[Advances in the studies of pancreatic kininogenase in male reproduction].

With the increasing attention to the relationship between male reproductive system diseases and microcirculation disorders, pancreatic kininogenase, a drug to improve microcirculation, is becoming a focus in the studies of the treatment of male reproductive diseases. It is reported recently that pancreatic kininogenase has a similar effect to type-5 phosphodiesterase inhibitors and may become a new drug for the treatment of ED. This article mainly discusses the possible action mechanisms of pancreatic kininogenase from the aspects of kallikrein-kinin system and pancreatic kininogenase promoting semen liquefaction and improving sperm quality and erectile function.

Current Situation and Reconsideration on the Study of Integrated Chinese and Western Medicine Andrology.

The development of Chinese medicine and Western medicine andrology is based on different social background and academic systems, either Chinese medicine or Western medicine andrology has their limitations, therefore, integration of Chinese and Western medicine (ICWM) andrology is in a great need. After more than 30 years of development, andrology has made great achievements in the construction of specialized academic association, holding academic conferences and publication of academic monographs, and the research progress on this field is mainly in the combination of disease and syndrome, microdifferentiation of symptoms and signs and basic research development. However, the comprehensive theoretic system of ICWM andrology has not yet established, and the related studies are still on the primary stage. In the future studies, great efforts still need to be made to expand the methods for the investigation of ICWM, and make innovations in the field of andrology.

[Roles of cyclins in the progression of spermatogenesis].

Spermatogenesis is a complex and precise process of differentiation of germ cells, which involves three stages: mitosis of spermatogonia, meiosis of spermatocytes and formation of spermatozoa. The process is controlled by many factors, including regulation of cyclins in spermatogenic cells, which plays a pivotal role. Cyclins form heterologous dimer compounds with protein kinase activity by binding to cyclin-dependent kinases, then phosphorylate multiple proteins and promote the orderly conduct of each phase of the cell cycle. In recent years, cyclins A, B, D and E have been found to play important roles in the regulation of spermatogenesis. This article presents an overview on the roles of these four cyclins in regulating the progression of spermatogenesis.

Identification of a novel mutation in FGFR1 gene in patients with Kallmann syndrome by high throughput sequencing.

Kallmann syndrome (KS) is a rare clinical and genetic heterogeneity disease, which is familial or sporadic. KS is known to have three patterns of inheritance: X linked recessive inheritance, autosomal dominant inheritance and rare autosomal recessive inheritance. Here, we report a sibling pedigree with autosomal dominant inheritance of KS, and we identified a novel heterozygous frameshift mutation c.299_300insCCGCAGACTCCGGCCTCTATGC (p.C101Rfs*17) in FGFR1 gene using whole-exome sequencing (WES). The mutation and affection status were cosegregated. The mutation is not present in the dbSNP, 1000 Genome, ExAC, and gnomAD databases. The discovery of this new mutation in the FGFR1 gene enriches the spectrum of FGFR1 mutations in patients with KS. ABBREVIATIONS: FGFR1: fibroblast growth factor receptor 1; HH: hypogonadotropic hypogonadism; KS: Kallmann syndrome; MRI: magnetic resonance imaging; WES: whole-exome sequencing.

[Bushen Daozhuo Granules for type â ¢ prostatitis: A multicenter randomized controlled clinical trial].

OBJECTIVE: To study the safety and efficacy of Bushen Daozhuo Granules (BDG) in the treatment of type Ⅲ prostatitis. METHODS: This multicenter randomized controlled clinical trial included 478 patients with type Ⅲ prostatitis, 290 in the trial group and 188 as controls, the former treated with BDG at 200 ml bid and the latter with tamsulosin hydrochloride sustainedrelease capsules at 0.2 mg qd, both for 4 weeks. Before treatment, after 4 weeks of medication, and at 4 weeks after drug withdrawal, we obtained the NIH Chronic Prostatitis Symptom Index (NIHCPSI) scores and compared the safety and effectiveness rate between the two groups of patients. RESULTS: Compared with the baseline, the NIHCPSI score was markedly decreased in the control group after 4 weeks of medication (21.42 ± 4.02 vs 15.67 ± 3.65, P < 0.05) but showed no statistically significant difference from that at 4 weeks after drug withdrawal (19.03 ± 3.86) (P>0.05), while the NIHCPSI score in the trial group was remarkably lower than the baseline both after 4 weeks of medication and at 4 weeks after drug withdrawal (10.92 ± 2.06 and 12.91 ± 2.64 vs 21.58 ± 3.67, P < 0.05). The trial group exhibited both a higher rate of total effectiveness and safety than the control (P < 0.05). CONCLUSIONS: BDG is safe and effective for the treatment of type Ⅲ prostatitis.

[Male factors and countermeasures for recurrent spontaneous abortion].

Recurrent spontaneous abortion (RSA) has a very complicated pathogenesis and male factors for this condition should not to be ignored, which are mainly related to genetics, immunology, infection, sperm quality, and others. In case of RSA, an etiological screening ought to be performed for the husband, which involves general, genetic and immunological examinations and infection detection. According to specific etiological factors, such measures as genetic consultation, immunotherapy, and traditional Chinese medication can be taken, which may contribute to the outcome of pregnancy.

[Explanation of 'Essence and Blood from the Same Source' in Theory of Chinese Medicine from the Roles of Vascular Endothelial Growth Factor in Spermatogenesis].

'Essence and blood from the same source', as one of basic theories of Chinese medi- cine (CM), is important for syndrome typing and clinical medication. Vascular endothelial growth factor (VEGF) can be produced and secreted in Leydig cells and Sertoli cells, which can not only promote the formation of new blood vessels, but also regulate synthesis of testosterone and the proliferation and dif- ferentiation of germ cells. The roles of VEGF in the spermatogenesis reveal scientific connotations of 'essence and blood from the same source', and it plays an important role in guiding clinical practice of CM.

[Lumbar disc herniation and andrological diseases].

Lumbar disc herniation is a common male disease. In the past, More academic attention was directed to its relationship with lumbago and leg pain than to its association with andrological diseases. Studies show that central lumber intervertebral disc herniation may cause cauda equina injury and result in premature ejaculation, erectile dysfunction, chronic pelvic pain syndrome, priapism, and emission. This article presents an overview on the correlation between central lumbar intervertebral disc herniation and andrological diseases, focusing on the aspects of etiology, pathology, and clinical progress, hoping to invite more attention from andrological and osteological clinicians.

[Effects of Yangjing capsule on the ultrastructure of seminal vesicles in aged rats].

OBJECTIVE: To observe the effects of Yangjing Capsule (YJC) on the ultrastructure of seminal vesicles in aged male rats, and explore its mechanism of improving the secretion of seminal vesicles. METHODS: Fifty male SD rats aged 18 -20 months were randomly and equally divided into a control group, a testosterone undecanoate group, and a high-dose, a medium-dose and a low-dose YJC group, all fed intragastrically for 30 days. Then the seminal vesicles of the rats were removed and the seminal fluid squeezed into the test tube to be weighed and measured for the concentration of seminal vesicle fluid fructose, and the bilateral seminal vesicles were placed in formaldehyde and glutaraldehyde fixatives for histological observation. RESULTS: The seminal vesicle gland viscera coefficient, seminal vesicle fluid weight and fructose concentration of the rats were (1164.5 +/- 212.6) g/g x 10(6), (0.83 +/- 0.30) g and (4.35 +/- 0.31) mg/ml in the control group, (1510.5 +/- 313.1) g/g x 10(6), (0.82 +/- 0.25) g and (5.35 +/- 0.71) mg/ml in the testosterone undecanoate group, (1484.3 +/- 262.7) g/g x 10(6), (1.14 +/- 0.18) g and (5.30 +/- 0.45) mg/ml in the high-dose YJC group, (1396.6 +/- 268.9) g/g x 10(6), (0.83 +/- 0.24) g and (4.71 +/- 0.41) mg/ml in the medium-dose YJC group, and (1475.0 +/- 305.2) g/g x 10(6), (0.74 +/- 0.28) g and (4.50 +/- 0.23) mg/ml in the low-dose YJC group. Compared with the control, high-dose YJC significantly improved seminal vesicle secretion (P < 0.05), while medium- and low-dose only achieved a trend of improvement. After HE staining, the YJC groups showed more active epithelial hyperplasia, increased cellular layers, rich and transparent cytoplasm with abundant secretory granules, fat droplets and lipofuscin, blurred glandular cavity edge, and eosinophilic intraluminal secretions, as compared with the control group. The structural change was most significant in the high-dose group. Statistically significant differences were observed in the numerical density and bulk density of the secretory granules between the YJC and control groups (P < 0.05). CONCLUSION: Yangjing Capsule can improve the secretion of seminal vesicles by increasing the secretory granules of the main

[Therapeutic efficacy of Bushengzhuyang Fang (Yangjing Capsule) on phytoestrogen-induced erectile dysfunction: an experimental study].

OBJECTIVE: To investigate the effect of Bushengzhuyang Fang (Yangjing Capsule, YJC) on penile erectile function and its action mechanisms in rats. METHODS: Fifty-six male SD rats were randomly divided into seven groups of equal number: blank control, daidzein, daidzein + testosterone, daidzein + sildenafil, daidzein + low-dose YJC, daidzein + medium-dose YJC, and daidzein + high-dose YJC. The rats in the blank control group were treated intragastrically with normal saline and those in the other groups with daidzein at the dose of 100 mg per kg per day for 30 days. Then the last five groups received additionally testosterone (4 mg per kg per day), sildenafil (2.5 mg per kg per day), low-dose YJC, (0.315 mg per kg per day), medium-dose YJC (0.63 mg per kg per day), and high-dose YJC (1. 26 mg per kg per day), respectively. At 0, 30 and 60 days of treatment, we observed the apomorphine-induced spontaneous erectile response and pathological changes in the corpus cavernosum of the rats, recorded the number of penile erection and erectile incubation period, and determined the serum levels of testosterone (T) and luteinizing hormone (LH). RESULTS: At 30 days of treatment, the number of apomorphine-induced erections was decreased, the erectile incubation period prolonged, and the serum levels of T and LH reduced remarkably in all groups of rats (P < 0.05). Compared with the findings at 30 days, the number of penile erections was significantly decreased at 60 days in the daidzein group (1.39 ± 0.42 vs 2.67 ± 0.33, P < 0.05) and daidzein + low-dose YJC group (1.33 ± 0.49 vs 2.83 ± 0.61, P < 0.05); the erectile incubation period was markedly ex- tended ([16.33 ± 3.11] vs [8.50 ± 0.93] min and [15.50 ± 3.21] vs [8.63 ± 1.54] min, P < 0.05); and the serum levels of T ([5.34 ± 0.89] vs [1.24 ± 0.30] ng/ml and [5.28 ± 1.12] vs [2.07 ± 0.76] ng/ml, P < 0.05) and LH ([3.62 ± 0.37] vs [2.09 ± 0.12] ng/ml and [3.79 ± 0.28] vs [2.17 ± 0.33] ng/ml, P < 0.05) were significantly reduced in the daidzein and daidzein + low-dose YJC groups, respectively. Pathological examination revealed slightly decreased cavernous sinuses and blood vessels in the corpus cavernosum of the rats in the daidzein + testosterone, daidzein + sildenafil, daidzein + medium-dose YJC, and daidzein + high-dose YJC groups as compared with those in the blank control group. CONCLUSION: High-dose Yangjing Capsule is efficacious for the recovery of erectile function in rats, especially for phytoestrogen-induced erectile dysfunction.

[Regulatory effect of Yangjing Capsule on the expressions of phosphor-Erk1 and phosphor-Akt1 in the corpus cavernosum of aged rats].

OBJECTIVE: To observe the effect of Yangjing Capsule on the expressions of P-Erk1 and P-Akt1 in the corpus cavernosum of aged rats and to explore its action mechanism. METHODS: Forty 24-month-old SD rats were equally randomized into an experimental and a control group, 10 selected from each group for detection of the eNOS expression before medication. The rats in the experimental group (n = 10) were treated intragastrically with Yangjing Capsule, while those in the control with physiological saline, both at 0.5 g per kg body weight per day for 4 weeks. Then all the rats were killed, and the corpus cavernosum tissues harvested for determination of the expressions of eNOS, P-Erk1 and P-Akt1 by HE staining, RT-PCR and immunohistochemistry. RESULTS: Obvious distension was observed in the experimental group, but not in the control. The expression of eNOS in the rat corpus cavernosum was significantly higher after treatment than before treatment in the experimental group (24.10 +/- 2.40 vs 18.80 +/- 2.04, P < 0.05), but presented no obvious difference in the control (18.15 +/- 1.98 vs 19.35 +/- 1.50, P > 0.05), and it was remarkably higher in the former than in the latter (P < 0.05). The expression of P-Erk1 was markedly lower in the experimental than in the control rats (0.71 +/- 0.13 vs 0.83 +/- 0.17, P < 0.01), but that of P-Akt1 exhibited no remarkable difference in the same condition of GAPDH between the two groups (0.58 +/- 0.17 vs 0.48 + 0.13, P > 0.01). CONCLUSION: Both P-Erk1 and P-Akt were expressed in the corpus cavernosum of the aged rats. Yangjing Capsule could improve the sexual function of aged rats, which might be associated with the lowered expression of P-Erk1.

[Effects of Yixin Kangtai capsule on spermatogenesis and the levels of superoxide dismutase and malondialdehyde in aged SD rats].

OBJECTIVE: To observe the effects of Yixin Kangtai Capsule (YKC) on sperm concentration and motility, superoxide dismutase (SOD) and malondialdehyde (MDA) in aged SD rats, and to explore its possible mechanisms of action. METHODS: We randomly assigned fifty 24-month-old male SD rats to five groups of equal number: blank control, testosterone undecanoate, high-dose YKC, medium-dose YKC and low-dose YKC, and treated them intragastrically with physiological saline at 10 ml/kg, testosterone un-decanoate suspension at 4 mg/kg, and YKC at 0.6 g/kg, 0.3 g/kg and 0.15 g/kg, respectively, once a day for 30 days. Then we harvested the epididymides, which were stripped of fat and envelope, cut into pieces and placed in the saline at 37 degrees C for 10 to 15 minutes. Then we detected the sperm parameters with the Weili CASA sperm analysis system, measured the levels of serum SOD and MDA, and, following HE staining, observed the histomorphological changes of the testicular tissue under the light microscope. RESULTS: Compared with the controls, the rats treated with high-, medium- and low-dose YKC exhibited significantly increased sperm concentration ([152.3 +/- 24.0] x 10(6)/ml vs [334.5 +/- 97.7], [302.7 +/- 158.9] and [221.4 +/- 75.6] x 10(6)/ml, P < 0.05) and markedly improved sperm motility ([26.5 +/- 2.0]% vs [35.5 +/- 5.9], [33.1 +/- 5.4] and [28.4 +/- 2.1]%, P < 0.01). High-dose YKC significantly increased the level of serum SOD ([22.0 +/- 5.3] U/ml, P < 0.01) and reduced the content of MDA ([13.6 +/- 4.6] nmol/ ml, P < 0.01). Testicular histology showed that YKC induced more active proliferation of cells, and increased the number of dividing cells and that of mature sperm in the lumen, with little interstitium, abundant blood vessels, and well-developed stromal cells. CONCLUSION: Yixin Kangtai Capsule can improve spermatogenesis in aged SD rats by regulating the levels of SOD and MDA.

[Yangjing capsule plus low-dose tadalafil for functional anejaculation].

OBJECTIVE: To search for an effective therapy for functional anejaculation (AE). METHODS: Fifty-five AE patients were randomized into a treatment group (n = 30) and a control group (n = 25), the former treated with Yangjing Capsule (once 5 pills, tid) and low-dose tadalafil (5 mg, qd alt, 1 h before bedtime), while the latter with oral ephedrine (25 mg before bedtime). Meanwhile, the patients were advised to expose themselves to sexual stimulation, reduce the frequency of sexual intercourses and quit masturbation. The medication lasted 1-3 months, followed by observation of the therapeutic effects. RESULTS: The total effectiveness rate was 83.34% in the treatment group, 11 cases cured, 8 obviously improved, 6 improved and 5 unimproved, significantly higher than 40.00% in the control group, 4 cases cured, 3 obviously improved, 3 improved and 15 unimproved (P < 0.05). CONCLUSION: Yangiing Capsule plus low-dose tadalafil is safe and effective for the treatment of functional anejaculation.

[Surveillance of adverse events following immunization in Minhang district of Shanghai from 2007 to 2010].

OBJECTIVE: To analyze the adverse events following immunization (AEFI) in Minhang District of Shanghai from 2007 to 2010 and evaluate the safety of vaccines. METHOD: The data of AEFI cases were collected and reported by the Vaccine Adverse Events Surveillance System (VAESS). The data were classified as non-serious or serious reaction according to the symptoms and medical records. RESULT: From 2007 to 2010, 5088 AEFI cases were reported to the surveillance system after 4.85 million doses of 24 kinds of vaccines (viral vaccines, bacterial vaccine and non-vaccine product) use. A total of 5013 non-serious AEFI were reported with a rate of 103.24/100 000 doses. Among the non-serious AEFIs, the majority were fever (3314 cases, 68.25/100 000 doses), followed by local reactions (1686 cases, 34.72/100 000 doses). A total of 75 serious AEFIs were reported, with a rate of 1.54/100 000 doses. The anaphylaxis (26 cases, 0.54/100 000 doses) accounted for the most among the serious AEFIs, followed by allergic rash (24 cases, 0.49/100 000 doses) and abscess at injection site (14 cases, 0.29/100 000 doses). The susceptibility of data on AEFI rose year by year from 2007 to 2010, and the reported rate rose from 40.48/100 000 in 2007 to 134.17/100 000 in 2010. CONCLUSION: To maintain the sensitivity of AEFI surveillance is key to detect rare serious adverse events. The sensitivity should be enhanced, at the same time, pediatricians should treat the AEFI with standard methods, so as to minimize the negative impacts of vaccination and to maintain the confidence among the public.

[Molecular mechanisms of proliferation and differentiation of spermatogonial stem cells].

Clinically many patients with non-obstructive azoospermia cannot benefit from assisted reproductive technology for absence of spermatozoa. However, the achievement in the studies of spermatogonial stem cells has brought hope to this cohort. This article reviews the molecular mechanisms of the proliferation and differentiation of spermatogonial stem cells, in such aspects as related genes, growth factors, and so on.

[46, XX testicular disorder of sex development: report of 2 cases and review of the literature].

OBJECTIVE: To investigate the phenotype, pathogenesis and molecular biological features of 46, XX testicular disorder of sex development. METHODS: We obtained the history of 2 patients with 46, XX testicular disorder of sex development, examined the cavitas pelvis by type-B ultrasonography, analyzed the karyotype of the chromosome, and detected the genes SRY, YRRM1, DYS240 and DAZ by PCR amplification. RESULTS: Microrchidia, azoospermia and maldevelopment of secondary sex characteristics were observed in both of the patients, but ultrasonography revealed no female internal genitals. Their chromosome gender was karyotyped as 46, XX, with the SRY gene positive in both, but the YRRM1 gene positive in only one of the cases. CONCLUSION: Chromosome karyotyping and detection of the SRY gene for patients with abnormal sex development can give us an insight into the genetic pathogenesis and provide us with scientific evidence for the diagnosis and treatment of the condition.

[Azoospermia factor and male infertility].

Azoospermia factor (AZF) microdeletions of the Y chromosome, which occur in 1 - 55% of infertile men, are closely associated with severe spermatogenic failure and represent the most frequent molecular genetic causes of azoospermia and severe oligozoospermia. Researches on AZF and its related genes, approaching the mechanisms of spermatogenic failure at the molecular level, are of great significance for the diagnosis, treatment and prognosis of male infertility. The detection of AZF microdeletions can provide scientific basis for correct diagnosis and reasonable therapy. This article outlines the structure and functional characteristics of AZF, as well as its relationship with male infertility, cryptorchidism, varicocele, Klinefelter syndrome, seminoma, and recurrent abortion.

[Kidney-tonifying and dampness-expelling Chinese herbal medicine combined with doxazosin for the treatment of chronic epididymitis].

OBJECTIVE: To study the clinical effects of kidney-tonifying and dampness-expelling Chinese herbal medicine combined with doxazosin in the treatment of chronic epididymitis. METHODS: A total of 64 patients with chronic epididymitis were equally randomized into a treatment and a control group, the former treated with kidney-tonifying and dampness-expelling Chinese herbal decoction combined with doxazosin, and the latter given doxazosin only, both for 4 weeks. The clinical symptoms were measured by Chronic Epididymitis Symptom Index (CESI), Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) before and after the treatment, and the therapeutic effects were evaluated. RESULTS: After 4 weeks of medication, the total mean scores on CESI, pain, and quality of life (QOL) were significantly decreased in both the treatment and the control groups (P < 0.05), even more significantly in the former than in the latter (P < 0.05), and so were the scores on SAS and SDS (P < 0.05), but with no significant differences between the two groups (P > 0.05). CONCLUSION: Either doxazosin alone or kidney-tonifying and dampness-expelling Chinese herbal decoction combined with doxazosin is obviously effective on chronic epididymitis, but the combined medication produces an even better efficacy.

[Qianlie Beixi capsule for unliquefiable semen: a clinical study of 180 cases].

OBJECTIVE: To investigate the efficacy and possible action mechanism of Qianlie Beixi Capsule in the treatment of unliquefiable semen. METHODS: A total of 240 patients with unliquefiable semen were randomly divided into a treatment group (n = 180), treated with Qianlie Beixi Capsule, and a control group (n = 60), given compound tablets of zinc and protein. The treatment lasted two courses of 45 days each, and the seminal changes were observed and recorded. RESULTS: Of the patients in the treatment group, 144 were cured, 12 responded and 24 failed to respond to the medication after the first course; and 158 were cured, 7 responded and 15 failed to after the second course, with the effectiveness rate of 91.67%. Meanwhile, sperm motility was obviously improved, with statistically significant difference from that of the controls (P < 0.01). CONCLUSION: Qianlie Beixi Capsule is effective for unliquefiable semen by improving the function of the prostate and shortening the time of seminal liquefaction.

[Correlation of premature ejaculation with central lumber intervertebral disc herniation].

OBJECTIVE: To investigate the correlation of premature ejaculation (PE) with central lumber intervertebral disc herniation (CLIDH) and the pathogenesis of PE, and to search for a convenient, effective and non-invasive method for the treatment of PE. METHODS: A total of 263 selected PE patients underwent CT, and those that were found with CLIDH were randomized into a treatment group (n=180) and a control (n=60), the former treated by lumbar traction and the latter with sertraline hydrochloride tablets, both for 24 weeks. CIPE-5 scores of all the patients were analyzed, and the ejaculation latency and sexual satisfaction were recorded before and after the treatment. RESULTS: Among the 263 PE patients, CLIDH was confirmed in 240 (91%). After the treatment, CIPE-5 scores, ejaculation latency and sexual satisfaction were markedly improved in the treatment group, with significant statistic difference from pre-treatment (P < 0.01). Significant differences were also observed between the treatment and the control groups after the treatment (P < 0.05), but not in the control group between pre- and post-treatment. CONCLUSION: CLIDH may be one of the important causes of most "unexplainable" PE cases. And lumbar traction, non-invasive, highly effective and easily manipulable, has provided a new access to the diagnosis and treatment of the PE patients with CLIDH.