Effect of Shanhaidan Granules combined with tadalafil on erectile dysfunction: A multi-center clinical trial / 中华男科学杂志

Objective@#To observe the clinical effect and safety of Shanhaidan Granules (SHDG) combined with tadalafil tablets (TT) in the treatment of ED.@*METHODS@#In this open multi-center case-control clinical trial, we enrolled 247 ED patients according to the designed criteria, and treated them orally with SHDG at 10 g per time tid (n = 74), TT at 5 mg per time bid (n = 52), or SHDG + TT at the above doses (n = 121), all for 8 weeks. Before and after medication, we recorded the IIEF-6, erection hardness scores (EHS), traditional Chinese medicine syndromes (TCMS) scores, penile cavernous blood flow parameters and adverse reactions, and compared them between the 3 groups of patients.@*RESULTS@#After 8 weeks of treatment, all the patients showed significantly increased IIEF-6, EHS and TCMS scores in comparison with the baseline (P < 0.05). The total effectiveness rates in the SHDG, TT and SHDG + TT groups were 60.8%, 67.3% and 69.4% respectively based on the IIEF-6 scores, remarkably higher in the TT and SHDG + TT groups than in the SHDG group (P < 0.05), and 40.5%, 32.7% and 63.6% respectively according to the TCMS scores, markedly higher in the SHDG and SHDG + TT groups than in the TT group (P < 0.05). Single-center data manifested significantly increased peak systolic velocity (PSV) of the penile artery in the SHDG + TT and TT groups (P < 0.05). The improvement values of relevant parameters were remarkably higher in the SHDG + TT group than in the TT and SHDG groups, so were IIEF-6 scores in the TT than in the SHDG group, and TCM syndromes in the SHDG than in the TT group. No medication-related adverse events were found in any of patients after treatment, except for some mild side effects including muscle soreness and gastrointestinal reactions in a few cases, all soon relieved, none with abnormalities in blood and urine routine tests or hepatic and renal function indicators.@*CONCLUSIONS@#Shanhaidan Granules combined with tadalafil can significantly improve the erectile function and reduce TCM syndromes in ED patients, and therefore can be applied effectively and safely in clinical practice./.

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.

On-demand versus on-time dosing of tadalafil for erectile dysfunction: a prospective multi-center study / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of tadalafil on demand and on time in men with erectile dysfunction.</p><p><b>METHODS</b>We conducted a multi-centered randomized controlled study on 120 ED males, who were assigned to take tadalafil at 10 mg/ 20 mg on demand before sexual activity and at the same dose on time twice a week for 8 weeks. Before and at 4 and 8 weeks after treatment, and 1 month after withdrawal, we obtained the scores on IIEF-5, ED Inventory of Treatment Satisfaction (EDITS) and the short form of Psychological and Interpersonal Relationship Scales (SF-PAIRS) , and compared the safety and efficacy of medication between the two groups of patients.</p><p><b>RESULTS</b>Totally, 110 patients accomplished the trial, 56 in the on-time and 54 in the on-demand group. At 4 and 8 weeks of medication and 1 month after withdrawal, the IIEF-5 scores were improved in both the on-time and on-demand groups, even more significantly in the former than in the latter at 8 weeks of treatment (21.6 +/- 2.9 vs 18.5 +/- 1.7) and 1 month after withdrawal (20.9 +/- 2.1 vs 17.9 +/- 2.3) (P < 0.05). The EDITS scores were significantly higher in the on-time than in the on-demand group at 8 weeks of treatment (31.7 +/- 6.9 vs 28.6 +/- 5.8) and 1 month after withdrawal (30.6 +/- 4.7 vs 27.9 +/- 6.5) (P < 0.05). The scores on the sexual self-confidence, spontaneity and time-concern domains of SF-PAIRS were remarkably improved after medication as compared with the baseline (P < 0.05), even more significantly in the on-time than in the on-demand group at 1 month after withdrawal. Both dosing schedules were well tolerated and no significant differences were observed in safety between the two groups.</p><p><b>CONCLUSION</b>On-time dosing of tadalafil is efficacious and well tolerated in the treatment of ED, and has an even better effect than on-demand dosing at 8 weeks of medication and 1 month after withdrawal.</p>

Expression of ARA55 mRNA in prostate carcinoma tissues and its significance / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the expression of ARA55 mRNA in the prostate carcinoma tissues and its clinical significance.</p><p><b>METHODS</b>Real-time RT-PCR was used to examine the expression of ARA55 mRNA in the samples of the prostate carcinoma tissues from 32 patients.</p><p><b>RESULTS</b>ARA55 mRNA expressed in different degrees in all the samples. The Ct values were 20.57 +/- 0.20 and 16.33 +/- 0.31 at T1-T2 and T3-T4 stages, 23.13 +/- 0.13 and 17.3 +/- 0.19 for those with Gleason score < or =7 and >7, 24.70 +/- 0.27 and 17.21 +/- 0.34 for those with PSA < or =10 microg/L and >10 microg/L, and 23.82 +/- 0.21 and 16.71 +/- 0.32 for those that responded to endocrinological therapy and those that failed to, respectively. There was a significant difference between the former and the latter.</p><p><b>CONCLUSION</b>ARA55 mRNA expression is significantly correlated with the clinical characteristics of the patient. And ARA55 can be regarded as a prognostic molecular marker for prostate carcinoma as well as a predictor of endocrinological therapeutic effect on the disease.</p>

Current situation of researches on the molecule mechanism of hormone refractory prostate cancer / 中华男科学杂志

Most cases of prostate cancer become hormone refractory after 12 to 18 months of androgen deprivation therapy. The etiology of the disease is thought to be multifactorial, associated with genetic, dietary, and environmental factors. The article reviews the current situation of researches at home and abroad on the molecule mechanism of hormone refractory. It expounds the influence of the androgen receptor and its genetic mutation, apoptosis and the gene changes of p53, p21, EphB2 on prostate cancer. It is hoped to be of some directive value for the studies of prostate cancer.