[Low-dose testosterone undecanoate capsules combined with tadalafil for late-onset hypogonadism accompanied with ED]

OBJECTIVE

To observe the clinical effect of low-dose testosterone undecanoate capsules combined with tadalafil on late-onset hypogonadism (LOH) accompanied with ED.

METHODS

Ninety cases of LOH accompanied with ED who met the inclusion criteria were randomly divided into a control group and a combination therapy group, the former treated with tadalafil and the latter with low-dose testosterone undecanoate capsules combined with tadalafil. The LOH symptoms, IIEF-5 scores, sexual encounter profile (SEP) scores, prostate volumes, and the levels of total testosterone (TT), free testosterone (FT) and prostatic specific antigen (PSA) were recorded and compared between the two groups before and after treatment.

RESULTS

The IIEF-5 and SEP scores and the TT and FT levels were 20.6 +/- 3.8, 4.02 +/- 1.08, (15.4 +/- 3.4) nmol/L and (0.391 +/- 0.062) nmol/L, respectively, in the combination therapy group after treatment, significantly higher both than 15.7 +/- 3.9, 1.49 +/- 0.82, (10.1 +/- 1.2) nmol/L and (0.200 +/- 0.045) nmol/L before treatment (P < 0.01) and than 8.6 +/- 3.6, 3.50 +/- 1.21, (10.2 +/- 1.2) nmol/L and (0.210 +/- 0.051) nmol/L in the control group after treatment (P < 0.01).

CONCLUSION

Low-dose testosterone undecanoate capsules combined with tadalafil has a definite clinical effect and no obvious adverse reactions in the treatment of LOH accompanied with ED.

[Low-dose daily de-escalatory administration of tadalafil for psychological erectile dysfunction]

OBJECTIVE

To investigate the effect of low-dose daily de-escalatory administration of tadalafil on psychological erectile dysfunction (ED).

METHODS

We randomized 84 psychological ED patients into an observation and a control group of equal number to receive low-dose daily de-escalatory administration and on-demand medication of tadalafil, respectively, both for 2 months. We compared the scores on IIEF-5 and erection hardness (EHS) between the two groups before and after the treatment.

RESULTS

The treatment and follow-up were accomplished for 79 cases, with 5 withdrawals in the control group. The IIEF-5 and EHS scores were remarkably improved in both the observation and control groups after treatment. The rate of therapeutic effectiveness was significantly higher in the observation group than in the control (95.2% vs 86.5%, P < 0.05).

CONCLUSION

Low-dose daily de-escalatory administration of tadalafil is highly effective and even better than on-demand medication of tadalafil for psychological ED.

[Combination of compound Xuanju capsule and tamoxifen citrate for idiopathic oligozoospermia]

OBJECTIVE

To evaluate the clinical effects of Compound Xuanju Capsule combined with tamoxifen citrate on the seminal parameters of men with idiopathic oligozoospermia.

METHODS

We equally assigned 120 men with idiopathic oligozoospermia to receive Compound Xuanju Capsule plus tamoxifen citrate (experiment group) or tamoxifen citrate alone (control group). After 3 months of medication, we compared the concentration and total number of sperm with the baseline, and analyzed the influence of the duration of natural infertility on the therapeutic effect.

RESULTS

Both the concentration and total number of sperm were significantly increased in both the experiment and the control groups after 3 months of medication as compared with the baseline (P < 0.05), and the increases were even more significant in the former than in the latter group (P < 0.05). The therapeutic efficacy was remarkably better in the patients with natural infertility < or = years than in those > 3 years (P < 0.05).

CONCLUSION

Compound Xuanju Capsule combined with tamoxifen citrate produces satisfactory results in the treatment of idiopathic oligozoospermia, and therefore can be used as a first-line therapy for this disease.

[Jinleng undershorts palliates varicocele]

OBJECTIVE

To investigate the effect of Jinleng undershorts on the elevated scrotal temperature induced by varicocele as well as on other clinical symptoms of the disease.

METHODS

Fifty-one varicocele patients received the treatment of wearing Jinleng undershorts for 30 min twice a day for a course of 90 days. Comparisons were made between the scrotal temperatures and other clinical symptoms of varicocele before and after the treatment.

RESULTS

After 90 days of treatment with Jinleng undershorts, the left scrotal temperature of the varicocele patients was significantly reduced from (32.16 +/- 0.79) degrees C to (31.53 +/- 0.77) degrees C (P < 0.01), and the right scrotal temperature decreased from (31.91 +/- 0.73) degrees C to (31.81 +/- 0.63) degrees C (P > 0.05). Compared with pretreatment, significant improvement was found in such symptoms as wetness, fever and swelling of the scrotum, backache, headache, dizziness, fatigue and anxiety (P < 0.05), as well as in testicular pain (P < 0.01) and IIEF-5 score, which was increased from 15.89 +/- 6.13 to 20.04 +/- 3.87 (P < 0.01).

CONCLUSION

Jinleng undershorts can be used for the treatment of mild and moderate varicocele.

Similarity of strain- and route-dependent murine responses to an adenovirus vector using the homologous thrombopoietin cDNA as the reporter genes

Replication-deficient adenovirus (Ad) vectors are effective in transferring genes in vivo, but their use is associated with significant variation in the extent and/or duration of expression observed among different strains of experimental animals and different routes of administration of the vector. We have minimized the variables of the heterologous transgene and animal-to-animal variation by constructing an Ad vector encoding murine thrombopoietin (mTPO, AdmTPO), a homologous protein that induces a physiologic response (elevation of blood platelet levels) that can be followed sequentially over time in the same animal. Using the C57BL/6 and BALB/c stains, liver administration was accomplished by intravenous administration and skeletal muscle administration by direct injection. Despite the use of a homologous cDNA as a transgene, the Ad genome was rapidly lost from the liver after intravenous administration over the first 1 to 2 weeks, with no difference in pattern of decline between the C57BL/6 and BALB/c strains. Both strains exhibited a cytotoxic T lymphocyte (CTL) response directed against the AdmTPO vector. Consistent with the decline in vector genome over time, the initial high levels of mTPO mRNA in the liver declined to an undetectable level within 2 weeks. Platelet counts peaked at 8- to 10-fold above baseline within the first 2 weeks, and then gradually declined, returning to normal level by 50 to 60 days. Intravenous administration of the AdmTPO vector to beta2-microglobulin-deficient mice resulted in a longer persistence of elevated platelets levels, although the eventual return of platelet levels to normal in these mice suggests the elimination of the Ad vector cannot be explained solely by CTL response. Although the intramuscular administration of the AdmTPO vector resulted in platelet levels with a lower peak and minor differences over time compared with the intravenous route, the C57BL/6 and BALB/c strains demonstrated the same rapid loss of Ad genome and mTPO mRNA levels in the muscle as in the liver. Together, these observations suggest that simplifying the experimental design by eliminating the variable of host response to a heterologous transgene, and by following the consequences of gene transfer in the same animals over time, there can be remarkable similarity in strain- and route-dependent responses to an Ad vector.

Enhancement of in vivo adenovirus-mediated gene transfer and expression by prior depletion of tissue macrophages in the target organ

Based on the hypothesis that tissue macrophages present an obstacle for adenovirus (Ad) vector-mediated gene transfer to internal organs, this study evaluated the consequences of transient depletion of Kupffer cells on subsequent transfer of the Ad vector genome and Ad vector-directed gene expression in the livers of experimental animals. Depletion of Kupffer cells in mice by intravenous administration of multilamellar liposomes containing dichloromethylene-bisphosphonate permitted subsequent intravenous administration of an Ad vector to provide a higher input of recombinant adenoviral DNA to the liver, an absolute increase in transgene expression, and a delayed clearance of the vector DNA and transgene expression. These observations suggest that the tissue macrophages pose a significant hurdle to Ad vector-mediated gene transfer and that strategies to transiently suppress macrophage defenses might be useful in enhancing the efficiency of this in vivo gene transfer system.

Circumvention of anti-adenovirus neutralizing immunity by administration of an adenoviral vector of an alternate serotype

Effective gene transfer and expression following repetitive administration of adenoviral (Ad) vectors in experimental animals is limited by anti-Ad neutralizing antibodies. Knowing that anti-Ad humoral immunity is serotype-specific, we hypothesized that anti-Ad neutralizing immunity could be circumvented using Ad vectors of different serotypes (Ad2, Ad5) within the same subgroup (C) to transfer and express beta-glucuronidase (beta glu) in the lung. Sprague-Dawley rats received an intratracheal administration of either Ad2 beta glu or Ad5 beta glu, and, 14 days later, repeat administration of either the same vector or a vector of a different serotype. Analysis of serum and bronchoalveolar lavage fluid following initial vector administration demonstrated systemic and local serotype-specific neutralizing antibodies. For both the Ad2 and Ad5 vectors, beta glu expression 24 hr following the second administration of the same serotype was < 30% of that of naive animals. In contrast, beta glu expression 24 hr following second administration of a different serotype Ad vector was similar to expression at 24 hr of naive animals receiving a single administration (Ad5 beta glu followed by Ad2 beta glu, as well as Ad2 beta glu followed by Ad5 beta glu; p > 0.2 both comparisons). Although the alternative serotype bypassed anti-Ad neutralizing immunity, persistence of expression was reduced compared to that following administration to naive animals. Compatible with this observation, systemic administration of the same vectors to C57B1/6 mice demonstrated induction of cytotoxic T lymphocytes directed against the beta glu transgene, as well as products of the Ad genome. Interestingly, intratracheal administration of vectors with different serotypes and different transgenes to rats resulted in longer expression (but still not normalized) compared to that achieved with vectors of different serotypes but the same transgene. These observations demonstrate that alternate use of Ad vectors from different serotypes within the same subgroup can circumvent anti-Ad humoral immunity to permit effective gene transfer after repeat administration, although the chronicity of expression is limited, likely by cellular immune process directed against both the transgene and viral gene products expressed by the vector.