The significance and diagnostic value of semen analysis in chronic bacterial prostatitis has been extensively debated and remains controversial. To investigate the diagnostic relevance of semen culture in the bacterio...The significance and diagnostic value of semen analysis in chronic bacterial prostatitis has been extensively debated and remains controversial. To investigate the diagnostic relevance of semen culture in the bacteriological workup of prostatitis patients, we retrospectively analyzed a clinical database of 696 symptomatic patients. All patients were routinely subjected to a four-glass test, followed by semen culture and analysis. This allowed to dissect from the database three different diagnostic scenarios, and to compare the ＇two-glass＇ pre-/post- massage test and the standard ＇four-glass＇ test with a ＇five-glass＇ test （four-glass plus post-VB3 semen culture）. The ＇five-glass＇ test showed 3.6- or 6.5-fold increases in relative sensitivity and lesser reductions （-13.2% or -14.7%） in relative specificity for traditional uropathogens （TUs） compared with the four-glass or two-glass test, respectively. The area under the ROC curve and Jouden＇s index were increased, whereas positive and negative likelihood ratios were lower than comparators, indicating that the ＇five-glass＇ assay may be superior in confirming the negative outcome of both standard tests. The five-, four-, and two-glass tests detected TUs （Enterobacteriaceae, Enterococci, etc.） in 120, 33, and 20 patients and unusual pathogens （Streptococci, other Gram-positive species, Mycoplasmata, and others） in 130, 56, and 45 patients, respectively. When patients were subjected to pharmacological treatment, including a combination of a fluoroquinolone and a macrolide, no differences in eradication rates were observed between groups diagnosed with different tests, irrespective of pathogen category. Eradication was associated with long-term sign/symptom remission; no significant intergroup differences in sign/symptom scores were observed throughout a 24-month off-therapy follow-up period. In conclusion, our data support the usefulness of semen analysis in the diagnostic workup ofprostatitis patients when this test is used to complement the four-glass Meares and Stamey test. Improvement of microbiological assays conveys important diagnostic and therapeutic implications.展开更多
The aim of this study is to observe the therapeutic effect of Inonotus Obliquus Polysaccharide(IOP)on chronic nonbacterial prostatitis(CNP)and its effect on the helper T cells(Th17)and regulatory T cells(Treg)immune i...The aim of this study is to observe the therapeutic effect of Inonotus Obliquus Polysaccharide(IOP)on chronic nonbacterial prostatitis(CNP)and its effect on the helper T cells(Th17)and regulatory T cells(Treg)immune imbalance.The CNP rat models established by injecting Xiaozhiling injection were randomly divided into the model group,cernilton(40 mg/kg,i.g.)group and low-dose(35 mg/kg,i.g.),medium-dose(70 mg/kg,i.g.)and high-dose(140 mg/kg,i.g.)groups,with the same volume of saline injected into the same site as the control group.The prostate’s wet weight and body mass served as the basis for calculating the prostate index.The serum level of prostate-specific antigen(PSA)was detected by ELISA and the histopathology of prostate tissue was detected by HE staining.The protein expression of Foxp3,ROR-γt and STAT3 in rat prostatic tissue was determined by Western blot.The levels of Th17 and Treg cells infiltrated into the spleen were measured by flow cytometry.The results showed that treatment with IOP significantly reduced the levels of prostate index and serum PSA,and attenuated the pathological injury of the prostate tissue induced by CNP.With respect to samples induced by CNP alone,IOP treatment repressed the increased mRNA levels of IL-6,IL-17,IL-21,IL-23,ROR-γt and STAT3 in prostate tissue,while increasing the mRNA levels of IL-10,TGF-βand Foxp3 in prostate tissue.Meanwhile,IOP treatment attenuated the upregulation of the protein expression levels of ROR-γt and STAT3 in prostate tissue.Additionally,the protein expression of Foxp3 in prostate tissue was increased in the IOP-treated group.Flow cytometry analysis further demonstrated that IOP treatment regulated the balance between Th17 and Treg cells in the spleen in rat with CNP.Our study is the first to elucidate that IOP has significant therapeutic effects on CNP through regulation of Th17/Treg balance.Collectively,the study provides evidence for the potential of IOP to treat CNP.展开更多
We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category Ⅱ chronic bacterial prostatitis （CBP）. The aim of this study is to retrospectively compare the microbi...We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category Ⅱ chronic bacterial prostatitis （CBP）. The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin （500 rag, thrice-weekly） with a once-daily 500- or 750-mg dose of ciprofloxacin （Cipro-500 or Cipro-750 cohort, respectively）. Combined administration of azithromycin （1500 mg week^-1） with ciprofloxacin at the rate of 750 mg day^- 1 for 4 weeks rather than at 500 mg day^- 1 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen （PSA） were sustained throughout an 18-month follow-up period in both groups. Ejaculatory pain, haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups, but the latter subsided more promptly in the Cipro-750 cohort. In total, 59 Cipro-750 patients showed mild-to-severe erectile dysfunction （ED） at baseline, while 22 patients had no ED on microbiological eradication and throughout the follow-up period. In conclusion fluoroquinolone-macrolide therapy resulted in pathogen eradication and CBP symptom attenuation, including pain, voiding disturbances and sexual dysfunction. A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks. Our results are open to further prospective validation.展开更多
OBJECTIVE:To investigate the protective effects of Guilong prescription(归龙方,GL)on chronic prostatitis(CP)and unravel the underlying mechanisms of its pharmacological effects.METHODS:The composition of GL was determ...OBJECTIVE:To investigate the protective effects of Guilong prescription(归龙方,GL)on chronic prostatitis(CP)and unravel the underlying mechanisms of its pharmacological effects.METHODS:The composition of GL was determined via linear ion trap/electrostatic field orbital trap tandem highresolution mass spectrometry,and the identified compounds were performed network pharmacological analysis to predict possible pathways of the effects of GL on CP.A CP rat model was established by carrageenan,and rats were randomly assigned into a Control group,Sham group,CP group,GL low dose(3.5 g/kg)group,GL medium dose(7 g/kg)group,and GL high dose(14 g/kg)group.Hematoxylin-eosin staining of the prostate,and prostate blood-perfusion measured by laser speckle contrast analysis were used to evaluate the efficacy of GL.Expression of intercellular cell adhesion molecule-1(ICAM-1)and induce nitric oxide synthase(i NOS)were determined by immunohistochemistry,and the content of interferon-γ(IFN-γ),interleukin-1β(IL-1β),interleukin-4(IL-4),interleukin-10(IL-10),chemokine ligand 1(CXCL1)and tumor necrosis factor-α(TNF-α)were determined by electro-chemiluminescence assays.The expression of p38 mitogen-activated protein kinase(p38 MAPK),phosphatidylinositol 3-kinase(PI3K),ribosomeassociated complex-alpha serine/threonine-protein kinase(Akt),nuclear factor-κ-gene binding p65(NF-κB p65),inhibitor of NF-κB-α(IκBα),glycogen synthase kinase-3β(GSK-3β),and their phosphorylated forms were tested by Western blot.RESULTS:In GL,a total of 48 compounds were identified,including 14 flavonoids,14 alkaloids,11 carboxylic acids,4 lactones,2 glycosides,2 terpenoids and 1 aldehyde.Network pharmacological analysis suggested that the mechanism of GL may be related to PI3K-Akt signaling pathway and cytokine expression.After treatment with GL,inflammatory pathological changes in the prostate of rats were significantly improved,and blood perfusion of the prostate was significantly decreased.GL reduced the expression of IFN-γ,CXCL1,TNF-α,IL-1β,i NOS,ICAM-1,p38 MAPK,p-p38 MAPK,PI3K,p-PI3K,NF-κB,p-NF-κB,IκBα,p-IκBα,GSK-3β,p-GSK-3β,p-Akt in CP rats,and increased the expression of IL-4 and IL-10 in CP rats.CONCLUSION:The chemical compositions of GL were first identified.GL can improve pathological changes in the prostate and recover the prostate blood perfusion of CP rats.The possible mechanisms of GL on CP involve increasing the expression of anti-inflammatory cytokines IL-4 and IL-10,inhibiting pro-inflammatory cytokines TNF-α,IL-1β,and IFN-γ,and down regulating the expression of CXCL1,i NOS,and ICAM-1 via inhibiting PI3K-Akt and NF-κB signaling pathway.展开更多
The expressed prostatic secretions （EPSs） of men with chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）, infertile men and normal men were subjected to microbiological study. EPSs were collected from the ...The expressed prostatic secretions （EPSs） of men with chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）, infertile men and normal men were subjected to microbiological study. EPSs were collected from the subjects, which included 26 normal men, 11 infertile patients and 51 CP/CPPS patients. DNA was extracted from each specimen, and the V3 regions of the 16S rRNA genes were amplified using universal bacterial primers. The results showed that the EPS 16S rRNA gene-positive rate in the CP/CPPS and infertile patients was much higher than in the normal men, but without any difference among the three patient groups. The denaturing gradient gel electrophoresis （DGGE） method was used to characterize the EPS bacterial community structure of the prostate fluid from patients with CP/CPPS or infertility issues. Principal component analysis （PCA） and partial least squares （PLS） analyses of PCR-DGGE profiles revealed that the EPS bacterial community structure differed among the three groups. Three bands were identified as the key factors responsible for the discrepancy between CP/CPPS patients and infertile patients （P〈O.05）. Two bands were identified as priority factors in the discrepancy of category IliA and category IIIB prostatitis patients （P〈O.05）. According to this research, the ecological balance of the prostate and low urethra tract, when considered as a microenvironment, might play an important role in the maintenance of a healthy male reproductive tract.展开更多
Qian Lie Xian Yan Suppository (前列腺炎栓) was rectally applied to treat 104 patients with nonspecific chronic prostatitis ( damp-heat syndrome with blood stasis) in contrast to 30 patients treated with traditional Ch...Qian Lie Xian Yan Suppository (前列腺炎栓) was rectally applied to treat 104 patients with nonspecific chronic prostatitis ( damp-heat syndrome with blood stasis) in contrast to 30 patients treated with traditional Chinese drug Ye Ju Hua Shuan (野菊花栓Suppository of Flos Chrysanthemi Indici). The results show that chronic prostatitis is markedly improved by using Qian Lie Xian Yan suppository, with a short-term cure rate of 23.1% and a total effective rate of 84.6%, superior to that of the control group. The animal experiment indicates that Qian Lie Xian Yan suppository has better anti-inflammatory and analgesic effects, with an action of promoting blood circulation.展开更多
Objective To observe the clinical effects of chronic non-bacterial prostatitis treated with warm needling moxibustion. Methods One hundred and twenty-five cases were randomly divided into warm needling moxibustion gro...Objective To observe the clinical effects of chronic non-bacterial prostatitis treated with warm needling moxibustion. Methods One hundred and twenty-five cases were randomly divided into warm needling moxibustion group （42 cases）, acupuncture group （41 cases） and western medicine group （42 cases）. Of which, in warm needling moxibustion group, acupuncture combined with warming acupuncture were provided①puncture on Shènshū（肾俞 BL 23）, Gānshū （肝俞BL 18） and Zhìbiān （秩边BL 54） without retention of needles,②Guānyuán （关元CV 4）, Zhō ngjí （ 中极CV 3）, Yīnlíngquán （ 阴陵 GB 34） and Sānyīnjiāo （三阴交 SP 6） ,with warming acupuncture, once a day; in acupuncture group, the prescriptions and needling technique were the same as those in warm needling moxibustion group, without moxibustion; in western medicine group, Cernilton was applied twice a day, one pill for each time. After one course treatment, the therapeutic effects and NIH-Chronic Prostatitis Symptom Index （NIH-CPSI） of 3 groups were compared. Results The total effective rate was 88. 10% in warm needling moxibustion group, 63.41% in acupuncture group, and 66.67% in western medicine group. The clinical effect in warm needling moxibustion group was superior to that in either acupuncture group or western medicine group （both P〈0.05）. The score of NIH-CPSI was 11.92 ±7.11 in warm needling moxibustion group, 16.08±6.83 in acupuncture group, and 15.66±5.88 in western medicine group. The score of each group was obviously reduced （both P〈0.01 ） after treatments, in which, the reduction in warm needling moxibustion group was most obvious （both P〈0.0t）. Conclusion A good therapeutic effect of chronic non-bacterial prostatitis was received by warm needling moxibustion.展开更多
The urinary, psychosocial, organ-specific, infection, neurological/systemic and tenderness （UPOINT） phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prosta...The urinary, psychosocial, organ-specific, infection, neurological/systemic and tenderness （UPOINT） phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS） in western populations. To validate the utility of the UPOINT system and evaluate the effect of multimodal therapy based on the UPOINT system in Chinese patients with CPICPPS, we performed this study. Chinese patients with CP/CPPS were prospectively offered multimodal therapy using the UPOINT system and re-examined after 6 months. A minimum 6-point drop in National Institutes of Health-Chronic Prostatitis Symptoms Index （NIH-CPSI） was set to be the primary endpoint. Finally, 140 patients were enrolled in the study. The percentage of patients with each domain was 59.3%, 45.0%, 49.3%, 22.1%, 37.9%, and 56.4% for the UPOINT, respectively. The number of positive domains significantly correlated with symptom severity, which is measured by total NIH-CPSI scores （r = 0.796, P 〈 0.001）. Symptom duration was associated with a greater number of positive domains （r = 0.589, P〈 0.001）. With 6 months follow-up at least, 75.0% （105/140） had at least a 6-point improvement in NIH-CPSI after taking the therapy. All NIH-CPSI scores were significantly improved from original ones： pain 10.14 ± 4.26 to 6.60 ± 3.39, urinary 6.29 ± 2.42 to 3.63 ± 1.52, quality of life 6.56 ± 2.44 to 4.06 ± 1.98, and total 22.99 ± 7.28 to 14.29 ±5.70 （all P〈 0.0001）. Our study indicates that the UPOINT system is clinically feasible in classifying Chinese patients with CP/CPPS and directing therapy.展开更多
Aim： To investigate whether chronic bacterial prostatitis might increase oxidative stress and oxidative damage in chronic bacterial prostatitis patients （CBPP）, and to explore its possible mechanism. Methods： Enro...Aim： To investigate whether chronic bacterial prostatitis might increase oxidative stress and oxidative damage in chronic bacterial prostatitis patients （CBPP）, and to explore its possible mechanism. Methods： Enrolled in a casecontrol study were 70 randomly sampled CBPP and 70 randomly sampled healthy adult volunteers （HAV）, on whom plasma nitric oxide （NO）, vitamin C （VC）, vitamin E （VE） and β-carotene （β-CAR） level, erythrocyte malondialdehyde （MDA） level, as well as erythrocyte superoxide dismutase （SOD）, catalase （CAT） and glutathione peroxidase （GPX） activities were determined by spectrophotometry. Results： Compared with the HAV group, values of plasma NO and erythrocyte MDA in the CBPP group were significantly increased （P 〈 0.001）; those of plasma VC, VE and β-CAR as well as erythrocyte SOD, CAT and GPX activities in the CBPP group were significantly decreased （P 〈 0.001）. Findings from partial correlation for the 70 CBPP showed that with prolonged course of disease, values of NO and MDA were gradually increased （P 〈 0.001）, and those of VC, VE, β-CAR, SOD, CAT and GPX were gradually decreased （P 〈 0.05- 0.001）. The findings from stepwise regression for the 70 CBPP suggested that the model was Y= -13.2077 ＋ 0.1894MDA ＋ 0.0415NO - 0.1999GPX, F = 18.2047, P 〈 0.001, r = 0.6729, P 〈 0.001. Conclusion： The findings suggest that there exist increased oxidative stress and oxidative damage induced by chronic bacterial prostatitis in the patients, and such phenomenon was closely related to the course of disease.展开更多
The aim of this study is to assess the status of treatment of chronic prostatitis(CP)in Chinese men.A population-based cross-sectional survey was performed,in which 15000 men aged between 15 and 60 years were randomly...The aim of this study is to assess the status of treatment of chronic prostatitis(CP)in Chinese men.A population-based cross-sectional survey was performed,in which 15000 men aged between 15 and 60 years were randomly selected to receive a questionnaire designed to assess National Institutes of Health Chronic Prostatitis Symptoms Index(NIH-CPSI)status,therapeutic efficacy and 28 other items.A total of 12743 men(84.95%)completed the questionnaire,of whom 1071(8.4%)were identified as having prostatitis-like symptoms and 517(4.5%)were diagnosed with CP according to NIH-CPSI criteria and prostatitis-like symptomatology.Of the CP patients,372(65%)underwent long-term routine treatment 12 times per year.Additionally,217(72.8%)patients received antibiotic therapy and 215(79.3%)men showed therapeutic effects.The treatment cost USD 1151(8059 yuan)per person per year on average.Most CP patients received routine treatment,in most cases with antibiotics.Treatment was costly and most CP patients were not satisfied with its effectiveness.Antibacterial treatment might have been effective primarily in patients with bacterial disease.展开更多
Levofloxacin is a synthetic fluoroquinolone that is usually used to treat chronic bacterial prostatitis. We investigated the safety and efficacy of levofloxacin compared with ciprofloxacin for the treatment of chronic...Levofloxacin is a synthetic fluoroquinolone that is usually used to treat chronic bacterial prostatitis. We investigated the safety and efficacy of levofloxacin compared with ciprofloxacin for the treatment of chronic bacterial prostatitis in Chinese patients. This was a multicenter, open-label, randomized controlled non-inferiority trial. Four hundred and seventy-one patients with clinical symptoms/ signs were enrolled into the study, and 408 patients were microbiologically confirmed chronic bacterial prostatitis, who were randomized to either oral levofloxacin （500 mg q,d.） or ciprofloxacin （500 mg b.i^d.） for 4 weeks. Bacterial clearance rate, clinical symptoms/signs, adverse reactions and disease recurrence were assessed. The clinical symptoms and signs （including dysuria, perineal discomfort or pain） and bacteria cultures in 209 patients treated with levofloxacin and 199 patients treated with ciprofloxacin were similar. The most common bacteria were Escherichia cofiand Staphylococcus aureus. One to four weeks after the end of 4 weeks treatment, the bacterial clearance rate （86.06% vs. 60.03%; P〈O.05） and the clinical efficacy （including clinical cure and clinical improvement（93.30% vs. 71.86%; P〈0.05）） were significantly higher in the levofloxacin-treated group than in the ciprofloxacin-treated group. The microbiological recurrence rate was significantly lower in the levofloxacin-treated group than in the ciprofloxacin-treated group （4.00% vs. 19.25%; P〈0.05）. Rates of adverse events and treatment-related adverse events were slightly lower in the levofloxacin-treated group than in ciprofloxacin-treated group. Levofloxacin showed some advantages over ciprofloxacin in terms of clinical efficacy and disease recurrence, with a low rate of adverse events, for the treatment of chronic bacterial prostatitis in Chinese patients.展开更多
Some published evidence has revealed that the dendritic cells can interact with pathogens that exist in the inner foreskin. This information provides a new vision that pathogens could play a role through the redundant...Some published evidence has revealed that the dendritic cells can interact with pathogens that exist in the inner foreskin. This information provides a new vision that pathogens could play a role through the redundant prepuce; numerous studies have failed to find pathogens in prostates of patients who had chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）. However, no studies have reported an association between foreskin length and CP/CPPS. Hence, we conducted a retrospective case-control study of clinical data from 322 CP/CPPS patients （case group） and 341 nonCP/CPPS patients （control group）. Demographic characteristics, lifestyle factors, and foreskin lengths were collected and analyzed. Multivariate logistic regression was adopted to calculate the odds of foreskin length for CP/CPPS. According to the multivariate logistic regression results, when the foreskin length covered up more than half of the glans penis, the odds for CP/CPPS were higher with an increased foreskin （odds ratio （OR）： 1.66, 95% confidence interval （CI）： 1.04-2.66）. In comparison, when the glans penis was completely covered by the foreskin, the OR value increased to 1.86 （95% CI, 1.2-2.88）. The study results showed an association between foreskin length and the odds of CP/CPPS. When the foreskin length covered up more than half of the glans penis, there were greater odds for CP/CPPS. This possible mechanism might result from interaction between pathogens and DCs in the inner foreskin, consequently activating T-cells to mediate allergic inflammation in the prostate and producing the autoimmunizations causing CP/CPPS.展开更多
This study aims to validate our hypothesis that acid-sensing ion channels （ASICs） may contribute to the symptom of pain in patients with chronic prostatitis （CP）. We first established a CP rat model, then isolated...This study aims to validate our hypothesis that acid-sensing ion channels （ASICs） may contribute to the symptom of pain in patients with chronic prostatitis （CP）. We first established a CP rat model, then isolated the L5-S2 spinal dorsal horn neurons for further studies. ASICla was knocked down and its effects on the expression of neurogenic inflammation-related factors in the dorsal horn neurons of rat spinal cord were evaluated. The effect of ASICla on the Ca2＋ ion concentration in the dorsal horn neurons of rat spinal cord was measured by the intracellular calcium （[Ca~＊]i） intensity. The effect of ASICla on the p38/mitogen-activated protein kinase （MAPK） signaling pathway was also determined. ASICla was significantly upregulated in the CP rat model as compared with control rats. Acid-induced ASICla expression increased [Ca2＋]i intensity in the dorsal horn neurons of rat spinal cord. ASICla also increased the levels of neurogenic inflammation-related factors and p-p38 expression in the acid-treated dorsal horn neurons. Notably, ASICla knockdown significantly decreased the expression of pro-inflammatory cytokines. Furthermore, the levels of p-p38 and pro-inflammatory cytokines in acid-treated dorsal horn neurons were significantly decreased in the presence of PcTx-1, BAPTA-AM, or SB203580. Our results showed that ASIC1a may contribute to the symptom of pain in patients with CP, at least partially, by regulating the p38/MAPK signaling pathway.展开更多
This study aimed to assess the association between psychological disorders and erectile dysfunction(ED)in patients with different degrees of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).This was a retrosp...This study aimed to assess the association between psychological disorders and erectile dysfunction(ED)in patients with different degrees of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).This was a retrospective study conducted from June 2017 to October 2019 and included 182 outpatients.Patients were interviewed using the Structured Interview on Erectile Dysfunction(SIEDY)for pathogenic quantification.The National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI)and the International Index of Erectile Function-5(IIEF-5)were used for the evaluation of CP/CPPS and ED.The Generalized Anxiety Disorder-7(GAD-7)and Patient Health Questionnaire-9(PHQ-9)were used to assess anxiety symptoms and depressive symptoms.The number of patients with mild CP/CPPS and mild ED,mild CP/CPPS and moderate-to-severe ED,moderate-to-severe CP/CPPS and mild ED,and moderate-to-severe CP/CPPS and moderate-to-severe ED was 69(37.9%),36(19.8%),35(19.2%),and 42(23.1%),respectively.The corresponding PHQ-9 scores of the four groups were 6.22,7.19,10.69,and 7.71,respectively.The corresponding GAD-7 scores of the four groups were 5.26,6.31,8.77,and 6.36,respectively.Among patients with moderate-to-severe CP/CPPS,the PHQ-9 and GAD-7 scores of the moderate-to-severe ED group were significantly lower than those of the mild ED group(P=0.007 and P=0.010,respectively).The prevalence of ED and premature ejaculation(PE)in patients with moderate-to-severe CP/CPPS was significantly higher than that in patients with mild CP/CPPS(P=0.001 and P=0.024,respectively).Our findings proved that the severity of ED was negatively associated with psychological symptoms in outpatients with moderate-to-severe CP/CPPS.展开更多
The effect of acupuncture and moxibustion in the treatment of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) is definite,and progress has been made in the studies of its functional mechanism.This paper disc...The effect of acupuncture and moxibustion in the treatment of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) is definite,and progress has been made in the studies of its functional mechanism.This paper discusses the related studies on the mechanism of acupuncture and moxibustion in the treatment of CP/CPPS from five aspects:regulating immunity,anti-oxidative stress,regulating neural functions,improving urodynamics,and regulating blood circulation.It is found that acupuncture and moxibustion can decrease the level of pro-inflammatory factors,increase the level of anti-inflammatory factors,and regulate the level of inflammatory regulatory factors,thus to regulate immunity.Acupuncture and moxibustion can improve the body’s ability of anti-oxidative stress,regulate the balance state of oxidation and anti-oxidation,thus to relieve tissue damage,and regulate neural functions by modulating neurotransmitters and autonomic nerves.Acupuncture and moxibustion can improve urodynamics and relieve abnormal urination symptoms by regulating the contraction of pelvic floor muscles,can also promote blood circulation to treat the pelvic congestion.It is expected that this paper can provide reference for the clinical application and research of acupuncture and moxibustion for CP/CPPS.展开更多
We studied the efficacy of culture-specific antibiotic therapy for chronic bacterial prostatitis （CBP） patients with or without prostatic calculi. This study included 101 patients （21-62 years old） who met the con...We studied the efficacy of culture-specific antibiotic therapy for chronic bacterial prostatitis （CBP） patients with or without prostatic calculi. This study included 101 patients （21-62 years old） who met the consensus criteria for CBP （National Institutes of Health category II）. According to the results of transrectal ultrasonography （TRUS）, all patients were divided into two groups： Group 1, CBP with prostatic calculi, n=39; Group 2, CBP without prostatic calculi, n=62. All patients received optimal antimicrobial therapy for 4 weeks and followed up for a minimum of 3 months （range： 3-8 months）. In addition to expressed prostatic secretions （EPS） and urine culture, all patients were asked to complete the National Institutes of Health Chronic Prostatitis Symptom Index （NIH-CPSI） and the subjective global assessment （SGA）. The microbiological eradication rate at the end of treatment were 32/39 （82.1%） and 54/62 （87.1%）, while the rates for continued eradication at the end of study were 17/39 （43.6%） and 45/62 （72.6%） in Group I and Group 2 （P〈0.01）, respectively. We observed a decrease in the total NIH-CPSI score median values from 24 to 19 in Group I and from 24 to 11 in Group 2. The pain subscore （P〈0.01）, urinary sunscore （P〈0.05） and quality of life （QoL; P〈0.05） as well as the total NIH-CPSI score （P〈0.01） were significantly improved after antimicrobial treatment in Group 2 compared to Group 1. Response, defined as a decrease of the NI H-CPSI total score by at least 50%, was seen in Group I versusGroup 2 in 38.5% and 58.1% （P〈0.01）, respectively. Our results showed that prostatic calculi influence the antimicrobial efficacy in men with CBP, There was a noticeable decrease in the cure rate of CBP patients with prostatic calculi due to relapse after antimicrobial therapy.展开更多
MicroRNAs (miRNAs) are con sidered to be involved in the pathogenic in itiatio n and progress! on of chronic non bacterial prostatitis (CNP);however, the comprehensive expression profile of dysregulated miRNAs, releva...MicroRNAs (miRNAs) are con sidered to be involved in the pathogenic in itiatio n and progress! on of chronic non bacterial prostatitis (CNP);however, the comprehensive expression profile of dysregulated miRNAs, relevant signaling pathways, and core machineries in CNP have not been fully elucidated. In the current research, CNP rat models were established through the intraprostatic injection of carrageenan into the prostate. Then, next?generation sequencing was performed to explore the miRNA expression profile in CNP. Gene Ontology (GO) and Kyoto En cyclopedia of Genes and Geno mes (KEGG) bioinformatical an a lyses were conducted to reveal the enriched biological processes, molecular functions, and cellular components and signaling pathways. As a result, 1224, 1039, and 1029 known miRNAs were annotated in prostate tissues from the blank control (BC), normal saline injection (NS), and carrageenan injection (CAR) groups (n = 3 for each group), respectively. Among them, 84 miRNAs (CAR vs BC) and 70 miRNAs (CAR vs NS) with significantly different expression levels were identified. Compared with previously reported miRNAs with altered expression in various inflammatory diseases, the majority of deregulated miRNAs in CNP, such as miR-146b-5p, miR?155-5p, miR-150-5p, and miR-139-5p, showed similar expression patter ns. Moreover, bioinformatics analyses have en riched mitoge reactivated protei n kinase (MAPK), cyclic adenosine monophosphate (cAMP), endocytosis, mammalian target of rapamycin (mTOR), and forkhead box 0 (FoxO) signaling pathways. These pathways were all invoIved in immune response, which indicates the critical regulatory role of the immune system in CNP initiati on and progression. Our inv estigatio n has presented a global view of the d iff ere ntially expressed miRNAs and potential regulatory networks containing their target genes, which may be helpful for identifying the novel mechanisms of miRNAs in immune regulation and effective target-specific theragnosis for CNP.展开更多
Objective:To investigate the short-term efficacy difference between sensation of transmission along meridian acupuncture and non-sensation of transmission along meridian acupuncture in the treatment of chronic nonbact...Objective:To investigate the short-term efficacy difference between sensation of transmission along meridian acupuncture and non-sensation of transmission along meridian acupuncture in the treatment of chronic nonbacterial prostatitis.Methods:A randomized,controlled,and single-blind clinical study was performed to collect 63 patients with chronic nonbacterial prostatitis who met the inclusion criteria and were randomly assigned to a transmission sensation group(31 patients)and a non-transmission sensation group(32 patients).The two groups of patients took the same acupuncture points.When they were lying down on their backs,Guānyuán(关元 CV4),Zhōngjí(中极 CV3)and Dàhè(大赫 K112)were taken.When they were lying down on their stomachs,Shènshū(肾俞 BL 23),Cìliáo(次髎 BL32)and Huìyáng(会阳 BL35)were taken.Among them,the transmission sensation group was treated with transmission sensation along meridian to apply deep needling to the lower abdomen and lumbosacral acupuncture points with lifting,thrusting,and twirling method,so that the needling sensation was transmitted to the bladder,perineum and urethra.The non-transmission sensation group was treated with non-transmission sensation along meridian,and the acupuncture points were treated with conventional acupuncture until the patient felt soreness and distending etc.and the arrival of qi.Both groups of patients were treated with electro-acupuncture during acupuncture,and the sparse-dense wave(sparse wave 4 Hz,dense wave 20 Hz),and the needle retention continued for 20 min.All patients were treated for 3 times with once every other day,and the treatment lasted for one week.The CV4,CV3 and KI12 were used in the first and third treatments,and the BL23,BL32 and BL35 were used in the second treatment.The National Institute of Health chronic prostatitis syndrome index(NIH-CPSI)and Hamilton Anxiety Rating Scale(HAMA)were observed,and the clinical efficacies of the patient were observed.Results:After treatment,the NIH-CPSI scores(18.29±1.25,21.56±1.28)and HAMA scores(10.29±1.16,11.25±1.14)in the transmission sensation group and non-transmission sensation group were all lower than the pre-treatment NIH-CPSI score(24.90±1.45,24.94±1.25)and HAMA(14.10±1.53,14.47±1.22)in the transmission sensation group and non-transmission sensation group,the differences were statistically significant(all P<0.05).The difference value between the pre-treatment and post-treatment NIH-CPSI scores of the transmission sensation group(6.61±0.97)was higher than that of the nontransmission sensation group(3.48±0.59),and the difference was statistically significant(P<0.05).The difference value between the pre-treatment and post-treatment HAMA scores of the transmission sensation group(3.81±0.81)was higher than that of the non-transmission sensation group(2.77±0.54).The total effective rate of the transmission sensation group(35.48%)was higher than that of the nontransmission sensation group(12.50%),and the difference was statistically significant(P<0.05).Conclusions:Both the method of transmission sensation along meridian and the method of nontransmission sensation along meridian can effectively relieve the clinical symptoms and anxiety symptoms of patients with chronic nonbacterial prostatitis,improve the quality of life,and the method of transmission sensation along meridian had a more advantageous effect.展开更多
Chronic prostatitis can affect the sperm＇s quality. Previous studies have shown that transrectal microwave thermotherapy （TRMT） results in symptomatic relief in patients with chronic prostatitis, but the effects on...Chronic prostatitis can affect the sperm＇s quality. Previous studies have shown that transrectal microwave thermotherapy （TRMT） results in symptomatic relief in patients with chronic prostatitis, but the effects on sperm have not been carefully investigated. This study evaluates the impact of TRMT on the relief or decrease of symptoms and quality of sperm when used to treat patients with chronic nonbacterial prostatitis. Sixty patients were enrolled in the study. TRMT treatment was administered over 5 days, 1 h per day. Semen examination was carried out pretreatment and immediately at the conclusion of the 5-day treatment. Also, it was repeated 1 month, 3 months, and 6 months later. The treatment＇s symptom relief efficacy was evaluated using the National Institutes of Health Chronic Prostatitis Symptom Index （NIH-CPSI）. After the treatment, the overall NIH-CPSI scores were lower compared to those of pretreatment. In addition, the white blood cells and lecithin in expressed prostatic secretion were normal after the treatment. The sperm count was decreased by 23.8% 3 months after the treatment, sperm motility was reduced by 10.3% immediately after treatment, and sperm deformity was increased by 17.2%. The sperm volume and PH were not affected. However, the sperm quality recovered after treatment and the malformation rate was also lower at 6 months after treatment. TRMT is a favorable and safe treatment option for patients with nonbacterial chronic prostatitis. It could relieve the patient＇s symptoms and impact on sperm quality in the short-term.展开更多
Aim: To assess the efficacy and safety of anal submucosal injection (ASI) of amikacin in chronic bacterial prostatitis (CBP). Methods: Fifty male outpatients with CBP were randomly divided into two groups. Thirty case...Aim: To assess the efficacy and safety of anal submucosal injection (ASI) of amikacin in chronic bacterial prostatitis (CBP). Methods: Fifty male outpatients with CBP were randomly divided into two groups. Thirty cases of ASI group were given amikacin 400 mg daily by ASI for ten times and the other twenty cases of intramuscular injection (IM) group were given the same drug dally by IM. All patients were evaluated with NIH-Chronic prostatitis symptom index (NIH-CPSI), the bacteria culture of the expressed prostate secretion (EPS), proctoscopic examination, rectal biopsy and the clinical manifestation were checked at pretreatment and on day 7 and 90 after cessation of therapy. Results: The cure rate, apparent effective rate and effective rate of ASI group and IM group were 33.3% vs 5% (P<0.05), 43.3% vs 10% (P<0.05) and 16.7% vs 20% (P>0.05), respectively. The score of NIH-CPSI in both of ASI group and IM group decreased significantly 7 days after cessation of therapy, both ASI and IM of amikacin could relieve symptoms within a short time. However, 3 months after cessation of therapy the score of NIH-CPSI in ASI group continued down in spite of no significant differences compared with 7 days after cessation of therapy, but the score of IM group was rebound nearly closed to level of pretreatment at 23.8±8.5 and significantly higher than that of ASI group. The amount of white blood cell (WBC) of EPS in ASI group increased slightly at 7 days after cessation of therapy without significant difference with pretreatment (P>0.05), but it significantly decreased at 3 months after cessation of therapy, the amount of WBC of EPS in ASI group was lower than that of IM group at 3 months after cessation of therapy (P<0.05). Proctoscopic examination of anal canal were normal after ASI therapy and the rectum biopsy showed no obvious histopathologic abnormality at the site of injection except mild focal submucosal infiltration of lymphocytes and plasma cells at 7 days after cessation of therapy which disappeared on 3 months after cessation of therapy. All patients had no evident complications. Conclusion: ASI could be recommended as a new safe, effective, painless method of antibiotics administration in the treatment of CBP.展开更多
文摘The significance and diagnostic value of semen analysis in chronic bacterial prostatitis has been extensively debated and remains controversial. To investigate the diagnostic relevance of semen culture in the bacteriological workup of prostatitis patients, we retrospectively analyzed a clinical database of 696 symptomatic patients. All patients were routinely subjected to a four-glass test, followed by semen culture and analysis. This allowed to dissect from the database three different diagnostic scenarios, and to compare the ＇two-glass＇ pre-/post- massage test and the standard ＇four-glass＇ test with a ＇five-glass＇ test （four-glass plus post-VB3 semen culture）. The ＇five-glass＇ test showed 3.6- or 6.5-fold increases in relative sensitivity and lesser reductions （-13.2% or -14.7%） in relative specificity for traditional uropathogens （TUs） compared with the four-glass or two-glass test, respectively. The area under the ROC curve and Jouden＇s index were increased, whereas positive and negative likelihood ratios were lower than comparators, indicating that the ＇five-glass＇ assay may be superior in confirming the negative outcome of both standard tests. The five-, four-, and two-glass tests detected TUs （Enterobacteriaceae, Enterococci, etc.） in 120, 33, and 20 patients and unusual pathogens （Streptococci, other Gram-positive species, Mycoplasmata, and others） in 130, 56, and 45 patients, respectively. When patients were subjected to pharmacological treatment, including a combination of a fluoroquinolone and a macrolide, no differences in eradication rates were observed between groups diagnosed with different tests, irrespective of pathogen category. Eradication was associated with long-term sign/symptom remission; no significant intergroup differences in sign/symptom scores were observed throughout a 24-month off-therapy follow-up period. In conclusion, our data support the usefulness of semen analysis in the diagnostic workup ofprostatitis patients when this test is used to complement the four-glass Meares and Stamey test. Improvement of microbiological assays conveys important diagnostic and therapeutic implications.
基金Shanxi Province Traditional Chinese Medicine Administration Research Project(Grant No.2022ZYYC094)Science and technology innovation project of universities in Shanxi Province(Grant No.2022L342)+1 种基金Shanxi Leader Team of Medical Science&Technology Innovations(Grant No.2020TD02)Discipline Construction Project of Chinese Medicine Chemistry(Grant No.2024XKJS-25).
文摘The aim of this study is to observe the therapeutic effect of Inonotus Obliquus Polysaccharide(IOP)on chronic nonbacterial prostatitis(CNP)and its effect on the helper T cells(Th17)and regulatory T cells(Treg)immune imbalance.The CNP rat models established by injecting Xiaozhiling injection were randomly divided into the model group,cernilton(40 mg/kg,i.g.)group and low-dose(35 mg/kg,i.g.),medium-dose(70 mg/kg,i.g.)and high-dose(140 mg/kg,i.g.)groups,with the same volume of saline injected into the same site as the control group.The prostate’s wet weight and body mass served as the basis for calculating the prostate index.The serum level of prostate-specific antigen(PSA)was detected by ELISA and the histopathology of prostate tissue was detected by HE staining.The protein expression of Foxp3,ROR-γt and STAT3 in rat prostatic tissue was determined by Western blot.The levels of Th17 and Treg cells infiltrated into the spleen were measured by flow cytometry.The results showed that treatment with IOP significantly reduced the levels of prostate index and serum PSA,and attenuated the pathological injury of the prostate tissue induced by CNP.With respect to samples induced by CNP alone,IOP treatment repressed the increased mRNA levels of IL-6,IL-17,IL-21,IL-23,ROR-γt and STAT3 in prostate tissue,while increasing the mRNA levels of IL-10,TGF-βand Foxp3 in prostate tissue.Meanwhile,IOP treatment attenuated the upregulation of the protein expression levels of ROR-γt and STAT3 in prostate tissue.Additionally,the protein expression of Foxp3 in prostate tissue was increased in the IOP-treated group.Flow cytometry analysis further demonstrated that IOP treatment regulated the balance between Th17 and Treg cells in the spleen in rat with CNP.Our study is the first to elucidate that IOP has significant therapeutic effects on CNP through regulation of Th17/Treg balance.Collectively,the study provides evidence for the potential of IOP to treat CNP.
文摘We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category Ⅱ chronic bacterial prostatitis （CBP）. The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin （500 rag, thrice-weekly） with a once-daily 500- or 750-mg dose of ciprofloxacin （Cipro-500 or Cipro-750 cohort, respectively）. Combined administration of azithromycin （1500 mg week^-1） with ciprofloxacin at the rate of 750 mg day^- 1 for 4 weeks rather than at 500 mg day^- 1 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen （PSA） were sustained throughout an 18-month follow-up period in both groups. Ejaculatory pain, haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups, but the latter subsided more promptly in the Cipro-750 cohort. In total, 59 Cipro-750 patients showed mild-to-severe erectile dysfunction （ED） at baseline, while 22 patients had no ED on microbiological eradication and throughout the follow-up period. In conclusion fluoroquinolone-macrolide therapy resulted in pathogen eradication and CBP symptom attenuation, including pain, voiding disturbances and sexual dysfunction. A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks. Our results are open to further prospective validation.
基金National Major Scientific and the Technological Special Project:Establishment of a Clinically Oriented Preclinical Research and Development Technology Platform for New Chinese Medicines based on Famous Doctors'Prescriptions(No.2017ZX09301011)"Decoding Traditional Chinese Medicine"Project of Beijing University of Chinese Medicine:New Drugs Research and Development of Chinese Medicine based on Famous Doctors and Famous Prescriptions(No.90010961020020)the Horizontal Project:Preclinical Pharmacology and Pharmacodynamic Research of a New Chinese Medicine—Guilong Granules(No.2016110031007799)。
文摘OBJECTIVE:To investigate the protective effects of Guilong prescription(归龙方,GL)on chronic prostatitis(CP)and unravel the underlying mechanisms of its pharmacological effects.METHODS:The composition of GL was determined via linear ion trap/electrostatic field orbital trap tandem highresolution mass spectrometry,and the identified compounds were performed network pharmacological analysis to predict possible pathways of the effects of GL on CP.A CP rat model was established by carrageenan,and rats were randomly assigned into a Control group,Sham group,CP group,GL low dose(3.5 g/kg)group,GL medium dose(7 g/kg)group,and GL high dose(14 g/kg)group.Hematoxylin-eosin staining of the prostate,and prostate blood-perfusion measured by laser speckle contrast analysis were used to evaluate the efficacy of GL.Expression of intercellular cell adhesion molecule-1(ICAM-1)and induce nitric oxide synthase(i NOS)were determined by immunohistochemistry,and the content of interferon-γ(IFN-γ),interleukin-1β(IL-1β),interleukin-4(IL-4),interleukin-10(IL-10),chemokine ligand 1(CXCL1)and tumor necrosis factor-α(TNF-α)were determined by electro-chemiluminescence assays.The expression of p38 mitogen-activated protein kinase(p38 MAPK),phosphatidylinositol 3-kinase(PI3K),ribosomeassociated complex-alpha serine/threonine-protein kinase(Akt),nuclear factor-κ-gene binding p65(NF-κB p65),inhibitor of NF-κB-α(IκBα),glycogen synthase kinase-3β(GSK-3β),and their phosphorylated forms were tested by Western blot.RESULTS:In GL,a total of 48 compounds were identified,including 14 flavonoids,14 alkaloids,11 carboxylic acids,4 lactones,2 glycosides,2 terpenoids and 1 aldehyde.Network pharmacological analysis suggested that the mechanism of GL may be related to PI3K-Akt signaling pathway and cytokine expression.After treatment with GL,inflammatory pathological changes in the prostate of rats were significantly improved,and blood perfusion of the prostate was significantly decreased.GL reduced the expression of IFN-γ,CXCL1,TNF-α,IL-1β,i NOS,ICAM-1,p38 MAPK,p-p38 MAPK,PI3K,p-PI3K,NF-κB,p-NF-κB,IκBα,p-IκBα,GSK-3β,p-GSK-3β,p-Akt in CP rats,and increased the expression of IL-4 and IL-10 in CP rats.CONCLUSION:The chemical compositions of GL were first identified.GL can improve pathological changes in the prostate and recover the prostate blood perfusion of CP rats.The possible mechanisms of GL on CP involve increasing the expression of anti-inflammatory cytokines IL-4 and IL-10,inhibiting pro-inflammatory cytokines TNF-α,IL-1β,and IFN-γ,and down regulating the expression of CXCL1,i NOS,and ICAM-1 via inhibiting PI3K-Akt and NF-κB signaling pathway.
文摘The expressed prostatic secretions （EPSs） of men with chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）, infertile men and normal men were subjected to microbiological study. EPSs were collected from the subjects, which included 26 normal men, 11 infertile patients and 51 CP/CPPS patients. DNA was extracted from each specimen, and the V3 regions of the 16S rRNA genes were amplified using universal bacterial primers. The results showed that the EPS 16S rRNA gene-positive rate in the CP/CPPS and infertile patients was much higher than in the normal men, but without any difference among the three patient groups. The denaturing gradient gel electrophoresis （DGGE） method was used to characterize the EPS bacterial community structure of the prostate fluid from patients with CP/CPPS or infertility issues. Principal component analysis （PCA） and partial least squares （PLS） analyses of PCR-DGGE profiles revealed that the EPS bacterial community structure differed among the three groups. Three bands were identified as the key factors responsible for the discrepancy between CP/CPPS patients and infertile patients （P〈O.05）. Two bands were identified as priority factors in the discrepancy of category IliA and category IIIB prostatitis patients （P〈O.05）. According to this research, the ecological balance of the prostate and low urethra tract, when considered as a microenvironment, might play an important role in the maintenance of a healthy male reproductive tract.
文摘Qian Lie Xian Yan Suppository (前列腺炎栓) was rectally applied to treat 104 patients with nonspecific chronic prostatitis ( damp-heat syndrome with blood stasis) in contrast to 30 patients treated with traditional Chinese drug Ye Ju Hua Shuan (野菊花栓Suppository of Flos Chrysanthemi Indici). The results show that chronic prostatitis is markedly improved by using Qian Lie Xian Yan suppository, with a short-term cure rate of 23.1% and a total effective rate of 84.6%, superior to that of the control group. The animal experiment indicates that Qian Lie Xian Yan suppository has better anti-inflammatory and analgesic effects, with an action of promoting blood circulation.
文摘Objective To observe the clinical effects of chronic non-bacterial prostatitis treated with warm needling moxibustion. Methods One hundred and twenty-five cases were randomly divided into warm needling moxibustion group （42 cases）, acupuncture group （41 cases） and western medicine group （42 cases）. Of which, in warm needling moxibustion group, acupuncture combined with warming acupuncture were provided①puncture on Shènshū（肾俞 BL 23）, Gānshū （肝俞BL 18） and Zhìbiān （秩边BL 54） without retention of needles,②Guānyuán （关元CV 4）, Zhō ngjí （ 中极CV 3）, Yīnlíngquán （ 阴陵 GB 34） and Sānyīnjiāo （三阴交 SP 6） ,with warming acupuncture, once a day; in acupuncture group, the prescriptions and needling technique were the same as those in warm needling moxibustion group, without moxibustion; in western medicine group, Cernilton was applied twice a day, one pill for each time. After one course treatment, the therapeutic effects and NIH-Chronic Prostatitis Symptom Index （NIH-CPSI） of 3 groups were compared. Results The total effective rate was 88. 10% in warm needling moxibustion group, 63.41% in acupuncture group, and 66.67% in western medicine group. The clinical effect in warm needling moxibustion group was superior to that in either acupuncture group or western medicine group （both P〈0.05）. The score of NIH-CPSI was 11.92 ±7.11 in warm needling moxibustion group, 16.08±6.83 in acupuncture group, and 15.66±5.88 in western medicine group. The score of each group was obviously reduced （both P〈0.01 ） after treatments, in which, the reduction in warm needling moxibustion group was most obvious （both P〈0.0t）. Conclusion A good therapeutic effect of chronic non-bacterial prostatitis was received by warm needling moxibustion.
文摘The urinary, psychosocial, organ-specific, infection, neurological/systemic and tenderness （UPOINT） phenotype system has been validated to be an effective phenotype system in classifying patients with chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS） in western populations. To validate the utility of the UPOINT system and evaluate the effect of multimodal therapy based on the UPOINT system in Chinese patients with CPICPPS, we performed this study. Chinese patients with CP/CPPS were prospectively offered multimodal therapy using the UPOINT system and re-examined after 6 months. A minimum 6-point drop in National Institutes of Health-Chronic Prostatitis Symptoms Index （NIH-CPSI） was set to be the primary endpoint. Finally, 140 patients were enrolled in the study. The percentage of patients with each domain was 59.3%, 45.0%, 49.3%, 22.1%, 37.9%, and 56.4% for the UPOINT, respectively. The number of positive domains significantly correlated with symptom severity, which is measured by total NIH-CPSI scores （r = 0.796, P 〈 0.001）. Symptom duration was associated with a greater number of positive domains （r = 0.589, P〈 0.001）. With 6 months follow-up at least, 75.0% （105/140） had at least a 6-point improvement in NIH-CPSI after taking the therapy. All NIH-CPSI scores were significantly improved from original ones： pain 10.14 ± 4.26 to 6.60 ± 3.39, urinary 6.29 ± 2.42 to 3.63 ± 1.52, quality of life 6.56 ± 2.44 to 4.06 ± 1.98, and total 22.99 ± 7.28 to 14.29 ±5.70 （all P〈 0.0001）. Our study indicates that the UPOINT system is clinically feasible in classifying Chinese patients with CP/CPPS and directing therapy.
文摘Aim： To investigate whether chronic bacterial prostatitis might increase oxidative stress and oxidative damage in chronic bacterial prostatitis patients （CBPP）, and to explore its possible mechanism. Methods： Enrolled in a casecontrol study were 70 randomly sampled CBPP and 70 randomly sampled healthy adult volunteers （HAV）, on whom plasma nitric oxide （NO）, vitamin C （VC）, vitamin E （VE） and β-carotene （β-CAR） level, erythrocyte malondialdehyde （MDA） level, as well as erythrocyte superoxide dismutase （SOD）, catalase （CAT） and glutathione peroxidase （GPX） activities were determined by spectrophotometry. Results： Compared with the HAV group, values of plasma NO and erythrocyte MDA in the CBPP group were significantly increased （P 〈 0.001）; those of plasma VC, VE and β-CAR as well as erythrocyte SOD, CAT and GPX activities in the CBPP group were significantly decreased （P 〈 0.001）. Findings from partial correlation for the 70 CBPP showed that with prolonged course of disease, values of NO and MDA were gradually increased （P 〈 0.001）, and those of VC, VE, β-CAR, SOD, CAT and GPX were gradually decreased （P 〈 0.05- 0.001）. The findings from stepwise regression for the 70 CBPP suggested that the model was Y= -13.2077 ＋ 0.1894MDA ＋ 0.0415NO - 0.1999GPX, F = 18.2047, P 〈 0.001, r = 0.6729, P 〈 0.001. Conclusion： The findings suggest that there exist increased oxidative stress and oxidative damage induced by chronic bacterial prostatitis in the patients, and such phenomenon was closely related to the course of disease.
基金National Natural Science Fundation of China(No.30471724).
文摘The aim of this study is to assess the status of treatment of chronic prostatitis(CP)in Chinese men.A population-based cross-sectional survey was performed,in which 15000 men aged between 15 and 60 years were randomly selected to receive a questionnaire designed to assess National Institutes of Health Chronic Prostatitis Symptoms Index(NIH-CPSI)status,therapeutic efficacy and 28 other items.A total of 12743 men(84.95%)completed the questionnaire,of whom 1071(8.4%)were identified as having prostatitis-like symptoms and 517(4.5%)were diagnosed with CP according to NIH-CPSI criteria and prostatitis-like symptomatology.Of the CP patients,372(65%)underwent long-term routine treatment 12 times per year.Additionally,217(72.8%)patients received antibiotic therapy and 215(79.3%)men showed therapeutic effects.The treatment cost USD 1151(8059 yuan)per person per year on average.Most CP patients received routine treatment,in most cases with antibiotics.Treatment was costly and most CP patients were not satisfied with its effectiveness.Antibacterial treatment might have been effective primarily in patients with bacterial disease.
文摘Levofloxacin is a synthetic fluoroquinolone that is usually used to treat chronic bacterial prostatitis. We investigated the safety and efficacy of levofloxacin compared with ciprofloxacin for the treatment of chronic bacterial prostatitis in Chinese patients. This was a multicenter, open-label, randomized controlled non-inferiority trial. Four hundred and seventy-one patients with clinical symptoms/ signs were enrolled into the study, and 408 patients were microbiologically confirmed chronic bacterial prostatitis, who were randomized to either oral levofloxacin （500 mg q,d.） or ciprofloxacin （500 mg b.i^d.） for 4 weeks. Bacterial clearance rate, clinical symptoms/signs, adverse reactions and disease recurrence were assessed. The clinical symptoms and signs （including dysuria, perineal discomfort or pain） and bacteria cultures in 209 patients treated with levofloxacin and 199 patients treated with ciprofloxacin were similar. The most common bacteria were Escherichia cofiand Staphylococcus aureus. One to four weeks after the end of 4 weeks treatment, the bacterial clearance rate （86.06% vs. 60.03%; P〈O.05） and the clinical efficacy （including clinical cure and clinical improvement（93.30% vs. 71.86%; P〈0.05）） were significantly higher in the levofloxacin-treated group than in the ciprofloxacin-treated group. The microbiological recurrence rate was significantly lower in the levofloxacin-treated group than in the ciprofloxacin-treated group （4.00% vs. 19.25%; P〈0.05）. Rates of adverse events and treatment-related adverse events were slightly lower in the levofloxacin-treated group than in ciprofloxacin-treated group. Levofloxacin showed some advantages over ciprofloxacin in terms of clinical efficacy and disease recurrence, with a low rate of adverse events, for the treatment of chronic bacterial prostatitis in Chinese patients.
文摘Some published evidence has revealed that the dendritic cells can interact with pathogens that exist in the inner foreskin. This information provides a new vision that pathogens could play a role through the redundant prepuce; numerous studies have failed to find pathogens in prostates of patients who had chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）. However, no studies have reported an association between foreskin length and CP/CPPS. Hence, we conducted a retrospective case-control study of clinical data from 322 CP/CPPS patients （case group） and 341 nonCP/CPPS patients （control group）. Demographic characteristics, lifestyle factors, and foreskin lengths were collected and analyzed. Multivariate logistic regression was adopted to calculate the odds of foreskin length for CP/CPPS. According to the multivariate logistic regression results, when the foreskin length covered up more than half of the glans penis, the odds for CP/CPPS were higher with an increased foreskin （odds ratio （OR）： 1.66, 95% confidence interval （CI）： 1.04-2.66）. In comparison, when the glans penis was completely covered by the foreskin, the OR value increased to 1.86 （95% CI, 1.2-2.88）. The study results showed an association between foreskin length and the odds of CP/CPPS. When the foreskin length covered up more than half of the glans penis, there were greater odds for CP/CPPS. This possible mechanism might result from interaction between pathogens and DCs in the inner foreskin, consequently activating T-cells to mediate allergic inflammation in the prostate and producing the autoimmunizations causing CP/CPPS.
基金This research was supported in part by grants from the National Natural Science Foundation of China （No. 81400757） National College Students Innovation and Entrepreneurship Training Program （No. 201510366009） and Anhui Provincial Natural Science Foundation （1508085QH 171 ）.
文摘This study aims to validate our hypothesis that acid-sensing ion channels （ASICs） may contribute to the symptom of pain in patients with chronic prostatitis （CP）. We first established a CP rat model, then isolated the L5-S2 spinal dorsal horn neurons for further studies. ASICla was knocked down and its effects on the expression of neurogenic inflammation-related factors in the dorsal horn neurons of rat spinal cord were evaluated. The effect of ASICla on the Ca2＋ ion concentration in the dorsal horn neurons of rat spinal cord was measured by the intracellular calcium （[Ca~＊]i） intensity. The effect of ASICla on the p38/mitogen-activated protein kinase （MAPK） signaling pathway was also determined. ASICla was significantly upregulated in the CP rat model as compared with control rats. Acid-induced ASICla expression increased [Ca2＋]i intensity in the dorsal horn neurons of rat spinal cord. ASICla also increased the levels of neurogenic inflammation-related factors and p-p38 expression in the acid-treated dorsal horn neurons. Notably, ASICla knockdown significantly decreased the expression of pro-inflammatory cytokines. Furthermore, the levels of p-p38 and pro-inflammatory cytokines in acid-treated dorsal horn neurons were significantly decreased in the presence of PcTx-1, BAPTA-AM, or SB203580. Our results showed that ASIC1a may contribute to the symptom of pain in patients with CP, at least partially, by regulating the p38/MAPK signaling pathway.
基金the Fundamental Research Funds for the Central.Universities of Central South University(20191039 to ZCL)the National Natural Science of China(81570627 to ZYT)+1 种基金the Natural Science Foundation of Hunan Province,China(2020115906 to DIL)the China Postdoctoral Science Foundation(2020M670107ZX to DJL).
文摘This study aimed to assess the association between psychological disorders and erectile dysfunction(ED)in patients with different degrees of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).This was a retrospective study conducted from June 2017 to October 2019 and included 182 outpatients.Patients were interviewed using the Structured Interview on Erectile Dysfunction(SIEDY)for pathogenic quantification.The National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI)and the International Index of Erectile Function-5(IIEF-5)were used for the evaluation of CP/CPPS and ED.The Generalized Anxiety Disorder-7(GAD-7)and Patient Health Questionnaire-9(PHQ-9)were used to assess anxiety symptoms and depressive symptoms.The number of patients with mild CP/CPPS and mild ED,mild CP/CPPS and moderate-to-severe ED,moderate-to-severe CP/CPPS and mild ED,and moderate-to-severe CP/CPPS and moderate-to-severe ED was 69(37.9%),36(19.8%),35(19.2%),and 42(23.1%),respectively.The corresponding PHQ-9 scores of the four groups were 6.22,7.19,10.69,and 7.71,respectively.The corresponding GAD-7 scores of the four groups were 5.26,6.31,8.77,and 6.36,respectively.Among patients with moderate-to-severe CP/CPPS,the PHQ-9 and GAD-7 scores of the moderate-to-severe ED group were significantly lower than those of the mild ED group(P=0.007 and P=0.010,respectively).The prevalence of ED and premature ejaculation(PE)in patients with moderate-to-severe CP/CPPS was significantly higher than that in patients with mild CP/CPPS(P=0.001 and P=0.024,respectively).Our findings proved that the severity of ED was negatively associated with psychological symptoms in outpatients with moderate-to-severe CP/CPPS.
基金Supported by Program of Shanghai Pudong New Area Famous Traditional Chinese Medicine。
文摘The effect of acupuncture and moxibustion in the treatment of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) is definite,and progress has been made in the studies of its functional mechanism.This paper discusses the related studies on the mechanism of acupuncture and moxibustion in the treatment of CP/CPPS from five aspects:regulating immunity,anti-oxidative stress,regulating neural functions,improving urodynamics,and regulating blood circulation.It is found that acupuncture and moxibustion can decrease the level of pro-inflammatory factors,increase the level of anti-inflammatory factors,and regulate the level of inflammatory regulatory factors,thus to regulate immunity.Acupuncture and moxibustion can improve the body’s ability of anti-oxidative stress,regulate the balance state of oxidation and anti-oxidation,thus to relieve tissue damage,and regulate neural functions by modulating neurotransmitters and autonomic nerves.Acupuncture and moxibustion can improve urodynamics and relieve abnormal urination symptoms by regulating the contraction of pelvic floor muscles,can also promote blood circulation to treat the pelvic congestion.It is expected that this paper can provide reference for the clinical application and research of acupuncture and moxibustion for CP/CPPS.
文摘We studied the efficacy of culture-specific antibiotic therapy for chronic bacterial prostatitis （CBP） patients with or without prostatic calculi. This study included 101 patients （21-62 years old） who met the consensus criteria for CBP （National Institutes of Health category II）. According to the results of transrectal ultrasonography （TRUS）, all patients were divided into two groups： Group 1, CBP with prostatic calculi, n=39; Group 2, CBP without prostatic calculi, n=62. All patients received optimal antimicrobial therapy for 4 weeks and followed up for a minimum of 3 months （range： 3-8 months）. In addition to expressed prostatic secretions （EPS） and urine culture, all patients were asked to complete the National Institutes of Health Chronic Prostatitis Symptom Index （NIH-CPSI） and the subjective global assessment （SGA）. The microbiological eradication rate at the end of treatment were 32/39 （82.1%） and 54/62 （87.1%）, while the rates for continued eradication at the end of study were 17/39 （43.6%） and 45/62 （72.6%） in Group I and Group 2 （P〈0.01）, respectively. We observed a decrease in the total NIH-CPSI score median values from 24 to 19 in Group I and from 24 to 11 in Group 2. The pain subscore （P〈0.01）, urinary sunscore （P〈0.05） and quality of life （QoL; P〈0.05） as well as the total NIH-CPSI score （P〈0.01） were significantly improved after antimicrobial treatment in Group 2 compared to Group 1. Response, defined as a decrease of the NI H-CPSI total score by at least 50%, was seen in Group I versusGroup 2 in 38.5% and 58.1% （P〈0.01）, respectively. Our results showed that prostatic calculi influence the antimicrobial efficacy in men with CBP, There was a noticeable decrease in the cure rate of CBP patients with prostatic calculi due to relapse after antimicrobial therapy.
基金the National Natural Science Foundation of China (Grant No. 81630019, 31430028, 81401518, and 81470986)Anhui Provincial Institutes for Translational Medicine (Grant No. 2017ZHYX02)+1 种基金Cultivation Project of Young Top-Notch Talent Support from Anhui Medical University (AHMU)Funding for Distinguished Young Scientists of the First Affiliated Hospital of AHMU.
文摘MicroRNAs (miRNAs) are con sidered to be involved in the pathogenic in itiatio n and progress! on of chronic non bacterial prostatitis (CNP);however, the comprehensive expression profile of dysregulated miRNAs, relevant signaling pathways, and core machineries in CNP have not been fully elucidated. In the current research, CNP rat models were established through the intraprostatic injection of carrageenan into the prostate. Then, next?generation sequencing was performed to explore the miRNA expression profile in CNP. Gene Ontology (GO) and Kyoto En cyclopedia of Genes and Geno mes (KEGG) bioinformatical an a lyses were conducted to reveal the enriched biological processes, molecular functions, and cellular components and signaling pathways. As a result, 1224, 1039, and 1029 known miRNAs were annotated in prostate tissues from the blank control (BC), normal saline injection (NS), and carrageenan injection (CAR) groups (n = 3 for each group), respectively. Among them, 84 miRNAs (CAR vs BC) and 70 miRNAs (CAR vs NS) with significantly different expression levels were identified. Compared with previously reported miRNAs with altered expression in various inflammatory diseases, the majority of deregulated miRNAs in CNP, such as miR-146b-5p, miR?155-5p, miR-150-5p, and miR-139-5p, showed similar expression patter ns. Moreover, bioinformatics analyses have en riched mitoge reactivated protei n kinase (MAPK), cyclic adenosine monophosphate (cAMP), endocytosis, mammalian target of rapamycin (mTOR), and forkhead box 0 (FoxO) signaling pathways. These pathways were all invoIved in immune response, which indicates the critical regulatory role of the immune system in CNP initiati on and progression. Our inv estigatio n has presented a global view of the d iff ere ntially expressed miRNAs and potential regulatory networks containing their target genes, which may be helpful for identifying the novel mechanisms of miRNAs in immune regulation and effective target-specific theragnosis for CNP.
基金Supported by Scientific Research Project of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine:2018YJ12Innovation and entrepreneurship training program for Post-graduates of Shanghai University of Traditional Chinese Medicine:Y201825
文摘Objective:To investigate the short-term efficacy difference between sensation of transmission along meridian acupuncture and non-sensation of transmission along meridian acupuncture in the treatment of chronic nonbacterial prostatitis.Methods:A randomized,controlled,and single-blind clinical study was performed to collect 63 patients with chronic nonbacterial prostatitis who met the inclusion criteria and were randomly assigned to a transmission sensation group(31 patients)and a non-transmission sensation group(32 patients).The two groups of patients took the same acupuncture points.When they were lying down on their backs,Guānyuán(关元 CV4),Zhōngjí(中极 CV3)and Dàhè(大赫 K112)were taken.When they were lying down on their stomachs,Shènshū(肾俞 BL 23),Cìliáo(次髎 BL32)and Huìyáng(会阳 BL35)were taken.Among them,the transmission sensation group was treated with transmission sensation along meridian to apply deep needling to the lower abdomen and lumbosacral acupuncture points with lifting,thrusting,and twirling method,so that the needling sensation was transmitted to the bladder,perineum and urethra.The non-transmission sensation group was treated with non-transmission sensation along meridian,and the acupuncture points were treated with conventional acupuncture until the patient felt soreness and distending etc.and the arrival of qi.Both groups of patients were treated with electro-acupuncture during acupuncture,and the sparse-dense wave(sparse wave 4 Hz,dense wave 20 Hz),and the needle retention continued for 20 min.All patients were treated for 3 times with once every other day,and the treatment lasted for one week.The CV4,CV3 and KI12 were used in the first and third treatments,and the BL23,BL32 and BL35 were used in the second treatment.The National Institute of Health chronic prostatitis syndrome index(NIH-CPSI)and Hamilton Anxiety Rating Scale(HAMA)were observed,and the clinical efficacies of the patient were observed.Results:After treatment,the NIH-CPSI scores(18.29±1.25,21.56±1.28)and HAMA scores(10.29±1.16,11.25±1.14)in the transmission sensation group and non-transmission sensation group were all lower than the pre-treatment NIH-CPSI score(24.90±1.45,24.94±1.25)and HAMA(14.10±1.53,14.47±1.22)in the transmission sensation group and non-transmission sensation group,the differences were statistically significant(all P<0.05).The difference value between the pre-treatment and post-treatment NIH-CPSI scores of the transmission sensation group(6.61±0.97)was higher than that of the nontransmission sensation group(3.48±0.59),and the difference was statistically significant(P<0.05).The difference value between the pre-treatment and post-treatment HAMA scores of the transmission sensation group(3.81±0.81)was higher than that of the non-transmission sensation group(2.77±0.54).The total effective rate of the transmission sensation group(35.48%)was higher than that of the nontransmission sensation group(12.50%),and the difference was statistically significant(P<0.05).Conclusions:Both the method of transmission sensation along meridian and the method of nontransmission sensation along meridian can effectively relieve the clinical symptoms and anxiety symptoms of patients with chronic nonbacterial prostatitis,improve the quality of life,and the method of transmission sensation along meridian had a more advantageous effect.
文摘Chronic prostatitis can affect the sperm＇s quality. Previous studies have shown that transrectal microwave thermotherapy （TRMT） results in symptomatic relief in patients with chronic prostatitis, but the effects on sperm have not been carefully investigated. This study evaluates the impact of TRMT on the relief or decrease of symptoms and quality of sperm when used to treat patients with chronic nonbacterial prostatitis. Sixty patients were enrolled in the study. TRMT treatment was administered over 5 days, 1 h per day. Semen examination was carried out pretreatment and immediately at the conclusion of the 5-day treatment. Also, it was repeated 1 month, 3 months, and 6 months later. The treatment＇s symptom relief efficacy was evaluated using the National Institutes of Health Chronic Prostatitis Symptom Index （NIH-CPSI）. After the treatment, the overall NIH-CPSI scores were lower compared to those of pretreatment. In addition, the white blood cells and lecithin in expressed prostatic secretion were normal after the treatment. The sperm count was decreased by 23.8% 3 months after the treatment, sperm motility was reduced by 10.3% immediately after treatment, and sperm deformity was increased by 17.2%. The sperm volume and PH were not affected. However, the sperm quality recovered after treatment and the malformation rate was also lower at 6 months after treatment. TRMT is a favorable and safe treatment option for patients with nonbacterial chronic prostatitis. It could relieve the patient＇s symptoms and impact on sperm quality in the short-term.
文摘Aim: To assess the efficacy and safety of anal submucosal injection (ASI) of amikacin in chronic bacterial prostatitis (CBP). Methods: Fifty male outpatients with CBP were randomly divided into two groups. Thirty cases of ASI group were given amikacin 400 mg daily by ASI for ten times and the other twenty cases of intramuscular injection (IM) group were given the same drug dally by IM. All patients were evaluated with NIH-Chronic prostatitis symptom index (NIH-CPSI), the bacteria culture of the expressed prostate secretion (EPS), proctoscopic examination, rectal biopsy and the clinical manifestation were checked at pretreatment and on day 7 and 90 after cessation of therapy. Results: The cure rate, apparent effective rate and effective rate of ASI group and IM group were 33.3% vs 5% (P<0.05), 43.3% vs 10% (P<0.05) and 16.7% vs 20% (P>0.05), respectively. The score of NIH-CPSI in both of ASI group and IM group decreased significantly 7 days after cessation of therapy, both ASI and IM of amikacin could relieve symptoms within a short time. However, 3 months after cessation of therapy the score of NIH-CPSI in ASI group continued down in spite of no significant differences compared with 7 days after cessation of therapy, but the score of IM group was rebound nearly closed to level of pretreatment at 23.8±8.5 and significantly higher than that of ASI group. The amount of white blood cell (WBC) of EPS in ASI group increased slightly at 7 days after cessation of therapy without significant difference with pretreatment (P>0.05), but it significantly decreased at 3 months after cessation of therapy, the amount of WBC of EPS in ASI group was lower than that of IM group at 3 months after cessation of therapy (P<0.05). Proctoscopic examination of anal canal were normal after ASI therapy and the rectum biopsy showed no obvious histopathologic abnormality at the site of injection except mild focal submucosal infiltration of lymphocytes and plasma cells at 7 days after cessation of therapy which disappeared on 3 months after cessation of therapy. All patients had no evident complications. Conclusion: ASI could be recommended as a new safe, effective, painless method of antibiotics administration in the treatment of CBP.
