Like so many "paid for" registry optimizers it's all a big con.
I run Advanced System Care Pro (only because I got a free upgrade) and it,as with yourself,comes up with in excess of 100 registry issues over and above anything the free version ever found.
These so called problems are most likely to be the registry alterations made by programs which you have recently been using. It's OK to delete them but they will just be reinstated the next time you run the same program - but it sure as hell looks good on paper if you are trying to persuade someone to part with their cash.
Having said that mine does update without a problem.