Apatinib Combined with Local Irradiation Leads to Systemic TumorControl via Reversal of Immunosuppressive Tumor Microenvironmentin Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#This study aimed to investigate the potential systemic antitumor effects of stereotactic ablativeradiotherapy (SABR) and apatinib (a novel vascular endothelial growth factor receptor2 inhibitor) via reversing the immunosuppressive tumor microenvironment for lung carcinoma. @*Materials and Methods@#Lewis lung cancer cells were injected into C57BL/6 mice in the left hindlimb (primary tumor;irradiated) and in the right flank (secondary tumor; nonirradiated). When both tumors grewto the touchable size, mice were randomly divided into eight treatment groups. These groupsreceived normal saline or three distinct doses of apatinib (50 mg/kg, 150 mg/kg, and 200mg/kg) daily for 7 days, in combination with a single dose of 15 Gy radiotherapy or not tothe primary tumor. The further tumor growth/regression of mice were followed andobserved. @*Results@#For the single 15 Gy modality, tumor growth delay could only be observed at the primarytumor. When combining SABR and apatinib 200 mg/kg, significant retardation of both primaryand secondary tumor growth could be observed, indicated an abscopal effect wasinduced. Mechanism analysis suggested that programmed death-ligand 1 expressionincreased with SABR was counteract by additional apatinib therapy. Furthermore, whenapatinib was combined with SABR, the composition of immune cells could be changed.More importantly, this two-pronged approach evoked tumor antigen–specific immune responsesand the mice were resistant to another tumor rechallenge, finally, long-term survivalwas improved. @*Conclusion@#Our results suggested that the tumor microenvironment could be managed with apatinib,which was effective in eliciting an abscopal effect induced by SABR.

Single-stage posterior total En bloc spondylectomy for the treatment of metastatic tumors of the lower lumbar spine / 中华骨科杂志

Objective:To investigate the feasibility and clinical outcome of single-stage posterior total en bloc spondylectomy via posterior approach for lowerlumbar spinal malignant tumors.Methods:The clinical data of 23 patients with metastatic tumors of the lower lumbar spine who underwent single-stage posterior total En bloc spondylectomy in our hospital from January 2012 to June 2018 were analyzed retrospectively. There were 14 males and 9 females, age 57.9±10.8 years old (range, 37-74 years old). All patients were treated with single-stage posterior total en blocspondylectomy, titanium mesh implantation and posterior pedicle screw fixation. Observation items included operation time, intraoperative blood loss, postoperativehospital stays,the visual analogue scale (VAS) and the Eastern Cooperative Oncology Group (ECOG) physical condition score of the patients before operation,1 month after operationand 6 months after operation, the American spinal injury association (ASIA) spinal cord injury grade pre-operation andpostoperation, perioperative complications, local recurrence and survival state.Results:The median fellow-up time of this group was 20 months (range 6-56 months). At the end of the last follow-up, there were 3 patients who survived, the average follow-up time of the three patients who survived to the last follow-up was 37.3±11.7 months. One of them had local recurrence, but survived with tumor. The operative time was 155-510 min, with an average of 258±96 min, the intraoperative blood loss was 750-2 500 ml, with an average of 1 258.7±528.6 ml, and the postoperative hospital stay was 10-30 d, with an average of 18.4±4.6 d. VAS score decreased from 7.4±0.8 before operation to 2.6±0.6 1 month after operation, and ECOG score decreased from 1.6±0.9 before operation to 0.9±0.76 months after operation, showing statistically significant differences ( P<0.05). 6 patients presented with postoperative acute nerve root stimulation, 3 patients presented with postoperative cerebrospinal fluid leakage, 3 patients presented with postoperative surgical site infection, 1 with pulmonary infection, and 3 patients presented with titanium mesh displacement. Conclusion:Single-stage posterior total En bloc spondylectomy is feasible for the treatment of metastatic tumors of the lower lumbar spine. Although the operation is quite challenging due to its special anatomical structure and biomechanical characteristics,the long-term follow-up effect is satisfactory.

The influence of perceived stress and coping style of pediatric nurses on professional burnout / 中国实用护理杂志

Objective To understand the current situation of pediatric nurses' perceived stress,coping style and professional burnout,analyze the influence of pediatric nurses' perceived stress and coping styles on professional burnout,and to provide references for reducing pediatric nurses' professional burnout.Methods A questionnaire survey was conducted on 415 pediatric nurses from 9 tertiary level A hospitals in Tianjin using general information questionnaires,Chinese Perceived Stress Scale(CPSS),Simplified Coping Style Questionnaire (SCSQ),and Maslach Burnout Inventory(MBI).Results Pediatric nurses'MBI scores were divided into emotional exhaustion score (25.19 ± 9.98) points,depersonalization total score (10.70 ± 4.65) points,personal achievement sense (29.72 ± 9.62) points,and higher degree of burnout.Correlation analysis showed that the perceived stress was positively correlated with emotional exhaustion and depersonalization dimensions,and negatively correlated with the dimension of personal accomplishment (r =0.398,0.236,-0.388,P ＜0.01);positive coping dimensions were negatively correlated with emotional exhaustion and depersonalization dimensions,and positively correlated with the dimension of personal accomplishment(r =-0.544,-0.205,0.608,P＜0.01);negative coping dimensions and emotional depletion and depersonalization dimensions were positively correlated,and negatively correlated with individual achievement dimension (r =0.559,0.298,-0.652,P ＜0.01).Multiple stepwise regression analysis showed that perceived stress and negative coping style had influence on emotional exhaustion,depersonalization,and individual achievement dimension.Positive coping style had influence on emotional exhaustion and personal achievement dimension (R2=0.105-0.501,P＜0.01).Conclusions Pediatric nurses have higher professional burnout.Perceived stress and coping styles have an impact on professional burnout.Pediatric nurses should take more active measures to relieve perceived stress and reduce burnout.

Surgical treatment for distal humerus type C fractures / 中国骨伤

Distal humerus type C fracture is a rare and complicated intra-articular injury. Non-surgical treatment is difficult to achieve accurately reduction and reconstruction of articular surface, while open reduction and internal fixation is the best treatment option. Olecranon osteotomy could provide adequate surgical exposure, and is the most commonly used surgical method, but complications such as non-union osteotomy, internal fixation failure occurred. To avoid sacrificing integrity of olecranon, paratricipital approach, triceps reflecting approach, triceps reflectin ganconeus pedicle approach, triceps splitting and triceps tongue-shaped flap approach have been applied to fracture revealed. However, there is a certain contradiction of choice between surgical exposure and extension function of elbow due to limitations of different approaches. With the promotion of "double-column" theory, double plates has significant mechanical advantages over single plates. Even if parallel double-plate has more advantageous than vertical double-plate in vitro biomechanical experiments, it is not clear whether there is any difference between two methods in clinical application. Elbow arthroplasty may be the final choice for C-type fractures that could not be reconstructed on articular surface, but its long-term efficacy remains to be observed due to technical limitations.

A prenatal ultrasound study of cerebral sulci and gyrus development in fetuses with tetralogy of Fallot / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the development of the cerebral sulci and gyrus and cerebral blood flow in fetuses with tetralogy of Fallot (ToF) in the second and third trimesters using ultrasound imaging.</p><p><b>METHODS</b>Forty fetuses (23-33weeks) with ToF diagnosed using ultrasound imaging between December, 2015 and September, 2016 were analyzed in this study. The development of the cerebral sulci and gyrus was evaluated by measuring the parietal-occipital fissure (POF) depth, POF angle, sylvian fissure (SF) depth, SF width, uncovered insular width, calcarine fissure (CF) depth, hemisphere depth on the views of POF, SF and CF, uncovered insular ratio, biparietal diameter (BPD), and head circumference (HC). Cerebral hemodynamics were assessed by measuring the umbilical artery resistance index, umbilical artery pulsation index, middle cerebral artery pulsation index (MCA-PI), middle cerebral artery resistance index, the cerebral-to-placental resistance ratio, and the cerebroplacental ratio.</p><p><b>RESULTS</b>In ToF fetuses, the POF depth, SF depth, CF depth, BPD, HC and hemisphere depth on the views of parietal-occipital sulcus and calcarine sulcus were significantly smaller than those in the control group (P<0.05). The middle cerebral artery resistance index, middle cerebral artery pulsation index, the cerebral-to-placental resistance ratio and the cerebroplacental ratio were also significantly lower in ToF fetuses than in the control group (P<0.05).</p><p><b>CONCLUSION</b>The cerebral sulci and gyrus in ToF fetuses in second and third trimesters show underdevelopment compared with those in normal fetuses, and the changes in hemodynamics caused by abnormal cardiac structure might be one of the reasons for cerebral sulci and gyrus underdevelopment in fetuses with ToF.</p>

Ultrasonographic Characteristics of Cortical Sulcus Development in the Human Fetus between 18 and 41 Weeks of Gestation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Fetal brain development is a complicated process that continues throughout pregnancy. Fetal sulcus development has typical morphological features. Assessment of fetal sulcus development to understand the cortical maturation and development by prenatal ultrasound has become widespread. This study aimed to explore a reliable method to assess cortical sulcus and to describe the normal sonographic features of cortical sulcus development in the human fetus between 18 and 41 weeks of gestation.</p><p><b>METHODS</b>A cross-sectional study was designed to examine the fetal cortical sulcus development at 18-41 weeks of gestation. Ultrasound was used to examine the insula, sylvian fissure (SF), parieto-occipital fissure (POF), and calcarine fissure (CF). Bland-Altman plots were used for assessing the concordance, and the intraclass correlation coefficient was used for assessing the reliability.</p><p><b>RESULTS</b>SF images were successfully obtained in 100% of participants at 22 weeks of gestation, while the POF images and CF images could be obtained in 100% at 23 weeks of gestation and 24 weeks of gestation, respectively. The SF width, temporal lobe depth, POF depth, and the CF depth increased with the developed gestation. The width of uncovered insula and the POF angle decreased with the developed gestation. By 23 weeks of gestation, the insula was beginning to be covered. Moreover, it completed at 35 weeks of gestation. The intra- and inter-observer agreements showed consistent reproducibility.</p><p><b>CONCLUSIONS</b>This study defined standard views of the fetal sulcus as well as the normal reference ranges of these sulcus measurements between 18 and 41 weeks of gestation. Such ultrasonographic measurements could be used to identify fetuses at risk of fetal neurological structural disorders.</p>

Efficacy and safety of Wanfeile in the treatment of erectile dysfunction: Report of 100 cases and review of the literature / 中华男科学杂志

Objective@#To investigate the clinical effect and safety of Wanfeile in the treatment of erectile dysfunction (ED).@*METHODS@#Totally 100 ED patients received oral Wanfeile at 100 mg, once every 3 days, for a course of 3 months. We compared the IIEF-5 scores of the patients before and after medication and among the patients with different degrees of ED. We evaluated the total clinical effectiveness of Wanfeile and analyzed adverse reactions.@*RESULTS@#The total effectiveness rate of Wanfeile was 95.6%. All the patients showed significant improvement in the IIEF-5 scores after treatment as compared with the baseline (P <0.05). Adverse reactions were observed in 5 cases (5.50%), all mild and transient.@*CONCLUSIONS@#Wanfeile is safe and efficacious for the treatment of ED.

Penile necrosis resulting from post-circumcision microwave diathermy: A report of 9 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the pathogenesis and treatment of penile necrosis resulting from microwave diathermy following circumcision.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data about 9 cases of penile necrosis resulting from postoperative microwave diathermy following circumcision. The 9 males, aged 20 - 39 (mean 26) years, underwent traditional circumcision for redundant prepuce or phimosis in other hospitals, followed by microwave diathermy for 30 - 60 minutes daily, which resulted in penile necrosis. With no response to conservative therapy, the patients were referred to our hospital at 3 -30 days postoperatively. Of the 9 patients, 5 presented with dry gangrene and 4 with moist gangrene. Six of the patients underwent partial penectomy, including 1 that received penis lengthening.3 months later, while the other 3 underwent total penectomy for total penile necrosis followed by penile reconstruction 3 months later, with deep inferior epigastric perforator (DIEP) flaps and by implantation of the 12th costal cartilage in 2 cases and with epigastric groin island flaps and by urethroplasty in the other.</p><p><b>RESULTS</b>The patients were followed up for 2 - 8 years, and all could urinate smoothly in the standing position. Of the 6 men treated by partial penectomy, 1 received penis lengthening and achieved a penile length of 7 cm and 5 had the remaining penile length of 3 -5 cm, 4 with erectile function and the other 2 capable of sexual intercourse. The 3 men treated by total penectomy achieved nearly normal external appearance of the penis, with a finalized length of (11.7 ± 1.3) cm, a circumference of (11.4 ± 2.1) cm, and a normal feel of the skin. Of the 3 cases of penile reconstruction, 2 achieved sufficient erectile hardness of the penis (grade 3) for sexual intercourse, while the other 1 remained impotent.</p><p><b>CONCLUSION</b>Post-circumcision microwave diathermy may result in penile necrosis, for the management of which, early debridement is necessitated and penile lengthening or reconstruction can be performed according to the severity of the lesion and needs of the patient.</p>

Ultrasound measurement of fetal posterior fossa at 11 to 13⁺⁶ gestational weeks for screening open spina bifida / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish the normal reference ranges of transabdominal ultrasound measurements of the posterior fossa structure in fetuses at 11 to 13⁺⁶ gestational weeks and explore their clinical value in screening open spina bifida (OSB).</p><p><b>METHODS</b>Between January, 2013 and September, 541 randomly selected normal fetuses underwent nuchal translucency at the gestational age 11 to 13⁺⁶ weeks. The parameters of the posterior fossa were measured in mid-sagittal view of the fetal face and the axial view of the transverse cerebellum insonated through the anterior fontanel by transabdominal ultrasound to establish the normal reference ranges. The measurements were obtained from 3 fetuses with OSB for comparison with the reference ranges.</p><p><b>RESULTS</b>In normal fetuses, the parameters of the posterior fossa measured in the two views showed no significant differences (P>0.05). Two high echogenic lines were observed in normal fetuses, as compared with one in fetuses with OSB representing the posterior border of the brain stem and the anterior border of the fourth ventricle. The line between the posterior border of the fourth ventricle and the anterior border of the cisterna magna was not displayed in fetuses with OSB. The anteroposterior diameters of the brain stem, the fourth ventricle, and cisterna magna all increased in positive correlation with the crown-lump length in normal fetuses. In the 3 OSB fetuses, the anteroposterior diameter of the brain stem exceeded the 95th percentile and the anteroposterior diameter of fourth ventrical-cisterner magena was below the 5th percentile of the reference range for CRL; the brain stem to fourth ventrical-cisterner magena anteroposterior diameter ratio was increased to above 1.</p><p><b>CONCLUSION</b>The established normal reference ranges of the parameters of fetal posterior fossa may provide assistance in early OSB detection. The absence of the posterior border of the fourth ventricle and the anterior border of the cisterna magna and a brainstem to fourth ventrical-cisterner magena anteroposterior diameter ratio greater than 1 can be indicative of OSB at 11 to 13⁺⁶ gestational weeks.</p>

Prenatal diagnosis of dural sinus malformation by ultrasound / 中华医学超声杂志（电子版）

Objective To assess the prenatal features of dural sinus malformation (DSM) by ultrasound. Methods The prenatal ultrasonography and MRI examination were applied in three fetuses who were suspected as brain abnormalities and transferred to Shenzhen Maternity and Child Healthcare Hospital for detailed antenatal ultrasound examination. Comparative analysis was performed on MRI, autopsy and prenatal ultrasonography. The prenatal characteristics were summarized. Results In the sonograms of all three cases, the torcular Herophili and superior sagittal sinus were dilated. No blood lfow was detected within or around lesions by color Doppler imaging. Posterior intracranial dual sinus thrombosis was detected in one case. MRI examinations were applied in two fetuses. The results of prenatal ultrasonography were consisted with those of MRI, MRI imaging showed dilated torcular Herophili and superior sagittal sinus with short T1 and short T2 signal. The thrombosis was presented as iso-hypointense with focal eccentric hyperintense. One case was undertook autopsy and the result was consisted with the prenatal sonographic findings. Conclusions The typical sonographic features of DSM is dilated torcular Herophili and superior sagittal sinus with no blood lfow in color Doppler imaging. DSM should be excluded when anechoic area was detected at the rear part of midline.

Sonographic lenticulostriate vasculopathy in fetus / 中华医学超声杂志（电子版）

Objective To explore the value of prenatal diagnosis and sonographic features of lenticulostriate vasculopathy (LSV). Methods Prenatal ultrasonographic features of three cases of fetal lenticulostriate vasculopathy were retrospectively analysed associated with maternal TORCH screen, fetal magnetic resonance imaging, neonatal physical examination and TORCH screen. Results Prenatal sonographic diagnosis of case 1 demonstrated fetal LSV as well as fetal growth restriction (FGR), periventricular hemorrhage, mitral and tricuspid regurgitation, hydropericardium and catatact. Prenatal sonographic diagnosis of case 2 demonstrated fetal LSV, FGR, periventricular hemorrhage, mitral and tricuspid regurgitation. Prenatal sonographic diagnosis of case 3 showed fetal LSV and intraventricular hemorrhage. Maternal TORCH screens of case 1 and case 3 was negative, while in case 2 was positive. Neonatal examinations of case 1 showed cataract, hearing impairment and congenital infection. Case 3 showed prompted retinal hemorrhage, sinus bradycardia, hyperbilirubinemia and congenital infection. In case 2, maternal teratogenic pathogen screen was positive and the baby did not survive because the mother decided to stop pregnancy in 34 weeks. Conclusions Fetal LSV could be imaged by prenatal ultrasonography. Fetal LSV might indicate intrauterine infection when other abnormalities were accompanied. Ultrasound might be useful for the cases with negative maternal TORCH screen results.

Hand-assisted-drawing-needle running suture with a curved needle: an effective technique to create a W-ileal neobladder / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>An important milestone in the area of urinary diversion was the advent of a series of orthotopic bladder substitution (OBS). However, reconstruction of OBS by the traditional hand suture method (THSM) is a time-consuming process. Stapling techniques are considered to be inferior to hand-sewn methods. We report our experience and functional results in patients with W-ileal neobladder by a hand-assisted-drawing-needle running suture (HADNRS).</p><p><b>METHODS</b>Between April 1993 and December 2011, 347 patients (338 men and 9 women) aged 28 - 77 years (median age: 59 years) underwent radical cystectomy, followed by the creation of a modified W-ileal neobladder by HADNRS with a curved needle. A total of 347 (20 patients in 2003) were evaluated by urodynamic tests.</p><p><b>RESULTS</b>The operative time ranged from 110 to 310 minutes (mean 148 minutes), and the mean time of reconstruction by HADNRS, excluding ureterointestinal and ileouretral anastomosis, was (20.2 ± 4.3) minutes. Histopathological analysis of removed specimens showed that 317 patients had transitional cell bladder carcinoma. Of these 317 patients, 19 also had squamous carcinoma and 13 had adenocarcinoma. Glandularis and prostate cancer occurred in 16 and 14 patients, respectively. Three patients (0.8%) had neobladder abdominal fistula. No other early complications or injury to the surgeon's hands occurred due to HADNRS. Of the 20 cases with urodynamic examinations in 2003, two suffered from daytime incontinence and six had nocturnal incontinence. The maximum capacity of the neobladder was (492.9 ± 177.8) ml, and the maximum pressure within the reservoir at the end of filling was (32.1 ± 8.6) cmH2O.</p><p><b>CONCLUSION</b>Reconstruction of W-ileal neobladder by HADNRS is effective and economical.</p>

Ultrasonographic features of cornual pregnancy and analysis of misdiagnosed cases / 中华医学超声杂志（电子版）

Objective To summarize the ultrasonographic features and differential diagnosis of uterine cornual pregnancy.Methods Trans-abdominal and trans-vaginal ultrasound were performed in 93 uterine cornual pregnancy patients before surgery,ultrasonographic findings of uterine cornual pregnancy through different two approaches were analyzed and compared with surgical and pathologic findings.ResultsIn contrast with surgical and pathological diagnosis,66 cases(82.5%,66/80) of uterine cornual pregnancy were accurately diagnosed by ultrasonography before surgery,these cases were divided into gestational sac pattern (55 cases) and mixed mass pattern(11 cases); 11 cases were misdiagnosed as interstitial tubal pregnancy,2 cases were misdiagnosed as pregnancy in rudimentary horn,1 case was misdiagnosed as choriocarcinoma,misdiagnosed rate were 17.5%(14/80); uterine cornual pregnancy presented as adnexal mass in ultrasound in 13 cases,while ruptured uterine cornual mass were found in surgery,in which location and type of the masses couldn't be accurately diagnosed by ultrasound.Ultrasonographic features of uterine cornual pregnancy presented as a gestational sac located in extended cornual of uterus,surrounded by thin myometrium,and connected with endometrium.The misdiagnosed causes were: (1) Uterine cornual mass was not connected with endometrium or surrounded by thin myometrium,which were misdiagnosed as interstitial tubal pregnancy.(2) Uterine cornual pregnancy with thick lateral myometrium were misdiagnosed as pregnancy in rudimentary horn.(3)Uterine cornual pregnancy presented as cornual mass with abundant blood flow was misdiagnosed as choriocarcinoma.Conclusions Uterine cornual pregnancy can be accurately diagnosed by trans-abdominal and trans-vaginal ultrasound.Ultrasonographic features are helpful in differential diagnosis of uterine cornual pregnancy.

Comparative study of enhancing effect on mRNA expression of hematopoietic growth factors in rat bone marrow mesenchymal stem cells by ginseng polysaccharide and ginsenoside / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study mRNA expression levels of main hematopoietic growth factors in bone marrow mesenchymal stem cells (BM-MSC), and to compare effect on mRNA expression levels treated by ginseng polysaccharide and ginsenoside.</p><p><b>METHODS</b>Relative quantification real-time polymerase chain reaction (RT-PCR) was used to observe mRNA expression levels of IL4, Csf2, Kitlg, Csf1, IL6, Lif, Csf3, IL11, Epo, and IL3, etc. in rat BM-MSC treated with ginseng polysaccharide (20 microg/mL) or ginsenoside (20 microg/mL) at 12, 24, and 36 h.</p><p><b>RESULTS</b>IL4 and Csf2 mRNA expressions were not detected. Relative expression of Kitlg, Csf1, IL6, Lif, Csf3, IL11, Epo and IL3 mRNA ranked in an attenuating order when compared with Gapdh mRNA. mRNA expression of Epo and IL3 was not significantly changed at any time point by treatment of ginseng polysaccharide or ginsenoside in rat BM-MSC (P > 0.05). mRNA expression of Csf1, IL6, Lif, Csf3 and IL11 were significantly enhanced at 12 and 36 h by treatment of ginseng polysaccharide (P < 0.05) and that of Csf1, IL6, Lif, Csf3, and Kitlg were significantly enhanced at 24 h in rat BM-MSC (P < 0.05). The enhanced mRNA expression was Csf3 at 12 h, Csf3, IL6 and Lif at 24 h, and Csf3, IL6, Lif, IL11, and Kitlg, respectively at 36 h by treatment of ginsenoside in rat BM-MSC.</p><p><b>CONCLUSIONS</b>The enhancement of ginseng polysaccharide was stronger than that of ginsenoside on mRNA expression of hematopoietic growth factors in the initial stage. As time went by, the enhancement of ginsenoside gradually increased and exceeded that of ginseng polysaccharide.</p>

Efficacy and safety of vardenafil in the treatment of erectile dysfunction: a report of 700 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of long-term on-demand use of vardenafil in the treatment of erectile dysfunction (ED).</p><p><b>METHODS</b>We conducted a questionnaire investigation among 891 ED patients treated by on-demand use of oral vardenafil at 20 mg every 3 days from March 2007 to January 2010, covering the general information of the patients, their need for and attitudes towards the treatment, clinical efficacy and adverse events of the drug, and satisfaction of the patients and their partners after 12 weeks of treatment.</p><p><b>RESULTS</b>Treatment and follow-up were completed in 700 patients, of whom 504 (72%) achieved sufficient hardness and duration of penile erection and overall sexual satisfaction, 84 (12%) admitted to improvement of erectile hardness and duration but not adequate satisfaction, and the other 112 (16%) experienced no significant changes. Significant differences were found in IIEF-5 scores, Rigiscan test results and partners TSS scores before and after the treatment (P < 0.05). Most frequent adverse events included flushing (15%), dizziness and headache (10%), dyspepsia (3%), and nasal congestion (1%).</p><p><b>CONCLUSION</b>Long-term on-demand use of oral vardenafil, in addition to its safety and good tolerance, can effectively improve the erectile function of ED patients, their success rate of sexual intercourse, and overall quality of sexual life.</p>

Perinatal management and outcome of different types of fetal arrhythmia / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the perinatal management and outcome of different types of fetal arrhythmia.</p><p><b>METHODS</b>A retrospective analysis was conducted among the fetuses with arrhythmia identified by M-mode and pulsed Doppler echocardiography in a single institution between October 2003 and December 2010.</p><p><b>RESULTS</b>A total of 130 fetuses were found to have fetal arrhythmia. The most common arrhythmia during pregnancy was extrasystole (n=59), followed by bradycardia (n=23), tachycardia (n=16), atrial flutter (AF, n=3), atrioventricular block (AVB, n=12) and other arrhythmia (n=17). The overall incidence of cardiac anomalies (commonly fetal bradycardia) was 9.2% in these cases. The prognosis of arrhythmia differed significantly between cases of different classifications. The type of fetal arrhythmia (P=0.024), presence of congenital heart defect (CHD, P=0.000) and fetal hydrops (P=0.008) were significant risk factors associated with termination of pregnancy.</p><p><b>CONCLUSION</b>Fetal arrhythmias without CHD or hydrops under close monitoring often have good clinical outcome, while fetal bradycardia is associated with a high mortality rate. CHD and the presence of fetal hydrops are significant risk factors for pregnancy termination.</p>

Replacement of plaque by buccal mucosa in the treatment of Peyronieś disease: a report of 27 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical results of the replacement of plaque by buccal mucosa in the treatment of Peyronie's disease.</p><p><b>METHODS</b>We performed surgical replacement of the plaque by free autograft of buccal mucosa on 27 patients with Peyronie's disease, ranging in age from 24 to 72 years (mean 53), varying in disease course between 1 and 13 years, with a penile curvature angle of 30 degrees - 80 degrees in erection. Of the total number, 15 patients had the plaque located in the dorsal root, 6 in the dorsal shaft, 3 in the subcoronal shaft and 3 in the ventral shaft of the penis; 24 had 1 plaque, 2 had 2 and 1 had 3, ranging in size from 0.7 cm x 0.7 cm to 1.6 cm x 1.0 cm.</p><p><b>RESULTS</b>Satisfactory results were achieved in all the cases, with no such complications as hematoma, infection, oral numbness, and tightness of the mouth. Of the 24 cases that were followed up for 0.5 to 7 years, complete straightening of the penis was achieved in 21, slight residual curvature (< 15 degrees) was noted in 3, a little shortening of the penis (< 1 cm) in 2, and erectile pain in 3.</p><p><b>CONCLUSION</b>Buccal mucosa, with a stable elasticity and no shrinkage, can be recommended for wide use in the surgical treatment of Peyronie's disease.</p>

Type V phosphodiesterase inhibitor erection-provoking test with audio-visual sexual stimulation for the diagnosis of erectile dysfunction / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the type V phosphodiesterase (PDE-5) inhibitor erection-provoking test with audio-visual sexual stimulation in the diagnosis of erectile dysfunction.</p><p><b>METHODS</b>A total of 853 out-patients diagnosed with erectile dysfunction were divided into an injury and a non-injury group. After scored on IIEF-5 questionnaires, all the patients received oral administration of PDE-5 inhibitors and, 30 minutes later, audio-visual sexual stimulation. The data on penile erection were recorded with Rigiscan Plus.</p><p><b>RESULTS</b>The patients with mild, moderate and severe ED accounted for 18.8, 31.9 and 49.3% in the injury group, and 50.6, 39.8 and 9.6% in the non-injury group, with statistic differences between the two groups in the mild and severe parts (P < 0.05). The rates of conspicuous effectiveness, effectiveness, ineffectiveness and total effectiveness of the combined method were 13.0, 14.5, 72.5 and 27.5% in the injury group, but 55.7, 20.7, 23.6 and 76.4% in the non-injury group, with significant differences (P < 0.05).</p><p><b>CONCLUSION</b>The PDE-5 inhibitor erection-provoking test with audio-visual sexual stimulation is a simple, practical, safe and effective method for the differentiation of organic from psychological erectile dysfunction.</p>

Methodology of measuring induced postnatal fetal long bones / 中华医学超声杂志（电子版）

Objective To investigate the effects of different standard cross sections and angles on the measurement accuracy of induced postnatal fetal long bones. Methods Fetal long bones (femori and humeri) in 30 cases with induced abortion were measured utilizing ultrasound from different angles and /or at different directions. The values measured from different sections and angles with vernier calipers were compared prenatally and postnatally. Results There was no apparent difference between the pre-induced abortion and those of the post-induced abortion. The results in the 30 cases showed that: (1) the values measured from anterior 90 degree, the long bone length would best match with the bare long bone length up to 96.7%, the match rate of other angles and/or directions was up to 80%; (2) no apparent statistical difference was between the length of left and right bone and no difference was found using 4 different directions and 3 different angles; (3)there was no difference between the left and right femuri and humeri.Conclusions Though the measured value from anterior 90 degree direction was the most accurate one, the statistical analtical results showed no difference among 12 values measured from 3 different angles and/or 4 different directions.

Surgical treatment of a rare case of penile squamous cell carcinoma in a 65-year-old man / 亚洲男科学杂志(英文版)

Penile squamous cell carcinoma has been commonly reported in the past decades. We describe a rare case of a huge squamous cell carcinoma of the penis in a 65-year-old patient with a 4-year history of tumor growth, for which total penectomy, perineal urethrostomy and bilateral inguinal lymphadenectomy were carried out. We suggest that aggressive surgical intervention should be recommended for those with well-differentiated penile carcinoma regardless of the size of the tumor.