeeded. Consequently the wives were planning to divorce, unwilling to attempt sexual activity again. We performed examinations and sexual education for the patients in the sexual function inspection room of Shanghai Institute of Andrology. The inspection room consisted of an inner and an outer section separated by a one-way transparent glass, through which what happened in the outer section could be observed from the inner section. The husband was given 20 mg of tadalafil to induce penile erection, followed by Doppler ultrasonographic determination of penile hemodynamics. Meanwhile, the wife was allowed to observe her husband's penile erection through the glass to get sensory stimuli and relieve the mental burden. In the end, the doctor advised the couple to try sexual intercourse.</p><p><b>RESULTS</b>In nature, the 6 wives were all impatient, while their husbands were all introverted. Doppler ultrasonography displayed normal penile hemodynamics. After sensory stimulation, the wives gained confidence in their husbands' erectile function. A one month follow-up visit showed that all the 6 couples could perform sexual intercourse normally.</p><p><b>CONCLUSION</b>This sexual function inspection room can help doctors and wives to observe the status of the patient's penile erection, and meanwhile disburden the mind of the wives by giving them sensory stimuli, which contributes much to successful attempt at sexual intercourse.</p>

Leptin level in azoospermic patients and its clinical value / 中华男科学杂志

<p><b>OBJECTIVE</b>To detect the levels of seminal plasma leptin (SPL) and serum leptin (SL) in patients with azoospermia, and to explore the methods of using SPL and SL alone or the combination of SPL, SL and follicle stimulating hormone (FSH) for the differential diagnosis of obstructive azoospermia (OA) and non-obstructive azoospermia (NOA).</p><p><b>METHODS</b>We enrolled in this study 45 patients with diagnosed OA, 41 with unexplained NOA and 30 men with normal semen parameters as controls. The azoospermia patients underwent percutaneous aspiration from the epididymis (PESA) or aspiration/extraction from the testis (TESA/TESE), and all the subjects were detected for the levels of serum FSH, SPL and SL. Individual and multiple indexes were evaluated by Fisher's discriminant analysis combined with ROC curve analysis.</p><p><b>RESULTS</b>There were no significant differences in the body mass index (BMI) among the three groups. Compared with the normal control, the OA patients showed an obviously elevated level of SPL (P = 0.048), and the NOA patients remarkably increased levels of FSH (P = 0.000), SL (P = 0.000) and SPL (P = 0.000). In comparison with the OA group, the levels of FSH (P = 0.000), SL (P = 0.006) and SPL (P = 0.033) were significantly increased in the NOA group. For the differential diagnosis of OA and NOA, the areas under the ROC curve of SPL and SL were 0.658 (P = 0.014) and 0.702 (P = 0.002) , respectively, both significantly greater than 0.5, while that of the combination of SPL, SL and FSH was the greatest (0.953). In addition, with 0.026 x SPL +0.05 x SL +0.106 x FSH -2.197 as the combined indicator value and -0.289 as the cut-off value (> or = cut-off value for NOA), the sensitivity and specificity of the combination were 0.878 and 0.902, respectively, both reached the maximum.</p><p><b>CONCLUSION</b>Both the levels of SPL and SL are valuable for the differential diagnosis of OA and NOA, but the joint consideration of SPL, SL and FSH may provide better indicators.</p>

The feeder layer of human embryonic fibroblasts supports the growth of human spermatogonial stem cells / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the methods and conditions for the isolation, purification and culture of human spermatogonial stem cells (SSCs) on the feeder layer cells of human embryonic fibroblasts (hEFs).</p><p><b>METHODS</b>SSCs isolated and purified from normal human fetal testicular tissues by sequential two-step enzyme digestion and Percoll uncontinuous density gradient centrifugation were cultured on the feeder layer cells of hEFs isolated from 5-9 weeks old human embryos. The surface markers SSEA-1 and OCT4 of the SSCs were detected by immunohistochemistry; the alkaline phosphatase (AKP) activity of the SSC clones measured; and the expressions of the SSC-related genes determined by RT-PCR.</p><p><b>RESULTS</b>SSCs survived, proliferated and formed colonies on the feeder layers, and the colonies were highly positive for SSEA-1 and OCT4, with strong AKP activity and high expressions of the SSC-related genes.</p><p><b>CONCLUSION</b>The feeder layer of hEFs supports the growth of human spermatogonial stem cells.</p>

IIEF-5 cannot be used as a tool for differential diagnosis of vasculogenic erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the 5-item version of the international index of erectile function (IIEF-5) as a method to differentiate the causes of vasculogenic erectile dysfunction (ED).</p><p><b>METHODS</b>In all, 103 ED patients (mean age 46.8 +/- 18.7) were reviewed by IIEF-5. Penile blood flow was also assessed in each patient after an intracavernosal injection (ICI) and audio-visual sex stimulation by duplex Doppler ultrasonography. The 99mTc-(113m)In dual radioisotope test was performed to confirm specific vascular causes in the vasculogenic ED cases. Kruskal-Wallis TEST was employed to compare the scores of IIEF-5 with the results of ICI, duplex Doppler ultrasonography and the 99mTC-(113m)In dual radioisotope test.</p><p><b>RESULTS</b>Of the total number of ED cases, 37 (37/103, 35.9%) were nonvasculogenic, 18 (18/103, 17.5%) arteriogenic, 35 (35/103, 34.0%) venogenic and 13 (13/103, 12.6%) combined vasculogenic. There was no significant difference in the IIEF-5 scores either between the vasculogenic group and the non-vasculogenic one (P = 0.253) or among different groups of the vasculogenic ED patients.</p><p><b>CONCLUSION</b>IIEF-5 cannot be used as a tool for differential diagnosis of vasculogenic ED, or to compare its specific vascular causes, nor can the scores of IIEF-5 reflect penile vascular conditions.</p>

A multi-center clinical trial of Qianlieantong tablets for chronic prostatitis / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the efficacy and safety of Qianlieantong Tablets in the treatment of chronic prostatitis.</p><p><b>METHODS</b>A multi-center, self-controlled open clinical trial was conducted. A total of 280 subjects with chronic prostatitis were enrolled and treated by Qianlieantong Tablets, 3 times a day, 5 tablets each time. Before and after 2 and 4 weeks after the administration, NIH-CPSI scores and white blood cell counts in the prostate secretion were recorded.</p><p><b>RESULTS</b>Of the 273 subjects evaluated, the rates of excellence, effectiveness and ineffectiveness were 35.2% (n = 96), 47.6% (n = 130) and 17.2% (n = 47), respectively, with a total effectiveness rate of 82.8%. After 4 weeks'medication, the scores of the subjects on NIH-CPSI pain, voiding and quality of life and white blood cell counts in prostate secretion were significantly decreased compared with pre-treatment (P < 0.01). No adverse events or laboratory abnormality related to the medication were observed.</p><p><b>CONCLUSION</b>Qianlieantong Tablets has a significant effect on chronic prostatitis with high safety, particularly indicated in chronic prostatitis with pelvic pain.</p>

Survey on reproductive health status of Shanghai college students / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore reproductive health condition of college students in Shanghai and provide scientific basis for reproductive health education.</p><p><b>METHODS</b>From July 2004 to March 2005, 1192 college students (majors including medicine, science and engineering, arts and culture; 618 medical students and 549 non-medical; 555 male and 612 female) from seven time-day colleges in Shanghai were investigated with a reproductive health questionnaire involving sex. The questionnaire was constituted by 72 topics, involving the need of education, sex attitude, sex videos, sex hygiene knowledge and sexually transmitted diseases (STDs), etc.</p><p><b>RESULTS</b>39.33% (459/1167) students thought they had accepted formal sex education; 49.19% (574/1167) students chose lecture as the favorite way; 41.90% (489/1167) students thought the reproductive health education would not increase the incidence of premarital sexual behavior; 64.10% (748/1167) students thought it was necessary to give college students reproductive health instructions and knowledge. On the other hand, we found 45.05% (250/555) boys and 27.45% (168/612) girls could accept the premarital sexual behaviors; 35.32% (196/555) boys and 39.38% (241/612) girls could accept premarital pregnancy; 44.39% (518/1167) students could calculate the safe period accurately; 71.38% (833/1167) students knew emergency contraception measures; 57.67% (673/1167) students knew how to and when to use condoms; To our surprise, only 2.19% (12/549) non-medical students and 12.14% (75/618) medical students knew exactly the whole 4 sexually transmitted diseases that needed to be essentially prevented in China.</p><p><b>CONCLUSION</b>At present, the reproductive health condition of college students in Shanghai is sophisticated. Much more education on sex safety, self-protection skills and acquired immunodeficiency syndrome (AIDS) knowledge, etc should be reinforced.</p>

A controlled randomized trial of the use of combined L-carnitine and acetyl-L-carnitine treatment in men with oligoasthenozoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To determine the efficacy and safety of combined L-carnitine and acetyl-L-carnitine therapy in infertile males with oligoasthenozoospermia.</p><p><b>METHODS</b>One hundred fifty patients with oligoasthenozoospermia were randomized selected into treatment and control groups. The treatment group with 90 patients were given L-carnitine (2 g/d) and acetyl-L-carnitine (1 g/d) orally, twice a day. The patients in control group were given Vitamin E 100 mg plus Vitamin C 100 mg, tid. The oral therapy lasted three months and patients accepted sperm analysis every one month. The L-carnitine level in seminal plasma was examined by high performance liquid chromatography (HPC). Side effects as well as pregnant rate were observed.</p><p><b>RESULTS</b>In the treatment group, 85 patients out of 90 finished the three month treatment. Female spouses of 10 patients (11.6%) achieved pregnancy. Moreover, their forward motile sperm per ejaculation, total motile sperm, as well as the concentration of L-carnitine in seminal plasma were increased significantly (P < 0.01). In control group, 53 patients out of 60 completed three months therapy. Two pregnancy (3.7%) was observed. Though some increase was seen in number of forward motile sperm and total motile sperm per ejaculation, the changes were not statistically significant (P > 0.05). The difference of the pregnant rate between two groups was statistically significant. No side effects were found.</p><p><b>CONCLUSION</b>Combined treatment with L-carnitine and acetyl-L-calmitine can be an effective and safe option for treating oligoasthenozoospermia by means of significantly improving forward motile sperm and total motile sperm per ejaculation, as well as increasing pregnant rates.</p>

Effects of growth hormone supplementation on erectile function and expression of nNOS in aging rats / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the effects of growth hormone( GH) supplementation on erectile function and expression of nNOS in the intracavernosal nerves in aging rats.</p><p><b>METHODS</b>Twenty male Sprague-Dawley rats aged 18 months were randomly divided into Groups A and B, and ten 2-month-old male Sprague-Dawley rats included in Group C. 1 U/(kg x d) GH was given to Group A, and the same volume of saline to Groups B and C. After 8 weeks of treatment, evaluation was made of the erections induced by apomorphine (APO), maximal intracavernous pressure (ICP) induced by intracavernous papaverine injection and expression of nNOS in the intracavernosal nerves by streptavidin-peroxidase immunohistochemical techniques.</p><p><b>RESULTS</b>After 8 weeks of treatment, the erection frequency, maximal ICP and expression of nNOS in the intracavernosal nerves of the rats in Groups A and C were significantly higher than those in Group B (P < 0.05 or P < 0.01).</p><p><b>CONCLUSION</b>Growth hormone supplementation can improve the erectile function of aging rats, which may be attributed to the increase in the expression of nNOS in the intracavernosal nerves.</p>

Comparison between sildenafil plus sertraline and sertraline alone in the treatment of premature ejaculation / 中华男科学杂志

<p><b>OBJECTIVE</b>To compare the efficacy and safety of sildenafil plus sertraline with those of sertraline alone in the treatment of premature ejaculation (PE).</p><p><b>METHODS</b>Seventy-two patients with PE but without any obvious organic cause were enrolled in this study. They were randomly divided into Groups A and B of equal number. Group A received 50 mg sertraline daily 4 to 6 hours before planned sexual activity for 12 weeks, and Group B were given 50 mg sertraline daily plus 50 mg sildenafil as needed, 1 hour before planned sexual activity, for 12 weeks. Before and after the treatment, the mean intravaginal ejaculation latency time, the intercourse satisfaction, the mean number of coituses per week and the drug-related side effects were evaluated.</p><p><b>RESULTS</b>The mean intravaginal ejaculatory latency time was (0.59 +/- 0.12), (3.9 +/- 0.15) minutes (P < 0.001) at baseline and post-treatment in Group A, and (0.56 +/- 0.11), (5.6 +/- 0.12) minutes (P < 0.001) in Group B, improved in both of the 2 groups, but more significantly in Group B (P < 0.05). Before and after the treatment, the mean intercourse satisfaction domain values of the IIEF were (8.9 +/- 1.2), (10.8 +/- 1.1) (P < 0.05) and (8.8 +/- 1.1), (13.8 +/- 1.3) (P < 0.001) in Groups A and B, respectively, significantly greater in Group B than in Group A (P < 0.05) after the treatment; the mean numbers of coituses per week in Groups A and B were (0.9 +/- 0.2), (1.9 +/- 0.3) (P < 0.05) and (1.0 +/- 0.2), (2.7 +/- 0.2) (P <0.001) respectively, significantly larger in Group B (P<0.05) after the treatment. As for the side effects, there was a higher rate of headaches (P < 0.01) and flushing episodes (P < 0.001) in Group B than in Group A.</p><p><b>CONCLUSION</b>Sertraline combined with sildenafil can produce significantly better results than sertraline alone in patients with premature ejaculation. However, the combined treatment is associated with a slight increase in the drug-related side effects.</p>

Effect of aging on male sexual function in 93 patients using international index of erectile function / 中华男科学杂志

<p><b>OBJECTIVES</b>To investigate the influence of aging on male sexual function.</p><p><b>METHODS</b>The study selected 93 ED patients, aged from 23 to 64, who responded to the International Index of Erectile Function (IIEF) questionnaire. The questionnaire includes 15 items related to male sexual activity, which are organized into 5 domains, namely, erectile function (EF), orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS) and overall satisfaction (OS). For statistical analysis, ANOVA with DUNCAN test was conducted, and statistical significance was set at P < 0.05. Some other risk factors of ED such as hypertension, diabetes etc. had been excluded.</p><p><b>RESULTS</b>According to the age, the subjects were divided into 5 groups. With age increasing, the proportion of moderate and severe in each group increased from 16.17% to 57.14%, whereas EF score decreased from (19.50 +/- 4.64) to (15.27 +/- 5.64), OF score decreased from (6.93 +/- 2.86) to (5.62 +/- 2.94), SD score decreased from (6.33 +/- 1.63) to (4.50 +/- 2.94), IS score decreased from (10.17 +/- 1.94) to (6.93 +/- 2.90), OS score decreased from (5.00 +/- 0.89) to (3.15 +/- 1.84). The tendency took on linearity (P < 0.01). Aging was negatively correlated to above mentioned scores (r = 0.98, P < 0.01).</p><p><b>CONCLUSION</b>Aging could be thought as a risk factor of ED, which is negatively correlated with male's EF, OF, IS, OS and SD scores, furthermore. IIEF questionnaire is a useful tool assessing epidemiology of ED.</p>

The effects of testosterone undecanoate on relaxation of rat corpus cavernosum smooth muscle in vitro / 中华男科学杂志

<p><b>OBJECTIVES</b>To investigate the role of Undecanoate (Andriol), as a kind of testosterone, in regulating the relaxation of isolated rat corpus cavernosum in vitro.</p><p><b>METHODS</b>The castrated rats were given high and low dosage Andriol respectively, compared with intact and castrated rats. After treatment of 4 weeks, the corpora cavernosa were cut, trimmed as to strips. Norepinephrine(NE) was added to contract each of the tissue strips. Next, sodium nitroprusside(SNP), electric functional stimulation(EFS) were used to relax the strips. Percent relaxations were examined.</p><p><b>RESULTS</b>High-dose Andriol(20 mg/kg) was significantly effective to castrated rats on percent relaxation induced by 10(-3) mol/L SNP and EFS. Low-dose Andriol(10 mg/kg) was also effective to relax strips induced by 10(-3) mol/L SNP. According to statistics, the differences were significant (P < 0.01).</p><p><b>CONCLUSIONS</b>The percent relaxations of castrated rats were increased after taking Andriol, and it could increase the relaxation of corpara cavernosa.</p>