Efficacy and safety of aildenafil citrate in Chinese men with erectile dysfunction: a multicenter,randomized, double-blind,placebo-controlled crossover trial

BackgroundTo evaluate the efficacy and safety of aildenafil citrate in the treatment of erectile dysfunction (ED) in Chinese population.MethodsA multicenter, randomized, double-blind, placebo-controlled, double-cycle crossover trial was conducted in three medical centers. Male patients with mild to moderate ED were randomized into two groups and received either aildenafil citrate or placebos, followed by a crossover administration after a 7-day washout. The primary outcome was the duration of penile rigidity over 60% measured by RigiScan^® Plus. Main secondary outcomes were the duration of penile rigidity over 80% and erectile hardness score (EHS).ResultsA total of 60 patients with mild to moderate ED were enrolled in the study and 57 of them completed the trial (30 in the aildenafil group and 27 in the placebo group). The median duration of penile tip rigidity over 60% was 4.25 (0.00, 19.00) min in the aildenafil group, as compared with 0.50 (0.00, 2.75) min in the placebo group (P<0.001). The median duration of penile base rigidity over 60% was 3.25 (0.00, 12.50) min in the aildenafil group, as compared with 0.00 (0.00, 2.50) min in the placebo group (P<0.001). The duration of penile base rigidity over 80% was significantly increased in the aildenafil group versus the placebo group (P=0.002). The EHS was significantly improved in the aildenafil group (P<0.001). No severe adverse events associated with aildenafil citrate occurred in both groups.ConclusionsThese results suggested that aildenafil citrate was efficient and well-tolerated in the treatment of Chinese men with mild to moderate ED.Trial RegistrationChinese Clinical Trial Registry ChiCTR1900026025.     

术后同步放化疗在Ⅲ期低位直肠癌中的应用价值

目的 探讨Miles术后同步放化疗对改善Ⅲ期低位直肠癌患者预后的价值.方法 对2002-2003年行Miles术的132例Ⅲ期直肠癌患者的临床资料进行回顾性分析.根据患者意愿分为术后同步放化疗组（78例）和单纯化疗组（54例）.采用奥沙利铂加亚叶酸钙加氟尿嘧啶进行化疗 放疗方案为15MVX线,2 Gy/次,5次/周,总剂量50 Gy 与第1个疗程的化疗同步进行放疗.结果 术后随访5年,单纯化疗组和同步放化疗组分别有12例（22.2%）和6例（8.3%）局部复发,差异有统计学意义（P＜0.05）.两组远处转移率分别为51.9%（28/54）和47.4%（37/78）,差异无统计学意义（P＞0.05）.两组5年生存率分别为29.6%和47.4%,差异有统计学意义（P＜0.05）.除了6例（7.7%）放射性肠炎外,同步放化部组与单纯化疗组恶心呕吐和白细胞下降等不良反应的差异无统计学意义（P＞0.05）.结论 对于行Miles术Ⅲ期直肠癌患者,术后予以同步放化疗可降低局部复发率,提高5年生存率,是一项安全有效的辅助治疗方法.     

肌纤维转化生长因子- β信号激活与急性肌损伤炎症反应的相关性研究

目的:探讨肢体创伤后急性肌损伤炎症反应过程中肌纤维自身转化生长因子- β(TGF- β)信号对肌内炎症的影响。 方法:取野生C57BL/6小鼠（野生小鼠组）、肌纤维条件性TGF- β受体Ⅱ敲除小鼠（敲除小鼠组)各16只。肌毒素腓肠肌内注射诱导小鼠急性肌损伤。比较两组小鼠在注...     

经外环口以下途径显微镜下精索静脉结扎术治疗精索静脉曲张术后复发的疗效分析

目的:分析精索静脉曲张(VC)术后复发的病因,探讨经外环口以下途径显微镜下精索静脉结扎术(MV)治疗复发VC的疗效。方法:回顾性分析2015年4月至2019年4月青岛大学附属医院收治的16例VC术后复发患者的病例资料。中位年龄27(18～36)岁。5例既往曾行精索内静脉高位结扎术,11例曾行腹腔镜精索静脉结扎术;16例...     

Optimize the management of urological tube-related emergencies during the coronavirus disease 2019 (COVID-19) pandemic

BackgroundTo introduce and determine the value of optimized strategies for the management of urological tube-related emergencies with increased incidence, complexity and operational risk during the global spread of coronavirus disease 2019 (COVID-19).MethodsAll emergent urological patients at Tongji Hospital, Wuhan, during the period of January 23 (the beginning of lockdown in Wuhan) to March 23, 2020, and the corresponding period in 2019 were recruited to form this study’s COVID-19 group and control group, respectively. Tongji Hospital has the most concentrated and strongest Chinese medical teams to treat the largest number of severe COVID-19 patients. Patients in the control group were routinely treated, while patients in the COVID-19 group were managed following the optimized principles and strategies. The case incidence for each type of tube-related emergency was recorded. Baseline characteristics and management outcomes (surgery time, secondary complex operation rate, readmission rate, COVID-19 infection rate) were analyzed and compared across the control and COVID-19 periods.ResultsThe total emergent urological patients during the COVID-19 period was 42, whereas during the control period, it was 124. The incidence of tube-related emergencies increased from 53% to 88% (P<0.001) during the COVID-19 period. In particular, the incidence of nephrostomy tube-related (31% vs. 15%, P=0.027) and single-J stent-related problems (19% vs. 6%, P=0.009) increased significantly. The mean surgery times across the two periods were comparable. The number of secondary complex operations increased from 12 (18%) to 14 (38%) (P=0.028) during the COVID 19-period. The number of 2-week postoperative readmission decreased from 10 (15%) to 1 (3%) (P=0.049). No participants contracted during the COVID-19 period.ConclusionsUrological tube-related emergencies have been found to have a higher incidence and require more complicated and dangerous operations during the COVID-19 pandemic. However, the optimized management strategies introduced in this study are efficient, and safe for both urologists and patients.     

Mutation profile and its correlation with clinicopathology in Chinese hepatocellular carcinoma patients

BackgroundHepatocellular carcinoma (HCC) is one of the most common causes of cancer worldwide. Although many studies have focused on oncogene characteristics, the genomic landscape of Chinese HCC patients has not been fully clarified.MethodsA total of 165 HCC patients, including 146 males and 19 females, were enrolled. The median age was 55 years (range, 27–78 years). Corresponding clinical and pathological information was collected for further analysis. A total of 168 tumor tissues from these patients were selected for next-generation sequencing (NGS)-based 450 panel gene sequencing. Genomic alterations including single nucleotide variations (SNV), short and long insertions and deletions (InDels), copy number variations, and gene rearrangements were analyzed. Tumor mutational burden (TMB) was measured by an algorithm developed in-house. The top quartile of HCC was classified as TMB high.ResultsA total of 1,004 genomic alterations were detected from 258 genes in 168 HCC tissues. TMB values were identified in 160 HCC specimens, with a median TMB of 5.4 Muts/Mb (range, 0–28.4 Muts/Mb) and a 75% TMB of 7.7 Muts/Mb. The most commonly mutated genes were TP53, TERT, CTNNB1, AXIN1, RB1, TSC2, CCND1, ARID1A, and FGF19. SNV was the most common mutation type and C:G>T:A and guanine transformation were the most common SNVs. Compared to wild-type patients, the proportion of Edmondson grade III–IV and microvascular invasion was significantly higher in TP53 mutated patients (P<0.05). The proportion of tumors invading the hepatic capsule was significantly higher in TERT mutated patients (P<0.05). The proportion of Edmondson grade I-II, alpha fetoprotein (AFP) <25 µmg/L, and those without a history of hepatitis B was significantly higher in CTNNB1 mutated patients (P<0.05). CTNNB1 mutations were associated with TMB high in HCC patients (P<0.05). Based on correlation analysis, the mutation of TP53 was independently correlated with microvascular invasion (P=0.002, OR =3.096) and Edmondson grade III–IV (P=0.008, OR =2.613). The mutation of TERT was independently correlated with tumor invasion of the liver capsule (P=0.001, OR =3.030), and the mutation of CTNNB1 was independently correlated with AFP (<25 µmg/L) (P=0.009, OR =3.414).ConclusionsThe most frequently mutated genes of HCC patients in China were TP53, TERT, and CTNNB1, which mainly lead to the occurrence and development of HCC by regulating the P53 pathway, Wnt pathway, and telomere repair pathway. There were more patients with microvascular invasion and Edmondson III–IV grade in TP53 mutated patients and more patients with hepatic capsule invasion in TERT mutated patients, while in CTNNB1 mutated patients, there were more patients with Edmondson I–II grade, AFP <25 µmg/L, and a non-hepatitis B background. Also, the TMB values were significantly higher in CTNNB1 mutated patients than in wild type patients.     

低氧环境对椎间盘自发性吸收的影响及其作用机制

目的探讨低氧环境对椎间盘自发性吸收的影响及其作用机制。方法取SPF级成年日本大耳兔9只,雌雄不限,平均体质量2 kg。将兔处死后取脊柱髓核组织,经消化、分离、培养后获得传代髓核细胞,将生长良好的髓核细胞制成细胞悬液。根据不同时效的低氧环境将细胞分为5组对照组(常氧浓度下培养6 h)、低氧6 h组(2%O2浓度下培养6 h)、低氧12 h组(2%O2浓度下培养12 h)、低氧24 h组(2%O2浓度下培养24 h)和低氧48 h组(2%O2浓度下培养48 h)。采用实时聚合酶链反应法检测缺氧诱导因子(HIF)-1α、3型酸敏感离子通道(ASIC3)及水通道蛋白3(AQP3)mRNA表达水平,采用流式细胞仪检测各组髓核细胞凋亡情况。采用SPSS 24.0软件对数据进行分析。结果与对照组比较,低氧各组细胞凋亡率均明显升高,差异均有统计学意义(均P<0.01);与低氧12、24和48 h组比较,低氧6 h组细胞凋亡率最高,差异均有统计学意义(均P<0.01)。与对照组比较,低氧各组细胞HIF-1α和ASIC3 mRNA表达水平均明显上升,AQP3 mRNA表达水平均明显下降,差异均有统计学意义(均P<0.01);与低氧12、24和48 h组比较,低氧6 h组HIF-1α和ASIC3 mRNA表达水平最高,差异均有统计学意义(均P<0.01)。结论短时间低氧环境可以促进髓核细胞凋亡,从而加速椎间盘突出组织自发性吸收进程,其机制可能与HIF-1α和ASIC3的表达增加及AQP3的表达下降有关。     

浆细胞性乳腺炎的中西医结合治疗

目的:探讨中西医结合治疗浆细胞性乳腺炎的疗效.方法:对72例浆细胞性乳腺炎病人,给予内服中药"浆乳方",并配以外治法(箍围、引流、手术、乳痈扩创、挂线、冲洗、乳头矫形术)进行治疗.通过术后病理分析、疗效观察及长期随访,评估中西医内外合治对浆细胞性乳腺炎的疗效.结果:"浆乳方"联合外治法治疗浆细胞性乳腺炎,治愈率达98.61%(71/72),复发率为1.4%(1/72).结论:中西医结合治疗浆细胞性乳腺炎的治愈率较高,复发少,并能保持良好的乳房外形,值得推广.     

人工肱骨头置换治疗肱骨近端4部分骨折及骨折脱位

目的：探讨应用人工肱骨头置换治疗肱骨近端4部分骨折及骨折脱位的近期疗效。方法：25例肱骨近端4部分骨折及骨折脱位的患者,男11例,女14例;年龄56～77岁,平均68.2岁;均行人工肱骨头置换治疗。应用Neer疗效评分系统,根据患者疼痛、功能、肩关节活动范围评价术后疗效。结果：术后随访12～40个月,平均29.3个月。所有病例术后均无感染、神经损伤、假体周围骨折、假体松动、脱位等并发症。Neer评分优8例,良11例,可6例,优良率76%。结论：通过标准的手术操作及术后积极合理的康复锻炼,人工肱骨头置换治疗肱骨近端4部分骨折及骨折脱位近期疗效满意。     

乳腺癌钼靶X线钙化与HER-2/neu表达的关系及其意义

目的探讨乳腺癌钼靶X线钙化与HER-2／neu表达的关系及其临床意义。方法分析152例乳腺癌钼靶X线片的钙化特点；并将切除的肿瘤标本行HER-2／neu检测，分析钼靶X线钙化特征与HER-2／neu表达之间的关系。结果乳腺癌钼靶X线钙化组HER-2／neu过度表达率高于无钙化组（61．6％vs．35．4％）（P〈0．01）；在73例钙化中，以钙化伴随毛刺征为主要表现者，HER-2／neu过度表达率高于单纯钙化组（P〈0．05）。根据钙化形态特征，蠕虫状钙化组HER-2／neu过度表达率明显高于非蠕虫状钙化组（P=0．01）。钼靶X线钙化簇最大径≥25mm者，多在HER-2／neu过度表达组（P〈0．05），而钙化颗粒数≤20枚／cm^2者，多在HER-2／neu阴性表达组（P〈0．01）。结论乳腺癌钼靶X线钙化与HER-2／neu过度表达关系密切，可为乳腺癌治疗策略的制定和预测预后提供参考。志．2008．17（5）：436—439】