Background:Intratumor heterogeneity (ITH), a critical driver of tumor evolution and immune evasion, remains inadequately characterized at the transcriptomic level in colorectal cancer (CRC), and its clinical implications are not yet fully understood. Methods:We integrated transcriptomic datasets from TCGA-COAD/READ and two independent GEO cohorts (GSE40967 and GSE87211) to develop an RNA-seq-based ITH score using the DEPTH2 algorithm and to con0struct an ITH-related gene (ITRG) prognostic model. A unified cutoff value of 0.64 was established to stratify patients into high- and low-ITH groups. Using 52 survival-associated ITRGs, we generated a nine-gene prognostic signature selected from 101 distinct combinations of feature selection techniques and modeling algorithms and validated its performance in two external datasets. The tumor microenvironment and potential responsiveness to immune checkpoint inhibitors were evaluated using ssGSEA, ESTIMATE, and TIDE algorithms. SHAP analysis, together with in vitro and in vivo experiments, was employed to identify and functionally validate key regulatory genes. Results:Patients in the high-ITH group had markedly poorer overall survival (OS) than those in the low-ITH group. The ITH score correlated strongly with aggressive clinical features, including T3/4 invasion depth, N1/2 nodal status, and AJCC stage III. The nine-gene prognostic signature demonstrated consistent predictive capability across the TCGA training cohort and both GEO validation cohorts. In TCGA, the model yielded time-dependent AUCs of 0.669, 0.664, and 0.645 for 1-, 3-, and 5-year OS, respectively, and retained its status as an independent prognostic indicator in multivariate Cox regression analysis; in GSE40967 and GSE87211, the corresponding AUCs ranged from 0.544-0.573 and 0.648-0.744. The high-risk subgroup was characterized by a stromal immune phenotype enriched with cancer-associated fibroblasts and macrophages, elevated expression of multiple immune checkpoints, increased TIDE scores, and higher tumor mutational burden. SHAP analysis identified IL20RB as the top risk-associated gene, whose knockdown significantly suppressed CRC cell proliferation, migration, invasion, and tumorigenicity in vitro and in vivo. Conclusion:This study introduces and validates a transcriptomic ITH score and a nine-gene ITRG-based prognostic model that delineate the immune landscape and enables effective survival stratification in CRC, complementing the limitations of current staging systems. Additionally, IL20RB is highlighted as a promising therapeutic target, supporting the development of personalized immuno-targeted combination therapies in CRC.

Erectile dysfunction (ED) is a highly prevalent and refractory complication of type 2 diabetes mellitus (T2DM), with penile cavernosal dysfunction, inflammation, apoptosis, and fibrosis as core pathological features. Here we identify gut microbiota dysbiosis and its downstream metabolite arachidonic acid (AA) as critical mediators of T2DM-associated erectile dysfunction (T2DM-ED) through a systemic gut-penis axis. Gut dysbiosis is sufficient to induce an ED phenotype, as demonstrated by fecal microbiota transplantation (FMT) from T2DM-ED rats into pseudo-germ-free recipients, which successfully transferred the erectile impairment with significantly decreased ICP/MAP ratios. Recipient rats showed impaired colonic barrier integrity, mucosal damage, goblet cell depletion, and downregulated tight junction proteins (Occludin, Claudin-4). Multi-omics integration of 16S rRNA sequencing and serum metabolomics identified AA as a key elevated metabolite that drives inflammatory signaling via the HIF-1α and NF-κB pathways. In penile corpus cavernosum tissue, ED-FMT rats displayed smooth muscle loss, fibrosis, increased apoptosis, and hyperactivation of the TLR4—MyD88—NF-κB—HIF-1α axis. In primary corpus cavernosum smooth muscle cells (CCSMCs), AA stimulation recapitulated pathological activation, including a pro-apoptotic shift in the Bax/Bcl-2 ratio, elevated Cleaved Caspase-3, reduced α-SMA, increased COX-2, stabilized HIF-1α, and excessive PGE2 production; these effects were abolished by pharmacological inhibition of NF-κB. Mechanistically, gut dysbiosis-induced systemic AA accumulation triggers inflammatory damage, apoptosis, and functional impairment in penile smooth muscle via the TLR4—MyD88—NF-κB/HIF-1α cascade. These findings define a gut—AA—NF-κB—penis axis that drives T2DM-ED pathogenesis, highlighting AA and its downstream signaling as promising therapeutic targets for diabetic erectile dysfunction.

Erectile dysfunction (ED) is a prevalent complication of both type 1 and type 2 diabetes mellitus (DM), but the shared molecular mechanisms underlying this complication remain unclear. This study employed an integrative multiomics approach to identify conserved pathways in diabetic ED. A type 2 diabetes mellitus-related erectile dysfunction (T2DM-ED) rat model was established and validated functionally. Transcriptomic analysis of cavernous tissue identified differentially expressed genes (DEGs), which were cross-referenced with a public type 1 diabetes mellitus-related erectile dysfunction (T1DM-ED) dataset, revealing 141 shared DEGs enriched in extracellular matrix (ECM)-receptor interaction, focal adhesion, phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt), and advanced glycation end products (AGE)-receptor for advanced glycation end products (RAGE) signaling. Machine learning prioritized five consistently downregulated hub genes (periostin [POSTN], elastin [ELN], collagen type VI alpha 3 chain [COL6A3], collagen type V alpha 2 chain [COL5A2], and secreted protein acidic and rich in cysteine [SPARC]), as validated by quantitative polymerase chain reaction (qPCR) and Western blot. Their encoded proteins (periostin, elastin, collagen VI, collagen V, and SPARC) were significantly suppressed. Further analysis revealed downregulation of the expression of the focal adhesion kinase (FAK)-PI3K-Akt survival pathway and brain-derived neurotrophic factor (BDNF) and increased apoptosis (cleaved caspase-3) and CD68+ macrophage infiltration. Single-cell RNA sequencing (scRNA-seq) mapping localized these hub genes to stromal and neural cells. These findings reveal a pathological microenvironment of ECM imbalance, impaired survival signaling, and inflammation, which are common to both diabetic ED subtypes. We conclude that macrophage-driven inflammation and ECM disruption converge to inhibit FAK-PI3K-Akt signaling, accelerating structural and functional decline. This inflammatory-ECM signaling axis represents a promising therapeutic target for diabetic ED.

This study aimed to investigate the application of ultrasound attenuation imaging (ATI) and shear wave elastography (SWE) in the examination of patients with metabolism-related fatty liver disease (MAFLD). A total of 210 patients were retrospectively selected and divided into MAFLD group (n=84) and no MAFLD group (n=126). ROC curve was used to analyze the diagnostic efficacy of ATI value and SWE value for MAFLD. The MAFLD groups were divided into mild group (n=39), moderate group (n=28) and severe group (n=17). Spearman correlation was used to analyze the relationship between ATI values, SWE values and the severity of MAFLD. Waist circumference, BMI, ALT, AST, TG, CHOL, ATI and SWE in MAFLD group were higher than those in non-MAFLD group (P<0.05). ROC analysis showed that the AUC of ATI value in the diagnosis of MAFLD was 0.837 and the sensitivity, specificity and cutoff values were 83.46%, 70.35% and 0.63 dB/cm/MHZ. Waist circumference and BMI were significantly lower in the mild MAFLD group than in the moderate MAFLD group (P<0.05) and ALT, AST, TG, CHOL, ATI and SWE levels gradually increased with the severity of MAFLD (P<0.05). Correlation analysis showed that ATI was positively correlated with MAFLD severity (r=0.553, P<0.001, 95% CI=0.384~0.686) and SWE was significantly positively correlated with MAFLD severity (r=0.606, P<0.001, 95% CI=0.450~0.726). Both ATI and SWE are effective in the diagnosis and evaluation of MAFLD, but ATI is more effective in the diagnosis and SWE.

Objective:The cause and mechanism of non-obstructive azoospermia (NOA) is complicated; therefore, an effective therapy strategy is yet to be developed. This study aimed to analyse the pathogenesis of NOA at the molecular biological level and to identify the core regulatory genes, which could be utilised as potential biomarkers.Methods:Three NOA microarray datasets (GSE45885, GSE108886, and GSE145467) were collected from the GEO database and merged into training sets; a further dataset (GSE45887) was then defined as the validation set. Differential gene analysis, consensus cluster analysis, and WGCNA were used to identify preliminary signature genes; then, enrichment analysis was applied to these previously screened signature genes. Next, 4 machine learning algorithms (RF, SVM, GLM, and XGB) were used to detect potential biomarkers that are most closely associated with NOA. Finally, a diagnostic model was constructed from these potential biomarkers and visualised as a nomogram. The differential expression and predictive reliability of the biomarkers were confirmed using the validation set. Furthermore, the competing endogenous RNA network was constructed to identify the regulatory mechanisms of potential biomarkers; further, the CIBERSORT algorithm was used to calculate immune infiltration status among the samples.Results:A total of 215 differentially expressed genes (DEGs) were identified between NOA and control groups (27 upregulated and 188 downregulated genes). The WGCNA results identified 1123 genes in the MEblue module as target genes that are highly correlated with NOA positivity. The NOA samples were divided into 2 clusters using consensus clustering; further, 1027 genes in the MEblue module, which were screened by WGCNA, were considered to be target genes that are highly correlated with NOA classification. The 129 overlapping genes were then established as signature genes. The XGB algorithm that had the maximum AUC value (AUC=0.946) and the minimum residual value was used to further screen the signature genes. IL20RB, C9orf117, HILS1, PAOX, and DZIP1 were identified as potential NOA biomarkers. This 5 biomarker model had the highest AUC value, of up to 0.982, compared to other single biomarker models; additionally, the results of this biomarker model were verified in the validation set.Conclusions:As IL20RB, C9orf117, HILS1, PAOX, and DZIP1 have been determined to possess the strongest association with NOA, these five genes could be used as potential therapeutic targets for NOA patients. Furthermore, the model constructed using these five genes, which possessed the highest diagnostic accuracy, may be an effective biomarker model that warrants further experimental validation.

ObjectiveStudies have found that gut microbiota may be associated with the development of erectile dysfunction (ED); however, the exact link between the two remains unclear. This study aimed to elucidate the relationship between the gut microbiota and the risk of ED from a genetic perspective.MethodsWe investigated the relationship between the gut microflora and ED using two-sample Mendelian randomization. GWAS-pooled data for ED were obtained from 223805 participants in Europe. GWAS summary data for ED were obtained from 223805 subjects in Europe and that for the gut microbiota were obtained from 18340 participants in 24 cohorts. We used the inverse-variance weighted (IVW) estimator as the primary method for the preliminary analysis, and the MR-Egger, weighted median (WM), simple model, and weighted model as secondary methods. We used Cochrane’s Q-test, to detect heterogeneity, MREgger to detect pleiotropy, and the leave-one-out method to test the stability of the MR results. Ultimately, we genetically predicted a causal relationship between 211 gut microbiota and ED.ResultsA total of 2818 SNPs associated with gut microflora were screened in the ED correlation analysis based on the assumption of instrumental variables. The results of MR analysis showed a causal relationship between the six gut microbes and ED occurrence. The results of the fixed effects IVW method revealed five gut microflora, including Lachnospiraceae (OR, 1.265; P = 0.008), Lachnospiraceae NC2004 group (OR, 1.188; P = 0.019), Oscillibacter (OR, 1.200; P = 0.015), Senegalimassilia (OR, 1.355; P = 0.002), Tyzzerella3 (OR, 1.133; P = 0.022), to be negatively associated with ED. In addition, the IVW method revealed Ruminococcaceae UCG-013 (OR, 0.827; P = 0.049) to be positively associated with ED. Quality control results showed no heterogeneity or horizontal pleiotropy in the MR analysis (P > 0.05).ConclusionsSix gut microbes were genetically associated with ED; of which, Ruminococcaceae UCG-013 was causally associated with a reduced risk of ED development. Our findings provide a new direction for research on the prevention and treatment of ED; however, the mechanisms and details require further investigation.

AimOrgasm is the ultimate pleasurable sexual experience in sexual life, a phenomenon that is difficult to depict and uncertain. A satisfying sexual life plays a vital role in the physical and mental health of men and women, the relationship between husband and wife, and family harmony. In the past, it was thought that female orgasm was related to the G-spot in the vagina, but it has never been proven. In this review, we focus on the anatomy of the vaginal vestibule, vagina, Urethra, Skene gland, and clitoris to explore the origin of female orgasm.MethodsThe published articles were reviewed, including original articles, reviews, letters to the editor, and case reports, regarding the female reproductive system.ResultsThe concept of the clitourethrovaginal complex (CUV) explains the mechanism of the female orgasm, which is not produced by a single organ acting alone, but by the synergistic action of multiple organs and tissues.ConclusionThe concept of CUV complex not only reveals the principle of female orgasm but also provides new ideas for the diagnosis and treatment of female sexual medicine in the future.

目的 研究宫腔内人工授精(IUI)精液处理过程中不同离心力对精液相关参数及妊娠率、流产率的影响.方法 选取2017年6月至2019年12月大连市妇女儿童医疗中心(集团)共150个周期123对夫妇的IUI临床资料作为研究对象,按照离心力分为300×g组、400×g组、500×g组,比较三组间年龄、不育年限、周期数、内膜厚度等基线资料及精液处理前后的浓度、前向运动精子百分比(PR)、优质精子回收率、精子DNA碎片指数(DFI)、妊娠率、流产率等指标.结果 三组年龄、不孕年限、周期数、内膜厚度、女方体重指数、精液浓度、PR及优质精子回收率比较,差异无统计学意义(P>0.05);300×g组精子DFI处理前后比较,差异具有统计学意义(P<0.05);400×g、500×g组处理前后精子DFI比较,差异无统计学意义(P>0.05);三组妊娠率、流产率比较,差异无统计学意义(P>0.05).结论 辅助生殖过程中处理精液时300×g离心力可适当提高精子DNA完整性,不同离心力优化精液对IUI妊娠率、流产率无影响.

BACKGROUND:Studies have validated the potential of methylated cell-free DNA as a biomarker in various tumors, and methylated DNA in plasma may be a potential biomarker for cancer.AIM:To evaluate the diagnostic value of RASSF1A methylation in plasma for colorectal cancer (CRC) and hepatocellular carcinoma (HCC).METHODS:A total of 92 CRC patients, 67 colorectal polyp (CRP) patients, 63 HCC patients, and 66 liver cirrhosis (LC) patients were enrolled. The plasma DNA was subjected to DNA extraction, double-strand DNA concentration determination, bisulfite conversion, purification, single-strand DNA concentration determination, and digital polymerase chain reaction (PCR) detection. The methylation rate was calculated. The diagnostic value was evaluated by the area under the curve (AUC).RESULTS:The age and sex in the CRC and CRP groups and the HCC and LC groups were also matched. The DNA methylation rate of RASSF1A in plasma in the CRC group was 2.87 ± 1.80, and that in the CRP group was 1.50 ± 0.64. DNA methylation of RASSF1A in plasma showed a significant difference between the CRC and CRP groups. The AUC of RASSF1A methylation for discriminating the CRC and CRP groups was 0.82 (0.76-0.88). The AUCs of T1, T2, T3 and T4 CRC and CRP were 0.83 (0.72-0.95), 0.87 (0.78-0.95), 0.86 (0.77-0.95), and 0.75 (0.64-0.85), respectively. The DNA methylation rate of RASSF1A in plasma in the HCC group was 4.45 ± 2.93, and that in the LC group was 2.46 ± 2.07. DNA methylation of RASSF1A in plasma for the HCC and LC groups showed a significant difference. The AUC of RASSF1A methylation for discriminating the HCC and LC groups was 0.70 (0.60-0.79). The AUCs of T1, T2, T3 and T4 HCC and LC were 0.80 (0.61, 1.00), 0.74 (0.59-0.88), 0.60 (0.42-0.79), and 0.68 (0.53-0.82), respectively.CONCLUSION:RASSF1A methylation in plasma detected by digital PCR may be a potential biomarker for CRC and HCC.

目的 探讨应用术前彩色多普勒超声观测精索内睾丸动脉数量的准确性及应用价值,为精索静脉结扎手术起到安全指导作用,以便最大限度保护睾丸功能.方法 选取2020年8月至2021年5月大连医科大学附属第一医院诊治的91例精索静脉曲张患者作为研究对象.术前应用彩色多普勒超声,在手术侧精索切口处准确区分精索内部结构,记录并观察睾丸动脉数量,与术中最终实际探查的动脉数量作比较.同时观察睾丸动脉、输精管动脉的收缩期峰值流速以及动脉阻力指数.结果 91例患者均顺利完成手术,共进行107根精索的结扎手术,术前超声判定的精索内睾丸动脉数量与术中实际数量吻合的为96根精索,另外11根不一致.采用Kappa一致性检验,K值为0.810,两者一致性较好,差异具有统计学意义(P<0.05).输精管动脉与睾丸动脉的收缩期峰值流速、内径比较,差异具有统计学意义(P<0.05).输精管动脉与睾丸动脉的动脉阻力指数比较,差异无统计学意义(P>0.05).结论 通过术前超声可准确识别精索内睾丸动脉数量,并且能区分睾丸动脉及输精管动脉,对保留睾丸动脉的低位精索静脉切断术起到指导作用,可提高手术效率,避免术中误伤睾丸动脉.

Old blood clots and congested mucosa were visible within the right seminal vesicle, and jelly-like sediments were observed within the left seminal vesicle (Supplementary Figure 2). The vas deferens ampulla Dear Editor, The patient was a 29-year-old male seeking medical treatment for a 2-year history of primary infertility, and no reproductive abnormalities were observed in his 29-year-old spouse. The study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Dalian Medical University (Dalian, China), and the informed consent was provided by the patient for the publication of his clinical data. The patient denied a history of urinary tract infection and epididymitis, but reported a history of hematospermia. Palpation revealed no palpable varicoceles, normalsized epididymides, palpable vasa deferentia, and the bilateral testes of 20 ml in volume. Test results revealed no abnormalities in the levels of sex hormones (Supplementary Table 1). Semen analysis showed severe asthenozoospermia (Supplementary Table 2). Seminal plasma biochemistry analysis showed fructose level of 1.8 mmol l−1 (normal level >8.3 mmol l−1). Magnetic resonance imaging (MRI) and transrectal ultrasound scan (TRUS) indicated hemorrhage in the right seminal vesicle and bilateral seminal vesicle dilation (Supplementary Figure 1). During TRUS, the patient masturbated until ejaculation, while retaining an transrectal ultrasound probe (Esaote S.p.A., Genoa, Italy) in his rectum, which tracked the process of ejaculation in real time (Supplementary Video 1). Calcification blockage within the ejaculatory ducts and verumontanum was observed (Figure 1). The patient was diagnosed with partial ejaculatory duct obstruction (EDO) and underwent transurethral seminal vesiculoscopy. Using a pediatric rigid ureteroscope (6/7.5 Fr; Richard Wolf GmbH, Knittlingen, Germany), the urethra and verumontanum were examined. However, the openings of the bilateral ejaculatory ducts were not detected due to the presence of mucosal edema. Guided by the soft end of the guidewire, the prostatic utricle was accessed through the verumontanum orifice, and the calcification within the orifice was cleared (Figure 1). The ureteroscope was then inserted into the seminal vesicles at the 5 o’clock and 7 o’clock positions of the prostatic utricle by puncturing the wall with the hard end of the guidewire. Transurethral vesiculoscope-assisted laser incision of the prostatic utricle to treat partial ejaculatory duct obstruction

早泄(PE)是最常见的男性性功能障碍之一,目前致病机制复杂、治疗手段相对缺乏,以及疗效的某些不确定性等令泌尿男科或性医学医师颇感棘手.因此,中国性学会牵头制定了《中国早泄患者门诊流程指南》,旨在规范PE门诊诊疗流程,通过规范、标准化的诊疗路径更好地提高PE诊疗效果.

[This corrects the article DOI: 10.1155/2017/1202710.].

Background and study aims: Although the function of microRNA21 (miR-21) in the invasion and metastasis of colon cancer has been extensively studied, the mechanisms of invasion and migration related pathways between and its targets are still not elucidated. This study explored the mechanisms of the pathway between miR-21 and the target genes in vitro and in vivo. Materials and methods: We transfected pmiRZip21 or Leti3 into colon cancer cells. The levels of miR-21 expression, mRNA transcription and protein of target genes were analysed by TaqMan microRNA assays, RT-PCR and western blot, respectively. Scratch migration and trans-well assays were used to evaluate metastasis and invasion. To build a subcutaneous tumour animal model, detect the level of miR-21 and the target genes and then identify the mechanisms in vivo. Results: MiR-21 expression levels in colon cancer cells transfected with pmiRZip21 in vivo or in vitro were decreased (P < 0.05). The mRNA and protein levels of TIMP-3 and RECK were up-regulated after inhibiting miR-21 in vitro and in vivo (P < 0.05), but those of BMPR-II and PCDH17 were not. In pmiRZip21-transfected colon cancer cells, invasion and migration were significantly decreased both in vitro and vivo (P < 0.05). Conclusions: Up-regulation of TIMP-3 and RECK, by inhibiting miR-21 expression can decrease tumour invasion and metastasis ability in vitro and in vivo, and has potential as a possible target site in antitumour therapy. More effects in vivo have to be investigated in further research. (C) 2019 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.

阴茎勃起功能障碍(erectile dysfunction,ED)是成年男性的常见病和多发病,不仅影响患者及其伴侣的生活质量,也是心血管疾病的早期症状和危险指标.RigiScan问世以来,夜间阴茎勃起硬度检测和视听性性刺激检测在泌尿外科及男科学领域中得到了广泛的应用.然而,临床上仍存在RigiScan的使用适应证不明确、使用方法不规范、判断标准不统一等问题.因此,需要更权威的指导性文件来规范其在ED诊治领域及司法鉴定中的应用,以使更多的ED患者受益.因此,中国性学会组织相关临床专家根据现有的循证医学证据共同研究并制定本共识,旨在为临床医生提供规范的ED诊治指导和参考.

To study fascia and space anatomy layers in retroperitoneum, in order to find correct methods in bloodless and the anatomical retroperitoneal laparoscopic radical nephrectomy (LRN), and improve operation skills.From march 2016 to march 2017, a total of 61 patients were analyzed who underwent retroperitoneal laparoscopic radical nephrectomy, 33 tumors were located in left kidney, and 28 in the right kidney, the diameter of renal tumor was 3.4cm~7.5cm, with the mean diameter was 5.6cm, we complement bloodless and the anatomical retroperitoneal LRN by exposing and separating relatively bloodless planes such as anterior pararenal space, pre-psoas space, the space between anterior lamella and prerenal fusion fascia.All 61 operations were successfully operated, with no case transferred to open operation.The mean operative time was 61 min (range from 43 to 98 min), and the mean intraoperative blood loss was 75ml (range from 30 to 150ml), all patients discharged from hospital on 4 to 8 days after surgery.Rupture of peritoneum were 7 cases had rupture of peritoneum, adrenal gland laceration and slight bleeding were 5 cases.No case had blood transfusion and other severe complications during surgery.On the basis of fascia and space anatomy layers in retroperitoneum, through identifying and separating relatively bloodless planes such as anterior pararenal space, pre-psoas space, the space between anterior lamella and prerenal fusion, we can exposing the operation space, renal and adjacent organs can be discrimination directly.Dissection through this planes also easy to perform, so we can complement operaion bloodlessly and anatomically.This method is a safe and effective procedure, it can decrease operation time, blood loss and complication rates effectively, and provide a better choice for the patient whom demand radical nephrectomy.

5-Fluorouracil (5FU)-based adjuvant therapy is the first-line therapy for treating stage II and III colon cancer after surgery. However, its therapeutic efficacy is limited because of chemoresistance, especially in deficient mismatch repair (dMMR) colon cancer. Here, we first used laser capture microdissection to obtain purified cells from four dMMR and four proficient mismatch repair (pMMR) colon cancer tissues. Second, microRNA (miRNA) microarray chips were used to identify miRNAs that are differentially expressed between these two classes of tumors. Third, we analyzed their differential expression by qRT-PCR in a panel of 5-FU-resistant colon cancer cell lines. We identified that miR-1290 was one of the most upregulated miRNAs in both dMMR colon cancer tissues and 5-FUresistant cells. We also found that miR-1290 was positively correlated with dMMR status and predicted poor prognosis in stage II and III colon cancer patients who received 5-FUbased chemotherapy. Furthermore, we demonstrated that inhibition of the expression of miR-1290 enhanced sensitivity to 5-FU treatment in vitro and in tumor xenografts in vivo by direct targeting hMSH2. Our study indicates that miR-1290 may become a promising biomarker of dMMR colon cancer and predicts the prognosis of stage II and III patients who receive 5-FU-based adjuvant therapy.

OBJECTIVE:To evaluate the safety, efficacy and tolerability of China-made sildenafil citrate (Jinge) in the treatment of ED.METHODS:We conducted a multi-center, randomized, double-blind and placebo-controlled clinical trial among 222 ED patients in five urological or andrological clinics of China. The patients were randomly assigned to receive sildenafil citrate (SC, n = 111) or placebo (n = 111) for 8 weeks. We obtained and analyzed the demographic and clinical characteristics of the patients, the scores of International Index of Erectile Function (IIEF), the success rate of sexual intercourse, and the incidence of adverse events.RESULTS:No statistically significant differences were found between the patients of the SC and those of the placebo group in the mean age (［47.2±11.32］ yr vs ［46.67±13.08］ yr, P>0.05), psychological etiology (27.93% vs 23.42%, P>0.05), organic etiology (21.62% vs 29.73%, P>0.05) or mixed etiology (50.45% vs 46.85%, P>0.05), nor in height, weight, nationality, or history of smoking, drinking or allergy. Compared with the placebo controls, the SC-treated patients showed significant increases in the excellence rate of effectiveness (29.91% vs 78.90%, P<0.01), success rate of sexual intercourse (29.16% vs 63.87%, P<0.01), and total effectiveness rate (34.58% vs 77.98%, P<0.01). The effectiveness rates on organic, psychogenic and mixed types ED were remarkably higher in the SC group (64.52%, 83.33%, and 82.14%) than in the placebo control (46.15%, 21.21%, and 25.00%) (P<0.01). Mild or temporary adverse events were observed in 32 cases in the SC group as compared with 13 in the placebo control.CONCLUSIONS:China-made sildenafil citrate is an effective, safe and well-tolerated drug for ED of different etiologies in the Chinese population.

目的 探讨分析不对成双眼皮整形修复术的临床应用价值.方法 选取2016年1月1日至2016年12月31日在我院接受治疗的40例双眼皮不对称患者,将其随机平均分为观察组和对照组,每组各20例.对照组患者采取传统的重睑成形术,观察组患者在对照组基础上实施小切口去脂与连续埋线进行整形修复.对比分析两组患者在临床治疗中的整形修复效果.结果 两组患者经过不同的修复方法后,观察组治疗后双眼皮对称效果显著优于对照组(P<0.05),且手术时间、伤口愈合时间、术中出血量明显低于对照组(P<0.05).结论 采用小切口与连续埋线的重睑成形术对不对称双眼皮整形修复的效果显著,手术时间、愈合时间等都低于传统的重睑成形术,值得在临床治疗中进一步推广、应用.