Low-intensity extracorporeal shockwave therapy for Peyronie's disease: A preliminary study of 32 cases / 中华男科学杂志

<p><b>Objective</b>To investigate the clinical effect of low-intensity extracorporeal shockwave therapy (LI-ESWT) on Peyronie's disease.</p><p><b>METHODS</b>From October 2016 to December 2017, we treated 32 cases of Peyronie's disease by LI-ESWT, with the therapeutic index of 0.09 mJ/mm2 and a pulse frequency of 120 beats/min. Each plaque was approached from two angles, each angle with a shockwave output of 900 times, and the larger ones from three points, each with an output of 600 times in addition to 300 times from the distal and proximal ends of the plaque, respectively. All the patients received 12 courses of treatment (2 courses a week) with a break of 3 weeks between the 1st and 2nd 6 courses. Then we observed the plague size and penile curvature of the patients, obtained their scores on the Visual Analogue Scale (VAS) and International Index of Erectile Function 5 (IIEF-5), and recorded their adverse reactions.</p><p><b>RESULTS</b>The plagues were softened or diminished in different degrees in 9 of the 32 cases and erectile pain was alleviated in 15 cases after treatment. Penile curvature at erection, however, showed no significant improvement. The IIEF-5 scores were increased in 18 of the patients complicated with varied degrees of erectile dysfunction after LI-ESWT. No obvious complications were observed in any of the patients.</p><p><b>CONCLUSIONS</b>Low-intensity extracorporeal shockwave therapy has a certain effect on Peyronie's disease by relieving plague-induced pain and improving the patient's penile erection and quality of life.</p>

Focused low-intensity extracorporeal shock wave therapy for erectile dysfunction: Preliminary observation of 32 cases / 中华男科学杂志

<p><b>Objective</b>To make a preliminary investigation on the safety and efficacy of focused low-intensity extracorporeal shock wave therapy (LI-ESWT) in the treatment of erectile dysfunction (ED).</p><p><b>METHODS</b>We treated 32 ED patients by focused LI-ESWT with the device of Medispec's ED1000. Before and at 4 and 12 weeks after treatment, we evaluated the erectile function of the patients using the International Index of Erectile Function-erectile function domain (IIEF-EF), Erection Hardness Score (EHS), Sexual Encounter Profile questions 2 and 3 (SEP2 and SEP3), and Global Assessment Questionnaire questions 1 and 2 (GAQ1 and GAQ2), and recorded the incidence rate of adverse events.</p><p><b>RESULTS</b>The patients averaged 30.69 years of age. Compared with the baseline, the mean IIEF-EF score of the patients was significantly increased at 4 and 12 weeks after LI-ESWT (14.94 vs 20.97 and 21.47, P <0.01), and so were the EHS (1.75 vs 2.66 and 2.56, P <0.01) and the "Yes" answers to SEP2 (21.88% vs 68.75% and 71.88%), SEP3 (0 vs 43.75% and 56.25%), GAQ1 (NA vs 81.25% and 71.88%) and GAQ2 (NA vs 65.63% and 68.75%). The total effectiveness rates at 4 weeks and 12 weeks were 75% and 71.88% respectively. One of the patients felt penile shaft pain with mild ecchymosis after LI-ESWT but was recovered without special treatment a week later.</p><p><b>CONCLUSIONS</b>LI-ESWT can significantly improve the erectile function of ED patients with no obvious adverse effects within 12 weeks after treatment.</p>

Effect of stent-assisted coil embolization for the treatment of A1 segment anterior cerebral artery aneu-rysms / 医学研究生学报

Objective It is difficult to conduct the intravascular interventional treatment of A1 segment anterior cerebral ar-tery aneurysms. This article aimed to investigate the effect of stent-assisted coil embolization for the treatment of A1 segment anterior cerebral artery aneurysms. Methods Retrospective analysis was made on the clinical data of 8 patients with A1 segment anterior cer-ebral artery aneurysms who were treated in Department of Neurosurgery in Nanjing General Hospital of Nanjing Military Command from June 2015 to July 2017. All the patients underwent endovascular intervention under static inhalation combined with general anesthesia. Immediately after the operation,angiography was performed to observe the embolization of the aneurysm and imaging follow-up was per-formed. The follow-up period was 6 to 30 months,with an average of (13±9) months,followed by Glasgow Outcome Scale (GOS) sco-ring. Results Immediate postoperative angiography showed that all 8 aneurysms were completely embolized and the parent artery re-mained. Seven patients had no ruptured hemorrhage and no new neu-rological dysfunction,with 5 points of GOS score and good prognosis. Five patients underwent DSA follow-up after surgery with no developed aneurysm. Conclusion Stent-assisted coil embolization is techni-cally feasible in treating A1 segment anterior cerebral artery aneu-rysms,which is a choice worthy of clinical promotion.

Stent-assisted technique for the management of subarachnoid hemorrhage caused by ruptured vertebral artery dissecting aneurysm / 医学研究生学报

Objective The stent-assisted technique is widely applied in the treatment of subarachnoid hemorrhage caused by ruptured vertebral artery dissecting aneurysm(VADA). This study investigated the perioperative complications and long-term clinical effect of stent-assisted coiling in the management of VADA-induced subarachnoid hemorrhage. Methods The clinical data on 19 cases of VADA-induced subarachnoid hemorrhage were analyzed retrospec-tively. All the patients underwent digital subtraction angiography (DSA)and stent-assisted coiling within 24 hours after admission.Two of the patients were diagnosed with bilateral VADA and treated with double stents,4 with a single stent,2 with the low-profile visualized intraluminal support device(LVIS),and 11 with double Enter-prise stents. Results Operations were successfully performed in all the cases. Three of the patients died within 2 weeks after surger-y,2 from post-operative rebleeding and the other 1 from some unknown cause;1 patient developed severe postoperative cognitive dys-function,while the other 15 were well recovered. The survived patients were followed up for 6 to 36 months,during which no obvious new neurological deficits were observed. Follow-up DSA revealed 2 cases of recurrence,1 case of stenosis in the stent,and 2 cases of vertebral artery occlusion. Conclusion Stent-assisted coiling is a safe and effective method for the management of VADA-induced subarachnoid hemorrhage,and double-stent implantation may achieve an even better effect.

Stent-assisted coiling for distal anterior cerebral artery aneurysm / 医学研究生学报

Objective Distal anterior cerebral artery aneurysm(DACAA)is rare and difficult to be treated. The aim of this study was to investigate the clinical effect of stent-assisted coiling in the treatment of DACAA. Methods We retrospectively analyzed the clinical data about 15 patients with 15 DACAAs treated by stent-assisted coiling,with all the aneurysms occluded and the parent ar-teries preserved,including 4 ruptured and 11 unruptured aneurysm,8 in the A2 and 7 in the A3 segment. The follow-up ranged from 6 to 33 months,during which we evaluated the prognosis of the patients by radiological and clinical examinations. Results There were no operation-related complications in any of the cases. One patient died of subarachnoid hemorrhage-induced cerebral vasospasm. Fol-low-up angiogram revealed complete occlusion of the aneurysms in 9 cases. The last follow-up Glasgow Outcome Scale score was 5 in all the 14 survived patients. No rupture,rebleeding or fresh neurologic deficits was observed in any of the patients. Conclusion Stent-assisted coiling is safe and effective,with a low short-term recurrence rate,in the treatment of distal anterior cerebral artery aneurysm.

Microsurgical bypass for varicocele with nutcracker syndrome / 中华男科学杂志

Objective@#To investigate the clinical effect and feasibility of internal spermatic vein-inferior epigastric vein (ISV-IEV) bypass surgery in the treatment of varicocele complicated by left renal vein nutcracker syndrome (NCS).@*METHODS@#We retrospectively analyzed the clinical data about 30 cases of varicocele with left renal vein NCS treated by ISV-IEV bypass surgery in our hospital from June 2014 to February 2017. We reviewed the follow-up data and results of ultrasonography, routine urianlysis and semen routine examination.@*RESULTS@#All the operations were successfully accomplished and postoperative color Doppler ultrasonography showed that varicocele was cured in all the cases. At 6 months after surgery, sperm concentration and the percentage of grade a+b sperm were significantly improved (［34.47 ± 8.60］ ×10⁶/ml and ［63.54% ± 9.58］ %) as compared with the baseline (［19.90 ± 8.97］ ×10⁶/ml and ［37.93 ± 8.73］ %) (P <0.05). Hematuria was cured in 23 and alleviated in 1 of the 24 cases. Proteinuria disappeared in all the 14 cases, with neither scrotal pain symptoms nor obvious complications.@*CONCLUSIONS@#ISV-IEV bypass surgery, with its advantages of safety, effectiveness, minimal invasiveness, and simple operation, deserves wide clinical application in the treatment of varicocele with left renal vein NCS.

Embedding sutures of single inner- and outer-prepuce flap for the treatment of concealed penis: A report of 37 cases / 中华男科学杂志

Objective@#To evaluate the clinical effect of embedding sutures of single inner- and outer-prepuce flap in the treatment of concealed penis.@*METHODS@#This retrospective analysis included 37 cases of concealed penis treated by embedding sutures of single inner- and outer-prepuce flap between July 2011 and May 2015. Catheters were pulled out from the patients within 24 hours and the dressing removed about 1 week after surgery. All the patients were followed up for 12－24 months postoperatively for evaluation of the long-term outcomes of surgery.@*RESULTS@#One-stage wound healing was achieved in all the patients. No foreskin flap necrosis, inflammation, edema, voiding dysfunction, or painful erection was found during the follow-up. The penises were extended by 2－4 cm. No complications were observed axcept 8 cases of mild prepuce edema, which all subsided with 6 months postoperatively.@*CONCLUSIONS@#Embedding sutures of single inner- and outer-prepuce flap, with the advantages of simple operation, rapid recovery and few complications, is a desirable surgical option for the treatment of concealed penis.

Risk factors for allergic diseases in children aged 0-24 months in the Wuhu urban area, Anhui Province, China / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the prevalence of allergic diseases in children aged 0-24 months in the Wuhu urban area of Anhui Province and risk factors for allergic diseases.</p><p><b>METHODS</b>Cluster random sampling was performed to select 600 children aged 0-24 months and their mothers from the Wuhu urban area, and a questionnaire survey was conducted to collect the data of disease history, family history, mothers' conditions during pregnancy, and child-rearing situation. Univariate analysis and multivariate logistic regression analysis were performed for such data.</p><p><b>RESULTS</b>Among the 597 children included in the analysis, 56 (9.4%) were diagnosed with allergic diseases in the past. The univariate analysis showed that the age, use of antipyretic and analgesic drugs, a history of allergy in the father or grandparents, and the consumption of fish, shrimps, crabs, and shellfish during pregnancy were significantly associated with past allergic diseases (P<0.05). The multivariate logistic regression analysis showed that the age and a history of allergy in the father or grandparents were positively associated with past allergic diseases (OR=4.0-4.9, 2.7, and 2.4 respectively; P<0.05), while frequent consumption of fish, shrimps, crabs, and shellfish during pregnancy was negatively associated with past allergic diseases (OR=0.3; P<0.05).</p><p><b>CONCLUSIONS</b>A family history of allergy is an independent risk factor for allergic diseases in children aged 0-24 months in the Wuhu urban area of Anhui Province, while frequent consumption of fish, shrimps, crabs, and shellfish during pregnancy is a protective factor.</p>

8.5/11.5F transurethral seminal vesiculoscopy in the diagnosis and treatment of refractory hematospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the clinical application value of 8.5/11.5 F transurethral seminal vesiculoscopy in the diagnosis and treatment of refractory hematospermia.</p><p><b>METHODS</b>We retrospectively analyzed 78 cases of refractory hematospermia diagnosed and treated by 8.5/11.5 F transurethral seminal vesiculoscopy from June 2012 to June 2014. The patients underwent serum PSA examination, transrectal ultrasonography, seminal vesicle ultrasonography, and pelvis CT or MRI before surgery, and all received transurethral seminal vesiculoscopy under the 8.5/11.5 F rigid ureteroscope.</p><p><b>RESULTS</b>Operations were all successfully accomplished, which revealed abnormal opening of the ejaculatory duct in 5 cases, mucosal inflammatory hyperemia in the prostatic utricle and seminal vesicle in 78, dark red mucilage substance in the seminal vesicle in 34, seminal vesicle stones in 19, small polyp in the seminal vesicle in 2, and ejaculatory duct or seminal vesicle cyst in 4. All the patients received symptomatic treatment during the surgery. After surgery, hematouria was found in 13 cases, which disappeared within 2 weeks, pelvic hematoma in 1 case, which was cured by conservative treatment within 3 months, and epididymitis in 2 cases, which was controlled by anti-infection treatment. Hematospermia recurred in 3 cases during the 1-year postoperative follow-up.</p><p><b>CONCLUSION</b>8.5/11.5 F transurethral seminal vesiculoscopy, with its advantages of easy operation, wide field of vision, large channel for operation, and few complications, deserves general clinical application in the diagnosis and treatment of refractory hematospermia.</p>

Yimusake Tablet: safe and efficacious for premature ejaculation / 中华男科学杂志

<p><b>OBJECTIVE</b>To objectively evaluate the efficacy and safety of Yimusake Tablet in the treatment of premature ejaculation (PE) through a multi-centered large-sample trial.</p><p><b>METHODS</b>We conducted a multi-centered, open, fixed-dose, and self-compared clinical trial among 300 patients with diagnosed PE. The trial lasted 12 weeks, including 4 weeks without any medication and 8 weeks of treatment with Yimusake Tablet, 2 pills (1 g) per night. We observed the intravaginal ejaculation latency time (IELT) before and after treatment, evaluated the safety of medication, and performed a questionnaire investigation on the patients' satisfaction.</p><p><b>RESULTS</b>Of the 300 PE patients, 288 accomplished the clinical trial. The patients ranged in age from 22 to 60 years, averaging at 31.6 years. The mean IELT of the patient was 62.5 seconds at baseline, 168.9 seconds after 4 weeks of treatment with Yimusake Tablet, and 222.2 seconds after 8 weeks of medication. Among the 157 patients with normal erectile function (IIEF >21), the mean IELT was 71.4 seconds before treatment, 147.4 seconds after 4 weeks of medication, and 172.5 seconds after 8 weeks of medication. The patients' satisfaction was significantly increased after treatment. Those complicated by mild to moderate erectile dysfunction achieved different degrees of improvement in the IIEF-5 score, with a mean increase of 3.8. Only a few patients experienced mild adverse events, including constipation, dry mouth, nose bleeding, abdominal pain, and lumbosacral pain, which were all relieved without drug withdrawal.</p><p><b>CONCLUSION</b>Yimusake Tablet is a safe and effective medicine for the treatment of PE.</p>

Value of spermatic cord sonography in the early diagnosis and treatment of testicular torsion / 中华男科学杂志

<p><b>OBJECTIVE</b>To improve the early diagnosis and therapeutic outcomes of testicular torsion.</p><p><b>METHODS</b>We retrospectively reviewed the clinical data of 49 cases of testicular torsion along with the results of their intratesticular color Doppler flow imaging (CDFI) and spermatic cord sonography.</p><p><b>RESULTS</b>Of the 49 cases, 42 showed abnormal intratesticular blood flow, including 3 cases of increased blood flow, while the other 7 presented no obvious abnormality. Morphological abnormality of the spermatic cord was found in 47 cases. Twenty-eight cases underwent testis removal, and the other 21 received detorsion and orchidopexy, in which 12 testes were preserved with normal size and blood flow.</p><p><b>CONCLUSION</b>Spermatic cord sonography and intratesticular CDFI play an important role in the early diagnosis of testicular torsion. And early surgical exploration contributes to the preservation of the testis.</p>

Callotasis for segmental bone defects in the femur / 中南大学学报(医学版)

OBJECTIVE@#To study the clinical efficacy of callotasis for pathological segmental defects in child femur.@*METHODS@#Thirty-nine patients with segmental femoral defects suffered from suppurative osteomyelitis were treated with the bilateral, unilateral external fixation frame or intramedullary callotasis. The rolongational rate was from 2 to 2.5 cm per month after the operation.@*RESULTS@#After a 13 to 57 month follow-up, all cases were healed according to clinical examination and radiological observation. The prolongational length ranged from 9 to 31 centimeters. Average ratio of prolongation reached 49%. The healing index was 30 d/cm, and the healing time of non-union was 134 days. No recurrent suppurative osteomyelitis or fracture was observed.@*CONCLUSION@#Callotasis is a reliable, simple and hyperadaptable method for femural segmental defects.