Study progress in erectile dysfunction after radical pelvic surgery / 中华泌尿外科杂志

Radical pelvic surgery is a surgical method mainly used to treat tumors in the pelvic cavity, and erectile dysfunction (ED) is a common sexual dysfunction after surgery. The incidence of ED after radical pelvic surgery is not uniformly understood due to differences in surgical approaches and methods of investigation. The main causes of postoperative ED include intraoperative neurovascular injury, psychosomatic factors and preoperative patient characteristics, with intraoperative injury to the neurovascular bundle being the most common. Studies have shown that the occurrence of postoperative ED can be prevented by active intervention, but still lack of effective treatment measures. This article reviews and summarizes the clinical epidemiological features and research progress in recent years on ED after radical pelvic surgery, and discusses specific measures for the prevention and treatment of postoperative ED.

Effects of maximal androgen blockade therapy on serum calcium, phosphorus and other metabolic indices in elderly patients with prostate cancer / 中华老年医学杂志

Objective:To investigate the effect of maximal androgen blockade(MAB)therapy on serum calcium, phosphorus and other metabolic indices in elderly patients with prostate cancer.Methods:Clinicopathological data of prostate cancer patients treated with MAB in our department from January 2010 to December 2018 were retrospectively analyzed.All patients underwent prostate biopsy for definitive diagnosis.Detailed data on patient's age, body mass index(BMI), previous medical history, treatment plan and peripheral blood indicators before and after endocrine treatment, such as blood calcium, phosphorus, hemoglobin, fasting blood glucose, triglycerides and cholesterol, were collected.Results:Patients had a mean age of(75.5±5.8)years and a mean BMI of(24.6±3.2)kg/m 2.Blood calcium levels exhibited a downward trend after MAB treatment compared pre-treatment[(2.12±0.44)mmol/L vs.(2.17±0.31)mmol/L, t=0.82, P=0.42], but had no significant difference.Serum phosphorus concentrations were higher and the calcium-phosphorus ratio was lower after MAB treatment than before treatment[(1.02±0.26)mmol/L vs.(1.17±0.34)mmol/L, 2.10±0.28 vs.1.88±0.60, t=-4.12 and 3.56, P<0.01]. After MAB treatment, blood fasting glucose[(6.50±1.55)mmol/L vs.(5.34±1.04)mmol/L, t=-7.82, P<0.01], triglycerides[(1.66±1.32)mmol/L vs.(1.22±0.59)mmol/L, t=-3.38, P<0.01]and cholesterol[(4.70±1.08)mmol/L vs.(4.16±0.90)mmol/L, t=-4.72, P<0.01]were elevated, while hemoglobin concentrations[(122.11±20.43)g/L vs.(130.78±23.98)g/L, t=3.98, P<0.01]were decreased compared with pre-treatment levels. Conclusions:MAB therapy can cause varying degrees of metabolic abnormalities in calcium and phosphorus metabolism, hemoglobin concentrations, blood glucose and lipid levels in elderly prostate cancer patients.The above indicators should be closely monitored during treatment, and treatment-related complications should be proactively prevented.

Study on the relationship between age-related hearing loss and cognitive impairment / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the correlation between age-related hearing loss and cognitive impairment.@*Methods@#201 elderly patients, who were admitted to the Department of Otorhinolaryngology of Peking University People′s Hospital from March 1, 2017 to March 31, 2017, were evaluated with hearing screening and the Montreal Cognitive Assessment Scale. Among them, 101 were female and 100 were male, aged 60-90 years old. Taking the cognitive level as the dependent variable, and taking the age, sex, education, occupation, marital status, residence, and average hearing loss (average hearing threshold of 500, 1 000, 2 000, and 4 000 Hz), as well as the length of conscious hearing loss as the independent variables, the single factor analysis and multivariate linear regression analysis were used to screen the main factors affecting the cognitive level of the elderly.@*Results@#Of the 201 elderly patients, 39 had normal hearing, 65 had mild hearing loss, 80 had moderate hearing loss, 16 had severe hearing loss, and 1 had profound hearing loss. The average degree of hearing loss was the influencing factor of cognitive impairment, and it mainly affected the directional force and abstract ability in the cognitive domains (P<0.05); The age, self-reported hearing loss, years of education, marital status, past ear diseases, and hypertension were relatively independent factors that affected the cognitive level(P<0.05).@*Conclusions@#Age-related hearing loss is the risk factor for the cognitive impairment, especially for abstraction and orientation, in the elderly. The self-reported hearing loss is an independent risk factor for cognitive impairment.

The correlation between the hearing frequency and staging of Meniere′s disease / 中华耳鼻咽喉头颈外科杂志

Objective@#To study the relationship between the average hearing of different frequencies and the audiometry staging in patients with Meniere′s disease.@*Methods@#A total of 259 patients from 1996 to 2016 were collected .All patients underwent pure tone audiometry, of which 93 patients underwent 3 000 Hz audiometry. The patients were divided into five groups according to the frequencies of hearing(Ⅰ: 500, 1 000, 2 000, 3 000 Hz; Ⅱ: 250, 500, 1 000, 2 000, 3 000 Hz; Ⅲ: 250, 500, 1 000, 2 000; Ⅳ: 500, 1 000, 2 000, 4 000 Hz; Ⅴ: 500, 1 000, 2 000 Hz), then calculated the average audiometry and made the hearing staging. The obtained data were analyzed by chi-square test and Bonferroni correction was performed among the groups, P<0.05 was defined as a statistically significant criterion.@*Result@#There were no significant difference between the five groups(P=0.441>0.05).@*Conclusions@#The choice of different pure tone audiometry frequency has no significant effect on the hearing staging. It would be more likely upstaging when plus 250 Hz. There is no statistically significant difference in staging between the latest guidelines and the 1995 guidelines.500, 1 000 and 2 000 Hz are recommended when 3 000 Hz examine is not available.

The characteristics and independent associated factors of positive surgical margin after radical prostatectomy / 中华泌尿外科杂志

Objective To analyze the associated factors of positive surgical margin after radical prostatectomy.Methods A retrospective analysis was conducted on 320 patients who underwent radical prostatectomy from June 2007 to June 2017,whose age was 45-80 years(mean 67.9) and PSA was 0.05-123.19 ng/ml (mean 14.4ng/ml).The patients were divided into groups by age,PSA,PI-RADS score,clinical stage,biopsy Gleason score and operation approach.Chi-square test was used for single factor analysis and binary logistic regression analysis for multivariate analysis to evaluate the correlation between clinical and pathological data and positive cutting edge.Result Among the total 320 patients,there were 94 (29.4％) patients had positive surgical margin after radical prostatectomy.There were 26 (21.0％) positive surgical margin located at ventral sites,18(14.5％) located at dorsal sites,21 (16.9％) located at base,and 59(47.6％) located at tip.The positive rate of surgical margin was different in different positive areas of MRI (P ＜0.01),among which the MRI showed cancer located in the tip of prostate had the highest positive rate (47.6％) of surgical margin after prostatectomy.Univariate risk factor analysis was performed which showed that PSA(P =0.023),positive needle percentage (P =0.001),biopsy pathologic Gleason score(P =0.029),PI-RADS score (P =0.022) and prostate cancer risk score (P =0.006) had significant correlation with positive surgical margin.The age (P =0.257),clinical stage (P =0.161) and operation approch (P =0.260) had no significant correlation.Then multivariate analysis showed that PI-RADS score (P =0.023) and positive needle percentage (P =0.047) could be used as independent predictors of positive surgical margin.Conclusions PI-RADS score and percentage of positive biopsy needles were independent risk factors for positive surgical margin after prostatectomy.There was highest positive rate of surgical margin when MRI showed cancer located at the tip of prostate.

The Pathway of FITC-Dexran after Post-Aural Injection / 听力学及言语疾病杂志

Objective To investigate the possible pathway of FITC-dextran to the cochlea after post-aural injection.Methods The FITC-dextran(weight between 3 000~5 000) was chosen as a tracer in this study.A total of 200 suckling mice were randomly divided into four groups, with 50 in each group.Each animal was then administered with FITC-dextran or dextran via either post-auricular or intra-muscular injection, to a total dose of 20 μl (5 mg/ml).Samples were obtained at 0, 1/12, 1/4, 1/2, 1, 3, 5, 7, 12, and 24 hours after adminstmiceion, and the confocal technique was used to observe the distribution of the tracer.Taking into consideration the influence of spontaneous fluorescence, the fluorescence intensity ratio of the experimental and control groups was used as the final statistical data.Results FITC-dextran injected intramuscularly group: The fluorescence signal can be detected in the sigmoid sinus(SS) 3h after management, while in endolymphatic sac and cochlea at 12 h.FITC-dextran injected post-aurally group: After administration, an obvious fluorescence signal could be observed in the sigmoid sinus and endolymphatic sac immediately, cochlea at 30 min.The signal of the sigmoid sinus, endolymphatic sac and cochlea gradually increased successively, peaked at 5~15 min, 30 min and 60 min, and then decreased gradually.At 12 h, another small increases appeared, and the signal could not be detected at 24 h.Conclusion Compared with intramuscularly application, post-auricular injection can allow the drug to directly reach the endolymph.It is possible that the tracer first gathered in the SS via local blood circulation or infiltration, then entered the ES via micro-circulation around, and eventually arrived at the cochlea.

Research on the association of the laryngeal carcinoma and laryngopharyngeal reflux / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The objective of this study is to investigate the association between laryngeal carcinoma and laryngopharyngeal reflux.</p><p><b>METHODS</b>This was a case-control study with 31 laryngeal cancer patients who had undergone 24-hour ambulatory double pH monitoring and 76 in the control group which were divided into negative group (36 patients) and positive group (40 patients) by the score of RSI (reflux symptom index) and RFI (reflux findings index) scale. The results of reflux and parameters of 24-hour ambulatory double pH monitoring among the three groups were statistically analysed.</p><p><b>RESULTS</b>The smoking rate of 80.6% (25/31) in laryngeal carcinoma group was significantly higher than that of (36.1%, P < 0.0167) in the negative group while it did not vary in laryngeal carcinoma group and the positive group (65.0%, P > 0.0167). The drinking rate of 71.0% (22/31) in laryngeal carcinoma group was higher than that of (36.1%, P < 0.0167) in the negative group whereas there was no significant difference between laryngeal carcinoma group and positive group (50.0%, P > 0.0167). The positive rate of laryngopharyngeal reflux in laryngeal carcinoma group, the positive group, the negative group were 74.2% (23/31), 16.7% (6/36) and 52.5% (21/40) respectively, which was significantly different (P < 0.05). The positive rate of gastroesophageal reflux in the three groups above were 71.0% (22/31), 52.8% (19/36) and 75.0% (30/40), which had no significant difference (P > 0.05). The positive rate of laryngopharyngeal reflux differed in laryngeal carcinoma group and the negative group (P < 0.0167) while did not differ in laryngeal carcinoma group and the positive group (P > 0.0167). In the results of 24-hour ambulatory double pH monitoring, there was significant difference in the total and upright reflux number, the total reflux time, the percent times for the pH falling below 4, total reflux number which lasted more than 5 minutes and DeMeester Scores.</p><p><b>CONCLUSIONS</b>The positive rate of laryngopharyngeal reflux in laryngeal carcinoma group was very high while the drinking and smoking rate were also high. Therefore whether the laryngopharyngeal reflux is a risk factor of the laryngeal carcinoma, it needs further research.</p>