[Long-term outcomes of 125I brachytherapy combined with maximal androgen blockade for metastatic prostate cancer].

OBJECTIVE: To investigate the long-term clinical value of prostate 125I brachytherapy (BT) combined with maximal androgen blockade (MAB) in the treatment of metastatic prostate cancer (mPCa). METHODS: We retrospectively analyzed the clinical data on 173 cases of mPCa treated by MAB (n = 126) or BT+MAB (n = 47) from December 2011 to December 2016 and followed up for 6－76 (44.17 ± 19.73) months. We compared the PSA level, prostate volume, IPSS, progression-free survival, and the rates of 3- and 5-year overall survival between the two groups. RESULTS: After treatment, the minimum PSA level was significantly lower in the BT+MAB than in the MAB group ï¼»3.77 ± 4.14ï¼½ vs ï¼»5.96 ± 7.01ï¼½ ng/ml, P = 0.046) and the time to reach the minimum level was shorter in the former than in the latter (ï¼»5.19 ± 2.83ï¼½ vs ï¼»6.52 ± 3.34ï¼½ mo, P = 0.016). The prostate volume was markedly reduced in both of the groups at 1, 3 and 5 years after treatment as compared with the baseline, even more significantly in the BT+MAB than in the MAB group (P < 0.01), though with no statistically significant difference between the two groups before treatment (P = 0.307). The IPSS was remarkably decreased in both of the groups at 1 and 3 years (P < 0.01) but showed no significant difference at 5 years after treatment as compared with the baseline (P > 0.05) or between the two groups before and after treatment (P > 0.05). The progression-free survival was obviously longer in the BT+MAB than in the MAB group (ï¼»37.29 ± 15.73ï¼½ vs ï¼»29.41 ± 14.37ï¼½ mo, P = 0.011), and the rates of 3- and 5-year overall survival were higher in the former than in the latter (74.60% and 60.70% vs 62.60% and 51.50%, P = 0.227 and P = 0.356). Kaplan-Meier survival curves showed no statistically significant difference in the overall survival between the two groups (P = 0.105). CONCLUSIONS: Both MAB and BT+MAB are effective therapies for mPCa, but the latter can achieve a longer progression-free survival.

[Efficacy of compound Xuanju capsule in the treatment of chronic prostatitis with erectile dysfunction].

OBJECTIVE: To evaluate the efficacy and safety of Compound Xuanju Capsule (CXC) in the treatment of chronic prostatitis with erectile dysfunction (ED). METHODS: We obtained NIH-CPSI and IIEF-5 scores from 132 chronic prostatitis patients with ED and divided the patients into a control (n = 70) and a treatment group (n = 62), the former treated with oral levofloxacin 0.2 g bid for 4-6 weeks and oral Terazosin at 2 mg qd for 2 months, and the latter with oral CXC once 2 capsules tid for 2 months in addition to the above. RESULTS: None of the patients had serious medication-related adverse reactions. After treatment, the control group showed significantly decreased NIH-CPSI scores and slightly increased IIEF-5 scores as compared with the baseline (16.5 +/- 5.9 vs 25.1 +/- 5.5, P < 0.05 and 13.1 +/- 5.2 vs 11.3 +/- 4.5, P > 0.05), while the treatment group exhibited significant improvement in both NIH-CPSI (13.4 +/- 5.7 vs 25.5 +/- 5.3, P < 0.05) and IIEF-5 scores (17.5 +/- 6.5 vs 10.8 +/- 3.8, P < 0.05). The total effectiveness rate for ED was significantly higher in the treatment than in the control group (74.2% vs 20%, P < 0.05). CONCLUSION: Compound Xuanju Capsule can significantly alleviate both the symptoms of chronic prostatitis and ED in the treatment of chronic prostatitis patients with ED.

[Study on the correlation of the 5-HTTLPR polymorphism with premature ejaculation in Han Chinese population].

OBJECTIVE: To investigate the relationship between 5-HT transporter gene-linked polymorphism (5-HTTPLR) and the clinical characters of premature ejaculation in Han Chinese population. METHODS: By case-control study approach, we set primary premature ejaculation (PPE) group (119 cases), secondary premature ejaculation (SPE) group (60 cases) with IELT < 1 min in more than 90% coitus and normal control group (90 cases) with IELT ≥ 3 min. The gene polymorphism of the 5-HTT was detected by polymerase chain reaction analysis in all the cases, and the gene frequency differences among the three groups were evaluated. RESULTS: The frequency of the genotype S/S was higher in PPE group than in normal control group(51.3% vs. 37.8%,P<0.01), and the frequency of genetype L/S was lower in PPE group than in normal vontrol group(28.6% vs. 34.4%,P<0.05).The S allele was higher in PPE group than in control group (P<0.05), but there was no difference between the SPE group and the normal control group. CONCLUSION: The 5-HTTLPR polymorphism is associated with PPE, which shows that genetics may play an important role in the occurrence of PPE but not of SPE. The etiology of PPE and SPE is different.

[Efficacy and safety of selective serotonin re-uptake inhibitors in the treatment of premature ejaculation: a systematic evaluation].

OBJECTIVE: To evaluate the efficacy and safety of selective serotonin re-uptake inhibitors (SSRIs) in the treatment of premature ejaculation (PE). METHODS: From MEDLINE (Jan, 1950-Mar, 2008), EMBASE (Jan, 1980-Mar, 2008), The Cochrane Library (Issue 1, 2008) and CNKI (Jan, 1979-Mar, 2008), we retrieved and screened the randomized controlled trials (RCT) and randomized crossover trials (RT) as well as various related data, published and unpublished, on the treatment of PE with SSRIs. The methodological quality of the included trials was evaluated by 2 reviewers. Meta-analyses were conducted with RevMan 5.0 on the homogeneous studies. RESULTS: Totally 22 studies on 4 291 patients were included. Meta-analyses showed that after treated with sertraline, fluoxetine, paroxetine, citalopram, dapoxetine and fluvoxamine, the WMD (95% CI) values of the changes in intravaginal ejaculatory latency time (IELT) were 2.63 (1.80, 3.46), 2.21 (1.50, 2.92), 4.31 (2.71, 5.91), 3.82 (3.39, 4.25), 1.57 (1.31, 1.84) and 0.01 (0.71, 0.73) respectively; the RR (95% CI) values of the sexual satisfaction rate of the patients were 1.65 (1.12, 2.43), 2.93 (0.50, 17.31), 3.08 (2.27, 4.17), 2.48 (1.99, 3.09) and 2.93 (2.36, 3.65), and those of their partners were 1.47 (0.98, 2.21), 2.88 (0.38, 21.77), 4.81 (3.15, 7.36), 5.38 (3.75, 7.72) and 2.91 (1.09, 7.78) respectively for sertraline, fluoxetine, paroxetine, citalopram and dapoxetine. CONCLUSION: All the known SSRIs but fluvoxamine could prolong IELT, and some could improve the sexual satisfaction of both the patients and their partners, but their adverse effects should be noted. The moderate possibility of selection bias and publication bias in the included studies might have a negative impact on the evidence intensity of our results. We expect more reliable evidence from more randomized controlled trials.