Penile sensory thresholds in subtypes of premature ejaculation: implications of comorbid erectile dysfunction / 亚洲男科学杂志(英文版)

Penile hypersensitivity plays an important role in premature ejaculation (PE), but differences in penile sensitivity among subtypes of PE are unknown. Therefore, we compared penile sensory thresholds in PE subtypes of lifelong and acquired PE, PE with and without erectile dysfunction (ED), PE with an intravaginal ejaculation latency time ≤1 min and >1 min, and PE with and without orgasmic pleasure perceptual dysfunction. During August 2014 to January 2016, 136 patients with PE were included. Penile warm, cold, and vibratory thresholds were measured. Data of clinical characteristics, sexual life, Premature Ejaculation Diagnostic Tool (PEDT) score, and the 5-item version of the International Index of Erectile Function (IIEF-5) score were collected. Vibratory thresholds of the PE with ED group were higher in the right coronal sulcus (median amplitude: 4.92 vs 3.65 μ m, P = 0.02) and the right penile shaft (median amplitude: 3.87 vs 3.30 μ m, P = 0.03), while differences in penile sensory thresholds between other subtypes were not significant. The median PEDT score was lower in the PE without ED group (12 vs 14, P < 0.001). The IIEF-5 and PEDT scores were negatively correlated (r = -0.29, P < 0.001). Patients with orgasmic pleasure perceptual dysfunction had a lower median IIEF-5 score (20 vs 21, P = 0.02). Patients with PE and ED had lower penile sensitivity, and ED was associated with more severe symptoms and weaker orgasmic pleasure perception. In men with PE, management of comorbid ED is necessary. In case of side effects in erectile function, topical anesthetics should be cautiously used in men with PE and ED.

Therapeutic effect of Jinghuosu on oligospermia and asthenospermia / 中华男科学杂志

Objective@#To investigate the effects of the compound preparation Jinghuosu on oligospermia and asthenospermia.@*METHODS@#This multi-centered clinical study included 120 cases of mild to moderate idiopathic oligospermia or asthenospermia, all treated with oral Jinghuosu once a bag, bid, for 3 successive months. Before and at 1, 2 and 3 months after treatment, we detected sperm concentration, total sperm motility, progressive sperm motility and normal sperm morphology of each ejaculate, and recorded whether the patients had any adverse reactions.@*RESULTS@#After 3 months of treatment, all the patients showed obvious improvement in semen parameters, most significantly in sperm concentration, total sperm motility, and the percentages of progressive motile sperm and morphologically normal sperm (P <0.05). No significant adverse reactions were observed during the 3 months of medication.@*CONCLUSIONS@#Jinghuosu has a significant efficacy and no obvious adverse effect in the treatment of mild to moderate oligospermia and asthenospermia.

Construction of finite element model and stress analysis of anterior cruciate ligament tibial insertion

Objective: The aim of the present study was to develop a more realistic finite element [FE] model of the human anterior cruciate ligament [ACL] tibial insertion and to analyze the stress distribution in the ACL internal fibers under load. Methods: The ACL tibial insertions were processed histologically. With Photoshop software, digital images taken from the histological slides were collaged, contour lines were drawn, and different gray values were filled based on the structure. The data were exported to Amira software and saved as ".hmascii" file. This document was imported into HyperMesh software. The solid mesh model generated using HyperMesh software was imported into Abaqus software. The material properties were introduced, boundary conditions were set, and load was added to carry out the FE analysis. Results: The stress distribution of the ACL internal fibers was uneven. The lowest stress could be observed in the ACL lateral fibers under tensile and shear load. Conclusion: The establishment of ACL tibial insertion FE model and mechanical analysis could reveal the stress distribution in the ACL internal fibers under load. There was greater load carrying capacity in the ACL lateral fibers which could sustain greater tensile and shear forces

Safety and efficacy of L-carnitine and tadalafil for late-onset hypogonadism with ED: a randomized controlled multicenter clinical trial / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the safety and effect of L-carnitine combined with tadalafil in the treatment of late-onset hypogonadism (LOH) with erectile dysfunction (ED).</p><p><b>METHODS</b>We randomly divided 140 cases of LOH with ED aged 40 -70 years into a treatment and a control group to receive L-carnitine + tadalafil and testosterone undecanoate + tadalafil, respectively. After 8 weeks of treatment, we obtained the scores on IIEF-5 and Aging Male Symptoms (AMS), observed changes in the levels of sex hormones, analyzed the results of the routine blood test and PSA level, and evaluated the safety of medication.</p><p><b>RESULTS</b>Finally, 110 cases were included, 60 in the treatment group and 50 in the control. After 8 weeks of medication, the IIEF-5 and AMS scores were significantly improved as compared with the baseline both in the treatment group (17.7 +/- 3.5 vs 10.2 +/- 2.7 and 36.2 +/- 6.5 vs 48.8 +/- 5.8) and in the control group (16.7 +/- 2.6 vs 9.3 +/- 2.4 and 35.8 +/- 6.6 vs 50.7 +/- 5.0) (both P < 0.05), with no significant differences between the two groups (P > 0.05). As for the safety of medication, there were no significant differences between the two groups before and after treatment (P > 0.05). Two patients in the control group showed a PSA level > 4 microg/L, which was confirmed to be caused by prostatitis during follow-up.</p><p><b>CONCLUSION</b>L-carnitine combined with tadalafil is safe and effective for the treatment of LOH with ED.</p>

Efficacy of natural vitamin E on oligospermia and asthenospermia: a prospective multi-centered randomized controlled study of 106 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the therapeutic effect of natural vitamin E (VitE) on oligospermia and asthenospermia in in- fertile men.</p><p><b>METHODS</b>We conducted a prospective multi-centered randomized controlled study on 64 infertile men with oligospermia (31 as controls treated with Tamoxifen 10 mg bid and 33 as experimental cases treated with Tamoxifen 10 mg bid + VitE 100 mg tid) and 42 cases of asthenospermia (20 as controls treated with Levocarnitine oral solution 1 bottle bid and 22 as experimental cases treated with Levocarnitine oral solution 1 bottle bid + VitE 100 mg tid). We compared the control and experimental groups in sperm concentration and percentage of progressively motile sperm before and 3 months after medication, as well as the rate of clinical pregnancy and adverse events.</p><p><b>RESULTS</b>Among the oligospermia patients, the average sperm concentrations in the control and experimental groups were 8.00 x 10(6)/ml and 10.66 x 10(6)/ml before medication (P > 0.05). After medication, the numbers of cases evaluated as with no, slight, moderate and marked improvement in sperm concentration were 10 and 9 (P > 0.05), 16 and 14 (P > 0.05), 5 and 4 (P > 0.05) and 0 and 0 (P >0.05); and the numbers of natural pregnancies were 0 and 6 in the control and experimental groups (P < 0.01). Among the asthenospermia patients, the average rates of progressively motile sperm were 17.00% and 18.10% in the control and experimental groups before medication (P > 0.05). After medication, the numbers of cases evaluated as with no, slight, moderate and marked improvement in the percentage of progressively motile sperm were 7 and 2 (P < 0.01), 4 and 8 (P < 0.01), 3 and 2 (P > 0.05) and 1 and 1 (P > 0.05), and the numbers of natural pregnancies were 5 and 9 in the two groups (P < 0.01), but no adverse events were observed.</p><p><b>CONCLUSION</b>As a safe and effective adjuvant agent for the treatment of oligospermia and asthenospermia, vitamin E can improve sperm concentration, the percentage of progressively motile sperm, and finally the rate of natural pregnancy.</p>

Assisted reproductive technology in the treatment of male infertility: potential risks and tactics / 中华男科学杂志

Assisted reproductive technology (ART), developed in the end of last century, has been playing an irreplaceable role in the treatment of male infertility, though it does have its potential risks, including the induction of monozygotic twins, premature delivery, high incidence of birth defects, etc. How to avoid these risks has posed a challenge and demands earnest attention from andrologists. This article summarizes the main potential risks of ART and proposes some tactics concerning patient evaluation, health education and treatment standardization, so as to optimize the outcomes and minimize the risks. Meanwhile, emphasis is placed on the importance of etiological and anti-oxidant strategies in the treatment of male infertility.

Application of quantitative temperature testing in diagnosis of neurogenic erectile dysfunction / 法医学杂志

OBJECTIVE@#To explore the application of quantitative temperature testing (QTT) in forensic identification and clinical diagnosis of neurogenic erectile dysfunction (NED).@*METHODS@#TSA-II-NeuroSensory Analyzer was used to measure the thresholds of four kinds of sensory, including cold, cold pain, heat, heat pain, in 22 normal and 35 NED patients at dorsal glans (DG), left thigh interior (LTI) and left thenar (LT). To calculate the relative thresholds of the sensory mentioned above between DG and LTI (DG/LTI), and between DG and LT (DG/LT). Then to analyze those thresholds and the relative thresholds.@*RESULTS@#NED group showed significant higher threshold than the normal group in DG-heat, DG-heat pain, LTI-heat, LTI-heat pain, DG/LTI-heat, DG/LT-heat, DG/LT-heat pain (P < 0.05).@*CONCLUSION@#The threshold of QTT at dorsal glans could be used as an accessory indicator in forensic medicine and clinical diagnosis of NED.

Mutation screening of the TYR and P gene in three patients with oculocutaneous albinism / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To identify the mutations of the tyrosinase gene (TYR) and P gene in patients with oculocutaneous albinism (OCA).</p><p><b>METHODS</b>Polymerase chain reaction (PCR) and denaturing high performance liquid chromatography (DHPLC) were applied to detect the mutations in all exons of TYR gene and P gene. Then DNA sequencing and restriction endonuclease analysis were used to confirm the mutations detected by DHPLC. Novel mutations were screened in 100 unrelated persons with normal phenotypes to exclude the possibility of polymorphism.</p><p><b>RESULTS</b>Two mutations were detected in the P gene of the three patients and none in TYR gene. Heterozygous mutation of T450M in exon 13 of the P gene was detected in patient 1. Patient 2 had a heterozygous mutation of T450M in exon 13 and a heterozygous mutation of G775R in exon 23 of the P gene. Patient 3 had a heterozygous mutation of G775R as well. Restriction endonuclease analysis of the P gene exon 13 showed that the Oli I site had partly disappeared resulting from the heterozygous mutation T450M in patient 1 and patient 2, but not in 100 unrelated individuals. The heterozygous mutation T450M is a novel mutation.</p><p><b>CONCLUSION</b>Gene diagnosis of OCA can be carried out effectively by combining PCR, DHPLC, DNA sequencing and restriction endonuclease analysis.</p>

Strontium-89: a desirable therapeutic for bone metastases of prostate cancer / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of strontium-89 (89Sr) in the treatment of painful bone metastases of prostate cancer.</p><p><b>METHODS</b>A total of 116 patients with painful bone metastases of prostate cancer received bilateral orchiectomy and incretion, followed by intravenous injection of 89Sr at the dose of 1.48-2.22 MBq (40-60 microCi)/kg. The clinical effects were evaluated by follow-up analysis.</p><p><b>RESULTS</b>After the 89Sr treatment, appetite and sleep were evidently improved in 33.6% and 56.0% of the patients respectively, the applied dose of anodyne reduced in 61.2%, pain alleviated in 83.6%, with an absolute palliation rate of 24.1%. Pain relief started at 3-21 (10.2 +/- 6.5) days and lasted 3-12 (5.3 +/- 2.2) months. Flare ache occurred in 31.9% of the patients. Compared with pre-treatment, the mean score on Karnofsky's performance status (KPS) was 20.0% higher, and the WBC count decreased to 3.0-3.9 x 10(6)/L in 18.1% of the patients. Whole body bone scintigraphy of 53 followed-up patients showed that 39 (73.6%) of them exhibited an obvious decrease in the number of metastases, 10 (18.9% remained in a stabilized state and only 4 (7.5% deteriorated.</p><p><b>CONCLUSION</b>89Sr, capable of inhibiting bone metastasis, palliating pain and improving the quality of life with few adverse effects, can be used as a desirable therapeutic for painful bone metastases of prostate cancer.</p>

A follow-up study of arthroscopic combined reconstruction of anterior and posterior cruciate ligaments with allograft patellar tendon / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the therapeutic effect of combined reconstruction of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) simultaneously by using allograft patellar tendon under arthroscopy.</p><p><b>METHODS</b>From May 2003 to November 2005, 10 cases of ruptured ACL and PCL were fixated with compressed screws and reconstructed under arthroscopy with allograft patellar tendon simultaneously. The clinical results were evaluated according to IKDC, Lysholm, and Tegner clinical rating scales.</p><p><b>RESULTS</b>All patients were followed up for 12-30 months (mean: 18 months). At the last follow-up, there was no knee extension limitation and knee flexion was between 120 degree and 135 degree,with an average of 128.38 degree. The Lysholm score of the 10 cases was 66.5+/-5.6 before operation and 89.8+/-3.4 at last follow up. The difference was statistically significant (P less than 0.01). The average Tegner activity score decreased from 6.9+/-1.7 (range: 4-9) before injury to 5.5+/-1.6 (rang:2-9) at the follow-up (P equal to 0.53). At the end of follow-up, IKDC score was graded as A in 4 cases (40.0%), B in 5 (50.0%), and C in 1 (10.0%). Of the 10 patients, 8 returned to the same sports level as before injury and 2 were under the level.</p><p><b>CONCLUSION</b>Arthroscopic combined reconstruction of ACL and PCL with allograft patellar tendon has the advantages of minimal trauma in surgery and reliable satisfactory outcome.</p>

Bone-patellar tendon-bone graft in anterior cruciate ligament reconstruction: allograft versus autograft / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical result of arthroscopic anterior cruciate ligament (ACL) reconstruction with either allo- or auto- bone-patellar tendon-bone (B-PT-B) grafts.</p><p><b>METHODS</b>From February 2002 to January 2006, 142 of 187 cases of ACL ruptures who received ACL reconstruction with B-PT-B grafts were studied retrospectively. There were 93 male and 49 female whose age was from 15 to 57 years (mean 26 years). Patients were divided into 2 groups by graft selection: 38 patients with autograft and 104 with allograft. Clinical results were evaluated according to IKDC, Lysholm, Irgang and Larson scales. Sub-items of scales such as pain, swelling and laxity were specifically evaluated.</p><p><b>RESULTS</b>All of the patients were followed up with an average of 24 months (range from 6 to 43 months). All grafts were radiographically in good position at the time of follow-up. KT-1000 examination of affected knee showed less than 3 mm anterior translation difference compared with contralateral one's. Allograft group: 85 patients got normal IKDC score (81.7%). Lysholm score 82.8 +/- 8.5, Irgang score 79.2 +/- 7.3, Larson score 86.7 +/- 3.1. Autograft group: 29 patients got normal IKDC score (76.3%). Lysholm score 84.6 +/- 9.5, Irgang score 79.5 +/- 7.6, Larson score 88.9 +/- 6.8. No significant statistical difference was found between the 2 groups in the comprehend scale (P>0.05).</p><p><b>CONCLUSIONS</b>Both autograft and allograft group achieve good results, and the allograft B-PT-B could provide the similar clinical result as autograft, the preliminary result of allograft reconstruction might indicate predictable result in the future.</p>