Chlorogenic acid can improve spermatogenic dysfunction in rats with varicocele by regulating mitochondrial homeostasis and inhibiting the activation of NLRP3 inflammasomes by oxidative mitochondrial DNA and cGAS/STING pathway.

In recent years, Varicocele (VC) has been recognized as a common cause of male infertility that can be treated by surgery or drugs. How to reduce the damage of VC to testicular spermatogenic function has attracted extensive attention in recent years. Among them, overexpressed ROS and high levels of inflammation may play a key role in VC-induced testicular damage. As the key mediated innate immune pathways, cGAS-STING shaft under pathological conditions, such as in cell and tissue damage stress can be cytoplasmic DNA activation, induce the activation of NLRP3 inflammatory corpuscle, triggering downstream of the inflammatory cascade reaction. Chlorogenic acid (CGA), as a natural compound from a wide range of sources, has strong anti-inflammatory and antioxidant activities, and is a potential effective drug for the treatment of varicocele infertility. The aim of this study is to investigate the role of CGA in the spermatogenic dysfunction of the rat testis induced by VC and the potential mechanisms. The results of this study have shown that CGA gavage treatment ameliorated the pathological damage of seminiferous tubules, increased the number of sperm in the lumen, and increased the expression levels of Occludin and ZO-1, which indicated the therapeutic effect of CGA on spermatogenic dysfunction in the testis of VC rats. Meanwhile, the damage of mitochondrial structure was alleviated and the expression levels of ROS, NLRP3 and pro-inflammatory cytokines (IL-1ß, IL-6, IL-18) were significantly reduced in the testicular tissues of model rats after CGA treatment. In addition, we demonstrated for the first time the high expression status of cGAS and STING in testicular tissues of VC model rats, and this was ameliorated to varying degrees after CGA treatment. In conclusion, this study suggests that CGA can improve the spermatogenic function of the testis by reducing mitochondrial damage and inhibiting the activation of the cGAS-STING axis, inhibiting the activation of the NLRP3 inflammasome, and improving the inflammatory damage of the testis, highlighting the potential of CGA as a therapeutic agent for varicocele infertility.

Ursolic acid alleviates chronic prostatitis via regulating NLRP3 inflammasome-mediated Caspase-1/GSDMD pyroptosis pathway.

Ursolic acid (UA) is a naturally occurring pentacyclic triterpenoid widely found in fruits and vegetables. It has been reported that UA has anti-inflammatory effects. However, its efficacy and mechanism of action in the treatment of chronic prostatitis (CP) remain unclear. This study aimed to investigate the efficacy of UA treatment in CP and further explore the underlying mechanism. CP rat and pyroptosis cell models were established in vivo and in vitro, respectively. The efficacy of UA in inhibiting CP was evaluated via haematoxylin-eosin (HE) staining and measurement of inflammatory cytokines. RNA sequencing and molecular docking were used to predict the therapeutic targets of UA in CP. The expression of pyroptosis-related proteins was examined using various techniques, including immunohistochemistry, immunofluorescence, and flow cytometry. UA significantly ameliorated pathological damage and reduced the levels of proinflammatory cytokines in the CP model rats. RNA sequencing analysis and molecular docking suggested that NLRP3, Caspase-1, and GSDMD may be key targets. We also found that UA decreased ROS levels, alleviated oxidative stress, and inhibited p-NF-κB protein expression both in vivo and in vitro. UA improved pyroptosis morphology as indicated by electron microscope and inhibited the expression of the pyroptosis-related proteins NLRP3, Caspase-1, ASC, and GSDMD, reversed the levels of IL-1ß, IL-18, and lactate dehydrogenase in vivo and in vitro. UA can mitigate CP by regulating the NLRP3 inflammasome-mediated Caspase-1/GSDMD pathway. Therefore, UA may be a potential for the treatment of CP.

Meta-analysis of 18 F-PSMA-1007 PET/CT, 18 F-FDG PET/CT, and 68Ga-PSMA PET/CT in diagnostic efficacy of prostate Cancer.

OBJECTIVE: To compare 18 F-PSMA-1007 PET/CT, 18 F-FDG PET/CT and 68Ga-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, 68Ga-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 68Ga-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 68Ga-PSMA PET/CT had higher diagnostic efficacy of prostate cancer compared with 18 F-FDG PET/CT, among which 68Ga-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.

Identification and immuno-infiltration analysis of cuproptosis regulators in human spermatogenic dysfunction.

Introduction: Cuproptosis seems to promote the progression of diverse diseases. Hence, we explored the cuproptosis regulators in human spermatogenic dysfunction (SD), analyzed the condition of immune cell infiltration, and constructed a predictive model. Methods: Two microarray datasets (GSE4797 and GSE45885) related to male infertility (MI) patients with SD were downloaded from the Gene Expression Omnibus (GEO) database. We utilized the GSE4797 dataset to obtain differentially expressed cuproptosis-related genes (deCRGs) between SD and normal controls. The correlation between deCRGs and immune cell infiltration status was analyzed. We also explored the molecular clusters of CRGs and the status of immune cell infiltration. Notably, weighted gene co-expression network analysis (WGCNA) was used to identify the cluster-specific differentially expressed genes (DEGs). Moreso, gene set variation analysis (GSVA) was performed to annotate the enriched genes. Subsequently, we selected an optimal machine-learning model from four models. Finally, nomograms, calibration curves, decision curve analysis (DCA), and the GSE45885 dataset were utilized to verify the predictions' accuracy. Results: Among SD and normal controls, we confirmed that there are deCRGs and activated immune responses. Through the GSE4797 dataset, we obtained 11 deCRGs. ATP7A, ATP7B, SLC31A1, FDX1, PDHA1, PDHB, GLS, CDKN2A, DBT, and GCSH were highly expressed in testicular tissues with SD, whereas LIAS was lowly expressed. Additionally, two clusters were identified in SD. Immune-infiltration analysis showed the existing heterogeneity of immunity at these two clusters. Cuproptosis-related molecular Cluster2 was marked by enhanced expressions of ATP7A, SLC31A1, PDHA1, PDHB, CDKN2A, DBT, and higher proportions of resting memory CD4+ T cells. Furthermore, an eXtreme Gradient Boosting (XGB) model based on 5-gene was built, which showed superior performance on the external validation dataset GSE45885 (AUC = 0.812). Therefore, the combined nomogram, calibration curve, and DCA results demonstrated the accuracy of predicting SD. Conclusion: Our study preliminarily illustrates the relationship between SD and cuproptosis. Moreover, a bright predictive model was developed.

Relationship between pyroptosis-mediated inflammation and the pathogenesis of prostate disease.

The largest solid organ of the male genitalia, the prostate gland, is comprised of a variety of cells such as prostate epithelial cells, smooth muscle cells, fibroblasts, and endothelial cells. Prostate diseases, especially prostate cancer and prostatitis, are often accompanied by acute/chronic inflammatory responses or even cell death. Pyroptosis, a cell death distinct from necrosis and apoptosis, which mediate inflammation may be closely associated with the development of prostate disease. Pyroptosis is characterized by inflammasome activation via pattern recognition receptors (PRR) upon recognition of external stimuli, which is manifested downstream by translocation of gasdermin (GSDM) protein to the membrane to form pores and release of inflammatory factors interleukin (IL)-1ß and IL-18, a process that is Caspase-dependent. Over the past number of years, many studies have investigated the role of inflammation in prostate disease and have suggested that pyroptosis may be an important driver. Understanding the precise mechanism is of major consequence for the development of targeted therapeutic strategies. This review summarizes the molecular mechanisms, regulation, and cellular effects of pyroptosis briefly and then discuss the current pyroptosis studies in prostate disease research and the inspiration for us.

Research trends and hotspots of recurrent pregnancy loss with thrombophilia: a bibliometric analysis.

BACKGROUND: Thrombophilia is a group of disorders that result in a blood hypercoagulable state and induce thrombosis, which was found widely existed in recurrent pregnancy loss (RPL). More and more research about thrombophilia has been conducted but the association between thrombophilia and RPL remains uncertain. Thus, it's necessary to combine relevant literature to find the research hotspots and analyze the internal link between different study points, and then predict the development trend in RPL with thrombophilia. METHODS: Relevant articles between 1970 and 2022 were obtained from the Web of Science (WoS) database. Software VOSviewer and CiteSpace were used to perform the analysis and conduct visualization of scientific productivity and emerging trends. RESULTS: Seven hundred twenty-five articles published in recent 30 years by 3205 authors from 1139 organizations and 68 countries were analyzed. 37authors, 38 countries, and 53 organizations published papers ≥5. The United States was the most productive country and Univ Amsterdam was the most productive institution. Journal thrombosis and haemostasis had the most total citations. In keyword and clusters, factor-v-Leiden, inherited thrombophilia, activated protein-c, low-dose aspirin, molecular-weigh heparin, polymorphism had high-frequency focus on its etiology, diagnostics, and therapeutics. The strongest keyword bursts showed the research hotspots changed over time. CONCLUSIONS: There could be differences in the clinical relevance of different type of thrombophilia, as well as single and multiple thrombophilic factors. Anticoagulation and immunotherapy are currently the main treatment options. More clinical trials and basic research are expected and we should attach more attention to the whole management of in-vitro fertilization in the future.

Quality assessment and relevant clinical impact of randomized controlled trials on chronic prostatitis/chronic pelvic pain syndrome.

OBJECTIVE: This study evaluated the quality of randomized controlled trials (RCTs) on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS: We searched PubMed, Web of Science, and Embase for RCTs (original articles) on CP/CPPS published from database establishment to 2021. The RCT quality assessment was performed using the Consolidated Standards of Reporting of Trials (CONSORT) statement and the improved Jadad scale. RESULTS: In total, 77 RCTs were included. According to the evaluation, 26 (33.77%) papers presented the description of the specific random methods, only 6 (7.79%) papers described the allocation concealment methods, and 26 (33.77%) articles referred to the "blind method". Of the RCTs, 34 (44.16%) papers recorded the number of patients who withdrew from the study, and 67 (87.01%) papers reported adverse reactions. However, few reports mentioned the sample size calculation, clinical trial registration, or information about the relevant research programs and funding. In addition, 19 (24.68%) reports had Jadad scale scores of ≥ 4 points, and 58 (75.32%) reports had Jadad scale scores of ≤ 3 points. CONCLUSION: To date, the quality of RCT reports on CP/CPPS needs to be further improved, and the results of the RCTs should be accepted and utilized cautiously. It is suggested that researchers should follow the CONSORT statement and the improved Jadad scale to standardize the design and implementation of RCTs to improve the quality of RCTs and provide reliable evidence for the treatment of CP/CPPS.

Investigating the multi-target therapeutic mechanism of Guihuang formula on Chronic Prostatitis.

ETHNOPHARMACOLOGICAL RELEVANCE: Chronic prostatitis (CP) is a complex, intractable and prevalent urological disorder in men with no effective treatment. Guihuang formula (GHF) is a traditional Chinese medicine compound that is advantageous as a CP treatment, but its aetiology is poorly understood. Research and exploration of the mechanism of GHF will help the development of a potentially valuable drug for CP and provide deeper insight into CP. AIM OF THE STUDY: To examine and further clarify the multi-target therapeutic mechanism of GHF on CP. MATERIALS AND METHODS: The chemical components in GHF were identified using UPLC-Q/TOF-MS. The active components and potential targets of GHF for the treatment of CP were screened and analyzed using network pharmacology and molecular docking. We constructed a CP rat model to investigate the therapeutic effect of GHF on CP and verify the influence of key targets and core pathways based on the results of network pharmacology. RESULTS: A total of 143 ingredients were identified in GHF using UPLC-Q/TOF-MS, and 111 potential targets for GHF of CP were predicted. The "drug-ingredient-target-pathway" network was constructed and in compliance with the "Jun-Chen-Zuo-Shi" principle. GHF significantly reduced the prostate index, alleviated histological damage in the prostate, decreased CD3+ T cells and CD45+ leukocyte infiltration in the prostate, downregulated the expression of the proinflammatory cytokines IL-1ß, IL-6, IL-18, COX-2, MCP-1 and TNF-α, decreased ROS levels and alleviated the production of MDA accompanied by an increase of SOD and GSH-PX levels. Meanwhile, GHF suppressed apoptosis in macrophages, downregulated the mRNA levels of PI3K, AKT and P65 NF-κB and inhibited the phosphorylation of the PI3K, AKT and P65 NF-κB. CONCLUSION: A network pharmacology and experimental validation-based strategy was used to elucidate the underlying "multicomponent, multitarget, and multipathway" mode of action of GHF against CP. We verified that GHF inhibited oxidative stress and inflammatory response, suppressed apoptosis in macrophages, inhibited the activation of the inflammation-related PI3K/AKT/NF-κB pathway in CP rat. These findings extend the conventional views of "one drug hits one target", and offer novel insights and indication paradigm for the future discovery on the multi-target therapeutic mechanism of traditional Chinese medicine compound.

The Efficacy of Acupuncture on Patients with Erectile Dysfunction: A Review.

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.

Efficacy and Safety of Guihuang Formula in Treating Type III Prostatitis Patients with Dampness-Heat and Blood Stasis Syndrome: A Randomized Controlled Trial.

OBJECTIVE: To observe the efficacy and safety of Guihuang Formula (GHF) in treating patients with type III prostatitis and Chinese medicine syndrome of dampness-heat and blood stasis. METHODS: Sixty-six patients diagnosed with type III prostatitis with dampness-heat and blood stasis syndrome were randomly divided into the treatment group (GHF) and the control group (tamsulosin) using a random number table, with 33 cases each group. The treatment group received GHF twice a day, and the control group received tamsulosin 0.2 mg once daily before bedtime. Patients in both groups received treatment for 6 weeks and was followed up for 2 weeks. The outcomes included the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score, Chinese Medicine Symptoms Score (CMSS), expressed prostatic secretions (EPS) and adverse events (AEs). RESULTS: After treatment, the NIH-CPSI total score and domain scores of pain discomfort, urination and quality of life decreased significantly from the baseline in both groups (P<0.05). The CMSS score decreased in both groups (P<0.05). The WBC count decreased and lecithin body count increased in both groups (P<0.05). GHF showed a more obvious advantage in reducing the pain discomfort and quality of life domain scores of NIH-CPSI, reducing the CMSS score, increasing the improvement rate of the WBC and lecithin body counts, compared with the control group (P<0.05). There were no significant differences in decreasing urination domain score of NIH-CPSI between two groups (P>0.05). In addition, no serious AEs were observed. CONCLUSION: GHF is effective in treating type III prostatitis patients with dampness-heat and blood stasis syndrome without serious AEs. (Registration No. ChiCTR1900026966).

Knowledge domain and emerging trends in chronic prostatitis/chronic pelvic pain syndrome from 1970 to 2020: a scientometric analysis based on VOSviewer and CiteSpace.

BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common urological disease, and research on CP/CPPS has increased over the past 50 years. However, few studies have statistically analyzed these publications. In this work, we conducted the knowledge domain and highlighted current research hotspots and emerging trends in CP/CPPS from 1970 to 2020 based on VOSviewer and CiteSpace. METHODS: Relevant original articles were obtained from the Web of Science (WoS) database between 1970 and 2020. VOSviewer and CiteSpace software were used to perform the analysis and visualization of scientific productivity and emerging trends. RESULTS: Our results show that the articles related to CP/CPPS have dramatically increased every year from 1 publication in 1970 to 111 publications in 2020. The USA dominated the field in all countries, and Queen's University (Canada) has more extensive cooperating relationships with other institutions. J. Curtis Nickel may have a significant influence on CP/CPPS research with more publications and cocitations. The Journal of Urology is the foremost productive journal and has the most citations of all the journals. A total of 11 major clusters were explored based on the reference cocitation analysis (RCA). Definition, incidence rate or clinical characteristics, etiology or pathogenesis, epidemiological studies (cross-sectional study and cohort study), clinical studies (inflammation, pain, lower urinary tract symptoms (LUTS), α-blockers, antibiotic) and relationships with other diseases [benign prostatic hyperplasia (BPH), prostate cancer, sexual dysfunction] are the knowledge bases for CP/CPPS research. The treatment mode also changed gradually from anti-inflammatory therapy to symptom improvement, and NIH-CPSI was taken as the evaluation criterion. CONCLUSIONS: This scientometric study comprehensively reviewed publications related to CP/CPPS during the past 50 years using quantitative and qualitative methods, and the information provides some references for scholars to conduct further research on CP/CPPS.

Network Pharmacology-Based Strategy to Investigate Pharmacological Mechanisms of the Drug Pair Astragalus-Angelica for Treatment of Male Infertility.

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.

The role of cytoreductive nephrectomy in renal cell carcinoma patients with liver metastasis.

It is widely accepted that renal cell carcinoma (RCC) with liver metastasis (LM) carries a dismal prognosis. We aimed to explore the value of cytoreductive nephrectomy among these patients. Patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2017. The univariate and multivariate Cox proportional hazards models were conducted to select the prognostic predictors of survival. Patients were divided into nephrectomy and non-nephrectomy groups. Propensity score-matching (PSM) analyses were applied to reduce the above factors' differences between the groups. Overall survival (OS) was compared by Kaplan-Meier analyses. Data from 683 patients were extracted from the database. The univariate Cox regression and multivariate Cox regression revealed that factors including age, histologic type, T and N stages, lung metastasis, brain metastasis, and nephrectomy were significant predictors of survival in the patients. After the PSM analyses, we found that nephrectomy prolonged OS. Nephrectomy can prolong OS in eligible RCC patients with LM.

[Mechanisms of Huanshao Capsules protecting the reproductive function in rats with ornidazole-induced asthenozoospermia].

OBJECTIVE: To explore the possible mechanism of Huanshao Capsules (HSC) protecting the reproductive function in rats with ornidazole-induced asthenozoospermia (AZS). METHODS: Forty SD male rats were randomly divided into four groups of equal number, blank control, AZS model control, HSC and L-carnitine (LC) intervention. The AZS model was established in the latter three groups of rats by intragastrical administration of ornidazole at 400 mg/kg/d for 28 days, and meanwhile the animals in the HSC and LC groups were treated by gavage of HSC at 0.31 g/kg/d and LC at 100 mg/kg/d, respectively. Then, all the rats were killed for examination of the LC content, sperm concentration, sperm motility and expression of OCTN2 mRNA in the epididymis and observation of the histopathological changes in the testis tissue. RESULTS: Compared with the AZS model controls, the rats in the HSC and LC groups showed significantly increased LC content (2 880.3 vs 6 366.5 and 6 934.7 mg/L, P < 0.01), sperm concentration (ï¼»34.58 ± 10.25ï¼½ vs ï¼»46.19 ± 14.23ï¼½ and ï¼»42.25 ± 6.11ï¼½ ×106/ml, P < 0.01), sperm motility (ï¼»42.59 ± 7.54ï¼½% vs ï¼»61.34 ± 7.98ï¼½% and ï¼»61.34 ± 7.98ï¼½%, P < 0.01) and expression of OCTN2 mRNA in the epididymis (26.07% vs 27.26% and 27.15%, P < 0.01). The animals of the HSC group exhibited a higher comparability than those of the LC group to the blank controls in the morphology, arrangement and activity of spermatogenic cells. CONCLUSIONS: HSC can protect the reproductive function and improve sperm concentration and motility in the model rats with ornidazole-induced AZS, which may be associated with its abilities of up-regulating the expression of OCTN2 mRNA and increasing the LC content in the epididymis.

[Effect and safety of the Chinese medicine Qianlieshutong Capsules in the treatment of benign prostatic hyperplasia: A meta-analysis].

OBJECTIVE: To evaluate the effect and safety of Qianlieshutong Capsules (QC) in the treatment of BPH. METHODS: We searched 10 Chinese and English databases up to July 2019 for randomized controlled trials (RCT) on treatment of BPH with QC followed by a meta-analysis on the included articles using Cochrane Handbook 5.1.0 and Revman5.3 software. RESULTS: A total of 18 RCTs involving 1 802 cases of BPH were included out of the 175 articles identified. The baseline data from the RCTs were all comparable. Compared with the controls, the patients treated with QC showed a significantly higher rate of clinical effectiveness and better improvement in IPSS as well as in the maximum urinary flow rate (Qmax), postvoid residual urine (PVR) and prostate volume after 3 months of medication. No serious adverse drug events or reactions were reported. CONCLUSIONS: The existing data and methodology indicate the efficacy and safety of Qianlieshutong Capsules in the treatment of BPH, which, however, has to be further verified by more well-designed large-sample multi-center high-quality randomized controlled trials.

[Linggui Fang protects the reproductive system of asthenospermia rats: An experimental study based on the L-carnitine pathway].

OBJECTIVE: To explore the protective effect of the Chinese medicinal prescription Linggui Fang (LGF) on the reproductive system of the ornidazole-induced asthenospermia (AS) rat and its possible action mechanisms. METHODS: Forty male SD rats weighing 200－230 g were equally randomized into four groups, blank control, AS model control, LGF treatment and L-carnitine (LC) intervention. The AS models were made in the latter three groups by intragastrical administration of ornidazole at 400 mg/kg. Meanwhile, the rats in the LGF group were treated intragastrically with LGF at 17.5 g/kg, those in the LC group with LC at 100 mg/kg, and the control animals with 0.5% sodium carboxymethylcellulose (CMC-Na), all once a day for 4 successive weeks. Then, all the rats were sacrificed for examination of the semen parameters, determination of the LC content and OCTN2 mRNA expression in the epididymis and observation of the histopathological changes in the testis. RESULTS: Compared with the AS model controls, the rats in the other groups showed significantly higher percentages of progressively motile sperm and total motile sperm (P < 0.01) as well as a higher LC content in the epididymis (P < 0.01), but no statistically significant difference in sperm concentration (P > 0.05). The expression of OCTN2 mRNA was remarkably upregulated in the LGF and LC groups in comparison with that in the AS model control (P < 0.05). Compared with the rats in the blank control group, the AS model controls exhibited markedly increased morphologically abnormal seminiferous tubules, irregularly arranged, with narrowed lumens and reduced numbers of sperm and sperm cells, as well as significantly increased hollow seminiferous tubules with deficient and disorderly arranged spermatogenic cells and partial epithelial degeneration and vacuolization. Those in the LGF and LC groups, however, manifested almost normal testicular histomorphology, with basically regular arrangement of different layers of seminiferous tubules. CONCLUSIONS: ①Ornidazole induces AS in rats by reducing the LC content in the epididymis, while LGF can improve the sperm motility and testicular morphology of the rats and upregulate the expression of OCTN2 mRNA in the epididymis by increasing the LC concentration.