Effects of sildenafil treatment on patients with Peyronie’s disease and erectile dysfunction

Introduction

It has been shown on experimental rat models that type 5-phosphodiesterase isoenzyme (PDE₅) inhibitors have anti-fibrotic effects for Peyronie’s disease (PD); however, this issue has not been addressed clinically. The aim of this study was to document the effects of PDE₅ inhibitors used for erectile dysfunction (ED) seen in PD patients on the main course of the PD clinically.

Methods

A total of 39 PD patients with ED were divided into two groups. Patients in Group 1 (n = 18) served as controls and received 400 IU vitamin E per day. Those in Group 2 (n = 21) received 50 mg sildenafil per day for 12 weeks. Penile plaque volume was assessed by palpation and by duplex ultrasound. Erectile capacity, penile deformity and plaque characteristics were assessed by the International Index of Erectile Function questionnaire form (IIEF-5) and penile duplex ultrasound.

Results

Statistically significant improvement in all parameters was observed within both groups except for IIEF score in Group 1 when compared with the initial values. Significant reduction in plaques and pain were observed in 7 (33.3 %) and 14 (66.6 %) patients in Group 2 and 6 (33.3 %) and 9 patients (42.8 %) in Group 1, respectively. At the end of the therapy, improvement in IIEF score and reduction in pain were statistically significant in Group 2 compared with Group 1 (p = 0.028 and p = 0.045, respectively).

Conclusion

We conclude that continuous administration of oral PDE₅ inhibitors may be a candidate for medical treatment of PD; however, more controlled studies are needed.     

Protective effect of lovastatin on atherosclerosis-induced endothelial dysfunction

Ｐｒｏｔｅｃｔｉｖｅｅｆｅｃｔｏｆｌｏｖａｓｔａｔｉｎｏｎａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ┐ｉｎｄｕｃｅｄｅｎｄｏｔｈｅｌｉａｌｄｙｓｆｕｎｃｔｉｏｎＦａｎｇＺｈｅｎｙｉｎｇ房振英，ＬｉＹｅｆｅｉ李亚菲，ＺｈａｎｇＬｉｚｈｅｎ张丽贞，ＬｉｕＤａｊｉｎｇ...     

Clinical course and cause of death in elderly patients with idiopathic Parkins on’s disease

Objective To improve the therapeutic and preventive measure for elderly patients (75 years and over) with idiopathic Parkinson’s disease (OEIPD). Methods Fifteen OEIPD patients were observed prospectively over a long period of time. Their diagnosis was confirmed by autopsy. Based on clinical and pathological data, the causes of death were analyzed.Results The mean clinical course in OEIPD patients was 6.2±3.6 years. The majority of the 15 patients were the akinetic type and the akinetic type with tremor (80.0%). In the late stages of disease (4.8±3.5 year), choking occurred in 12 OEIPD patients who received nasal feeding for an average of 4 months after the occurrence of choking. The most common complication in 12 patients was repeated pulmonary infections with an average rate of 2.9±1.9. The causes of death were bronchial pneumonia and shock induced by pulmonary infection (11 cases, accounted for 73.3%), acute myocardial infarction (2 cases), one case with cardiac rupture and one case with rupture of aortic aneurysm. Conclusions The clinical course was shorter in OEIPD patients. Levodopa therapy should be started early in OEIPD patients. Bronchial pneumonia and infectious shock constitute the major cause of death and choking was one of the main causes of aspiration pneumonia. Nasal feeding should be started as early as possible after the appearance of choking. Silent aspiration can be reduced by teaching the patient to protect the airway by ’supraglottic swallowing’.     

Differential acetylcholine and choline concentrations in the cerebrospinal fluid of patients with Alzheimer’s disease and vascular dementia

Background An important aspect of Alzheimer’s disease (AD) is loss or impairment of cholinergic neurons. It is controversial whether there is a similar cholinergic impairment and cerebral deficit of acetylcholine (ACh) in the case of vascular dementia (VD). The purpose of this study was to explore the levels of ACh and choline (Ch) in the cerebrospinal fluid (CSF) of patients with AD and VD, and their possible relationship with cognitive impairment.Methods Twenty-two AD patients, twenty-two VD patients, and twenty normal controls were recruited and scored with a Mini-Mental State Examination (MMSE). CSF concentrations of ACh and Ch were measured using high-performance liquid chromatography with an electrochemical detector (HPLC-ECD) and the results were then compared to cognitive status.Results ACh concentrations in CSF of AD patients ［(10.7±5.1） nmol/L］ and VD patients ［(16.8±7.4） nmol/L］ were both significantly lower than in controls ［(34.5±9.0） nmol/L, t=10.67, P<0.001; t=6.91, P<0.001］. Both results correlated positively with MMSE scores (rs=0.88 and rs=0.85, respectively, P<0.01). The CSF concentration of Ch was significantly higher in VD patients ［(887.4±187.4） nmol/L］ compared to AD patients ［(627.6±145.1） nmol/L, t=6.4, P<0.001］ and controls ［(716.0±159.4） nmol/L, t=4.2, P=0.002］. CSF Ch concentration showed no difference between AD patients and normal controls, nor did it correlate with MMSE score in any of the three groups. Conclusions The positive correlation between ACh deficit and cognitive impairment suggests that ACh is an important neurotransmitter for memory. The similar decrease in ACh concentration in AD and VD patients may imply a similar pathogenesis for the process of cognitive impairment involved in these two disorders. The elevated CSF levels of Ch in VD patients compared to AD patients may be useful diagnostically. Cholinesterase inhibitors may be helpful not only for AD patients, but also for VD patients.     

Effect of Astragalus Injection on serious abdominal traumatic patients’ cellular immunity

Objective: To explore the change of serious abdominal traumatic patients’ cellular immunity and the effect of Astragalus Injection (AI) on it.Methods: Sixty-three serious abdominal traumatic patients were randomly assigned into two groups, the conventional group and the treated group, patients in the conventional group were given conventional treatment, while others in the treated group were given conventional treatment as the basis, with AI 20 ml was added into 250 ml of 5% glucose solution given through intravenous dripping, and then on the first day and 14th day, their T cell activated antigens as well as that of 10 healthy subjects were monitored.Results: On the first day, in the conventional group and treated group, the levels of CD ₃ ⁺ , CD ₄ ⁺ , CD ₄ ⁺ /CD ₈ ⁺ , CD ₁₆ ⁺ , CD ₆₉ ⁺ and CD ₃ ⁺ /homologous leucocytic antigen-DR (HLA-DR⁺) were apparently lower than those in the healthy group (P<0.05), while the CD ₈ ⁺ was significantly higher than that in the healthy group (P<0.05), and there was no significant difference between the conventional group and the treated group (P>0. 05); on the 14th days, the levels of CD ₃ ⁺ , CD ₄ ⁺ , CD ₄ ⁺ /CD ₈ ⁺ , CD ₁₆ ⁺ , CD ₆₉ ⁺ and CD ₃ ⁺ /HLA-DR⁺ of the treated group got closed to healthy subject value, and got even higher than those of conventional group (P<0.05); CD ₈ ⁺ got close to that of healthy subjects, while obviously lower than that of conventional group (P<0.05).Conclusion: After serious abdominal trauma, cellular immunity lowered, auxiliary use of AI was beneficial to the restoration of cellular immunity.     

Effect of Shengmai injection (生脉注射液) on vascular endothelial and heart functions in patients with coronary heart disease complicated with diabetes mellitus

Objective： To study the effect of Shengmai injection （生脉注射液, SMI） on vascular endothelial and heart functions in coronary heart disease patients complicated with diabetes mellitus （CHD-DM）. Methods： One hundred and twenty patients with CHD-DM, their diagnosis confirmed by coronary arteriography, were equally randomized into a control group treated with conventional treatment and a treated group treated with conventional treatment plus SMI. The changes in blood levels of nitric oxide （NO）, endothelin-1 （ET-1） and angiotensin Ⅱ （Ang Ⅱ）, as well as endothelium-dependent vascular dilating function and heart function in the patients were observed before treatment and after the 3-week treatment. Results： After being treated with SMI for 3 weeks, in the treated group, blood level of NO was raised significantly from 69.8±33.1 μmol/L to 120.1±50.8μmol/L, and ET-1 was lowered from 70.1±32.1 ng/L to 46.2±21.3 ng/L, respectively （P〈0.01）; that of Ang Ⅱ was lowered from 81.3±24.3 ng/L to 50.2±27.3 ng/L （P〈0.01）; brachial arterial post-congestion blood flow increasing rate was raised from 389.4±26.3% to 459.3±27.8% （P〈0.01）; and the improvement in heart function as seen through the ejection fraction （EF） was increased from 44±5% to 68±6% （P〈0.01）, all the changes being more significant than those in the control group （all P〈0.01）. Conclusion： SMI can improve not only the endothelial function in CHD-DM patients, but also heart contraction significantly.     

Apolipoprotein E genotype in patients with Alzheimer’s disease

Objective To explore the frequency and significance of ApoE gene polymorphisms in patients with sporadic Alzheimer’s disease (AD).Methods Single nucleotide polymorphisms of the ApoE gene were analyzed in 32 cases of AD and 26 controls, using PCR and gene sequencing.Results The single nucleotide polymorphism of ApoE gene 462C/G was significantly associated with AD (P&lt;0.05).Conclusions The 462C/G polymorphism might be a specific genotype in Chinese patients with sporadic AD.     

Urodynamic analysis and treatment of male Parkinson’s disease patients with voiding dysfunction

Background Parkinson＇s disease （PD） is an extrapyramidal neurological disorder.Urinary symptoms are frequently present in patients affected by PD.Symptoms such as urgency,frequency,nocturia,and urge incontinence significantly impact the patient＇s quality of life.We attempted to investigate the urodynamic changes and treatment of male PD patients with voiding dysfunction by means of a review.Methods Comprehensive urodynamic examinations were performed in 141 male patients with PD associated with voiding dysfunction.Appropriate treatments were given to subgroups that were divided based on test results,and the changes in urodynamic parameters as well as the treatment efficacy were observed.Results Detrusor hyperreflexia without bladder outlet obstruction （BOO） was observed in 35 patients,who exhibited significant improvements in the international prostate symptom score （IPSS）,maximum flow rate （Qmax）,bladder volume at the first desire to void,post-void residual （PVR）,and bladder compliance.Detrusor hyperreflexia associated with BOO was observed in 59 patients.The patients exhibited significant improvements in IPSS,Qmax,PVR,and bladder compliance.Detrusor dysfunction without BOO was observed in 19 patients,for whom the IPSS and the bladder volume at the first desire to void were improved after treatment.Detrusor dysfunction with BOO was found in 28 patients,with no significant improvement in the urodynamic parameters after the treatment.Conclusions Urodynamic examination is recommended for male Parkinson＇s disease patients with voiding dysfunction.Early and effective treatment can improve the bladder function and quality of life of these patients.     

Astudy of platelet organelles and mem brane glycoprotein in patientswith Binswanger’s disease

Ｏｂｊｅｃｔｉｖｅ　ＴｏｄｉｓｃｕｓｓｔｈｅｐｏｓｓｉｂｌｅｒｏｌｅｏｆｐｌａｔｅｌｅｔｓｉｎＢｉｎｓｗａｎｇｅｒ’ｓｄｉｓｅａｓｅｂｙｓｔｕｄｙｉｎｇｔｈｅｃｈａｎｇｅｓｏｆｏｒｇａｎｅｌｌｅｓａｎｄｍｅｍｂｒａｎｅｇｌｙｃｏｐｒｏｔｅｉｎｉｎｐｌａｔｅｌｅｔｓＭｅｔｈｏｄｓ　Ｔｈｅｏｒｇａｎｅｌｌｅｓ（ｄｅｎｓｅｂｏｄｉｅｓ，ａｌｐｈａｇｒａｎｕｌｅｓ，ａｎｄｍｉｔｏｃｈｏｎｄｒｉａ）ｗｉｔｈｉｎｐｌａｔｅｌｅｔｓｗｅｒｅｍｅａｓｕｒｅｄｗｉｔｈｔｒａｎｓｍｉｓｓｉｏｎｅｌｅｃｔｒｏｎｍｉ…     

Study of plasma effects during hypoxia and hemorrhagic shock on polymorphonuclear neutrophil－vascular endothelial cellinterac

Ｓｔｕｄｙｏｆｐｌａｓｍａｅｆｆｅｃｔｓｄｕｒｉｎｇｈｙｐｏｘｉａａｎｄｈｅｍｏｒｒｈａｇｉｃｓｈｏｃｋｏｎｐｏｌｙｍｏｒｐｈｏｎｕｃｌｅａｒｎｅｕｔｒｏｐｈｉｌ－ｖａｓｃｕｌａｒｅｎｄｏｔｈｅｌｉａｌｃｅｌｌｉｎｔｅｒａｃｔｉｏｎｓｉｎｖｉｔｒｏ￥...     

Clinical Study on Protective Effect of Astragalus Injection Plus Ligustrazin in Patients with Myocardial Ischemia Reperfussion Injury

Objective: To investigate the mechanism of protective effect of Astragalus (As) plus ligustrazine (Lt) against myocardial ischemia reperfusion injury (MIRI) during open heart surgery of cardiopulmonary bypass, and the treating principle of MIRI in TCM.Methods: Twenty-four patients were randomly divided into three treated groups and treated with As injection, Lt injection and both (As + Lt) respectively, 6 in each group, and the remainder 6 were taken as control group. Blood samples of them were collected before anesthesia (T1), 10 minutes after occlusion of aorta (T2), 10 minutes(T3) and 30 minutes(T4) after the release, and end of operation (about 180 minutes after release, T5) respectively to test the levels of aspartate aminotransferase ( AST ), lactate dehydrogenase (LDH), creatine kinase (CK), MB isoenzyme of CK (CK-MB), malondialdehyde (MDA) and the activity of Superoxide dismutase ( SOD ), nitric oxide ( NO ), nitric oxide synthetase (NOS).Results: The levels of AST, LDH, CK were reduced in the treated groups, showing significant difference (P< 0.05 or P < 0. 01 ) as compared with those in the control groups. Among them the effect in the AS + Lt group was the best. And NO activity in As group at T5 and As + Lt group at T4, T5 was higher than that in the control group.Conclusion : The mechanism of MIRI is Qi deficiency and blood stasis in TCM, its treating principles should be promoting Qi and removing blood stasis. According to the authors’ study, combined As + Lt therapy is more effective in protecting against MIRI than that using the 2 medicines separately.     

Neuropsychiatric disorders and cognitive dysfunction in patients with Cushing’s disease

Objective To review the main neuropsychiatric disorders and cognitive deficits in patients with Cushing's disease (CD) and the associated pathophysiological mechanisms underlying CD.These mechanistic d...     

Association of serum uric acid levels with the progression of Parkinson’s disease in Chinese patients

Background  Uric acid (UA) is suspected to play a neuro-protective role in Parkinson’s disease (PD). This study aimed to evaluate whether the serum UA level was associated with the disease progression of PD in a relatively large population of Chinese patients.

Methods  Serum UA levels were measured from 411 Chinese PD patients and 396 age-matched controls; following the uric acid colorimetric method, the serum creatinine (Scr) levels were also measured to reduce the bias caused by possible differences in renal excretion function. The disease progression was scored by Hoehn and Yahr (H&Y) scales and disease durations; PD group was divided into 3 subgroups according to H&Y scales. Independent-samples t test was performed to analyze the differences between PD group and control group. Multiple analysis of covariance was performed to analyze the differences between PD subgroups. Spearman rank-correlation was performed to evaluate the associations between serum UA or Scr level and disease progression.

Results  PD patients were found to have significantly lower levels of serum UA than controls ((243.38±78.91) vs. (282.97±90.80) µmol/L, P <0.01). As the disease progression, the serum UA levels were gradually reduced. There was a significantly inverse correlation of UA levels with H&Y scales (Rs= –0.429, P <0.01) and disease duration (Rs= –0.284, P <0.01) in PD patients of both females and males. No significant difference of the Scr level between PD patients and controls was found ((70.01±14.70) vs. (69.84±16.46) µmol/L), and the Scr level was not involved in disease progression.

Conclusion  Lower serum UA levels may possess a higher risk of PD, which may be a potential useful biomarker to indicate the progression of PD.

     

A Study on Protective Action of Astragalus Injection（黄芪注射液）in

Objective: To study the protective action of Astragalus Injection (AI) on ouabain-induced cardiac toxicity. Methods: Forty guinea-pigs were randomly divided into the AI group and the control group, AI injected intravenously in the AI group and 0.9% normal saline injected in the control group, ouabain was injected in contralateral of both groups intravenously 8 mins later. The time of cardiac ventricular tachycardia (VT) and cardiac ventricular fibrillation (VF), and the dose of ouabain were documented.Results: Compared with the control group AI could markedly prolong the time of VT and VF, and increase the dose of ouabain induces VT and VF (P<0.01). Conclusion: AI decreases the incidence of digitalism.     

Protective effects of erythropoietin pretreatment on myocardium with hypoxia／reoxygenation injury in rats

To establish the rat model with myocardial hypoxia/reoxygenation (H/R) injury, and investigate the protective effect of EPO pretreatment on the myocardium. Methods: Sixty male adult Wistar rats were randondv divided into 3 groups: control group, H/R group, and EPO group, 20 in each group. The rats in EPO group accepted injection of 5000 U/kg recombinant human erythropoietin (RHuEPO) through vein, and the other rats accepted the injection of the same volume of saline. Twenty-four hours after the injection, rats in the EPO and H/R groups were put into the hypoxia environment for 12h and then returned to the nonnoxic environment for 2 h, and then the samples of blood and myocardium were collected. Serum myocardial enzyme activity, apoptosis, ultrastructure, myocardial MDA contents, EPO receptor (EPOR) expression in cardiac myocytes and cardiac functions were tested. Results: EPOR expression was positive in cardiac myocytes of adult rat according to the result of immunohistochemitry assayng. Compared to those in H/R group, rats in EPO group presented lighter injury of myocardial ultrastructure, the reduction of serum myocardial erzyme activity, inhibition of apoptosis, the better recovery of cardiac functions, and the less production of oxygen-derived free radicals. Conclusion: Adult rat cardiac myocytes could express EPOR, and EPO pretreatment produced protective effects on myocardium with H/R injury.     

Clinical Study on Protective Effect of Xinmaitong Capsule on Damage of Vascular Endothelial Cells

Clinical Study on Protective Effect of Xinmaitong Capsule on Damage of Vascular Endothelial Cells@丘瑞香@贺敬波@蓝军     

Systematic examination of DNA variants in the parkin gene in patients with Parkinson’s disease

Increasing evidence suggests that genetic factors play an important role in the pathogenesis of Parkinson‘s disease(PD). Three genes, namely α-synuclein, parkin, and UCH-L1, have been implicated in familial PD. An exon deletion in the parkin gene is the mutation most frequentlymentioned in published data. The parkin gene was first identified by Japanese researchers, and, since fragment deletions in coding exons of this gene have been proven     

Microarray-based analyses of monocytes from Chinese Uygur patients with Parkinson’s disease and cognitive impairment

Parkinson＇s disease （PD）, a complex neurodegenerative disease, is characterized by the loss of dopamine neurons in the substantia nigra ot the midbraln. PD patients have varying degrees of cognitive impairment （CI） that we term PD-CI. However, the etiology of these changes remains unexplained. We chose three Uygur male patients with PD-CI and three healthy controls of the same of nationality and sex to explore the pathogenesis of Xinjiang Uygur PD-CI using microarray-based gene expression profiling of monocytes.