Abstract:Objective:To investigate the clinical efficacy of Zhuangdan Yanshi Decoction combined with dapoxetine hydrochlo-ride in the treatment of premature ejaculation with cholestasis and phlegm disturbance.Methods:A total of 120 patients diagnosed with premature ejaculation and treated in the Andrology Outpatient Department of Shaanxi Provincial Hospital of Traditional Chinese Medicine from March to December in 2022 were selected and randomly divided into treatment group and control group,with 60 cases in each group.The incubation period of intravaginal ejaculation(IELT),the Diagnostic Scale of Premature Ejaculation(PEDT),the Premature Ejaculation Assessment Scale(PEP),the 5-item Sexual Function Evaluation of Chinese Premature Ejaculation Patients(CIPE-5)and the improvement of traditional Chinese medicine symptom scores were compared before and after the treatment.And the adverse reactions were recorded as well.Results:A total of 105 cases were ultimately included,with 55 cases in the treatment group and 50 cases in the control group.Measurable improvements in IELT,PEDT scores,PEP scores,CIPE scores and TCM symptom scores had been found after treatment in both of two groups(P＜0.05).Moreover,the improvement in the treatment group was superi-or to that in the control group(P＜0.05).The total effective rate in the treatment group was 89.1％,which was higher than that(84％)in the control group,with no statistically significant difference between the two groups(P＞0.05).The incidence of adverse reactions in the treatment group was 9.1％,which was 24％in the control group.There was significantly difference between two groups(P＜0.05).Conclusion:The combination therapy with Zhuangdan Yanshi Decoction and dapoxetine hydrochloride for premature ejaculation associated with cholestasis and phlegm disturbance syndrome is definite,and it can reduce the side effects of drugs,which is better than oral dapoxetine hydrochloride alone.

Abstract:Objective:The aim of this study is to explore the influencing factors of fertility preservation decision-making in tes-ticular cancer patient and provide a basis for clinical decision.Methods:A descriptive qualitative study was conducted using purpos-ive sampling in 18 testicular cancer patients.Semi-structured interviews were performed,and data were analyzed through content analy-sis.Results:A total of 3 themes and 10 subthemes were extracted including individual factors(fertility circumstance,concerns a-bout sperm cryopreservation efficacy/quality,the preferred choice between treatment and fertility preservation,confidence in future fer-tility),medical factors(physicians' recommendations on fertility preservation,fertility-related information,urgency of treatment),and socio-environmental factors(traditional beliefs of fertility,family/partner support,accessibility/cost of cryopreservation).Conclusion:This study highlights many influencing factors of fertility preservation decision-making in testicular cancer patients,em-phasizing the need for clinicians to enhance awareness of fertility preservation,provide timely and targeted information,and advocate for policy interventions to reduce financial barriers.Strengthening healthcare support and systemic safeguards may optimize patients' de-cision-making outcomes.

Abstract:Objective:To analyze the effects of the Focused Solution Model Nursing intervention on quality of life,negative emotions of the patients with prostate cancer.Methods:A total of 82 prostate cancer patients who were diagnosed and treated at the General Hospital of Eastern Theater Command between September 2022 and September 2024 were included and randomly divided into study group and control group by the method of random number table,with 41 patients in each group.The patients in the study group were treated with Focused Solution Model Nursing intervention.And the routine care was used in the control group The quality of life and negative emotions were compared between the two groups by using the scales of World Health Organization Quality of Life-Brief(WHOQOL-BREF),HAMA and HAMD.Results:Compared to the control group,the patients in the study group exhibited signifi-cantly higher scores in the physiological,psychological,environmental,and social relationship domains of the WHOQOL-BREF scale(P＜0.05).The scores of HAMA and HAMD in study group were lower than those of the control group(P＜0.05).Additionally,all subscales of the Social Impact Scale including social exclusion,internalized shame,social isolation and economic discrimination were significantly lower than those of the study group(P＜0.05).Conclusion:Focused Solution Model Nursing intervention can effec-tively improve the quality of life and negative emotions of the prostate cancer patients in the clinical treatment.

Abstract:Prostate cancer is a common malignant tumor of the male urinary system.Early diagnosis is very important to improve the survival rate and quality of life of patients.In this paper,the screening methods for early prostate cancer will be systematically re-viewed,covering serum prostate-specific antigen(PSA)related testing,non-PSA related testing,as well as emerging genetic and ge-netic testing technologies.The principle,advantages and limitations of each screening method will be briefly analyzed as well.In order to avoid excessive puncture biopsy,a basis for reasonable clinical screening strategy for prostate cancer will be introduced,so as to re-alize early detection,diagnosis and treatment of disease and improve the prognosis of patients.

Abstract:Objective:To explore the clinical effects of sterilization of vas deferens by irrigation in clinic.Methods:Eighty-six male patients with voluntary sterilization were divided into control group(usual vasectomy,n=50)and observation group(sterilization of vas deferens by irrigation,n=36).The age,testicular volume,preoperative average concentration of spern,serum testosterone level,recovery duration evaluated by Artificial Obstruction Azoospermia(AOA)and degree of satisfaction were compared between the two groups of patients.Results:There were significant differences in recovery duration,degree of satisfaction between the two groups(P＜0.05).And there was no significant difference in age([32.0±5.5]years vs[31.0±6.3]years),testicular volume([16.0±4.8]mL vs[17.0±4.4]mL),preopera-tive average concentration of sperm([39.6±20.2]× 106/mL vs[40.2±22.6]× 106/mL)and levels of blood testosterone([4.3±0.8]ng/mL vs[4.4±0.8]ng/mL).There was significant difference in patency rate between the two sides of testicular ducts(91.7％vs 83.3％,P＜0.05).Conclusion:The method of sterilization of vas deferens by irrigation is worth popularizing in clinic.

Abstract:Objective:To compare the therapeutic efficacy and safety of local anesthesia and spinal anesthesia for the patients with varicocele(VC)who underwent microsurgical varicocelectomy(MV).Methods:We retrospectively analyzed the data of VC patients who underwent MV treatment at the Andrology Department of the Affiliated Ruikang Hospital of Guangxi University of Chinese Medicine from May 2020 to March 2023.Cases with complete clinical data and follow-up evaluation were selected and divided into a control group(spinal anesthesia)and an observation group(local anesthesia)according to different anesthesia methods.The surgical time(including anesthesia time),visual analogue scale(VAS)score for pain,hospital stay,treatment cost,sperm concentration,for-ward motile sperm rate,and normal sperm morphology rate after three months of surgery,as well as postoperative complications and re-currence rate were compared between the two groups.Results:A total of 107 eligible cases were included,with 56 cases in the con-trol group and 51 cases in the observation group.There was no significant difference in the VAS score for pain during and after four hours of surgery,as well as postoperative complications,and recurrence rate between the two groups(P＞0.05).There was an signif-icant increase in sperm concentration,forward motile sperm rate,and normal sperm morphology rate in both of two groups after three months of surgery(P＜0.05).However,there was no significant difference between the two groups three months after surgery(P＞0.05).The surgical time and hospital stay were shorter than those of the control group(P＜0.05).And the treatment cost in observa-tion group was lower than that of the control group(P＜0.05).Conclusion:Both local anesthesia and lumbar anesthesia for MV treatment of VC have good efficacy and safety.However,patients treated with MV under local anesthesia for VC have obvious advanta-ges in terms of operation time(including anesthesia time),hospital stay,and treatment cost,which is worthy of clinical promotion and application.

Abstract:Objective:To investigate the efficacy and safety of transurethral water vapor thermal therapy(WVTT)using the Rezūm system for benign prostatic hyperplasia(BPH)in the real world.Methods:A total of 181 patients with BPH were recruited from the Second Affiliated Hospital of Nanjing Medical University from August 2022 to December 2023,of whom 173 patients were treated with WVTT using the Rezūm system,while 8 patients were treated with WVTT combined with TURP.They were followed up at 1,3,and 6 months postoperatively to assess changes in the IPSS,QoL,Qmax,IIEF-5,and the occurrence of any complications.Results:All 181 surgeries in this group were successfully completed.The operation time of the Rezūm system was(4.6±1.4)mi-nutes.The postoperative indwelling catheterization time was(8.0±2.1)days.With a follow-up of at least 6 months,there was a significant decrease in PV,IPSS and QoL,and a remarkable increase had been found in Qmax as well(P＜0.05).There was no sig-nificant difference in IIEF-5 before and after the operation(P＞0.05).In this groups of patients,postoperative complications mainly included 95 cases(52.5％)of gross hematuria,6 cases(3.3％)of retrograde ejaculation,5 cases(2.8％)of urethral stricture,4 cases(2.2％)of prostatitis,and 10 cases(5.5％)of urinary tract infection.Four cases(2.2％)underwent surgical retreatment for BPH after surgery.Conclusion:In the real world,the use of Rezūm thermal steam ablation system for the treatment of BPH has sat-isfactory short-term effect,short surgical time,and significant improvement in IPSS,QoL,Qmax,which does not adversely affect sexu-al function.

Abstract:Urinary dysfunction caused by central nervous system or peripheral nerve disease represents a significant global medi-cal and social problem.Neurologic abnormalities,including traumatic brain injury(TBI),stroke,Alzheimer's disease,and Parkinson's disease,have been identified as potential risk factors for neurogenic urinary tract dysfunction.The relationship between TBI and neu-rogenic lower urinary tract dysfunction(NLUTD)will be introduced in this article,with the mechanisms,clinical manifestations,diag-nostic methods,and treatment strategies of NLUTD after TBI being evaluated as well,which provides a reference for the diagnosis and treatment.

Abstract:Objective:To investigate the clinical effect of transposition of gracilis muscle flap in repairing urethral perineal fis-tula after Miles operation.Methods:The clinical data of 3 patients with urethral perineal fistula treated in the Second Affiliated Hos-pital of Zhejiang University from September 2023 to November 2024 were analyzed retrospectively.All patients were male,aged from 59 to 68 years(mean 63 years).All patients underwent Miles operation because of low rectal cancer.Urethral perineal fistula occurred after 2 months to 13 years of the operation.The underlying comorbidities included diabetes(2/3),preoperative chemoradiotherapy(1/3),and chemotherapy alone(1/3).The endourethral fistula was located in the apical and membranous part of the prostate,with a diameter of 1.5-2.0 cm and a mean of 1.7 cm.Suprapubic cystostomy was performed one month before operation.In all 3 cases,perineal inverted"Y"incision was taken under general anesthesia to expose urethral fistula,cut off necrotic tissue and suture urethral fistula.The gracilis muscle of the right thigh was taken and turned through the perineal subcutaneous tunnel.and 6 stitches were suture at the urethral fistula.Results:The operations of all 3 patients were completed successfully.The follow-up period ranged from 2 months to 12 months,with an average of 8 months.There was no case of urinary incontinence after removal of catheter 3 weeks after operation.In two patients,urethrography was reviewed 1 month after surgery to show no fistula residue and urethral stenosis,and the fistula was removed.In one patient with a history of radiotherapy,urethrography was reviewed 1 month after surgery to show a small amount of contrast overflow around the urethra,and urethrography was reviewed again 3 months after surgery to show no contrast over-flow around the urethra.All the 3 patients had no disturbance of movement of the right lower limb,and the pain of different degrees of thigh incision was acceptable and basically relieved half a month after operation.Conclusion:Gracilis muscle flap is one of the ef-fective methods for repairing urethral perineal fistula after Miles operation,which has a precise surgical result and few complications.

Abstract:Objective:To explore the role of prostate health index(PHI)and its derivatives for early screening in patients with PI-RADS score 3 and prostate-specific antigen(PSA)levels of 4-20 μg/L.Methods:Clinical data of 203 patients with a score of 3 on the PI-RADS v2.1 scoring system who underwent ultrasound-guided transperineal prostate aspiration biopsy from April 2021 to April 2024 from Provincial Hospital of Shandong First Medical University,Qilu Hospital of Shandong University and Weifang People's Hospital were collected.Patients who met the inclusion criteria were divided into prostate cancer(PCa)group(62 cases)and benign prostatic hyperplasia(BPH)group(141 cases).Serum total prostate-specific antigen(tPSA),serum free prostate-specific an-tigen(fPSA),and PSA isoform 2(p2PSA)were routinely detected after admission.And prostate-specific antigen density(PSAD),prostate health index(PHI)and prostate health index density(PHID)were calculated with the basic personal information being col-lected.The efficacy of each parameter in early screening of patients with PI-RADS score of 3 and PSA level of 4-20 μg/L was as-sessed using ROC curve approach.Results:There was no statistical difference in tPSA,fPSA and fPSA/tPSA between the two groups(P＞0.05).There was a statistical difference in p2PSA,PSAD,PHI,PHID and age between the two groups(P＜0.05).PHI(AUC=0.783 7,95％CI:0.711 3-0.856 1)and PHID(AUC=0.782 3,95％CI:0.708 3-0.856 4)showed a good pre-dictive ability in the early screening of prostate cancer.In the clinically significant prostate cancer(csPCa)group,the ROC curve are-as of PHI and PHID were 0.823 0 and 0.788 5,respectively,which showed better predictive efficacy of prediction of csPCa.The ROC curves of the combined diagnostic indexes were plotted on the basis of the independent ROC curves,and the area under the curve of PHI combined with age,p2PSA and PHID(AUC=0.843 6)was the largest and had the best predictive ability among all the com-bined diagnostic indexes.Conclusion:In patients with PI-RADS score 3 and PSA level between 4 and 20 μg/L,PHI and its deriva-tives(PHI and PHID)provide a new way for early screening of prostate cancer compared with the traditional index tPSA,which has a high value of application in reducing the over-penetration.

Abstract:Objective:To analyze the effect of altitude on NIH-CPSI score in patients with chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS)Methods:Clinical data and the results of NIH-CPSI Questionnaire of the 321 patients with CP/CPPS at different altitudes were collected from March 2021 to March 2022.And the influence of altitudes on NIH-CPSI score of CP/CPPS was analyzed.Result:The NIH-CPSI score of patients living at an altitude of 4 300 m was significantly higher than that of patients living at an altitude of 1 500 m and 2 200 m.The CP/CPPS patients who lived in the higher altitude had more severe symptoms of pain and urination as well as lower scores of life quality(P＜0.05).Conclusion:NIH-CPSI score increased significantly with higher alti-tude,indicating more severe symptoms and decreased quality of life in CP/CPPS patients.These findings highlight the need for man-agement strategies for specific heights in patients with CP/CPPS.

Abstract:Objective:To investigate the relationship among seminal oxidation-reduction potential(nORP),sperm DNA frag-mentation(DFI)and semen parameters in patients with varicocele.Methods:Clinical data of 522 patients treated in the reproduc-tive andrology clinic of the Northern Theater General Hospital from November 2023 to December 2023 were retrospectively analyzed,in-cluding 435 men of childbearing age and 87 men of infertile age.The patients were divided into the varicocele group(n=116)and non-varicocele group(n=406)according to clinical diagnosis.The differences of seminal plasma nORP,DFI,sperm high DNA stain ability(HDS)and semen parameters were analyzed between the two groups.The relationship among general clinical data,seminal plasma nORP,semen parameters,DFI and HDS in patients with varicocele were further analyzed.According to the severity of varico-cele,the patients were divided into three groups,including mild,moderate and severe.And the differences of seminal plasma nORP and semen parameters,DFI and HDS among all groups were analyzed.The differences of seminal plasma nORP,semen parameters,DFI and HDS were compared between the varicocele and non-varicocele groups.Results:The total sperm count,sperm concentra-tion,progressive motility sperm percentage(PR％)and normal sperm morphology rate(NSMR)in patients with varicocele were sig-nificantly lower than those in control group(P＜0.05).And seminal plasma nORP,DFI and HDS in patients with varicocele were sig-nificantly higher than those in control group(P＜0.05).Seminal plasma nORP in patients with varicocele was significantly negatively correlated with total sperm,sperm concentration and NSMR(P＜0.05),and significantly positively correlated with DFI and HDS(P＜0.05).There were significant differences in nORP,total sperm count,sperm concentration,PR％,DFI and HDS among mild,moderate and severe varicocele groups(P＜0.05).Seminal plasma nORP,sperm concentration,PR％and DFI in severe group were significantly lower than those in mild and moderate groups(P＜0.05).Sperm count and HDS in severe group were significantly lower than those in mild group(P＜0.05).In infertile patients,seminal plasma nORP,DFI and HDS in varicocele group were significantly higher than those in control group(P＜0.05).And PR％in varicocele group was significantly lower than that in control group(P＜0.05).Conclusions:Seminal plasma nORP in patients with varicocele may be an important marker of oxidative stress affecting DFI and semen parameters.

Abstract:Objective:The aim of this study is to investigate the main active substances of Qilin pills by high performance liq-uid chromatogre-electrostatic field orbitrap mass spectrometry(HPLC-Q-Orbitrap/MS),and explore the mechanism of its action in the treatment of asthenozoospermia by combining network pharmacology and molecular docking.Methods:(1)Qilin pills were quantita-tively and qualitatively analyzed by HPLC-Q-Orbitrap/MS.(2)The top 100 compounds in Qilin pills were screened by content analy-sis and SwissADME,and their targets were predicted.The asthenozoospermia targets were searched through the database.And a"pro-tein-protein interaction"(PPI)network was constructed.KEGG and GO analysis was performed using the DAVID database.And a"drug-target-pathway"network was constructed.(3)SailVina was used for molecular docking.Results:(1)A total of 1 275 known components were found and ranked in Qilin pills by HPLC-Q-Orbitrap/MS analysis.(2)The top 100 compounds in Qilin pills predicted a total of 1 053 targets and 184 potential therapeutic targets for asthenozoospermia.KEGG pathway analysis and GO analysis showed that the treatment of asthenozoospermia by Qilin pills may be related to the steroid hormone synthesis pathway,the response to steroid hormones,the chromosomal region of cells and the activity of steroid hydroxylase.The mechanism of Qilin pills in treating as-thenozoospermia may be related to regulating the synthesis,metabolism and reaction process of sex hormone in the body.(3)The mo-lecular docking results of its key targets(CYP19A1,ESR1,HSP90AA1,p53,HIF1α and BCL2)showed that the key active ingredi-ents M030,M039,M043,M050,M055 and M073 of Qilin pills had spontaneous binding.It had a binding energy of less than-5 kJ/mol.Conclusion:The material basis of Qilin pills has been explored by this study.And the mechanism of action of Qilin pills in the treatment of asthenozoospermia is highly bound to the expression and response process of steroid hormones,which provides a theoretical basis for the clinical application of Qilin pills.

Abstract:Stem cells therapy is an emerging method for the treatment of erectile dysfunction(ED)in men.Compared with tra-ditional treatment,it has the advantage lies in the ability to treat the pathological damage of the penis in patients with ED,which pro-vides new ideas for solving erectile dysfunction fundamentally.However,due to the special anatomical structure of the penis,the thera-peutic effect of stem cells is sometimes unsatisfactory.Therefore,how to improve the effect of stem cells therapy for ED has become a new difficulty.Relevant researches on how to improve stem cell treatment of ED will be reviewed in this article.

Abstract:Objective:Previous studies have shown that insomnia is closely related to erectile dysfunction(ED).However,the causal relationship between them is still unclear.Mendelian randomization(MR)provides a new method for studying the relationship between the two,and the theory of heart-kidney interaction in TCM provides a new idea for exploring the causal relationship between them.Methods:Based on the statistical data collected by genome-wide association studies(GWAS),the causal relationship be-tween insomnia and ED was discussed by MR.Inverse variance weighted(IVW)is the main analysis method,and weighted median(WME),simple mode(SM),weighted mode(WM)and MR Egger method were the supplementary analysis to evaluate the causal effect.MR-Egger intercept test,Cochran Q test and leave-one-out method were used in sensitivity analysis to verify the reliability of MR results.Results:Thirty-nine SNPs significantly related to insomnia were finally included for MR analysis.The results of IVW method in MR analysis showed that insomnia had a significant causal relationship with the increased risk of ED(OR=3.111,95％CI=1.566-6.181,P=1.193 × 10-3).The results obtained by MR-Egger method,WME method,WM method and SM method were consistent with IVW method in the direction of effect.The sensitivity results suggested that the results of this study were robust.Conclusion:Our study reveals the causal relationship between insomnia and ED,which provides a new basis for future clinical practice and prevention and treatment of ED.

Abstract:Objective:To analyze the symptoms,diagnosis and treatment of upper urinary tract calculi patients combined with mild and moderate benign prostatic hyperplasia(BPH)after ureteral stent implantation.Methods:One hundred and six BPH pa-tients who were hospitalized for upper urinary tract calculi and had ureteral stents retained from January 2019 to December 2022 were selected and divided into 2 weeks group and 4 weeks group according to the time of removal of ureteral stents after surgery.Their gener-al clinical data were analyzed and compared.International Prostatic Symptom Scale(IPSS),postoperative ureteral Stent Symptom Questionnaire(USSQ),and incidence of adverse events after ureteral stent removal were recorded before and after removal.Results:The scores of IPSS were significantly increased in all patients,and symptoms in urinary tract had improved significantly after discharge(P＜0.05).Compared with the 2 weeks group,the USSQ score of the 4 weeks group was significantly increased(P＜0.05).And no significant adverse event was observed in the 2 weeks group after the removal of ureteral sten.Conclusion:IPSS score and USSQ score increased significantly during stent implantation in BPH patients with lithiasis.And complications increased sig-nificantly over time.Following thorough clinical assessment,early ureteral stent removal demonstrates both safety and efficacy,repre-senting an optimal therapeutic approach in selected cases.

Abstract:Objective:To evaluate the clinical efficacy of"Shibao Decoction"in the management of late-onset hypogonadism(LOH)caused by deficiency of kidney essence.Methods:Sixty male patients with late-onset hypogonadism of kidney essence defi-ciency type were randomly assigned to the treatment group and the control group,each with 30 cases.The patients in treatment group were treated with oral Shibao Decoction,while the control group was treated with oral Testosterone Undecanoate Capsules.The patients in both groups were treated for 12 weeks.The PADAM symptom score,TCM syndrome score,serum total testosterone(TT),serum free testosterone(FT),sex hormone binding globulin(SHBG),body mass index(BMI),total skeletal muscle mass index(SMI),appendicular skeletal muscle mass index(ASMI),FBG,FINS,and insulin resistance index(HOMA-IR)levels were compared be-tween the two groups.Results:After treatment,PADAM scores for each item and TCM symptoms score decreased,TT and FT in-creased in both groups,all with statistically significant differences from those of pre-treatment(P＜0.05).The level of SHBG in the control group decreased(P＜0.05),which had not changed significantly in the treatment group(P＞0.05).After treatment,SMI and ASMI increased in both groups significantly(P＜0.05).BMI decreased in the control group(P＜0.05),which had not changed significantly in the treatment group(P＞0.05).The level of FINS decreased in the control group(P＜0.05),which had not changed significantly in the treatment group(P＞0.05).FPG had not changed significantly in both groups(P＞0.05),and the insulin resist-ance index(HOMA-IR)had significantly improved in both groups,all with statistically significant differences from those of pre-treat-ment(P＜0.05).After treatment,the total effective rates of PADAM score and TCM syndrome score in the treatment group were 73.3％and 86.6％respectively,and the total effective rates in the control group were 66.7％and 76.6％respectively.The total ef-fective rates of the two scores in the treatment group were slightly higher than those in the control group(P＞0.05).There was no sig-nificant difference in the indicators between the two groups after treatment,and the treatment group is generally comparable with the control group in the therapeutic effects(P＞0.05).And no adverse reactions occurred during treatment in both groups.Conclu-sion:The"Shibao Decoction"has a remarkable therapeutic effect on late-onset hypogonadism caused by deficiency of kidney essence and has good safety.It can be used as an alternative to testosterone undecanoate and is worthy of clinical promotion and application.

Abstract:Objective:The aim of this study is to re-evaluate the systematic reviews and meta-analyses on statins for the treat-ment of erectile dysfunction(ED)and construct an umbrella review,thereby providing robust evidence-based for the clinical applica-tion of statins in ED treatment.Methods:A comprehensive computerized search was conducted across CNKI,Wanfang Database,VIP,WOS,Embase,PubMed,and Cochrane Library databases from their inception to September 12,2024,for all systematic reviews and meta-analyses addressing statin interventions in ED.The methodological quality,reporting quality,and evidence quality of the in-cluded studies were assessed and summarized using PRISMA 2020,AMSTAR 2,and GRADE systems.Results:Four systematic re-views and meta-analyses were included.According to the AMSTAR 2 evaluation,one paper was rated as low quality,while the remai-ning three were classified as very low quality.PRISMA 2020 evaluation results indicated that the average score of the four included studies was 29,with all being of medium quality but exhibiting partial deficiencies.The proportion of fully consistent items across the four studies ranged from 52.38％to 80.95％.GRADE system tool evaluation revealed 11 outcome indicators,of which only one was rated as intermediate evidence.The remainders were categorized as low or very low evidence,with no high-quality evidence identified.Conclusion:Statins demonstrate efficacy in treating ED.However,the current quality of relevant systematic reviews is suboptimal,with notable deficiencies in methodological,reporting,and evidential quality.Further high-quality studies are warranted to provide more reliable evidence-based medical guidance for clinical practice.