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Selective dorsal neurotomy (SDN) is a surgical treatment for primary premature ejaculation (PE), but there is still no standard surgical procedure for selecting the branches of the dorsal penile nerves to be removed. We performed this study to explore the value of intraoperative neurophysiological monitoring (IONM) of the penile sensory-evoked potential (PSEP) for standard surgical procedures in SDN. One hundred and twenty primary PE patients undergoing SDN were selected as the PE group and 120 non-PE patients were selected as the normal group. The PSEP was monitored and compared between the two groups under both natural and general anesthesia (GA) states. In addition, patients in the PE group were randomly divided into the IONM group and the non-IONM group. During SDN surgery, PSEP parameters of the IONM group were recorded and analyzed. The differences in PE-related outcome measurements between the perioperative period and 3 months' postoperation were compared for the PE patients, and the differences in effectiveness and complications between the IONM group and the non-IONM group were compared. The results showed that the average latency of the PSEP in the PE group was shorter than that in the normal group under both natural and GA states (P < 0.001). Three months after surgery, the significant effective rates in the IONM and non-IONM groups were 63.6% and 34.0%, respectively (P < 0.01), and the difference in complications between the two groups was significant (P < 0.05). IONM might be useful in improving the short-term therapeutic effectiveness and reducing the complications of SDN.
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Masculino , Humanos , Eyaculación Prematura/cirugía , Monitorización Neurofisiológica Intraoperatoria/métodos , Estudios Prospectivos , Procedimientos Neuroquirúrgicos/métodos , Pene/cirugía , Estudios RetrospectivosRESUMEN
Recent research has highlighted structural and functional abnormalities in the cerebral cortex of patients with premature ejaculation (PE). These anomalies could play a pivotal role in the physiological mechanisms underlying PE. This study leveraged functional magnetic resonance imaging (fMRI), a noninvasive technique, to explore these neural mechanisms. We conducted resting-state fMRI scans on 36 PE patients and 22 healthy controls (HC), and collected data on Premature Ejaculation Diagnostic Tool (PEDT) scores and intravaginal ejaculation latency time (IELT). Employing a surface-based regional homogeneity (ReHo) approach, we analyzed local neural synchronous spontaneous activity, diverging from previous studies that utilized a volume-based ReHo method. Areas with significant ReHo differences between PE and HC groups underwent surface-based functional connectivity (FC) analysis. Significant discrepancies in ReHo and FC across the cortical surface were observed in the PE cohort. Notably, PE patients exhibited decreased ReHo in the left triangular inferior frontal gyrus and enhanced ReHo in the right middle frontal gyrus. The latter showed heightened connectivity with the left lingual gyrus and the right orbital superior frontal gyrus. Furthermore, a correlation between ReHo and FC values with PEDT scores and IELT was found in the PE group. Our findings, derived from surface-based fMRI data, underscore specific brain regions linked to the neurobiological underpinnings of PE.
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Masculino , Humanos , Eyaculación Prematura , Mapeo Encefálico/métodos , Encéfalo , Corteza Cerebral , Imagen por Resonancia Magnética/métodosRESUMEN
Objective:To explore the application effect of three mode pre-rehabilitation strategy in gastric cancer patients after laparoscopic radical operation and its effect on the recovery of physical function and quality of life after operation.Methods:Totally 96 patients undergoing elective laparoscopic-assisted radical gastric cancer surgery admitted in the Second Affiliated Hospital of Anhui Medical University from January 2019 to September 2020 were divided into control group (48 cases) and observation group (48 cases) by the random number table. Finally two cases in control group were excluded. The control group received gastric cancer regular preoperative health guidance, the observation group received trimodal pre-habilitation strategy for 6-8 days on the basis of the control group. The perioperative indicators and complications were compared between the two groups. The 36-item Health Survey Summary (SF-36) scores were measured before and after intervention.Results:The first postoperative exhaust time, first out of bed time, first oral meal time, hospital stay in the observation group were (61.49 ± 6.71) hours, (19.54 ± 6.13) hours, (71.23 ± 6.79) days, (5.62 ± 1.03) days, which lower than (79.21 ± 8.15) hours, (22.95 ± 7.19) hours, (78.95 ± 7.21) days, (6.64 ± 1.17) days in the control group, and the differences were statistically significant between the two group ( t values were 2.48-11.53, all P<0.05). The incidence of complications was 6.25% (3/48) in the observation group and 21.74% (10/46) in the control group, and the difference was statistically significant between the two groups ( χ2=8.72, P<0.05). At 1 d before operation and 30 d after operation, the average scores of SF-36 were (68.74 ± 8.02), (65.85 ± 7.44) points in the observation group and (60.73 ± 7.43), (61.04 ± 6.85) points in the control group, and the differences were statistically significant ( t=5.02, 3.26, both P<0.05). Conclusions:Preoperative three mode pre-rehabilitation training for gastric cancer patients is beneficial to improving the state of exercise, nutrition and immune function, speeding up postoperative gastrointestinal function and overall rehabilitation, reducing the incidence of postoperative complications and improving the quality of life of patients.
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【Objective】 To evaluate the anti-HCV detection ability of our laboratory, and explore the factors that may affect anti-HCV detection, so as to provide data and basis for the evaluation of laboratory ability. 【Methods】 The number of initial reactive (IR) and repeated reactive(RR)samples and the reagent utilization rate in anti-HCV from 2019 to 2020 were compared with the national reagents of the same group. 【Results】 1)The average unqualified rate of anti-HCV detection was 0.25%, with the lowest rate at 0.19%, 33/17 774, and the highest rate at 0.37%, 44/11 940; 2)The retest rates of reagent 1 and reagent 2 were significantly different (P 0.05), while the RR/IR rates of reagent 1 and reagent 2 showed a slow upward trend; 4)The solo reagent unqualified rate of reagent 1 and reagent 2 showed statistically significant difference (P < 0.05); 5)The reagent utilization rate was basically the same as the national average level of reagents in the same group. 【Conclusion】 The anti-HCV detection indicators of our laboratory are relatively stable, but other factors such as personnel training, equipment performance and environment also have an impact on the detection ability of laboratories. Fine management of various element should be carried out, and external quality assessment reports of blood testing laboratory should be analyzed to further improve the anti-HCV detection ability of the laboratory.
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OBJECTIVE@#To explore the risk factors of anxiety and depression in patients with suspected coronavirus disease 2019 (COVID-19) so as to achieve early intervention and better clinical prognosis.@*METHODS@#Seventy-six patients with suspected COVID-19 in fever isolation wards of Second Hospital of Lanzhou University were enrolled From January 31, 2020 to February 22, 2020. Their clinical baseline data were collected. The anxiety of patients was assessed by Hamilton Anxiety Scale, and the depression of patients was assessed by Hamilton Depression Scale. Multivariate Logistic regression analysis was performed to explore the risk factors of anxiety and depression in these patients.@*RESULTS@#Female patients are more likely to have anxiety (=3.206, 95%: 1.073-9.583, <0.05) and depression (=9.111, 95%: 2.143-38.729, <0.01) than male patients; patients with known contact history of epidemic area and personnel in epidemic area are more likely to have depression (=3.267, 95%: 1.082-9.597, <0.05).@*CONCLUSIONS@#During the isolation treatment of suspected COVID-19 patients, early psychological intervention should be carried out for the female patients with known contact history of epidemic area and personnel in epidemic area, and drug treatment should be given in advance if necessary.
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Femenino , Humanos , Masculino , Ansiedad , Diagnóstico , Terapéutica , Betacoronavirus , Infecciones por Coronavirus , Diagnóstico , Psicología , Depresión , Diagnóstico , Modelos Logísticos , Pandemias , Neumonía Viral , Diagnóstico , Psicología , Factores de RiesgoRESUMEN
OBJECTIVE@#To study the effect of gestational age at birth on the neurobehavioral development of preschool children.@*METHODS@#A total of 25 254 preschool children from Ma'anshan of Anhui Province, Taizhou of Zhejiang Province, and Yangzhou of Jiangsu Province were enrolled. The preschool children were divided into three groups based on their gestational ages at birth: preterm group (2 760 cases; 28-36 weeks), early term group (6 005 cases; 37-38 weeks), and full term group (16 489 cases; ≥39 weeks). The Ages and Stages Questionnaires-Third Edition (ASQ-3) was employed to evaluate the children's neurobehavioral development.@*RESULTS@#The preterm group had significantly lower scores of the five domains of ASQ-3, communication, gross motor, fine motor, problem solving, and personal-social, than the full term group (P0.05). The multiple linear regression analysis indicated a significant positive correlation between gestational age and the five domains of ASQ-3 after adjustment for confounding factors including sex, age, body mass index, and parental education level (P<0.01).@*CONCLUSIONS@#Children born preterm have poorer neurobehavioral development than those born full term and early term, whereas children born full term and early term have similar neurobehavioral development. Gestational age at birth is an independent influencing factor for neurobehavioral development in preschool children.
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Preescolar , Humanos , Recién Nacido , Conducta Infantil , Desarrollo Infantil , China , Ciudades , Edad Gestacional , Encuestas y CuestionariosRESUMEN
Selective dorsal penile neurotomy is a surgical method proposed for the treatment of primary premature ejaculation in recent years. In view of the inconsistency of surgical methods and the controversy of the operation itself, Large-scale, multi-center research evidence is needed for comprehensive evaluation. This article starts with the etiology of premature ejaculation, and reviews the anatomical basis, indications, contraindications, surgical methods, efficacy evaluation, complications and combined treatment methods of selective dorsal neurotomy.
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BACKGROUND@#The precise pathophysiology of venous erectile dysfunction (VED) was still unclear. Dynamic infusion cavernosometry and cavernosography (DICC) was the gold standard approach for the diagnoses of VED. However, a standard operative procedure of DICC was needed and it was unclear whether DICC could show promise in accurate assessment and treatment of VED. The aim of this study was to establish an optimized operation process of DICC and evaluate the efficacy of DICC in the diagnoses and therapy of VED.@*METHODS@#One hundred and forty-seven VED patients identified by the color doppler duplex ultrasonography (CDDU) were included. Then the method of DICC was adopted to assess the severity of VED and all patients were divided into 4 groups, including (1) non-VED; (2) mild VED; (3) moderate VED and (4) severe VED. All patients received the treatment of psychotherapy. Drug therapy, the intervention embolism of corpus cavernosum and the implantation of penile prosthesis were applied if psychotherapy was ineffective for patients. The international index of erectile function (IIEF-5) scores of patients were collected and compared before and after treatment.@*RESULTS@#IIEF-5 score of non-VED group after psychotherapy (19.35 ± 3.59) and drug therapy (23.31 ± 0.75) was higher than that before psychotherapy (15.30 ± 2.72, t = -4.31, P 0.05). IIEF-5 score of severe VED group was increased under the treatment of implantation of penile prosthesis (23.25 ± 0.71) compared with that before treatment (8.00 ± 0.39, t = -53.25, P < 0.05).@*CONCLUSION@#DICC was a valid diagnostic tool that could identify patients with VED. And DICC had great effect on the diagnosis and individual therapy for patients with VED in varying degrees. Moreover, the manipulation of DICC needed uniform standards.
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Adulto , Humanos , Masculino , Persona de Mediana Edad , Embolización Terapéutica , Impotencia Vasculogénica , Diagnóstico , Terapéutica , Pene , Diagnóstico por Imagen , Ultrasonografía Doppler en Color , VenasRESUMEN
Objective :To analyze therapeutic effect of Mongolian medicine Guanxinshutong (MM) capsule on restenosis af—ter stenting in patients with acute myocardial infarction (AMI).Methods : The 108 AMI patients ,who received stenting in our hospital from May 2014 to May 2016 ,were selected.The patients were equally divided into routine treatment group and MM group (received MM capsule based on routine treatment group ) ,therapeutic processes of both groups was one year .Serum levels of endothelin (ET)—1 ,nitric oxide (NO) and C reactive protein (CRP) before and one year after treat—ment ;recurrence rate of angina pectoris ,coronary restenosis rate and incidence rate of adverse cardiac events during one—year follow—up were observed and compared between two groups .Results : Recurrence rates of angina pectoris on six months and one year after treatment were significantly lower than that of three months after treatment (9.25%,5.56%vs.33.33%) in MM group (P=0.002 ,0.001) ,and significantly lower than those of routine treatment group (25.93%, 22.22%) , P=0.023 ,0.012. On one year after stenting ,coronary restenosis rate of MM group was significantly lower than that of routine treatment group (9.26% vs.33.33%) , P=0.002. Compared with before treatment ,on one year af—ter treatment ,there were significant reductions in serum ET—1 and CRP levels ,and significant rise in NO level in two groups , P<0.01 all ;compared with routine treatment group on one year after treatment ,there were significant reductions in serum levels of ET—1 [(125.09 ± 33.41) ng/L vs.(107.16 ± 34.26) ng/L] and CRP [(18.59 ± 4.63) mg/L vs.(7.23 ± 3.74) mg/L] ,and significant rise in NO level [ (6.81 ± 1.47) μmol/L vs.(11.45 ± 1.35) μmol/L] in MM group , P<0.01 all.During one—year follow—up ,incidence rate of adverse cardiac events in MM group was significantly lower than that of routine treatment group (9.26% vs.25.93%) , P=0.023. Conclusion : Mongolian medicine Guanxinshutong cap—sule can significantly prevent restenosis ,reduce recurrence of angina pectoris ,serum ET—1 and CRP levels and incidence of adverse cardiac events ,and improve prognosis in AMI patients after stenting .
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Objective :To explore influence of dual-and triple-anticoagulant therapy on hemorrhage events ,laboratory in-dexes and cardiovascular events after percutaneous coronary intervention (PCI) in patients with atrial fibrillation (AF) complicated coronary heart disease (CHD).Methods : Clinical data of 100 AF + CHD patients were analyzed .All subjects received PCI and anticoagulant therapy after PCI .Dual-therapy group (n= 50) received dual-anticoagulant program and triple-therapy group (n=50) received triple-anticoagulant program.Levels of blood C reactive protein (CRP) ,fibrinogen (Fg) ,D-dimer (D-D) and platelet count (PLT) before and after treatment ,incidence of hemorrhage events and adverse cardiovascular events during treatment were compared between two groups .Results : Compared with dual-therapy group af-ter 12-month treatment ,there were significant reductions in blood levels of CRP [(16-81 ± 4-49) mg/L vs.(7-86 ± 1-64) mg/L] ,PLT [ (298-47 ± 54-33)×109/L vs.(148-89 ± 23-11)×109/L] ,Fg [ (5-59 ± 1-41) g/L vs.(2-14 ± 0-56) g/L] and D-D [(0-37 ± 0-08) mg/L vs.(0-21 ± 0-06) mg/L] in triple-therapy group ,P=0-001 all.Incidence rate of ad-verse cardiovascular events in triple-therapy group was significantly lower than that of dual-therapy group (6-00% vs. 22-00%, P=0-021) ,there was no significant in incidence rate of hemorrhage events between two groups , P=0-182-Conclusion : Triple-anticoagulant therapy can significantly improve therapeutic effect with high safety in AF + CHD pa-tients after PCI ,which is worth extending .
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OBJECTIVE@#To quantitatively analyze image quality of two sets of phantom (CatPhan504 and Cheese) Megavoltage computed tomography (MVCT) images acquired by Helical Tomotherapy with three scanning modes (Fine, Normal and Coarse), and to explore and validate a semi-automatic quality assurance procedure for MVCT images of Helical Tomotherapy.@*METHODS@#On Helical Tomotherapy, CatPan504 and Cheese phantoms were scanned with three pitch levels (Fine, Normal, Coarse: 4 mm, 8 mm, 12 mm/circle) respectively. Pylinac, Matlab and Eclipse were used to calculate and compare spatial resolution, noise level and low contrast resolution of images obtained under three scanning modes respectively. The spatial resolution can be evaluated by the blurring of line-pair CT value in the images of CatPhan504's CTP528 module. The noise level can be evaluated by the integral non-uniformity in the images of Cheese's uniformity module. the low contrast resolution can be evaluated by contrast-to-noise ratio of both phantoms' plug-in module, or visibility of the region of interest (Supra-Slice) in the images of CatPhan504's CTP515 module.@*RESULTS@#Analyses on CatPhan504's line pair module(CTP528 module) showed that the first three line pairs(the gap size are 0.500 cm, 0.250 cm and 0.167 cm respectively) could be clearly observed but blurring began to occur from the fourth line pair(the gap size is 0.125 cm) under Coarse mode. Meanwhile, the first four line pairs were all observable under the Normal and Fine modes. Integral non-integrity index(the value negatively correlated with the noise level) were 0.155 7, 0.136 8 and 0.122 9 for Coarse, Normal and Fine modes respectively. None of the Supra-Slice in CatPhan504's CTP515 module could be observed under three imaging modes. Low contrast contrast-to-noise ratio of Cheese phantom was similar under three modes and the insert visibility exhibited nearly linear growth with the increasing difference between CT average value of the insert material and background.@*CONCLUSION@#Superiority and inferiority of three image modes in terms of the three image quality index was not consistent. Evaluation results above could provide reference for more rational decision on scanning modes selection of helical tomotherapy, which was based on image visualization demands in clinical practice. The proposed method could also provide guidance for similar image quality assessment and periodic quality assurance.
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Tomografía Computarizada de Haz Cónico , Fantasmas de Imagen , Radioterapia de Intensidad Modulada , Tomografía Computarizada Espiral , Tomografía Computarizada por Rayos XRESUMEN
Objective@#To investigate the success rate and safety of percutaneous vasoseminal vesiculography with the disposable vasographic interventional therapy kit (VITK).@*METHODS@#This study included ninety-six 19-65 (mean 43) years old male patients with infertility, hematospermia, seminal vesicle cyst, ejaculatory duct cyst, ejaculatory dysfunction, or vas deferens injury, with disease courses varying from 1 month to 7 years. With an open, multi-centered, single-group, self-controlled design and using the disposable VITK, we treated the patients by percutaneous vasoseminal vesiculography via injection of contrast medium into the vas deferens cavity under local anesthesia.@*RESULTS@#Percutaneous vasoseminal vesiculography was successfully performed in 92 (97.87%) of the patients, which revealed abnormal seminal ducts in 51 cases (54.3%). Among the 28 infertile patients, 3 were found with bilateral and 5 with unilateral vas deferens obstruction. Vesiculitis was detected in 36 (81.8%) of the 44 hematospermia patients and bilateral vas deferens abnormality in 5 (38.5%) of the 13 patients with ejaculatory dysfunction. Transectional damage was observed in 2 patients with vas deferens injury induced by bilateral inguinal hernia repair. Three cases of seminal vesicle cyst and 4 cases of ejaculatory cyst were definitely diagnosed by vasoseminal vesiculography.@*CONCLUSIONS@#The disposable vasographic interventional therapy kit, with the advantages of simple operation and high safety, deserves a wide clinical application in vasoseminal vesiculography.
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Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Medios de Contraste , Quistes , Diagnóstico por Imagen , Conductos Eyaculadores , Diagnóstico por Imagen , Enfermedades de los Genitales Masculinos , Diagnóstico por Imagen , Hematospermia , Diagnóstico por Imagen , Hernia Inguinal , Cirugía General , Infertilidad Masculina , Diagnóstico por Imagen , Inyecciones , Complicaciones Posoperatorias , Diagnóstico por Imagen , Radiografía , Métodos , Vesículas Seminales , Diagnóstico por Imagen , Conducto Deferente , Diagnóstico por Imagen , Heridas y LesionesRESUMEN
Objective To observe the effect of prescription of traditional Chinese medicine (TCM) Lianggesan on clinical efficacy for treatment of patients with acute respiratory distress syndrome (ARDS). Methods Fifty-two patients consistent with the Berlin diagnostic criteria of ARDS admitted to the departments of intensive care unit (ICU) of Tianjin Hospital and of the First Tianjin Center Hospital from May 1, 2015 to April 30, 2016 were enrolled, and they were divided into a Chinese medicine group (24 cases) and a control group (28 cases) by lottery. The anti-infection, reduction of phlegm, mechanical ventilation and symptomatic support treatment were given to the two groups, additionally Chinese medicine group received TCM Lianggesan (particles) including ingredients: fructus forsythiae 30 g, radix scutellariae 10 g, fructus gardeniae 10 g, henon bamboo leaf 10 g, rhubarb 10 g, herba menthae 6 g, natrii sulfas 6 g, radix glycyrrhizae 15 g, adding water to punch the particles in 50 mL liquid, taken by nasal feeding or orally drinking, in the morning and in the evening, twice a day. Before and after treatment, the differences in levels of oxygenation index, tumor necrosis factor-α (TNF-α) and positive end expiratory pressure (PEEP) were compared between the two groups. Results After treatment, the oxygenation indexes of the two groups were significantly higher than those before treatment, the levels of TNF-α and PEEP of the two groups were significantly lower than those before treatment, and the degrees of changing in the Chinese medicine group were more significant than those of the control group [oxygenation index (mmHg, 1 mmHg = 0.133 kPa): 267.45±38.67 vs. 235.26±30.62, TNF-α (mg/L):24.37±5.46 vs. 28.31±5.41, PEEP (cmH2O, 1 cmH2O = 0.098 kPa): 4.58±1.61 vs. 5.93±1.61, all P < 0.05]. Conclusion TCM Lianggesan can effectively eliminate the inflammatory mediators of patients with ARDS, improve the respiratory function and promote the recovery of the disease.
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Premature ejaculation (PE) is a most common type of ejaculatory dysfunction, which has significant adverse effects on the life quality of the patients and their partners. Medication is currently the first choice for PE and psycho-behavior therapy is sometimes used as an adjuvant means. It is reported in a number of studies that medication alone or combined with psycho-behavior therapy has a great short-term efficacy and a very low risk of side effects. Conservative therapies for PE, however, have some obvious disadvantages such as easy recurrence after drug withdrawal, ineffectiveness in some cases, and so on. Thus, clinicians in China and abroad have developed and tried various surgical methods for the treatment of PE, most of which are reportedly safe and effective. However, International Society for Sexual Medicine guidelines for the diagnosis and treatment of PE recommended against surgical methods because of possible permanent loss of sexual function and insufficient reliable data, though without support from evidence or relevant literature. Although controversial, surgical treatment remains an effective and feasible strategy for refractory PE that does not respond to any conservative therapies. This review summarizes a variety of surgical techniques for PE, along with their basic principles, indications, effects and safety.
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Humanos , Masculino , Terapia Conductista , China , Tratamiento Conservador , Eyaculación , Eyaculación Prematura , Quimioterapia , Cirugía General , Calidad de Vida , Recurrencia , Parejas SexualesRESUMEN
Differences in intravaginal ejaculation latency reflect normal biological variation, but the causes are poorly understood. Here, we investigated whether variation in ejaculation latency in an experimental rat model is related to altered sympathetic nervous system (SNS) activity and expression of N-methyl-D-aspartic acid (NMDA) receptors in the paraventricular nucleus of the hypothalamus (PVN). Male rats were classified as "sluggish," "normal," and "rapid" ejaculators on the basis of ejaculation frequency during copulatory behavioral testing. The lumbar splanchnic nerve activity baselines in these groups were not significantly different at 1460 ± 480 mV, 1660 ± 600 mV, and 1680 ± 490 mV, respectively (P = 0.71). However, SNS sensitivity was remarkably different between the groups (P < 0.01), being 28.9% ± 8.1% in "sluggish," 48.4% ± 7.5% in "normal," and 88.7% ± 7.4% in "rapid" groups. Compared with "normal" ejaculators, the percentage of neurons expressing NMDA receptors in the PVN of "rapid" ejaculators was significantly higher, whereas it was significantly lower in "sluggish" ejaculators (P = 0.01). In addition, there was a positive correlation between the expression of NMDA receptors in the PVN and SNS sensitivity (r = 0.876, P = 0.02). This study shows that intravaginal ejaculatory latency is associated with SNS activity and is mediated by NMDA receptors in the PVN.
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Animales , Femenino , Masculino , Ratas , Copulación , Eyaculación/fisiología , Neuronas/fisiología , Núcleo Hipotalámico Paraventricular/fisiología , Ratas Sprague-Dawley , Receptores de N-Metil-D-Aspartato/metabolismo , Conducta Sexual Animal/fisiología , Nervios Esplácnicos/fisiología , Sistema Nervioso Simpático/fisiologíaRESUMEN
The nerve electrophysiological tests may differentiate the treatment of primary premature ejaculation (PPE) in our previous studies. However, no study verifies if the results will be affected by abstinence time. From January to December in 2016, fifty PPE patients ejaculated within 2 min and 28 control subjects were enrolled. The nerve electrophysiological tests, including dorsal nerve somatosensory evoked potential (DNSEP), glans penis somatosensory evoked potential (GPSEP), and penile sympathetic skin response (PSSR), were recorded before and immediately after ejaculation. The abstinence day was not correlated with the latencies of SEPs or PSSR neither in PE group (P = 0.170, 0.064, and 0.122, respectively) nor in control group (P = 0.996, 0.475, and 0.904, respectively). No statistically differences were found in the latencies of SEPs and PSSR before and after ejaculation in PE patients (P = 0.439, 0.537, and 0.576, respectively) or control subjects (P = 0.102, 0.198, and 0.363, respectively). Thus, abstinence time does not interfere with the nerve electrophysiological test, which is stable in determining the nerve function of PPE patients.
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Adulto , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Eyaculación , Estimulación Eléctrica , Fenómenos Electrofisiológicos , Potenciales Evocados Somatosensoriales , Pene/fisiopatología , Eyaculación Prematura/fisiopatología , Estudios Prospectivos , Abstinencia Sexual , Piel/inervación , Sistema Nervioso Simpático/fisiopatologíaRESUMEN
Erectile dysfunction (ED) associated with type 2 diabetes is a severe problem that requires effective treatment. Pancreatic kininogenase (PK) has the potential to improve the erectile function of ED patients. This study aims to investigate the effect of PK on erectile function in streptozotocin-induced type 2 diabetic ED rats. To achieve this goal, we divided male Sprague-Dawley rats into five groups. One group was not treated, and the other four groups were treated with saline, sildenafil, PK or sildenafil, and PK, respectively, for 4 weeks after the induction of type 2 diabetic ED. Then, intracavernous pressure under cavernous nerve stimulation was measured, and penile tissue was collected for further study. Endothelial nitric oxide synthase levels, smooth muscle content, endothelium content, cyclic guanosine monophosphate (cGMP) levels in the corpus cavernosum, and neuronal nitric oxide synthase levels in the dorsal penile nerve were measured. Improved erectile function and endothelium and smooth muscle content in the corpus cavernosum were observed in diabetic ED rats. When treating diabetic ED rats with PK and sildenafil at the same time, a better therapeutic effect was achieved. These data demonstrate that intraperitoneal injection of PK can improve erectile function in a rat model of type 2 diabetic ED. With further research on specific mechanisms of erectile function improvement, PK may become a novel treatment for diabetic ED.
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Animales , Masculino , Ratas , GMP Cíclico/metabolismo , Diabetes Mellitus Experimental/fisiopatología , Disfunción Eréctil/fisiopatología , Calicreínas/uso terapéutico , Músculo Liso Vascular/fisiopatología , Óxido Nítrico Sintasa de Tipo I/metabolismo , Óxido Nítrico Sintasa de Tipo III/metabolismo , Erección Peniana/fisiología , Pene/metabolismo , Ratas Sprague-Dawley , Citrato de Sildenafil/uso terapéutico , Resultado del Tratamiento , Agentes Urológicos/uso terapéuticoRESUMEN
Once-daily tadalafil administration has been well established; however, studies about tadalafil once-daily treatment in the Chinese population are lacking. In this phase 4, postmarketing study, we ascertained the long-term safety and effectiveness of tadalafil 2.5 mg and 5.0 mg once daily in Chinese men with erectile dysfunction (n = 635). The primary endpoint of the study was safety at 12 months as assessed by the proportion of patients experiencing at least one treatment-emergent adverse event (serious or nonserious). The secondary endpoints included safety and effectiveness, measured by the International Index of Erectile Function-Erectile Function (IIEF-EF) domain scores. Similar adverse events to the known safety profile of tadalafil, such as nasopharyngitis, upper respiratory tract infection, headache, and dizziness, were detected. No new cardiovascular safety concerns were observed. After 3 months of treatment, significant increases in IIEF-EF domain scores were detected for both 2.5-mg (least squares [LS] mean change: 6.3; 95% confidence interval [CI]: 5.4-7.1; P < 0.001) and 5.0-mg (LS mean change: 7.4; 95% CI: 6.8-7.9; P < 0.001) tadalafil doses, and significance was maintained up to 12 months. In addition, approximately 40% of patients regained normal erectile function (IIEF-EF ≥26) following 1 year of tadalafil once-daily treatment. The findings in this study provide evidence for the extended effectiveness and tolerability of tadalafil, demonstrating no new safety concerns, in a Chinese population and make once-daily tadalafil administration a viable option for improving sexual performance and satisfaction in Chinese men with erectile dysfunction.
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Pueblo Asiatico , Método Doble Ciego , Disfunción Eréctil/tratamiento farmacológico , Seguridad del Paciente , Inhibidores de Fosfodiesterasa 5/uso terapéutico , Vigilancia de Productos Comercializados , Estudios Prospectivos , Tadalafilo/uso terapéutico , Resultado del TratamientoRESUMEN
Objective@#To explore the topological properties of the degree and strength of nodes in the binary and weighted brain white matter networks of the patients with psychogenic erectile dysfunction (pED) and analyze the changes of myelin integrity, number and length of the white matter fibers in the topological space.@*METHODS@#Diffusion tensor imaging data were obtained from 21 patients with pED and 24 healthy controls matched in sex, age, and years of education and subjected to preprocessing. The whole cerebral cortex was divided into 90 regions, followed by fiber tracking, construction of the binary and weighted white matter networks, and calculation of the node degrees and connectivity strengths in different brain regions. The property values were compared between the two groups using the two-sample t-test, the results were corrected by multiple testing correction, and the correlation of the property values with the erectile function of the patients was subjected to Pearson's correlation analysis.@*RESULTS@#Compared with the healthy controls, the pED patients showed significantly decreased node degree of the left triangular part of inferior frontal gyrus (IFG) (7.54±1.44 vs 5.95±1.28, t = -3.88, corrected P = 0.02), medial orbital part of superior frontal gyrus (SFG) (10.08±3.60 vs 6.29±3.30, t = -3.67, corrected P = 0.02), and amygdala (6.50±2.11 vs 4.29±1.31, t = -4.16, corrected P = 0.01) in the binary networks, as well as the connectivity strength of the left triangular part of IFG (2.50±0.68 vs 1.72±0.50, t = -4.35, corrected P = 0.01), medial orbital part of SFG (3.17±0.97 vs 2.08±1.10, t = -3.53, corrected P = 0.03), and amygdala (1.80±0.69 vs 1.11±0.39, t = -4.03, corrected P = 0.01) in the fractional anisotropy (FA) weighted networks. The node degree of the left amygdala was negatively correlated with the total score (r = -0.47,P = 0.04), second item score (r = -0.46, P = 0.03), and third item score of IIEF-5 (r = -0.45, P = 0.04) in the pED patients.@*CONCLUSIONS@#The myelin integrity of the white matter fibers in the left frontal lobe and amygdale is impaired in pED patients, which leads to the aberrant generation, processing and regulation of their emotions. The decreased pivotal role and importance of the white matter fibers connecting the left amygdale may be associated with pED.
Asunto(s)
Humanos , Masculino , Amígdala del Cerebelo , Diagnóstico por Imagen , Anisotropía , Estudios de Casos y Controles , Imagen de Difusión Tensora , Disfunción Eréctil , Psicología , Lóbulo Frontal , Diagnóstico por Imagen , Vaina de Mielina , Patología , Sustancia Blanca , Diagnóstico por ImagenRESUMEN
Objective@#To investigate the effect of laparoscopic extraperitoneal (LSEP) high ligation of the spermatic vein in the treatment of varicocele.@*METHODS@#We retrospectively analyzed the clinical data about 80 cases of varieocele, 48 treated by LSEP and the other 32 by laparoscopic transabdominal retroperitoneal (LSTR) high ligation of the spermatic vein. We recorded the semen parameters before and at 1, 3 and 6 months after surgery, intraoperative blood loss, operation time, postoperative complications, time of gastrointestinal function recovery and rate of pregnancy, followed by comparison of the data obtained between the two groups of patients.@*RESULTS@#Semen parameters were remarkably improved in both the LSEP and LSTR groups of patients postoperatively as compared with the baseline (P 0.05). The intraoperative blood loss was less in the LSEP than in the LSTR group ([8.3 ± 5.2] vs [9.1 ± 6.1] ml, P >0.05), the operation time was shorter in the former than in the latter ([38.27 ± 9.23] vs [43.46 ± 11.72] min, P >0.05), and so was the time of gastrointestinal function recovery ([1.27 ± 0.26] vs [2.43 ± 0.41] d, P 0.05).@*CONCLUSIONS@#Laparoscopic extraperitoneal high ligation of the spermatic vein is safe and effective and has the advantage of quick recovery in the treatment of varicocele.